Toxic aspergilli from pistachio nuts.

Toxic aspergilli from pistachio nuts. Pistachio nut samples taken during various stages of development from orchards in Iran, showed that contamination with fungi occurred mainly during the later stages of nut development. Members of the genera Aspergillus and Penicillium occurred most frequently. Of the Aspergilli, the species A. niger, A. flavus and A. fischeri var. spinosus occurred most frequently, followed by A. terreus, A. tamarii and A. nidulans. Twenty-two isolates comprising 13 species were tested for toxicity to ducklings. Isolates of known toxic fungi included A. flavus, A. niger, A. parasiticus, A. ochraceus, A. versicolor, A. nidulans and A. terreus. The toxicity of A. fischeri var. spinosus is reported. Chemical analysis showed that all isolates of A. flavus and A. parasiticus produced aflatoxin B1, the isolates of A. versicolor and A. nidulans produced sterigmatocystin while the toxic isolate of A. ochraceus did not produce ochratoxins.


Experimental paracoccidioidomycosis in the Syrian hamster: morphology, ultrastructure and correlation of lesions with presence of specific antigens and serum levels of antibodies. Male hamsters (134) received intratesticular injection of a live cerebriform culture of Paracoccidioides brasiliensis and were sacrificed from 6 hours up to 123 days onwards. Tissues from testis, lymph nodes, lungs, liver, spleen, kidneys and intestines were examined microscopically; presence of specific antigens was saught in lesions of testis, regional lymph nodes and liver by indirect immunofluorescence (IF); inoculation site lesions were studied electron microscopically and circulating specific antibodies measured by complement fixation and IF tests. Up to 24 hours inoculation site lesions showed fungi surrounded by PMNs; 48 hours latter macrophages accumulated forming loose nodules; epithelioid granulomata appeared after 5 days. Fungi, scarce in early lesions, increased in numbers up to the time when epithelioid granulomata dominated the picture; in young granulomata fungi were abundant and small; older granulomata contained rare, vacuolated fungi. Ultrastructurally the space between fungi and host-cells was larger around reproducing forms decreasing in size as the parasites grew larger and being a virtual slit around old degenerated fungi. Immunofluorescence studies revealed that fungal walls were brightly fluorescent; in early lesions macrophages surrounding fungi or free in the intersticium contained fluorescent antigenic material in the cytoplasm; similar macrophages were observed in draining lymph nodes as early as 18 hours after inoculation, and latter, in macrophage nodules and Kupffer cells in the liver; epithelioid and giant cells appear to block diffusion of antigens, since in epithelioid granulomata fluorescence was limited to fungal walls. Disseminated paracoccidioidomycosis occurred in 100% of animals after day 5 of infection. Besides specific lesions (containing fungi), antigens were identified by immunofluorescence in 'non specific' lesions in the liver (diffuse or nodular Kupffer cell hyperplasia) and in the lymph nodes (histiocytic hyperplasia). Serum antibodies appeared in low titers, up to day 20, increasing onwards. From day 70 on, titers decreased and lesions changed from confluent epithelioid to loose granulomata infiltrated by PMNs; fungi that before were large and quiescent now were small and in active reproduction. Secondary amyloidosis was present in 85% of the amimals. In the hamster, Paracoccidioidomycosis develops as a chronic progressive disease and the lesions are related both to fungi and its antigens.


Dermatophyte species, microscopic and cultural examination. The dermatophytes Epidermophyton floccosum, Microsporum canis, Trichophyton mentagrophytes var. interdigitale, T. rubrum, and T. verrucosum were compared with respect to the direct microscopic examination of a clinical material and the number of colonies obtained by culture. It was found that the results of microscopy as well as of culture depended to a marked extent upon which species were the cause of the mycosis. The extremes were E. floccosum and T. mentagrophytes var. interdigitale which showed 7.5% and 32.5% isolates with negative microscopic findings and 45.5% and 5.0% isolates with larger than or equal to 10 colonies.


Experimental infection of guinea-pigs with atypical and dysgonic strains of microsporum canis. Pathogenicity tests with one dysgonic and six atypical strains of Microsporum canis were carried out on guinea-pigs. Five of the atypical strains were laboratory mutants from dysgonic strains isolated from living hosts. As sporulation and viability varied greatly between the strains, inocula consisted of suspensions of fungal fragments of known viable count. When a sufficiently active inoculum was used, lesions and fluorescent hairs were induced in the guinea-pigs by all but one of the strains tested. In each case the strain inoculated was reisolated from the lesions in pure culture. The significance of the results is discussed in the light of the unusual nature and origin of the strains.


[Substrate and parasubstrate regulation of physiological processes at various levels of the organization of living systems as illustrated by examples of the regulation of appetite, of the specific dynamic action of food and of the inhibition of processes of absorption]. It was demonstrated that in the organism of higher animals the adaptation regulation of food uptake and nutrient absorption and transport comprises, in addition to the classic mechanisms of substrate regulation, specialized non-substrate and parasubstrate mechanisms which control the uptake of food and other substrates at all three levels (organosystemic, organic and cellular). As to the organosystemic level, it was observed in duodenectomized rats that appetite inhibition is produced not only by a stimulation of the receptors and by an increase in the concentration of the food substrates and of the metabolites in the blood, but also by one of the intestinal appetite-inhibiting hormones, arenterin. As to the organic level, it was evidenced that the enzymatic and transport functions of the small intestine and the numerical composition of the enterocyte population in the different segments are determined by the substrate load on the respective areas of the small intestine as well as by the blood and chyme-mediated intersegmental reactions in the small intestine. As to the tissular and cellular levels, the possibility of a regulation of the enzymatic and transport systems of the microvilli by means of substrates contained in the mucous membrane of the small intestine and endogenous substances (permein and antipermein) was evinced.


[Regulatory properties of the intestinal enzymes of higher and lower animals as an adaptation mechanism in digestion and absorption]. It is shown that certain key enzymes in membranous digestion (alkaline phosphatase, peptidase, gamma-amylase) are allosteric and ensure the autoregulation and the homoeostasis of the final stages of hydrolysis and of the initial stages of nutrient transport. This mechanism was evidenced not only in vertebrates (mammals, birds, fishes), but also in invertebrates (drosophilae). The comparison of the triton and trypsin forms of the enzymes permitted to locate centres of regulation in the hydrophobic parts of amphipathetic enzymes (as illustrated by the examples of alkaline phosphatase and gamma-amylase of of the rat and of the drosophila). A considerable variability of the regulatory characteristics of the enzymes under investigation was demonstrated in the different varieties of drosophila. The authors present a hypothesis on the role of the regulatory properties of digestive enzymes in the physiology and the pathology of the digestive and transport systems of the small intestine.


[Use of dichlorvos in flour mills].

[Use of dichlorvos in flour mills]. In the framework of studies on the possible use of dichlorvos (DDVP) in flour mills, the authors investigated the effects of various parameters (such as concentration of the DDVP solution to be used, temperature, location of the samples, different kinds of samples and packages) on the formation of DDVP residues on milling products. It was found that a concentration of 0.6 ml of DDVP-50/m3 and temperatures ranging from 18 degrees to 22 degrees C are particularly suited for insect control. Under these conditions, the DDVP residues on the samples were degraded within a period of 2--4 weeks, according to the kind of product. Uncovered foods shall not be present in rooms where DDVP is being applied. In virtue of the present findings, DDVP is recommended for use in flour mills.


[Adaption of protein in infant feeding]. A regarding its intestinal microecological action like human milk performed infant formula with a protein content of 1,6%, exclusively as casein, caused in nature born infants the same retention of nitrogen as human milk did. In prematures addition of cystine led to an increased retention. The serum level of urea and the pH of the feces were enhanced up to an undesirable degree when an analogous formula with 2,3% casein was applicated.


[Alteration of the normal intestinal flora in human sucklings within the last 20 years]. Analyses of the feces-flora and the feces-pH of breastfed infants and of infants nourished with commercial formulae (Ki-Na, Milasan) performed since 20 years were evaluated. In both regimens decreasing numbers of Bifidobacteria could be remarked. The dominating position of this groups of bacteria was limited more and more. Since 1971 the Bifidobacterium biotype, characteristic of feces of breastfed infants could be proved no more. Simultaneously germs of the E. coli-group and neonmycine-resistent forms increased. With breast-milk Proteus distinctly increased in the feces, whereas, formulae on cow's milk basis caused the reversed effect. Bacteroides and the group of H2S producing bacteria remained unaltered. In the stools of breastfed infants the pH-value increased slowly. These tendencies were marked still stronger in prematures. Enhancing influences from the environment as possible reasons for these developments were discussed.


Nonhormonal perinatal carcinogenesis.

Nonhormonal perinatal carcinogenesis. General concepts of chemical carcinogenesis are reviewed and implications of these concepts in perinatal carcinogenesis, as well as interrelationships between embryonal mortality, teratogenicity, and carcinogenicity are discussed.


Teratogenic and carcinogenic effects of some chemicals during perinatal life in rats, Syrian golden hamsters, and minipigs. Teratogenic effects of ENU have been observed in the rat, Syrian golden hamster, and minipig. In BD and Wistar rats, as well as in hamsters, ENU is a potent carcinogen when administered prenatally. Other members of the homologous series of alkylnitrosoureas, except n-propylnitrosourea, have been shown to be less active or totally inactive as carcinogens in experiments on prenatal animals. Simultaneous oral administration of L-citrulline and sodium nitrite induced adenosarcomas of the kidney (Wilm's tumors) in 6 of 22 offspring. The importance of prophylactic measures in man during prenatal development is emphasized.


Tissue differentiation as a prerequisite for transplacental carcinogenesis in the hamster respiratory system, with specific respect to the trachea. The significance of tissue differentiation for the transplacental carcinogenicity of DEN was examined. In one experiment, pregnant Syrian golden hamsters received a single sc injection of DEN on one of the different days of pregnancy. Approximately 95% of the offspring of those mothers treated on one of the last 4 days (days 12--15) of gestation developed respiratory tract tumors. Transplacental DEN treatment before the 12th prenatal day failed to induce any neoplastic response in the young. In the second experiment, the differentiation of the prenatal Syrian golden hamster tracheal epithelium was examined histologically and by electron microscopy. We found that on the 12th prenatal day the ER occurred for the first time in its functionally competent form. On earlier prenatal days, the epithelial cells lacked this organelle. We conclude that this development of ER is a prerequisite for transplacental DEN carcinogenesis, since this organelle contains the nonspecific enzyme systems necessary for the transformation of DEN to its ultimate carcinogen.


Host factors affecting perinatal carcinogenesis by resorptive alkylnitrosoureas in rats. Host factors are operative in transplacental carcinogenesis. There are species, strain, sex, and individual differences in susceptibility to carcinogens. Rat fetuses are over 50 times more susceptible than adults to the oncogenic effects of ENU, yet are less susceptible to tumor induction with DMN. Immune mechanisms do not seem to affect the latency period, incidence, location, and type of neurogenic neoplasms, although tumor-specific antigens are demonstrable in neoplastic neuroectodermal cells. Although placental barriers, DNA repair capacities, age at exposure, hormonal interaction, and immune responsiveness may be singled out as possible causes for species, strain, sex, and individual variations in susceptibility to the neuro-oncogenic potential of ENU, no definitive proof of the mechanism of action of any of these factors has yet been presented.


Mechanism of perinatal tumor induction by neuro-oncogenic alkylnitrosoureas and dialkylaryltriazenes. The methylation by DMPT and MNU of DNA from rat liver and brain was investigated at various developmental stages. Following a single sc injection of [14C]DMPT (100 mg/kg body wt, 15 hr survival time) in pregnant rats (21st day of gestation), the extent of methylation of purine bases was similar in fetal liver and brain. During postnatal growth, this treatment resulted in an increasingly preferential methylation of liver DNA. In 30-day-old BD-IX rats, the concentration of 7-methylguanine in liver was approximately eight times higher than in brain DNA. This suggested that during prenatal development, both liver and brain DNA are transplacentally methylated by a proximate carcinogen produced by maternal organs. After a single ip injection of [3H]MNU (10 mg/kg body wt) to 10-day-old rats, O6-methylguanine was more rapidly removed from hepatic than from cerebral DNA. Within 1 week after the injection, the brain-to-liver ratio for 06-methylguanine increased from 1.4 to 98. These results are compatible with the hypothesis that the deficiency of various organs for repair excision of O6-alkylguanine from DNA correlates with their susceptibility to malignant transformation by monofunctional alkylating carcinogens.


Perinatal carcinogenesis: biologic curiosity or practical necessity? Factors that require consideration in extending carcinogen bioassay protocols to include transplacental exposure of rodent subjects are summarized. These include metabolic complexities and biologic problems, such as the differences in fetal susceptibility to lethal, teratogenic, and carcinogenic effects of the same compound at different stages of intrauterine development, and that, with the present limited knowledge of transplacental carcinogenesis, transplacental and neonatal exposure to suspected carcinogens may lead to insoluble problems of interpretation. The view is expressed that agents to which the human fetus may be substantially exposed, including drugs and food additives, should nevertheless be tested for carcinogenicity by transplacental exposure.


Prenatal diethylstilbestrol exposure and human genital tract abnormalities. The incidence of clear cell adenocarcinoma of the vagina and cervix associated with intrauterine exposure to DES and similar compounds during the first half of pregnancy has increased. Ninety percent of these cancers have occurred in patients 14 years of age or older. Although these carcinomas are exceedingly rare, nonneoplastic abnormalities including vaginal adenosis, cervical eversion (ectropion), and transverse cervical and vaginal ridges are frequent in the exposed population, particularly if the drug was administered early in pregnancy. Current evidence favors a disturbance in development of the müllerian duct as the explanation of these changes. Whether DES is only a teratogen or also a carcinogen is unknown, as is the possible role of other factors in the development of cancer. An increased incidence of cancer among exposed males has not been documented.


In vivo studies in Syrian golden hamsters: a transplacental bioassay of ten nitrosamines. The carcinogenic effects of low doses of 10 nitrosamines were determined in pregnant Syrian golden hamsters and their offspring. Compounds studied included dimethylnitrosamine, di-n-propylnitrosamine, di-n-butylnitrosamine, nitrosopiperidine, nitrosohexamethyleneimine, 2-dydroxypropyl-propyl-nitrosamine, 2-oxopropyl-propyl-nitrosamine, methylpropylnitrosamine, di(2-hydroxypropyl) nitrosamine, and 4-hydroxybutyl-butyl-nitrosamine. Tumor incidences of all organ systems were almost always higher and latencies shorter in the mothers than in the offspring. Exceptions occurred in the respiratory system in which several compounds induced a low incidence of tumors in the offspring but none in the mothers. Fetal susceptibility appeared greatest toward the end of gestation. For purposes of bioassay, transplacental exposure was less efficient than conventional adult treatment.


Rapid screening for chemical carcinogens: transforming activity of selected nitroso compounds detected in a transplacental host-mediated culture system. The transplacental host-mediated hamster cell culture system was used to test a variety of solvents and chemicals of unknown and known (positive and negative) activity for their ability to induce morphologic transformation of cells and growth in agar. Examination of approximately 13,000 colonies of cells from untreated animals yielded no transformants, thus demonstrating no spontaneous transformation in the system. Similar negative results were obtained after animals were treated with the solvents acetone, ethanol, dimethyl sulfoxide, dimethylformamide, and trioctanoin oil. Several known carcinogens, including benzo[a]pyrene, methylnitrosourethane, urethan, and diethylnitrosamine, were positive for transforming activity. Three pesticides, carbaryl, methomyl, and landrin, and their N-nitroso derivatives were tested. All the nitrosated forms had transforming activity, but only one of the pesticides, landrin, was positive. In all experiments conducted, results of the agar-growth test correlated well with tests for morphologic transformation. The transplacental hamster embryol cell culture system therefore detected transforming activity of N-nitroso compounds and some known carcinogens.


Incorporation of transplacental exposure into routine carcinogenicity bioassays. Theoretical and practical issues related to incorporating transplacental and neonatal exposure into routine toxicology assays for carcinogen detection are presented. In view of the many chemicals that have not been evaluated for carcinogenic potential, an integrated approach to carcinogenesis bioassay is suggested in which short-term tests to predict potential carcinogens and a combined transplacental-neonatal-conventional exposure protocol for animal studies are used.


Development of permanently proliferated and cornified vaginal epithelium in mice treated neonatally with steroid hormones and the implication in tumorigenesis. Five to ten daily injections of 5--20 micrograms 17 beta-estradiol, 20--100 micrograms testosterone and its propionate, and 100 micrograms 5 alpha-dihydrotestosterone starting within 24 hours after bith caused estrogen-independent persistent proliferation and cornification of the vaginal epithelium in female mice of the C57BL/Tw, C57BL/Ms, A/Ms, and A/CrgI strains. The permanently changed vaginas frequently resulted in tumorigenesis. In C57BL/Tw mice, some undifferentiated cells, which survive only for a few postnatal days in normal animals, appeared to transform into large cells and formed nodules after neonatal administration of 17 beta-estradiol. The primary normal epithelium was replaced by a sheet of fused nodules that showed persistent proliferation and cornification independent of estrogen. Occurrence of the estrogen-independent vaginal epithelium in C57BL mice receiving neonatal injections of 20 micrograms estradiol for 5 days was prevented by injections of 200 IU VA when given simultaneously with the estradiol. Light cells were found by electron microscopy in the epithelium of estradiol-plus VA-treated mice. How these cells may have prevented the occurrence of the permanently changed vaginal epithelium is discussed.


Transplacental effects of diethylstilbestrol in mice. The effect of prenatal exposure to DES on the postnatal development of male and female genital tract function was studied. We investigated the placental transfer of [3H]- or [14C]-radiolabeled DES in pregnant mice. DES-associated radioactivity in the fetal plasma approximated maternal plasma one-half hour after iv administration of [3H]DES; [3H]-acitivity associated with DES in the fetal genital tract was about threefold higher. The decrease in reproductive capacity of female offspring from mice treated with DES during gestation was dose related; a low incidence (10% or less) of cancer of the vagina, cervix, and/or uterus was also observed in these mice. Male offspring exposed prenatally to the highest dose (100 micrograms/kg) of DES in this study also had lower reproductive capacities. Lesions in the genital tract of these mice included epididymal cysts, inflammation, cryptorchidism, and nodular masses in the seminal vesicles and/or prostate gland. Such lesions and sterility were not observed at the lower DES doses. Histologic studies with neonatal mice raise the possibility that müllerian duct tissue may represent a site for the transplacental toxicity of DES in both the male and female fetus.


Diethylstilbestrol: evidence for metabolic activation in man, rat, and hamster. Oxidative biotransformation of radioactively and deuterium-labeled DES gives rise to several metabolites in intact Wistar rats, Syrian golden hamsters, and humans. With the use of radio gas chromatography and gas chromatography--mass spectrometry, the major urinary and biliary metabolites were tentatively identified as hydroxy and methoxy derivatives of DES and dienestrol, of which the relative amounts excreted depended largely on the species. Some of the metabolites are potentially reactive substances or have reactive metabolic precursors such as epoxides or allylic hydroxy compounds that might be associated with the adverse effects of DES.


Role of hormone imbalance in transplacental carcinogenesis induced in Syrian golden hamsters by sex hormones. Data are presented from studies on Syrian golden hamsters with the ENU precursors, EU, and NaNO2, given transplacentally and in adulthood, and with transplacentally administered DES. Hormone modification by gonadectomy of offspring prenatally exposed to ENU caused a significantly greater incidence and multiplicity of PNS neoplasms and other tumor types in orchidectomized males, compared with intact males, and in ovariectomized and intact females. That PNS tumors in gonadectomized males appeared within a significantly shorter latency period indicated that endogenously generated androgens inhibited neoplastic development. The endocrine imbalance also induced a higher incidence of neoplasia in other tissues and organs, e.g., skin melanomas, thyroid and adrenal cortex tumors, and notably gliomas in the CNS of ovariectomized female siblings. Exposure to single doses of ENU on days 12, 13, 14, and/or 15 caused PNS tumors predominantly in females and with an increased frequency in progeny treated during the final days of gestation. The spectrum of neoplasms was greater and their incidence significant in ENU-treated adult hamsters; the tumor types different from those of transplacentally treated animals (i.e., vascular, vaginal, and ovarian tumors and fore-stomach papillomas were seen). Determining factors in carcinogenesis at the time of carcinogen treatment possibly included stage of ontogenic development, degree of cell differentiation, hormone state of host, age, total dose, and duration of treatment. DES results indicated that the haster may be a useful model for reproducing lesions similar to those observed in children of mothers treated with this drug during pregnancy.


H-2 restriction of contact inhibition of epithelial cells. Medawar has suggested that the major histocompatibility gene complex (MHC) might be involved in the contact inhibition of movement shown by fibroblasts and epithelia. Contact inhibition of movement is that reaction of cells which stops the movement of one cell over another and thus leads to monolayering and other features of morphology typical of cells in culture and in vivo. By confronting epithelial outgrowths we have compared contact inhibition between syngeneic cells with that between allogeneic cells. Contact inhibition was more marked between allogeneic combinations than syngeneic combinations, when the genetic mismatch lay in certain parts of the MHC complex.


Macromolecular structural transitions in Pf1 filamentous bacterial virus. The filamentous bacterial virus Pf1 is a simple model for biological filaments. We have studied the structure of the virion and report here that the helix parameters of Pf1 change sharply with temperature at about 8 degrees C. Local interactions between protein subunits change by only a few tenths of an angstrom, but the changes are amplified between one end and the other of the virion to a rotation of 15 turns and a translation of 1,000 A. The limited nature of the phase transition is probably due to the constraints of 'knobs-into-holes' interaction between side chains of adjacent alpha-helical protein subunits. Treatment of the virion with ether causes a rearrangement of protein subunits into sheets, with the alpha-helices normal to the plane of the sheet. This phase transition suggests a model for virion assembly in the bacterial membrane.


Local destabilisation of a DNA double helix by a T--T wobble pair. Nuclear magnetic resonance is a technique which permits direct observation of the Waton--Click hydrogen-bonded ring imino protons (guanine N1H and thymine N3H). As the formation and disruption of hydrogen bonds of double-helical RNA and DNA structures are key events during various biological processes, NMR thus provides a useful tool for studying the fluctuational mobility of the individual base pairs. Indeed, several NMR studies of oligo- and polynucleotides have been carried out to probe the structure and dynamics of nucleic acids in solution (for a review see ref. 1). The present study constitutes the first part of our attempt to assess the influence of non-complementary base pairs on the stability of nucleic acid double helices. We report the spectral assignment and temperature-dependent NMR profiles of the hydrogen-bonded imino protons of the two DNA fragments shown in Fig. 1. The assignment is based solely on experimental grounds using the principle of chemical modification. It will be demonstrated that the introduction of a non-complementary (wobble) base pair in a DNA duplex introduces an extra melting site in addition to the sequential melting which starts with the terminal base pairs in the double helix structure.


Thromboxane molecules do not adopt the prostaglandin hairpin conformation. The hairpin conformational hypothesis has been proposed to rationalise much of the structure-activity and receptor-binding data which have accumulated for the prostaglandin (PG) hormones. The hairpin conformation, thought to be necessary for PG activity, requires that the alpha- and omega-chains of the molecule be extended and in parallel alignment, separated by a van der Waals contact distance for the full length of the chains, with the ends of the chains approximately 5.5 A apart. The similarity between the structures of the thromboxanes (TXs) and the PGs suggests that the profile of activity of TXs, like that of PGs, centres on subtle conformational variation of the hairpin geometry. Thromboxane B2 (TXB2) is a stable hydrolysis product of a highly reactive, short-lived intermediate, thromboxane A2 (TXA2), which is formed from the prostaglandin endoperoxide (PGH2) as indicated in Fig. 1. An examination of molecular models of TXA2 and TXB2 suggests that the structural differences between the ring moieties may have much less influence in altering the side-chain conformation of TXs than do substitutents on the relatively more flexible cyclopentane ring of a PG molecule. We report here the first diffraction analysis of a thromboxane structure and note that the molecular conformation is not hairpin shaped.


Isolation, cloning and sequence analysis of the cDNA for the alpha-subunit of human chorionic gonadotropin. A 621-base pair fragment of the cDNA for the alpha-subunit of human chorionic gonadotropin has been isolated by cloning in a plasmid vector, and the complete nucleotide sequence determined. The entire coding region, including the 24-amino acid pre-sequence and most of the untranslated regions, are present in the fragment.


Behavioural access to short-term memory in bees. Memory formation proceeds in temporal phases which differ in their effectiveness in controlling subsequent behavior and in their susceptibility to amnestic treatment. The initial phase of memory formation, frequently termed short-term memory, is generally considered a necessary precursor to long-term memory. However, the course of short-term memory differs widely between animal species and is dependent on experimental procedure. Information may even bypass the short-term phase en route to the long-term one. Experiments reported here using honey bees in a behavioural learning situation suggest that the greatest significance of short-term memory is its function as a mode of memory storage which may be altered effectively by new and contradictory information. Freely flying honey bees were presented two colour alternatives and rewarded on first one and then the other in a reversal learning paradigm. Subsequent colour preference was dependent on the interval between the two trials. Several new features of short-term memory are described. It is concluded that a single mechanisms of short- to long-term memory transfer cannot account for the observed bimodal interval dependent behaviour. Two mechanisms are proposed.


A new neuronal marker identified by phosphorylcholine-binding myeloma proteins. The difficulty of working with the intact brain in vivo has led to the increasing use of nerve cell cultures in neurobiology. However, dissociated cells cannot be unambiguously identified by morphological criteria before the third week in culture, for it is not until then that the basic morphology and size of neurones become stable so that these and other cell types can be easily distinguished. However, cultured neurones can be identified by various cytochemical techniques based on (1) the detection of neurotransmitters or receptors for transmitters, (2) the presence of the Thy 1 antigen and the receptor for tetanus toxin, which are present on the membrane of most neurones, and (3) the presence in neurones of neurone-specific enolase (NSE), a cytoplasmic enzyme, which can only be identified on fixed specimens. Furthermore, other cell types in culture can also be specifically labelled. For instance, antisera to galactocerebroside bind selectively to oligodendrocytes, and antibodies to a neural tumour bind selectively to Schwann cells. We report here the selective interaction of phosphorylcholine-binding myeloma proteins (PC-BMP) with mouse neurones in culture and  in suspension. Phosphorylcholine (PC) is found as part of lecithin and sphingomyelin molecules in variable amounts in eukaryotic and prokaryotic membranes, including plasma membranes.


Erythropoietin-stimulated erythropoiesis in long-term bone marrow culture. The proliferation of multipotential haematopoietic stem cells (CFU-S) is possible in some long-term bone marrow cultures. Granulocyte and macrophage progenitor (CFU-C) and megakaryocyte precursor cells (CFU-M) are present in these cultures and undergo full development into mature cells. In contrast, while immature erythroid progenitors ('early' BFU-E) are maintained in long-term culture, none of the more differentiated progeny (CFU-E) have been detected, and no morphologically recognisable erythroid cells have been observed. We now describe a modified culture system in which the 'early' BFU-E develop into 'late' BFU-E in response to added erythropoietin. Further maturation of these cells into CFU-E and non-nucleated erythrocytes can be achieved by mechanical agitation of the long-term cultures or by transferring the cells into dishes which do not allow cell attachment to occur.


Vascular endothelial and smooth muscle cells in culture selectively release adenine nucleotides. Endothelial cells in culture can modulate platelet aggregation and vascular tone, in part by producing prostacyclin (PGI2), a powerful vasodilator and inhibitor of platelet aggregation, but also by their ecto-ADPase activity, which initiates the conversion of pro-aggregating ADP to adenosine, a potent vasodilator and platelet inhibitor. We have now demonstrated that cultured aortic endothelial cells exposed to trypsin, thrombin or other stimuli can liberate a high proportion of their adenine nucleotides without substantial loss of lactate dehydrogenase. ADP rapidly accumulates extracellularly, reaching biologically active concentrations before there is further breakdown to adenosine. Whether this selective release of nucleotides is a response to damage, or whether it represents a specific secretory mechanism remains to be resolved. Cultured aortic smooth muscle cells can secrete adenine nucleotides in a similar manner, but extracellular conversion to adenosine occurs much faster.


Pretreatment with acetylaminofluorene enhances the repair of O6-methylguanine in DNA. Epidemiological and experimental evidence suggests that the interplay of environmental factors may be particularly relevant to the induction of cancer in man. We have investigated the possible interrelationships, at the level of DNA repair, of two chemically different hepatocarcinogens administered to rats. Animals were pretreated for several weeks by inclusion of 2-acetylaminofluorene (AAF) in the diet and a study was made of the capacity of liver to repair lesions subsequently introduced into DNA by a pulse of dimethylnitrosamine (DMN). Of particular interest was the repair of adducts at the O6 position of guanine as this product has been implicated as a critical reaction site for carcinogenesis by the monofunctional alkylating agents. We show here that the capacity of liver to repair O6-methylguanine in DNA is enhanced by prolonged exposure of rats to the chemically unrelated agent, AAF.


Evidence for a central postsynaptic action of clonidine. Intravenous administration of clonidine (1--100 micrograms/kg) produces a dose-dependent mydriasis in cats by inhibition of parasympathetic tone to the iris. The magnitude of CNS-induced pupillary dilation was similar in both normal anaesthetized cats and in anaesthetized preparations pretreated with reserpine (5 mg/kg i.p.) and alpha-methyl-p-tyrosine (2 x 300 mg/kg i.p.). Pretreatment reduced the concentrations of noradrenaline, dopamine and serotonin to less than 3% of that control levels in most parts of the CNS in which these amines were measured. Clonidine produced bradycardia in control animals but not in pretreated cats. In amine depleted animals in which only one eye was innervated by the ciliary nerves (parasympathetic), clonidine produced mydriasis only on the innervated side. These experiments confirm our previous observations that clonidine produces mydriasis in the cat by means of inhibition of parasympathetic tone to the iris. It is concluded that if clonidine produces this effect by stimulating noradrenergic, dopaminergic or serotonergic receptors, then clonidine exerts its centrally-induced mydriatic effect by acting on post-synaptic mechanisms.


The influence of (+)-propranolol on the inotropic effect of dihydro-ouabain in relation to stimulation frequency. 1. The influence of (+)-propranolol, 10(-6) to 4 x 10(-5) mol/l, upon the positive inotropic effect of dihydro-ouabain was studied on guinea-pig papillary muscle. At 1 Hz, negative inotropically effective concentrations of (+)-propranolol decreased the inotropic effectiveness of the glycoside. 2. For equivalent diminution of the basal force of contraction, either by reduction of stimulation frequency or by increasing concentrations of (+)-propranolol, a similar decrease in the inotropic effectiveness of dihydro-ouabain was observed. In contract, reduction of [Ca2+]o  had almost no effect on the effectiveness of the glycoside. 3. The inhibitory effect of (+)-propranolol on the inotropic effectiveness of dihydro-ouabain declined with reduction of stimulation frequency. At any stimulation frequency tested, the inhibitory effect of (+)-propranolol was proportional to the effect of a reduction of that particular frequency to the rested-state condition in the absence of (+)-propranolol. 4. The results are consistent with the hypothesis that the inhibition of the excitation-coupled sodium influx by (+)-propranolol is the cause of its inhibiting effect on the effectiveness of dihydro-ouabain.


Perfusion of the fourth cerebral ventricle with fentanyl induces naloxone-reversible bradycardia, hypotension, and EEG synchronisation in conscious dogs. Injection of fentanyl into the cisterna magna of the brain leads to hypotension and bradycardia in anesthetised dogs. To determine if this effect is related to the recently discovered opiate receptors fentanyl was perfused in increasing concentrations (2.5-20 microgram/ml) through the cerebro-ventricular system in conscious dogs. Blood pressure was recorded continuously from a punctured exteriorised carotid artery; heart rate was derived from the ECG. Baroreflex activity was tested repeatedly by clamping of both common carotid arteries. Cerebral activity was evaluated from the EEG. Perfusion of the fourth cerebral ventricle resulted in a concentration-related fall in heart rate by 43% and in an inhibition of the reflex response of heart rate to carotid clamping. In contrast, blood pressure fell only moderately by 14% and its reflex response was well maintained. The EEG pattern changed from frequencies in the beta-band (awake control) to gradual synchronisation with delta-activity corresponding to behavioural signs of tranquilisation and sleep-like states. All these effects were reversed by naloxone. No effects were seen when fentanyl was perfused through the lateral ventricles and third ventricle although this yielded similar serum concentration as after perfusion of the fourth ventricle. It is concluded that opiate receptors bordering the fourth cerebral ventricle mediate the cardiovascular and hypnotic action of fentanyl.


Failure of chronic lithium treatment to block tricyclic antidepressant-induced 5-HT supersensitivity. The ability of chronic lithium administration to modify tricylic antidepressant-induced supersensitivity development in cells receiving 5-hydroxytryptamine (5-HT) input was investigated using microiontophoretic techniques. In these experiments, chronic chlorimipramine (or imipramine) administration for a period of 14 days resulted in a 5-fold increase in the sensitivity of hippocampal pyramidal cells to iontophoretically applied 5-HT. This supersensitivity was not blocked by the concurrent administration of lithium. The data suggests that blockade of supersensitivity development by lithium as previously demonstrated in the dopamine system may not be generalized to all central amine systems.


Studies on tryptophan accumulation in brain during methiothepin-induced enhancement of 5-hydroxyindole synthesis. The elevation of brain tryptophan, 5-hydroxytryptophan and 5-hydroxyindoles (serotonin + 5-hydroxyindole acetic acid) that results from a tryptophan load is potentiated by prior administration of methiothepin, a serotonin receptor antagonist. Co-administration of valine with tryptophan attenuates these effects even in animals receiving methiothepin pretreatment. Administration of methiothepin and tryptophan to rats with widespread reduction of brain 5-hydroxyindole levels resulting from raphe lesions or 5,7-dihydroxytryptamine pretreatment still enabled brain tryptophan levels to rise considerably above the sum of increases found in animals receiving one or the other. Following transection of the spinal cord, the cranial portion still exhibited enhanced uptake of tryptophan and 5-hydroxyindole synthesis following methiothepin plus tryptophan treatment, however, both these events were absent in the caudal segment. Apparently, enhanced tryptophan uptake can proceed in the presence of minimal neuronal activity; however, when nerve impulse flow is eliminated, both 5-hydroxyindole synthesis and tryptophan uptake is impaired.


Effect of age on levels of diazepam in plasma and brain of rats. The pharmacokinetics and distribution in brain and cerebellum of diazepam after a single dose were studied in middle aged (6 months) and old (18 months) rats. Following the single intravenous bolus of 5 mg/kg diazepam was eliminated more slowly in old rats (T 1/2 (beta) = 3.1 H) than in middle aged rats (1.4H). This was due to an increase in the apparent volume of distribution Vd beta from 11.0 l/kg (control rats) to 29.5 l/kg. Concentrations of diazepam in brain and cerebellum were in the same range (0.5-1.1 ng/mg) in both groups after this dose. We conclude that the distribution of diazepam is age-dependent which might be due to an altered body composition.


Variations in serum complement following inulin infusion in man. Complement levels were determined in 12 normal human volunteers while receiving intravenous infusions of inulin for determination of standard inulin clearances. Significant decreases in beta IC globulin and total hemolytic complement activity were observed when inulin was infused, but not following infusion of saline as a control. These effects were noted only when steady-state inulin levels were greater than 26 mg%, suggesting a dose-dependent response. No evidence of increased coagulation was noted as measured by fibrinogen and fibrin degradation products. Since C4 levels remained largely unchanged following inulin infusion, it was concluded that the results most likely occurred through activation of the alternate complement pathway.


Changes in total body calcium on prolonged maintenance hemodialysis with high and low dialysate calcium. In vivo neutron activation analysis was used to measure sequential changes in total body calcium in 25 unselected patients with end-stage renal disease on dialysis for a period as long as 5 years. In 7 unselected patients (group 1), dialysis with a calcium solution of 5.0 mg/100 ml resulted in significant calculated daily loss of calcium (-321 +/- SEM 76 mg/day) while dialysis with 6.5 mg/100 ml resulted in a significant calculated calcium gain (182 +/- SEM 103 mg/day; p less than 0.0025). The remaining 18 patients (group 2) were dialyzed with a dialysate calcium of 6.5 mg/100 ml and sequential total body calcium measurements showed no significant calcium losses (-12 +/- SEM 68 mg/day) for a period as long as 2 years.


Platelets and platelet function in patients with chronic uremia on maintenance hemodialysis. In 20 chronic uremic patients on maintenance hemodialysis, who were not taking any medication known to affect platelet function, the following investigations were carried out: platelet count, fibrin/fibrinogen degradation products, fibrinogen and plasminogen concentration, platelet adhesiveness, clot retraction and platelet aggregation induced by ADP, ristocetin, fibrinogen, collagen and epinephrine. The only significant abnormal result was a decreased clot retraction. We consider many cases of so-called uremic bleeding to be caused by the medication taken and conclude that on well-controlled hemodialysis treatment, bleeding tendency should not be a major problem.


Perinephric abscess in patients with polycystic kidney disease undergoing chronic hemodialysis. 5 patients with polycystic kidney disease undergoing chronic hemodialysis who developed perinephric abscesses are described. Gallium-67 scintigraphy was helpful in making a diagnosis in 2 of these patients. All 5 patients initially presented with urinary tract infections. Perinephric abscess became evident over a variable period of time (2--28 days) following completion of antibiotic therapy for their urinary tract infection. Gallium-67 scintigraphy appears useful in detecting this complication, and nephrectomy should be considered once the diagnosis is confirmed.


Interrelationship between acetylcholine and prostaglandins in the control of sodium excretion and renin secretion in anesthetized dogs. I. The interrelationships between acetylcholine (ACH) and prostaglandins in the control of sodium excretion (UNaV) and of renin secretion (RS) were examined in unilaterally-nephrectomized, anesthetized dogs with or without treatment with indomethacin, an inhibitor of prostaglandin synthetase. Inrarenal infusion of ACH (40 microgram/min) in control animals produced diuresis and natriuresis. UNaV was 9.2 +/- 3.1 muEq/min during control periods and was 74.7 +/- 31.6 muEq/min after 40 min of infusion of ACH (p less than 0.05). UNaV was still 48.0 +/- 16.8 muEq/min after 100 min of infusion of ACH (p less than 0.05). RS rate was 930.6 +/- 188.5 U/min during control periods, and was 737.4 +/- 220.3 U/min after 100 min of infusion of ACH (p greater than 0.1). In the dogs treated with indomethacin, the natriuresis produced by ACH could not be sustained. UNaV was 46.6 +/- 12.1 muEq/min before and was 34.7 +/- 12.8 muEq/min 100 min following the infusion of ACH (p greater than 0.1). Arterial plasma renin activity was 3.29 +/- 0.83 ng/ml/h before and was 20.97 +/- 7.78 ng/ml/h after 100 min of infusion of ACH (p less than 0.025). The data suggest that prostaglandins are involved in the sodium excretion and the renin secretion produced by acetylcholine.


Renal effects of mannitol in the early stage of glycerol-induced acute renal failure in the rat. The effects of mannitol on the hemodynamics and excretory function of the kidney in control rats and in rats with acute renal failure (ARF), induced by glycerol, were studied using clearance, micropuncture and flowmeter techniques. In control animals, 20% mannitol significantly increased renal blood flow (RBF), urinary volume and sodium excretion and decreased urinary sodium concentration and fractional tubular sodium reabsorption. Glomerular filtration rate (GFR) and effective filtration pressure remained unchanged. 50% glycerol (10 ml/kg bw) was injected intramuscularly in other groups of rats to induce ARF. Functional impairment of the glycerol-treated animals consisted in a significant decrease in urinary sodium concentration, RBF, GFR and effective filtration pressure of superficial nephrons. Urea concentration in arterial plasma and urine volume increased significantly. Infusion of 20% mannitol into these animals led to a significant further decrease in GFR and net filtration pressure, but not in RBF. Urine volume increased to the same degree as in controls.


Some aspects of cellular immunity in untreated and maintenance hemodialysis patients. The cellular pattern of skin exudate in untreated uremic patients differed from that in healthy persons. The skin exudate composition in patients on maintenance hemodialysis approached normal values. Such normalization was, however, static: after sensitization with dinitrochlorobenzene--contrary to the control--both treated and untreated patients exhibited no changes in the cellular pattern of exudate. The activity of acid phosphatase in the cells of exudate was highly positive in control, almost normal in dialyzed, but weak in untreated uremic patients. Our investigations confirmed that cellular immunity in untreated and in maintenance hemodialysis patients is suppressed.


The renal handling of amylase in normal man. The renal glomerular and tubular transport rate of amylase was studied by measuring the urinary excretion of this protein before and during inhibition of tubular protein reabsorption by lysine. The excretion of amylase was compared with the excretion of albumin, beta-2 microglobulin and free light chains of immunoglobulins. This investigation showed that amylase is reabsorbed by the tubular cells, but only to a very modest degree compared with the reabsorption of the other three proteins. In the case of amylase only about 45% of the filtered molecules are reabsorbed, whereas more than 90% of the filtered amount of the other molecules is reabsorbed by the tubular cells. The excretion of amylase rose after lysine injection only by a factor 1.8, whereas excretion rose by a factor 28 for albumin, 1,500 for beta-2 microglobulin, 16 for kappa chains and 8 for lambda chains. Minimal values for tubular reabsorption were found to be 5.5 +/- (SD) 4.3 U/min for amylase, 174.0 +/- 35.7 micrograms/min for albumin, 90.5 +/- 14.4 micrograms/min for beta-2-microglobulin, 70.4 +/- 17.4 micrograms/min for kappa chains and 24.2 +/- 9.2 micrograms/min for lambda chains.


Regulatory interrelations between GABA and polyamines. I. Brain GABA levels and polyamine metabolism. Elevation of brain GABA levels by GABA-T inhibition is accompanied by a decrease of S-adenosylmethionine decarboxylase activity. This is followed by an increase of ornithine decarboxylase activity and a severalfold increase of brain putrescine levels. Spermidine and spermine levels are not significantly affected under these conditions. These unexpected findings support a regulatory interaction between GABA and polyamine metabolism.


Regulatory interrelations between GABA and polyamines. II. Effect of GABA on ornithine decarboxylase and putrescine levels in cell culture. GABA added to rat hepatoma (HTC) cells in spinner culture at the time of induction of cell proliferation increased levels of ornithine decarboxylase (ODC) up to two- to threefold above that of control cells. The increases in ODC were also reflected by concomitant increases of intracellular putrescine levels, while spermidine and spermine were unchanged. GABA seems to have a direct stabilizing effect on ODC, since the turnover of the enzyme was slowed almost twofold when measured in cells treated with 10(-2) M GABA. The stabilizing effect is most pronounced for GABA, although some amino acids such as asparagine, glutamine, and lysine as well as some GABA analogues and homologues also tend to increase ODC but to a significantly lesser extent than GABA itself. GABA metabolites had no effect on ODC. S-Adenosylmethionine decarboxylase and tyrosine aminotransferase were not affected by the presence of GABA. The GABA effect on ODC may be important in certain types of cells for the regulation of polyamine biosynthesis.


Levels and uptake of taurine in various brain regions after drug-induced generalized convulsions. In a study of the role of taurine in the genesis of epilepsy the effects of metrazol-induced convulsions on the uptake and distribution of taurine in the brain were measured. In vivo we found no significant uptake of taurine in the mouse brain; in rabbit brain in most areas significant taurine uptake was found. The physiological levels of taurine were much higher in mouse brain than in rabbit brain. In vivo the regional levels and the uptake of taurine were not significantly changed after generalized convulsions. Uptake in vivo was lowered in slices obtained from mice treated with metrazol. The lack of effect of metrazol convulsions on cerebral taurine in vivo indicates that further studies are needed to clarify the relationship between taurine, a putative inhibitory transmitter, and epilepsy.


Histochemical studies on catecholaminergic cells in the carp retina. Histochemical studies on catecholaminergic cells were conducted with the carp (Cyprinus carpio) retina. Catecholamine (CA)-containing cell bodies appear sparsely distributed among amacrine cells in the innermost cellular row of the inner nuclear layer (INL) and occasionally in the outer half part of the inner plexiform layer (IPL); only exceptionally are they found among ganglion cells. The fluorescent cells interspersed with the amacrine cells and in the IPL send their fiber processes toward both the outer plexiform layer (OPL) and the IPL; the fine fibers form dense networks in the INL and IPL. Pretreatment of the fish with intramuscular injection of reserpine (20 hr prior to enucleation) completely depleted CA from the retina. The fluorescence of catecholaminergic cells was enhanced, and the number of fluorescent cells visible was increased, by intravitreous injection of L-DOPA, DA, and NA (3 prior to enucleation). A combination of pretreatment with intramuscular reserpine and intravitreous NA was particularly effective. These results indicate that catecholamines may play an important role in the modulation of the membrane potential of horizontal cells.


GABA metabolism in cultured glial cells. GABA-transaminase has been characterized in cultured astrocytes. It is identical to the synaptosomal and perikaryal enzyme in terms of charge, molecular weight, and stability, but it differs in its affinity for GABA, which is much higher in the glial compartment. GABA-transaminase has been shown to be inducible by high GABA concentrations, which suggests that astrocytes have the possibility not only to transport GABA but also to metabolize the amino acid which is taken up.


Dopamine diffusion after microwave fixation at 986 MHz. It has been previously demonstrated by us that microwave irradiation at 2450 MHz causes diffusion of dopamine from rat brain regions of high dopamine concentration to contiguous regions low in dopamine. Because we have found that the heating pattern at 986 MHz is opposite to that seen at 2450 MHz, we attempted in the present study to eliminate DA diffusion by heating at 986 MHz. However, dopamine levels were elevated in frontal and parietal cortex, remainder of cortex, and amygdala after sacrifice by microwave irradiation at 986 MHz. Norepinephrine levels were unaffected by sacrifice method. Microwave-induced diffusion of certain substances must be considered in the interpretation of regional neurochemical data.


Activity and subcellular distribution of phospholipase A1 from neuronal cell-enriched fractions of the rabbit cerebral cortex. Glycerophosphatides, specifically labeled either in the 1 or in the 2 position, were used to measure the activity of neuronal phospholipase A1 and to investigate the subcellular distribution of the enzyme. The microsomes were found to possess the highest phospholipase activity, with a threefold increase as compared to the cell homogenate. A considerable enzymatic activity could still be observed in the plasma membranes isolated from the neuronal-enriched cell fraction. Microsomal phospholipase possessed the highest activity with phosphatidylcholine, whereas phosphatidylserine was cleaved at a much lower rate. The rate of release of labeled fatty acids from the substrates by the microsomal phospholipase decreased with increasing degree of unsaturation of the fatty acids at the 1 position. The presence of plasmalogens and of alkylacyl analogues in the incubation mixture caused an appreciable inhibition of the hydrolysis of the diacyl glycerophosphatides.


[On the so-called "hysteroepilepsy"].

[On the so-called "hysteroepilepsy"]. The authors examined on an outpatient basis 14 patients treated previously at the Neurological Department, Institute of Psychoneurology in Warsaw or at the Neurological Department of the Grochów Hospital in the years 1965--1972 in whom epilepsy had been diagnosed but who had also had hysterical seizures. Young women aged 20--30 years with temporal-lobe epilepsy prevailed in this group. In most of them hysterical seizures appeared within 5 years after the first epileptic seizure when the frequency of true seizures decreased. In more than half these patients it was possible to find a connection between the occurrence of hypsterical seizures and conflict situations. Psychiatric examination failed to find in most cases any symptoms of epileptic characteropathy, but mood disturbances of the type of depression with dysphoria were disclosed, other findings included immature personality, egocentrism and extraversion. Although the clinical material reviewed by the authors contained only a negligible proportion of cases, it may be possible that they are more numerous among outpatients and the correct diagnosis of these cases is particularly important for further treatment since anticonvulsants are insufficient and sociotherapy with psychotherapy are indicated.


[Psychomotor development of small children with epileptic attacks evaluated by a psychologist]. The reported investigations aimed at tracing the psychomoter development in small children with central nervous system damage for establishing whether there is any difference in the development of children in whom epileptic seizures developed as a manifestation of damage, in relation to children with palsies and epileptic seizures. The group of children observed comprised 46 cases aged from 1 to 3 years in two equal subgroups: children with epilepsy with maximal seizures and children with the diagnosis of cerebral infantile palsy with spastic quadriparesis and maximal epileptic seizures. The psychological investigations included clinical observation and experimental tests. The obtained results were subjected to analysis by the case study method. It was found that psychomotor development disturbances were more frequent in the group with cerebral palsy and epileptic seizures than in the group with epilepsy caused by brain damage. However, the level of psychomotor development of the observed children was not determined by palsy but the degree of damage to the central nervous system.


[Xylose test in patients with attacks of headaches (migraine, Horton's headache)]. The aim of this work was to study digestive tract function by means of xylose test in patients with attacks of headaches. The investigations were carried out in 14 patients with migraine, 10 with Horton's headache and 1 patient with both these conditions. In patients with migraine or Horton's headache the xylose test was normal in 65% of cases, in the remaining 35% (8 patients, 4 in each group) xylose elimination was abnormal, because it was below 30%. The authors discuss the factors which could influence the abnormal results of xylose test in these patients, since they had no signs of other diseases than the mentioned headaches.


[Encephalopathy after poisoning with organic mercury compounds]. Organic mercury compounds have greatest affinity to the central nervous system (cerebellar white matter, basal ganglia, occipital and frontal cortex). Anatomical changes observed in the brain are of degenerative type. Similar changes are found also in the myocardium, liver and kidneys. The authors observed for 2 years a family of three persons who contracted poisoning with organic mercury compounds after easting the meat of pigs and hens fed through negligence with wheat destined for sowing, containing methyl-mercurocyanoguanidine. The level of total mercury determined by the method of cold atomic absorption was in these patients four months after poisoning 650,500 and 175 ng/ml of blood (normal value from 1.56 to 18.72 ng/ml). During the observation it has been established that the severity of poisoning was related to the level of mercury found in the organism. Pharmacological treatment (Cuprenil, Thioctacid, vitamin B complex) and rehabilitation brough slight improvement after 2 years. Two patients with total blood mercury level 650 and 500 ng/ml were completely disabled due to encephalopathy with high grade ataxia, dysarthria and concentric narrowing of the field of vision. In the third patients with less severe poisoning (175 ng/ml) pathological manifestations disappeared completely after short treatment.


[Clinical analysis of late infantile form of muscular atrophy]. Clinical analysis of 47 cases of late infantile spinal muscular atrophy is reported. In 25.5% of cases mothers reported weak fetal movements in pregnancy and low muscular tonus after birth, these signs predicted early manifestation of the disease. In 89,2% of cases the first signs of the disease appeared within the first 3 years of life. Delayed motor development in infancy was observed in 59.6%. Immobilization developed between the ages of 2 and 18 years, usually after 7 years of disease duration, and it was not correlated with the age of onset of the first signs of the disease. Mental development was normal in 81.5% of cases. Familial character of the disease was found in 51.1% of cases and in some of them intrafamilial variability was observed.


[AMP-aminohydrolase of skeletal muscles in muscular diseases]. Determinations of AMP-aminohydrolase activity were done in muscles in 34 cases of different neuromuscular diseases, and 30 subjects without skeletal muscle changes. In the group of patients Duchenne's progressive dystrophy accounted for 10 cases, the remaining patients had limb-girdle dystrophy, polymyositis, myotonia, collagen diseases, myopathies of nuclear aetiology, and neurogenic muscle disease. The highest fall in the activity of the enzyme was observed in Duchenne's dystrophy. The authors discuss the possible mechanism of development of these abnormalities.


[Effect of various forms of physical exertion on selected types of sensory function]. The author reports changes in vibration and two-point discrimation sensitivity in groups of healthy young males after several days of intense physical effort and after one short-lasting intense exercise. The vibration sensitivity was a steady type of sensory function showing no significant changes after these workloads. The two-point discrimination sensitivity was, not infrequently, better after several days of effort in relation to preliminary state, and it was regarded as an evidence of adaptation to work. On the other hand, one sort-lasting exercise reduced significantly discrimination of two stimuli, especially on the lower extremities. This significant impairment of two-stimuli discrimination on the lower extremities in relation to the upper ones after intensive effort suggests easier exhaustion of pathways conveying sensation in the thoracic segment of the spinal cord. On the basis of these investigations the author thinks that aesthesiometric investigations carried out under strictly observed conditions may be useful for assessment of fatigue.


[Favorable effect of procaine administration in retrobulbar optic neuritis]. The author reports 12 cases of retrobulbar neuritis of recent onset in which intravenous procaine exerted unexpectedly an immediate favourable effect. The treatment consisted of intravenous drip infusion of 40 ml of 1% procaine in 400 ml of 5% glucose during 7 days. The author supposes that the therapeutic effect was due to the antiallgeric action of procaine (blocking of histaminergic receptors) and its spasmolytic influence.


[Place and role of clinical neurology in the opinion of students graduating from medical schools]. The attitudes and opinions of students of the 6th year of the medical faculties of four medical academies in Poland were studied. The proportion of students mentioning intention of specializing in neurology was 4--8%. Differences found in different medical academies between the attitude and opinions of students about the place and role of neurology among other specialities may be regarded as indicating the necessity of teaching modifications for stressing the importance of neurology in modern medicine and, especially, for emphasizing the consultative character of this speciality.


[Rare care of Ramsay Hunt syndrome associated with herpes zoster of the glossopharyngeal nerve]. The authors describe a rare coexistence of Ramsay Hunt syndrome with glossopharyngeal zoster in a 67-year-old patient. A trial of systematization of the nomenclature of Ramsay Hunt syndrome is suggested, on the basis of certain anatomophysiological data. It is concluded that in zoster involvement of the sensory elements in the geniculate ganglion and in otic ganglion should be accompanied by taste sensitivity disturbances, but often the patients fail to notice these disturbances and routine taste testing shows also no such tase impairment. Routine use of electrogustometry is postulated since this makes possible diagnostic-prognostic assessment followed by selection of appropriate treatment.


The density of neurons in the human hippocampus. The aim of this study was to determine the density and pattern of distribution of the neurons in the human hippocampus, and twenty-nine brains of healthy individuals were examined. The cells counted in each unit area were the pyramidal cells in the H-fields and the granule cells. Difference in density was found between all H-fields. The neuronal density was highest in the H2-fields. The density decreased through the transitional area H1-2 and H1, with the lowest density in H3. The neuronal density increased in all H-fields in the antero-posterior direction, while the granule cells decreased in density. In the individual brain there was a positive correlation found respectively between high and low cell density in the different H-fields. The pyramidal cell density decreased in persons more than 68 years old. No difference was found between neruonal cell density in the two sides of the brain. Sex did not influence the neuronal cell density.


[Transient focal ischemia in Fahr's disease]. In the reported case symmetrical calcifications were found in the basal ganglia and cerebellum which connected with congenital anomalies of cerebral vessels were the cause of intermittent episodes of right-sided hemiparesis with mutism in a man aged 39 years.


The fine structure of the cns in multiple sclerosis. II. Vesilcular demyelination in an acute case. Tubular vesicular and net-like dissolution of myelin sheaths associated with complete demyelination and preservation of axons, is described in the brain, obtained within 4 h of death, from a patient who died with acute multiple sclerosis (MS). It was rare, being found in only three out of twenty-three blocks examined, and was seen mainly in the partially demyelinated margin of an active plaque in the white matter. The possibility that post-mortem autolytic changes or fixation artefact might have accounted for the appearances is considered, but is thought unlikely. The findings, though not specific would be expected if current theories invoking myelin-directed 'autoimmune' mechanisms in MS pathogenesis are correct. However, other myelin-directed mechanisms cannot be excluded on the basis of this evidence alone.


[Simultaneous occurrence of meningioma and astrocytoma]. The authors present a case of a 47 year-old woman admitted to Neurosurgical Clinic with diagnosis of left frontal lobe tumour. At operation, during removal of glioma of the frontal lobe, a parasagital meningioma, 3 cm in diameter, was found and removed. Both tumours were adjacent. Histopatologic examination revealed: grade 1 astrocytoma and fibroblastic meningioma. Some clinical and pathological problems associated with simultaneous occurrence of two tumours of various histologic origin are discussed.


[Medulloblastoma with multiple metastases beyond the nervous system]. A case of desmoplastic cerebellar medulloblastoma with numerous metastases beyond the nervous system is reported. Fourteen months after the operation the patient began complaining about pains in hip and knee joints and dysphagia. One week before death profuse bleeding from the digestive tract developed. On autopsy numerous metastases were found in the bones, lymph nodes, spleen, pancreas and kidneys. Histological examination demonstrated that the metastases were composed of the same cells as the primary cerebellar tumour, but reticulin fibres were scant in them. In none of the metastatic lesions any significant reticulin proliferation was present, these fibres were found only around small vessels.


A quantitative study of cell proliferation in ependyma and choroid plexus in the postnatal rat brain. Profliferative activity in forebrain ependyma aand choroid plexus epithelium was studied in rats aged up to 42 days by means of autoradiography after injection of [3H]-thymidine. Labelling indices were higher in the lateral than in the third ventricle, while values for choroid plexus epithelium were lower than those for ependyma. In all areas examined, labelling indices showed a similar pattern of decline in the first two postnatal weeks reaching by day 12 a level about 20-30% of that on day 1. This low level, corresponding to a turnover time of 130 days for ependyma, was maintained tereafter up to day 42, indicating the persistence of proliferation in the young adult.


[Meningomyelocele with spinal cord cyst and internal hydrocephalus in a 9-month-old boy]. The authors describe a boy aged 9 months with open myelomeningocele which changed gradually into meningocele with spinal cord cyst. During treatment internal hydrocephalus developed requiring insertion of Pudenz-Heyer ventriculoatrial.  valve. The treatment was successful. The case illustrates the succession of changes which may develop in myelomeningocele and the relationship between the state of internal hydrocephalus and the volume of meningocele and spinal cyst (cerebrospinal fluid production exceeding its resorption).


Intracranial pressure time course in primary intracerebral hemorrhage. The course of intracranial pressure (ICP) over time was studied in 66 hypertensive and/or altherosclerotic patients harboring intracerebral hematomas. Patients with no disturbance of consciousness showed normal or only slightly elevated pressure. Conversely, most patients in deep coma exhibited high pressure with a tendency to rise further no matter what treatment was used. In the remaining patients with intermediate disturbances of consciousness, no definite correlation was found between ICP, clinical condition, and outcome. In all of the patients who underwent operation, the postoperative course of ICP over time was also studied and seemed to depend to a certain extent on the timing of the operation.


Visual evoked potentials: a noninvasive technique to monitor patients with shunted hydrocephalus. Visual evoked potentials (VEPs) to repetitive flash stimuli were abnormal in 10 patients with documented hydrocephalus. Abnormalities included latency delays, fatigability, and asymmetries. Both latency and wave form disturbances improved in the postshunt period. Clinical progression of the hydrocephalus occurred in several patients, and this correlated well with worsening of the VEPs. We suggest that this noninvasive technique may be valuable in following patients with cerebrospinal fluid shunts, patients with presumed "arrested" hydrocephalus, and patients who are being weaned from their shunts.


Cerebrospinal fluid bulk flow study: radioiodinated serum albumin (R131ISA) and technetium-99m-labeled diethylenetriaminepentaacetic acid (DTPA) retention in the ventricles of normal and hydrocephalic dogs. Eight normal dogs were studied and then made hydrocephalic (kaolin induced) to demonstrate and compare the use of R131ISA and 99mTcDTPA in cerebrospinal fluid (CSF) bulk flow studies. The radioisotopes were simultaneously injected into the CSF space in the cisterna magna of normal dogs and into the lateral ventricles of hydrocephalic dogs after an equal volume of CSF had been removed. The average dose of RISA was 100 muCi, and for TcDTPA it was 7 mCi. A bag of lactated Ringer's solution (500 ml) was used as a control phantom after being injected with the same dose of isotope as used in the animals. Brain scans were obtained with the gamma ray camera at 4 and 24 hours after injection. We used four criteria to evaluate results: clinical state of the animal, CSF ventricular pressures with challenges, percentage of retained isotope in counts per minute, and ventricular size at postmortem examination. The results demonstrate that the amount of isotope retention over 20 hours and the clinical state of the dog are better correlated when RISA is used than when TcDTPA is used. The study indicates that RISA is more reliable than TcDTPA as an indicator of CSF bulk flow in both normal and hydrocephalic dogs.


Time course of serotonin-induced vasoconstriction. Canine cerebral arterial segments tested in a tissue bath were found to escape from the vasoconstrictor effects of serotonin, the basilar segments more rapidly than the middle cerebral segments. At low doses (10(-9) M), serotonin caused a small, prolonged contraction, whereas at higher doses (10(-6) M), a more forceful phasic response was seen. Verapamil blocked the phasic portion of the response but not the low amplitude sustained portion. Increasing the bath concentration of K+, Ba++, and tetraethylammonium markedly enhanced the constrictor response of low serotonin doses and significantly inhibited escape. Potentiation of the force and duration of vasoactive amine-induced arterial constriction by small increments of extracellular K+ might be important in the prolonged vascular narrowing associated with subarachnoid hemorrhage.


Ten years of national health service in Canada. Ten years ago the medical profession in Canada was conscripted into a compulsory national health insurance scheme without any prior consultation. Predictions that an open-ended, so-called "free" medical insurance scheme would lead to cost overruns and deterioration of medical services as well as inflationary trends have come true. Federal and provincial governments now attempt to contain costs by closing active treatment beds or filling them up with chronic patients and by attrition of existing facilities. Compulsory national health insurance has not led to lower morbidity nor greater longevity. It has only provoked an insatiable demand from the public for more "free" services, with the result that the system has become a quagmire of cost overruns and unfulfilled and unrealizable promises.


Blunt trauma to the high cervical carotid artery. Closed injuries to the neck, occasionally associated with mandibular fractures, can result in trauma to the internal carotid artery at the high cervical level opposite the uppermost cervical vertebrae. Such arterial injuries range from spasm to intimal tear with thrombus formation, medial tear, and aneurysm formation. These types of lesions may overlap. Ten patients are presented, five with traumatic carotid occlusions and five with traumatic aneurysms. The clinical diagnosis of traumatic cervical carotid occlusion may be difficult because of the absence of physical trauma to the neck. The diagnosis of aneurysm poses fewer problems. Oculopneumoplethysmography, computerized tomographic head scanning, and carotid arteriography with cross compression are the most useful diagnostic techniques. Thrombectomy should be carried out early, particularly in the presence of fluctuating neurological signs. Aneurysms that cannot be approached directly may necessitate carotid ligation.


Radionuclide cerebral angiography and the timing of aneurysm surgery. Forty-five patients with subarachnoid hemorrhage due to verified intracranial aneurysms were studied prospectively to determine whether delaying operations in those patients with abnormal cerebral perfusion, assessed by radionuclide dynamic scanning, would lower case management mortality. Twenty-nine patients had intracranial operations when their radionuclide dynamic scans demonstrated normal perfusion. The one death in this group occurred in a patient who suffered a massive hemorrhage during operation as the bone flap was elevated. There were no instances of delayed spasm after operation. Of the 16 remaining patients who were treated without operation, 5 died. Only 1 of these deaths resulted from recurrent hemorrhage. This patient had normal cerebral perfusion but was not operated upon because of severe associated medical problems. Cerebral infarction occurred in 10 of the 16 unoperated patients, all of whom had persistently decreased cerebral perfusion. Four of these patients died of their infarctions or related causes. Although a trend related vessel caliber as seen on arteriograms and perfusion delay seen on dynamic scanning, individual exceptions were numerous. This study shows that radionuclide scanning, a safe procedure, is useful for identifying two types of patients: those with normal perfusion prone to rebleeding in whom an early operation is safe and those in whom perfusion is decreased. The latter group is prone to cerebral infarction, but rebleeding from the aneurysm is unlikely. Operation should be delayed in these patients until cerebral perfusion returns to normal or for several weeks if cerebral perfusion remains diminished.


Computerized tomographic diagnosis: pitfalls for neurosurgeons. Computerized tomography as a diagnostic procedure is characterized by its high sensitivity but limited specificity. This lack of specificity may result in an erroneous diagnosis and, possibly, in ill-advised therapy unless clinical and objective data are carefully considered in interpreting the study. The most common pitfalls encountered are the phenomena of contrast enhancement of infarcts and mass effect associated with infarcts. Many different pathological processes can have similar enhancement patterns. The evolution of high density, acute hemorrhage to isodense areas in the chronic hematoma can become a serious diagnostic problem unless an appropriate history is available. The authors discuss 30 cases in which misinterpretation of CT scans resulted in erroneous diagnoses. Seventeen of these patients underwent operation.


The trapped temporal horn: a trap in neuroradiological diagnosis. Although the advent of computerized cranial tomography (CT) has decreased the number of pneumoencephalograms performed for the diagnosis of hydrocephalus and lesions of the posterior fossa, brain stem, and ventricles, there are some patients in whom pneumoencephalography should still be done because it adds valuable information to that obtained with CT. When the temporal horn becomes obstructed, the choroid plexus and ependymal surface "upstream" from the obstructing mass continue to produce cerebrospinal fluid (CSF). The temporal horn can thus enlarge enough to appear as a mass on CT because of its reduced x-ray attenuation coefficient. Pneumoencephalography is effective in this situation because air will flow past a mass that obstructs CSF and because the ventricular system dilates during pneumoencephalography. When pneumoencephalography is used in a patient with a trapped temporal horn, the partially trapped horn may enlarge approximately 24 hours later. With that precaution in mind, the neurosurgeon should find pneumoencephalography to be a useful adjunct to CT in delineating the cause of a trapped temporal horn. In the three patients reported here CT had indicated a unilateral trapped temporal horn; pneumoencephalography confirmed that finding and demonstrated both the location and the nature of the lesion. One patient had a Grade II astrocytoma fungating into the atrium of the right lateral ventricle, one had a mass extending into the right ventricle from the medial and superior ventricular wall with nodular encroachment on the ventricle, and one had a meningioma in the atrium of the right lateral ventricle.


Fracture and complete dislocation of the thoracic or lumbosacral spine: report of three cases. Severe fracture/dislocation of the thoracic (T) or lumbar (L) spine is usually associated with complete neurological dysfunction below the level of injury. Three cases of severe spinal fracture/dislocation are presented in this report. Two of these patients suffered only partial neurological deficit, which improved after open reduction, internal fixation, and bone fusion. Severe fracture/dislocation of the T or L spine may be quite obvious on lateral roentgenograms. Occasionally, however, the fracture site may be obscured by the overlying shoulders, hips, or soft tissues. If no lateral displacement is evident on anteroposterior (AP) films, a false impression of normal alignment may be given, as was the case in two of our patients. A careful interpretation of the AP view will provide the diagnosis in such cases. The subtle AP radiographic changes suggesting fracture/dislocation of the T or L spine are detailed. The mode of injury, physical findings, prognosis, and surgical treatment of such severe injuries are also briefly reviewed.


Growth-inhibitory effect of diphenylhydantoin on murine astrocytomas. In previous work reported from this laboratory we found that diphenylhydantoin (DPH) inhibited the growth of 7 of 10 tissue-cultured human astrocytoma cell lines in a microtiter system. In this report we describe significant growth inhibition by DPH of two murine astrocytoma tissue cultures and correlate these in vitro findings with the in vivo activity of DPH in rat subcutaneous and intracranial tumor models. In the in vivo studies, rats were inoculated either subcutaneously or intracranially with RT9 or C6 rat gliomas. DPH or placebo was injected intraperitoneally in doses ranging from 50 to 150 mg/kg daily for 15 days. The DPH-treated rats showed significantly slower rates of tumor growth than untreated rats (p less than 0.01) in both the subcutaneous and intracranial models. At sacrifice, the tumor volume of the rats with subcutaneous tumors treated with DPH (100 mg/kg daily) was 62% less than the tumor volume of the control rats. Also, the number of "clonogenic" cells and thus, indirectly, the number of actively dividing tumor cells was 54% less in the intracranial tumors of the DPH-treated rats. These findings indicate that DPH may be a potentially useful adjunctive agent in the clinical chemotherapy of astrocytic tumors. Furthermore, the data presented indicate that in vitro test results are predictive for in vivo effects, supporting the idea that tissue culture can be used to screen for the effectiveness of clinically used chemotherapeutic agents.


Carcinoma associated with lipomeningocele: case report. We report the case of a 41-year-old man with an epidermoid carcinoma that had developed on a meningocele with a fistulous tract that chronically drained cerebrospinal fluid. After a review of the literature, we discuss the cause of this rare occurrence. We think that the recurrent discharge of spinal fluid (never complicated by meningitis) may have caused a chronic irritation of the tissues and then the delayed development of a carcinoma, which is similar to a case found in the literature. In our case there was a "flow" of carcinomatous cells along the fistula, which entered the meningocele, invading the subdural space as far as the peduncle. Our patient, who had a benign lesion (meningocele), came under neurosurgical care only after the lesion had degenerated. The malignant degeneration of such a benign lesion emphasizes the need for surgical treatment as soon as possible.


Extravasation and arteriovenous shunting after epidural bleeding -- a radiological study. Eighteen patients with epidural bleeding had preoperative angiography with visualization of the meningeal arteries. Thirteen of these had extravasation of contrast medium from meningeal arteries and eleven also had shunting of contrast medium from meningeal arteries to meningeal or diploic veins. For easier demonstration of these findings, selective external carotid angiography and the use of larger amounts of contrast medium are recommended. Our results support the theory that the arteriovenous shunting has important implications on the pathophysiology of epidural bleeding. Failure to demonstrate extravasation and arteriovenous shunting may be explained in three ways: (1) inadequate angiographic technique; (2) arterial bleeding has stopped; (3) epidural bleeding is not arterial.


On the symmetry and asymmetry of the bifurcation of the common carotid artery: a study of bilateral carotid angiograms in 100 adults. Bilateral carotid angiograms of the neck in 100 consecutive adult patients show the bifurcation of the left common carotid artery to be located cranial to the right in 50% of the cases, while the right bifurcation was higher in 22%. The origin of the internal carotid artery was at the dorsal or dorsolateral aspect of the common carotid artery in 82% on the right side and in 94% on the left, while a dorsomedial or medial origin was found in 18% on the right side and in 6% on the left.


Medical hypnosis during therapeutic embolizations of the carotid and vertebral arteries. Iatrogenic neurological deficit constitutes the greatest risk during therapeutic embolization in the vascular territories of the carotid and vertebral arteries. Constant monitoring of the patient's neurological status is therefore essential. The authors discuss the use of medical hypnosis to circumvent general anesthesia and to reduce chemical sedation to a minimum. Their experience with this technique is presented.


Persistent trigeminal artery: unusual associated abnormalities. Multiple cases of vascular abnormalities associated with the persistent trigeminal artery or a variant thereof are presented. A persistent otic artery variant is the only known such case in the literature.


Treatment of external carotid arteriovenous fistula with detachable balloon. A simple fistula between the external carotid artery and the internal jugular vein was treated for the first time using Debrun's technique with a detachable balloon catheter. The nature of the fistulous connection makes the release of the balloon inflated with silicone completely harmless. The occlusion of the fistula, while maintaining the patency of the remaining branches of the external carotid artery, proves this technique to be the most appropriate for the treatment of arteriovenous fistulae in the neck.


Occipital approach for treatment of arteriovenous malformation of the vertebral artery by balloon occlusion. The successful treatment of a congenital vertebral fistula with the balloon catheter occlusion technique is reported. A new approach is presented (the occipital approach), based upon the pathological enlargement of the second intervertebral space anastomosis between occipital and vertebral arteries.


Bilateral occlusion of the cervical internal carotid arteries: a case with an unusual co-lateral circulation. The case of a man, aged 67,who had bilateral occlusion of the cervical internal carotid arteries with an unusual collateral circulation between the occipital artery and the anterior cerebral artery, is described.


The neuroradiological findings in a case of cerebral tuberculoma. This paper describes the neuroradioloigical findings in a case of cerebral tuberculoma. Computed tomography demonstrated a mass in contact with the cranial bone with marked contrast enhancement and accompanied by perifocal cerebral edema. External carotid angiography revealed a homogenous stain supplied from the middle meningeal artery. Furthermore, by radioisotope scan it appeared to be a region of increased uptake with a comparatively clear border and was thereby misdiagnosed as meningioma.


Spinal leptomeningeal carcinosis visualized by amipaque myelography. A case of metastases to the spinal subarachnoidal space from a primary anaplastic pulmonary tumor visualized by Amipaque myelography is reported.


[Interposition of a jejunal loop, using the Mouchet-Camey method, in gastric cancer surgery]. A series of 80 patients subjected to total gastrectomy for neoplasia is presented. Interposition of the jejunal loop according to Mouchet-Camey was employed as the reconstruction technique. The advantages of this method are highlighted, with particular reference to the results of a study of the absorption of 125I-oleic acid. The complications associated with the operation and the way in which they can be corrected are described.


[Intrahepatic lithiasis. Apropos of 36 cases of "regional" intraheptic lithiasis]. Out of 2,700 operations for cholelithiasis and its sequelae (1960-1976), 36 cases (1.3%) of intrahepatic lithiasis (i.l.), namely proximal to the origin of the common hepatic, were observed. The prime objective of treatment namely removal of calculi, was achieved indirectly (hepatocholedochus and/or papilla) in 84% of cases, directly (hilar) in 16%. The second objective, that of ensuring optimal bilio-enteric drainage, was achieved by papillostomy or hepaticojejunostomy depending on the lumen of the bile way (respectively less or more than 2 cm.). Operative mortality was nil, while long-term results have proved poor in 9.6% of cases. The i.l. problematic is dealt with in detail on the basis of this series.


[Treatment of the gastric tuberosity in sliding hiatal hernias]. A technique for the treatment of gastric tuberosity in hiatal hernias due to slippage is presented. It consists of overturning and attachment of the tuberosity to the anterior wall of the stomach and gastropexy according to Niessen. The excellent results obtained with this very simple and by no means traumatic operation suggest that, given the same results with regard to the disappearance of the hernia that the postoperative disturbances observed in a considerable number of cases treated by means of classic fundoplication.


[Evaluation of survival in a sample of patients treated with radical mastectomy for mammary carcinoma]. Survival and its modalities were studied in 40 patients subjected to Halsted's operation for breast cancer between 1960 and 1972. The following parameters were considered: age at time of surgery, onset of tumour before or after menopause, age of commencement of menopause, married or single, number of pregnancies, breast feeding, regularity of menstrual cycle, prior breast disease, time elapsed between first symptoms and mastectomy, side affected, quadrant affected, involvement of ipsilateral lymph nodes, histological type, complementary X-ray treatment, ovariectomy, and medical hormone therapy.


[Behavior of the "double erythrocyte sedimentation rate" in neoplastic pathology]. Special aspects of a particular ESR reading have been evaluated in a series of 273 patients admitted ver a number of years to the Departments of Surgical Anatomy and Operations Course and, thereafter, Surgical Symptomatology of the University of Milan (Head: Prof. Ugo Ruberti). The inhibitory phase of sedimentation observable in vitro is particularly and typically scanty in patients with malignant tumours. The negative results are also analysed critically, with mention of particular factors (metastasis, arteriopathies, etc.) of use in diagnosis and prognosis. In the light of present-day knowledge it is therefore considered that this "double" ESR reading points, with sufficient specificity, to an ongoing tumoral process.


[Early operation in acute cholecystitis]. 104 patients with acute cholecystitis were divided into four groups according to the kind of pre-operative treatment received: immediate; early; late; and interval operation. Total duration of hospital stay depended on the duration of pre-operative treatment. It was shortest (24.9 days) in those operated on within the first week, longest (71.1 days) in those operated on during the interval. Evidence of severe gallbladder wall changes (macroscopic and microscopic) was obtained in two thirds of patients, even after weeks of conservative treatment. Six patients (5.7%) died postoperatively, three of them after early operation. Overall mortality was only in part due to severe complications of the gallbladder disease.


[Treatment of esophageal achalasia].

[Treatment of esophageal achalasia]. 4 cases of oesophageal achalasia, 2 primary and 2 recurrences following multiple oesophagomyotomy are reported. The superiority of oesophagomyotomy carried out by the left transthoracic route (according to Ellis) in cases of primary achalasia is stressed. On the basis of the literature and reported experience, it is concluded that this approach is also preferable in recurrences when the previous operation was done by the abdominal route and the recurrence occurred within 6 months. In all other cases, particularly in the presence of an achalasic megaoesophagus, partial oesophagogastric resection with interposition of a jejunal loop (Merendino's operation) is the procedure of choice and the satisfactory results of using it are reported.


[Revascularization of the deep femoral artery in arterial insufficiency of the lower limbs. Clinical aspects and immediate results]. The main indications for revascularisation of the lower limb using the deep femoral artery are explained. In aorto-iliac disease with obstruction of the superficials, an aortofemoral by-pass is created, and the distal end of the prosthesis is sutured on the point of origin of the profunda in the form of a patch. In cases where the patients's local or general condition precludes the establishment of a femoro-popliteal by-pass in femoro-popliteal disease, endoarteriectomy is performed and a patch is applied from the CFA to the first segment of the profunda. Thirty-six cases in which the method described was applied are illustrated. These are culled from a total of 144 artery reconstructions performed in 1975--77. The results (33 asymptomatic cases 6 months after surgery, equal to 91.7%) are comparable with those obtained in by-passes with patent SFA in patients with aorto-iliac obstruction. In addition, the method often makes amputation unnecessary in patients with obstruction of the subinguinal trunks only, but unable to be treated by the establishment of a femoropopliteal by-pass.


[Cryotherapy of hemorrhoids. Analysis of 40 cases]. An appraisal is made of the results of cryotherapy in 40 carefully selected cases of haemorrhoids. It is shown that the method is effective if practised in accordance with the correct technique and where specifically indicated. The incidence of possible complications and recurrences is also discussed. Points in favour of the method include its greater tolerability, the possibility of using it in out-patient management, and the fact that it permits an earlier return to work. Attention must be paid to the narrowness of its indications and the anorectal diseases that may often be present.


[Short-term and long-term clinical study of the absence of nutritional syndromes, body weight increase, blood serum parameters, and return to work of patients gastrectomized using a special surgical technique. III]. Short- and long-term clinical results obtained following the employment of a surgical technique used for gastric resection, and described in two previous notes, are presented. Nutritional syndromes were not observed and body weight increased. These findings, coupled with the blood serum data and the fact that patients fully resumed their work, are compared with the less satisfactory results obtained with the techniques of Balfour and Reichel-Polya.


[Congenital anomalies of the gallbladder. A case of retrohepatic gallbladder contained in the coronary ligament]. A case of ectopic gall-bladder located retrohepatically in the coronary ligament is reported. Stress is laid on the interest and extreme rarity of this event which escaped observation at a first explorative laparotomy. Further confirmation is thus provided, within bile way malformations, of the need for attentive intraoperative exploration, including cholangiography.


[Surgery of malignant neoplasms of the esophagus]. A series of malignant cancers of the oesophagus operated in the period 1968-1978 is reported. The importance of preoperative denutrition is considered and the various nutritional techniques are outlined, with a note on their advantages and defects. Right intrathoracic oesophagogastroplasty carried out in malignant cancers of the middle third of the oesophagus is particularly discussed. This surgical technique is held to be preferable to intestinal transpositions in substitution of the oesophagus, and the results obtained in this series support the opinion.


[Surgical treatment in peripheral acute obliterating arterial diseases]. Vascular surgery of acute cases, embolism and thromboses encountered since 1973 in the Surgical division of Manerbio (BS) hospital is reviewed and reference made to the surgical treatment and results in 78 cases of direct vascular surgery in 68 acute patients. Following schematic presentation of the type of pathology observed and of the types of operation performed, stress is laid on the effectiveness of Vollmar rings in association with traditional Fogarty catheters in thrombectomy operations. The frequent need to associate by-pass or disobliteration of the acutely occluded segment with thrombectomy in acute thrombosis is also pointed out. The varied series involves most acute vascular pathology, inluding sapheno-femoral anastomosis, and the very low mortality and small number of amputations support surgical indications and the techniques employed.


[Personal clinical and neurophysiological experience in the surgically treated carpal tunnel syndrome]. In 18 cases of carpal tunnel syndrome treated by surgical decompression of the median nerve, a neurophysiological control was performed before and after surgery. In all cases improvement or disappearance of the pain was observed; improvement in motor function was less constant. Control of the median nerve conduction showed that in all cases with preoperative distal latency less than 6 msec. there was a normalization of the nerve conduction after only 3 months. In cases of distal latency over 6 msec, and especially in those with complete motor conduction block, the latency remain within patological limits even 15 months after surgery. This may be explained either by a slower conduction of the regenerated fibres or by a persistent myelinic and axonal damage of the nerve.


[Possibility of applying dynamic electrocardiography to function studies in flight]. A new dynamic ECG apparatus that has been operating since last June in a Roman Diagnosis Centre is described. The apparatus enables pilot cardiovascular function to be studied during flight. On the basis of long personal experience of tourist flying (single and twin engine craft), the exceptional usefulness of this apparatus for monitoring changes which the stress of flying can provoke in a pilot's cardiovascular apparatus is pointed out.


[International anti-malaria prevention today for the Italian airline]. The ease with which malaria can be transmitted over long distances as a result of air transport is illustrated with reference to the documentary evidence. The best ways of preventing this risk are also described.