[Character of functional connections between sensomotor cortex neurons during isolated and combined stimulation of thalamic nuclei]. In experiments on curarized cats pronounced transformations of the "excitatory" component of the "inhibitory-excitatory" dependence of two close neurones in the sensorimotor cortex were found following multiple isolated VPL and VL stimulation. The effects of repetitive stimulation of thalamic nuclei were opposite to each other: VPL stimulation mainly weakened the "excitatory" component of the "inhibitory-excitatory" connection, whereas VL stimulation generally enhanced it. In the course of combined stimulations of both nuclei the character of interneuronal relations, established under the influence of isolated stimuli, showed further changes. Modifications of interneuronal dependence, resulting from thalamic stimulation, could last for several minutes after cessation of all stimulations.


[Effect of coagulation of the reticular formation in the region of the NRP and NRT nuclei on the spread of brain biopotential synchronization in rabbits]. The influence of coagulation of NRP and NRT nuclei on the level of spatial synchronization of bioelectrical activity in the visual and motor cortical areas was studied in chronic experiments on alert rabbits. It was shown that elimination of these structures from activity diminishes the correlation of processes in the studied zones. The degree of the coagulation effect depends on the volume of destruction and on the degree of synchroneity of the background neocortical biopotentials. Destruction of the nuclei is attended with dominance of delta-frequencies in the power spectra and a drop of coherence function in the theta range. It is assumed that the NRP and NRT nuclei are functional links of the integral system which controls the level of spatial synchronization of bioelectrical processes in the rabbit cerebral cortex.


The amylase-producing microflora of semi-preserved canned sausages: identification of the bacteria and characterization of their amylases. Thirteen strains of amylase-producing bacteria were isolated from semi-preserved canned sausages and their ingredients. All belonged to the genus Bacillus, and could be separated into 4 different groups. Two groups were different strain of B. subtilis, one was B. amyloliquefaciens and the last was B. macerans. The identification of the different bacteria species was supported by disc gel electrophoresis of the supernatant culture fluid, after growth. The amylases were characterized with regard to temperature optimum, pH optimum and thermostability. Although some of the amylases appear to be quite thermostable, the only explanation for starch degradation in semi-preserved foods seems to be the amylase production from outgrowing spores which survived the heat treatment.


[Somatic parameters in patients with urinary calculi and their relationship to age, sex and kind of calculus]. In the present investigation in 515 carriers of nephroliths (311 males and 204 females) age, sex, type of constitution, body weight, physical load and blood pressure are set in relation to the various kinds of calculi. Here it was revealed that males more frequently fall ill with nephrolithiasis than females, that there exist certain age peaks, the pycnic typ of constitution preferredly appears in female carriers of calculi and the athletic type in male ones, the majority of all examined patients had in comparison to the normal an increased body weight, and a very large proportion of persons with only insignificant physical load is found among the carriers of calculi. The result of the relations of blood pressure was that only half of all patients with urolithiasis examined had a normotonic blood pressure.


[A modified method for the quantitative determination of urinary oxalic acid]. The present paper describes a modified method of the quantitative determination of oxalic acid in the urine which is based on the reduction of oxalic acid to glycolic acid and on the transformation with chromotropic acid to a colorimetrically well measurable complex of colours. The method ascertains a good reproducibility and is simply to be performed in every clinico-chemical laboratory.


[Indication for operation in acute kidney obstruction caused by urinary calculi]. We like to discuss the comment of our clinic: In case of an acute stone-conditioned renal blockage complicated by fever we immediately perform a decompression by means of elevation of the ureter catheter and the antibiotic therapy. A shivering attack accompanied by fever we regard as a threatening sign of pyelonephritis apostematosa and possibly after the first or second shivering attack we perform an opening. Apart from emphasizing the importance of the shivering attack we still might refer to the fact that for the establishment of the therapy of choice the complex evaluation of the clinical picture is necessary.


[Experiences with new methods for the preoperative localization and surgical removal of complicated kidney calculi]. In a survey is described the inpatients suffering from urolithiasis of the urological clinic Berlin-Friedrichshain of the last three years from 1 April 1975 to 31 March 1978. Especially the cast calculi of the renal calyx were analysed and the therapeutic approach was discussed. For the complete removal of coral calculi in our clinic preoperatively made tomographies and adequate graphs of the cast concrement in its relation to the hollow system at two levels also stood the test as the intraoperative use of the X-ray device "Renodor". The two methods were described in detail. Also in multiple and movable concrements in the system of the renal calyx the Renodor stood the test. Here we could make good experiences also with the fibrin pyelolithothomy--the indications and results of these methods are represented.


[Pseudomorphoses in calcium oxalate urinary calculi]. Pseudomorphoses of whewellite to weddellite reflect on transparent section preparations and in the REM appearances of cristallisation processes in the secondary whewellite formation via weddellite dehydration. As transformation products are found fine-grained polycrystalline as well as due to recrystallisation larger monocrystalline whewellite. An interesting analogy to this gives the thermic dehydration of weddellite crystals in direction to whewellite, which realises under formation of pseudomorphoses as topotactic process. The dissociation scars appearing in this case are strongly oriented to the crystal grid of weddellite.


[Results of follow-up studies in children with megaureters]. It is reported on the results of after-examinations in children with megaureters. The average interval between first operation and last after-examination is 8.1 years (1 to 14 years). Of altogether 63 children ten died, eight of their disease, including the postoperative complications. Eleven children were nephroureterectomized. In spite of the time of satisfying results concerning the renal function the prognosis is uncertain, particularly of the children with bilateral malformation. The number of the infections of the urinary tract is large and the deterioration of the function due to pyelonephritis is not to be foreseen. Changes or modifications of the operation technique and a strict dispensary care of the children let us hope for an improvement of the results during the next years.


[The long-term effect of various hormonal contraceptives on the excretion of sodium, potassium, calcium, magnesium, chloride, phosphorus, uric acid, oxalic acid, citric acid, sulfate and lysozyme in the 24 hour urine]. The influence of a long-term application of 4 different hormonal contraceptives on the excretion of various constituents of the urine was examined. A reverse effect after stoppage of the medication is to be established in none of the other parameters with the exception of calcium.


[Effect of sex steroids on the rat testicular blood supply]. The effect of oestradiolundecilate and testosterone oenanthate on the blood supply of the testicle of rats was investigated by means of the Xe-133 tissue clearance. The investigation shows the following results: 1. Oestradiolundecilate leads to a highly significant decrease of the blood supply of the testicles. 2. The effect of testosterone oenanthate depended upon the dosage. 0.3 mg three times a week led to a reduction of the blood supply, whereas below 3.0 mg three times a week no difference of the values of blood supply appeared in comparison to the initial values. Connections between the functional changes evoked by the application of the sexual steroids and the behaviour of the blood supply are discussed.


[Kidney calculi and medullary neoplasms]. Even though we do not find confirmed among our patients the high percentage of 25% of kidneys with medullary carcinoma in lithogenetic patients - this is certainly connected with the fact that our patients are in no way selected - we nevertheless are of the opinion that this picture of a disease should more considered and because of the danger of progression the possibilities of a preventive therapy which are at present at our disposal should increasedly be used.


[Chronic sodium chloride load--a possibility for the increase of tolerance for ischemia in the kidney]. After an ischaemia lasting 1 hour as well as after an extreme hypertension lasting 210 minutes in the kidney of a rat a significant increase of the renin activity in the juxtaglomerular apparatus was found. By chronic load with sodium chloride was tried to produce a decrease of renin. In contrast to an ischaemic lesion the kidneys of the animals loaded with salt revealed a better ischaemia tolerance than those of the unloaded animals. This is expressed by a significantly increased total blood supply and cortical blood supply. On the two experimental conditions a change of the distribution of the blood supply in favour of the inner compartments of the kidneys may be observed. In the oxygen histogram of the surface of the kidney the salt-loaded kidneys reveal a better oxygenation before and after the ischaemic lesion. The kidneys loaded before show an essentially more insignificant decrease of the urine excretion than the unloaded ones.


[Value of the electrophoresis mobility test in the differential diagnosis of obscure kidney findings]. The differential diagnosis of unclear carcinoma-suspicious renal findings often finishes with the test-exposition and nephrectomy. Also when all modern diagnostic possibilities are used not always a clear establishment of the diagnosis may be achieved. The cell electrophoresis mobility test after Field and Caspary may contribute to the differential-diagnostic clarification of the findings, when adequate antigens are used. For this purpose 10 own cases are discussed and these results are compared with suitable comparative groups. Summarizingly by the present study can be shown that the immunologic diagnostics of tumours in the field of unclear renal tumours may be a very good help in the diagnostics. When adequate antigens are used in the cell electrophoresis mobility test a coordination concerning the histospecificity can be achieved.


[A contribution to bladder amyloidosis]. It is reported on a localised primary amyolidosis of the urinary bladder with a progressing course. In contrast to the prevailing observations of other authors during two years an increasing bilateral urinary stasis developed so that finally after an at first unilateral nephrostomy due to an infected retention kidney the bilateral ureter-intestine-anastomosis became necessary. Apart from a short description of the amyloidosis from the general and especially urologi-al point of view it is particularly referred to diagnostic difficulties, since the various forms of amyloidosis have a different prognosis and demand a therapy.


[Epidemiology of burn injuries in the GDR (author's transl)]. Burn injuries in GDR have a slight decreasing tendency concerning both morbidity and mortality. The distribution of injuries to the districts of GDR can be explained by the distribution of population, not by distribution of industry. The overwhelming share of injuries consists of children with small scalds. Therapeutical results are comparable with results from international literature. Owing to the fact that in last years no further decisive improvement could be achieved, more attention must be devoted to the problem of primary prevention especially to target groups, resulting from anamnestic and clinical data analysis.


[Prophylaxis and treatment of infectious complications in burns (author's transl)]. To lower infectious complications and the mortality rate due to septicaemia in burned patients more knowledge should be acquired to increase the natural resistance of the organism of the burned. This can be done by administering Staphylococcal-Anatoxin, Antistaphylococcal-Plasma, Antipyocyaneus-Serum and convalescent-Serum.


[Arthrodesis of the knee joint (author's transl)]. Arthrodesis of the knee joint was performed in 75 patients. Solid fusion was achieved in 74 out of them. Average time for union was basically dependent upon type of pathological process and not upon fusion technique employed. In the last years compression arthrodesis with internal fixation by plates was used in all cases of degenerative, posttraumatic and rheumatoid arthrosis; in cases of tuberculosis and other infections of the knee joint external osteosynthesis by fixateur externe was the preferred procedure.


[Theoretical and methodical aspects of sociogynaecology (author's transl)]. The objectives and purpose of sociogynaecology are defined. Included in it are the following lines of research: (a) Health care for women; (b) Coordination, planning, and organisation of appropriate health services: (c) Social factors of relevance to health care for women: (d) Health education of women.


[Efficient organisational structures of in-patient and out-patient practice for satisfactory gynecologico-obstetric attention (author's transl)]. The strong need for integrated management of gynaecologico-obstetric attention as well as the role played by interdisciplinary cooperation as a prerequisite for high-continuity medico-social services are expounded against the background of health policies established for the current period up to 1980 and with close reference to experience obtained in every-day practice. The introduction of demand-oriented organisational forms by which to enhance the standards and effectiveness of health care for mother and child is essential to the general practice of sociogynaecology.


[Methodical problems in assessment of fertility development (author's transl)]. Birth control as well as medical attention to and counselling of women in the context of pregnancy, childbirth, development of fertility, and reproduction of population may be considered as major lines of sociogynaecology. An attempt is made in this paper to provide insights into methodical aspects with relevance to assessment and prognostication of those processes. Correlations are expounded between possibilities of birth control and fertility development, and reference is made to controlled variation of birth dates within the fertile phase of women together with the impact of such variation of fertility.


[Possible assessment of standards and efficiency of ambulatory gynaecological services as part of sociogynaecology (author's transl)]. There are no criteria, as yet, by which to measure the standards of gynaecological outpatient practice. Specific criteria should be devised for an assessment of efficient and service quality. The detection of carcinoma in situ so far has differed from region to region. The degree of detection, therefore, is believed to be a good measure of efficiency. Some general aspects of quality assessment are discussed. Work on such assessment of standards and efficiency is imperative in sociogynaecology both for a general enhancement of methods and the solution of problems relating to management, planning, and organisation of public health at large.


[Demographic and sociological setup of premature deliveries for live births in GDR 1973 (author's transl)]. A record was taken 1973 of 22,466 single and 3,287 multiple live births, with premature deliveries being subdivided by age, birth order, coverture, and vocational backgrounds of the mothers concerned. The distributions thus established have produced evidence to the effect that all the above factors may have an impact upon premature delivery. Yet, multiple births were found to distort the distributions of all parameters used. --- Reference is made to possible interpretations of such studies in terms of large-scale trends, resources, risk hypotheses, and clusters, with examples being proposed for the latter.


[Methodical aspects and results of studies into motivations for induced termination of pregnancy and the wish to have a child (author's transl)]. Medical and social aspects relating to human reproduction has been the heading of a research subject in the context of sociogynaecology. An account is given in this paper of medicosociological studies and survey approaches with regard to induced-termination patients, puerperae and a control population, with emphasis being laid on identifying attitudes, motivations, and general views on having children. -- Methodical aspects are reported and assessed together with preliminary results obtained from a GDR-representative sub-study into 2,776 induced-termination patients. Priorities issues included the social situation of the interviewees, their attitudes towards having a child and to induced termination of pregnancy, reasons given for termination decisions, as well as views on contraception and family planning.


[Cardiotocography -- proposal of system solution (author's transl)]. A system solution with new technical details and new demands on space distribution is proposed for the use of antenatal cardiotocography and cardiotocographic monitoring of labour. Bedside equipment will be reduced and widely shifted to a centralised control room by introduction of the system. All installations are of high flexibility to leave room for future developments in medical engineering and for necessary services. -- Large-scale use of the new technique with capacity utilisation of the hardware involved will be ensured by appropriate upgrading of labour room personnel as well as by techno-organisational improvement of work and minimisation of expenses on diagnosis and monitoring. The measures proposed work according to expectation and lead to good perinatological results.


[Comparison between immunological pregnancy test and ultrasonic examination for determination of early pregnancy (author's transl)]. Ultrasonic B-scan examination (Vidoson) and the Gravimun semiquantitative HCG test were applied simultaneously to 107 women, between the 35th and 95th day form menstruation. Control checks were made after another ten and 20 days. The findings so far recorded are likely to support the conclusion that the sensitivity of ultrasonography is higher than that of semiquantitative detection of HCG from urine and, therefore, more applicable to diagnosis of early pregnancy or assessment of disorders in early pregnancy.


[Incidence of gestational diabetes and changes in insulin secretion of pregnant women (author's transl)]. The 50-g oGTT was applied to pregnant women suspected of having contracted diabetes. Carbohydrate tolerances were pathological in 23.6 per cent of all probands and in borderline vicinity in 17.9 per cent. The oral glucose tainting test thus worked according to expectation by revealing a relatiively high frequency of disorders of the carbohydrate tolerance. Yet, impaired insulin secretion was established rarely, with high response having been recorded from only seven per cent and delayed insulin secretion from 4.1 per cent. Low response was not found at all. No correlations were found to exist, by the 50-g oGTT, between disorders of the carbohydrate tolerance and insulin secretion. The groups involved differed but little with regard to their IRI mean value curves. Sugar excretion in urine was found to be increased with significance in response to pathological carbohydrate tolerance in early pregnancy and may be used as a complementary criterion for diagnosis.


[Influence of na-salicylate on uterine motility in labour (author's transl)]. A dosage of 10 mg/kg body weight Na-salicylate has no depressive effect on uterine motility. The examination carried out intra partum in the condition of normal uterine activity support our opinion that relatively high doses of 3--5 g per day or the simultaneous administration of beta-adrenergical substances are necessary to obtain an effective tocolysis.


[Planimetric analysis of labour induced by means of prostaglandin F 2 alpha and oxytocin (author's transl)]. Planimetry has been used to analyse the tocographic tracings recorded from 29 deliveries induced by means of prostaglandin F 2 alpha as well as those recorded from 28 deliveries induced by means of oxytocin. The contraction-causing effect of prostaglandin was found to be milder than that of oxytocin. Prostaglandin F 2 alpha, consequently, proved to be superior to oxytocin in handling placental insufficiency.


[Localisation of placenta by liquid crystal thermography (author's transl)]. The efficiency of liquid crystals in placenta localisation was checked by comparison of thermographic results with those obtained from using the ultrasonic B-scan method. Ther  results obtained from the two techniques were in fair agreement in 93 of 106 cases or 87.7 per cent. The highest amount of agreement was recorded from the group with anterior-wall placenta. For placenta localisation the sensitivity of liquid crystal thermography was found to be inferior to that of the ultrasonic B-scan method.


Antibiotic resistance of salmonellae in Czechoslovakia -- situation and prospects. Antibiotic resistance of non-typhoid Salmonellae is in Czechoslovakia continuously monitored by a computer and its transferability is studied, on an all-nation level, within the Federal Plan of Scientific Investigation and Development. Restance and its transferability was surveyed in strains of Salmonella from humans, from farm animals, from the food chain as well as from surface and waste waters. Proportion of antibiotic-resistant Salmonella strains did not, in general, increase during the four-year period of 1973 to 1977. While resistant strains from humans as well as farm animals show a high degree of transferability, strains from food samples lack, in general, the transfer ability. This might be inferred that strains causing human salmonellosis which are carried to man trough foodchain, gain their character of transferability directly in the gut, i.e. from E. coli strains, and mainly due to presence of therapeutically given antibiotics.


[On the phenotypical characteristics of human pasteurella, and pasteurella-like isolates (author's transl)]. Fourty-two human isolates that had been designated Pasteurella, or pasteurella-like organisms in the bacteriological routine laboratory were phenotypically characterized considering conventional, morphological and physiological features, and respiratory quinones. Thirty-seven of these strains fitted into the large traditional species, P. multocida, the majority of them being associated with alterations of the respiratory tract, and the rest with intestinal diseases, or putrid wound secretions mostly following animal bite or scratch lesions. Two strains isolated from sputum, or sinus maxillaris punctate, respectively, were P. ureae, and one strain recovered from a septicemic blood samle proved to be Cardiobacterium hominis. A pasteurella-like strain isolated from putrid sputum and an unusual organism that had been isolated from the cerebrospinal fluid of an infant with putrid meningitis remained unidentified. The bacteriological data are discussed with respect to the diagnostics of Pasteurella and similar organisms and especially, the range of phenotypical variation within the species, P. multocida.


[Enzymological examinations on Clostrium oncolyticum M 55 ATCC 13,732 (author's transl)]. Since excenzymes are mainly involved in oncolysis by Cl. oncolyticum M 55 ATCC 13,732 the enzyme production of the strain should be examined under different growth conditions. The excretion of a protease and of two nucleases was observed in the nutrient medium for 72 h and the results obtained in a nitrogen atmosphere were compared with those obtained in an oxygen atmosphere. The cleavage of protein and of peptides was investigated by means of TLC. The importance of the exoenzymes for the oncolytic effect of Cl. oncolyticum M 55 was confirmed by animal experiments.


[Microbiological and parasitic risks associated with the stay in hot countries (author's transl)]. The microbiological and parasitic risks associated with the tremendous increase in the tourist traffic from West Germany and Austria into warmer countries are considerable even in the case of shorter stays, as has been confirmed by observations made on those returning from such areas. The most important groups of diseases -- worm diseases, amoebiasis, and malaria -- have maintained this ranking in Central and South America; in Africa, especially in the east, the incidence of malaria tropica is increasing. The proportions for Austria show that even numerically there are no great differences compared with West Germany. It seems that, as far as malaria is concerned, efficient prophylactic measures and reliable information are absent; at any rate, the cases of malaria tropica were severe and in the main no prophylactic measures had been taken. With the exception of Japan, the risk of hepatitis in all warmer countries and in the East in general is many times higher than in the Federal Republic of Germany and the length of stay is partly a determining factor. For instance, the risk of hepatitis is roughly forty times higher in India. All figures shown in this survey are supported by tables, literature, and personal experience.


[Germinal change and its significance in the hospital (author's transl)]. To receive objective informations about clinically supposed difference of bacteria spectrum in hospital infections within the last 20 years, we made statistical comparatively investigations between varying periods and in different fields. In the whole material of the Medical Department we found an increase of Proteus, Pseudomonas and Klebsiella (p = 0,01%) and an increase of Candida while Staphylococci, Streptococci, Pneumococci, Clostridium and Meningococci have clearly decreased. In the Department of Nephrology we found a significant increase of Proteus and Pseudomonas (in regard to the manifold findings also of Klebsiella) and a significant decrease of Enterococci (in regard to the manifold findings also of E. coli). In the Reanimation Department there were in opposite to a strong increase of Candida, followed by Pseudomonas, Klebsiella, Enterobacter and Pneumococci, a decrease of Staphylococcus aureus, Enterococci and Streptococci in the sputum findings. In the Urological Clinic while the period of report Pseudomonas and Enterobacter increased significantly, Staphlococcus aureus and Streptococci decreased significantly. In the Neurosurgical Clinic the part of the gramnegative germs of all germinal isolations increased from 8,3% to 51,5% at which especially E. coli, Enterobacter and Pseudomonas were more often found.


[Possibilities and limitations in the localisation of sources of infections (author's transl)]. In latent microbial hospitalism environmental checks of the patients, the staff and objects permit detection of pathogenic or potentially pathogenic bacteria which are silent epidemiologically. "One's own body" as a source of infection has not yet been sufficiently investigated in connection with auto-infections. Taking two staphylococcal epidemics as examples, reference is made to the monogenic and heterogenic forms of hospitalism as well as to the necessity of accurately identifying the strains for the purpose of localising the source of infection. In the monogenic form only one type of bacterial species is present (Table 2). In heterogenic hospitalism, infections are caused by various different species of bacteria or also by a single species. If this is the case, various biotypes, serotypes and phagotypes exist (Table 1). In addition, simple possibilities of biotyping the staphylococci are demonstrated. Defensive measures can be adopted selectively only when the epidemiology and the source of infection are known.


[Physicochemical fundamentals on the cleaning of hard surfaces (author's transl)]. The primary process in the cleaning of hard surfaces is the adsorption of the active substance of the detergent at the interfaces: liquid/gas, liquid/liquid, liquid/solid. This primary step in the cleaning process induces secondary processes which in turn are responsible for the soil removal from the surface of the substrate. The first requirement for a cleaning effect is that the dirt and the substrate be well wetted by the cleaning solution as a result of a reduction in surface tension and of the adsorption at the solid/liquid interface. The further secondary processes which effect the removal of dirt vary considerably, depending on the type of dirt (e.g. oils, pigments). In the case of oily and greasy dirt, rolling-up penetration, formation of mixed phases, emulsification and solubilization are of importance. For pigments, the surface pressure of the adsorption layer and the electrostatic repulsion are the determining factors. The processes of pigment dispersion, emulsification and solubilization are, in addition, extremely important for the stabilization of the dirty wash bath and the prevention of deposits on the substrate. The essential active substances of the detergents are surfactant and complexing agents, the first being unspecifically adsorbed by hydrophobic interactions, and the latter specifically by polar interactions. They influence one another mutually and are responsible for an optimal cleaning effect when they occur in suitable mixing ratios; the special constitutional characteristics of the individual surfactant and complexing agents, must also be considered.


[Mechanism of antimicrobial active components (author's transl)]. The extreme chemical heterogeneity of antimicrobial inhibitors may be compared with the large heterogeneity of the sites of attack. From the host of questions regarding the mechanism of action three problems are selected at random for discussion: 1. Penetration or transport of inhibitors into the cell. At least some of the inhibitors must penetrate into the cell and find their way to very specific points of action; and it does not go without saying that the antibiotics reach their targets without previously reacting with other cell components or without being "trapped" by the cytoplasmic membrane. In some instances an active transport, i.e. a "misuse" by antibiotics of a transport system for a substrate can be demonstrated. 2. Distribution of the targets in the cell. Distribution of the inhibitors over the possible targets is not uniform. The question why this is so remains unanswered. 3. The membrane as the point of attack for inhibitors. The probability that an inhibitor has a bactericidal effect also on resting cells is greatest with substances that act on the membrane. The question as to the function of the antibiotics for the active cell arises and the "defence function" of the antibiotics is called in question.


[Bovine mastitis: a problem of veterinary medicine, economics and food hygiene (author's transl)]. Veterinary medicine, dairying, and consumers are likewise interested in mastitis control. The veterinary point of view includes health and function of the udder as well as the production of milk of hygienic quality. Investigations in 6 dairy farms showed that a mastitis control program improved the udder health and resulted in economic benefits. Up to 67% of the subclinical infected udder quarters could be eliminated by prophylactical control measures, especially teat dipping and dry cow therapy. The frequency of clinical udder infections was reduced by about 50%. Furthermore in the first year 5.1% and 7.1% increase of milk and fat yield respectively could be noticed for cows being subject to the program for the whole time. These values could not be reached in the second year. In one herd the milk production increased by about 10% after a control period of two years. The owner of this herd (ca. 35 cows), who was very engaged in the program, obtained an economical benefit of ca. 3500 DM in the first and 7300 DM in the second year of the program. This realised a profit of1.85 DM in the first year and 3.85 DM in the second year per each DM cost in the control program. Mastitis as well as control measures do not implicate a special risk for the human health, because food and drug regulations enable the protection of the consumer in an optimal manner.


[Autoradiographic investigations on the effect of city smog extract on DNA synthesis and cell cycle of mammalian cells in vitro. I. Effect of city smog extract on DNA synthesis of kidney- and embryonic cells of the golden hamster in vitro (author's transl)]. We analysed the effect of city smog extract from Düsseldorf on DNA synthesis of mammalian cells in vitro. Airborne dust was extracted with aceton and thereafter transferred to dimethylsulfoxide. Dosage was calculated according to the benzo(a)pyrene content. We used logarithmically growing cultures of hamster kidney and embryonic cells. DNA synthesis was determined autoradiographically by incorporation of 3H-Thymidine. We found that city smog extract exerted a dose-dependent cytotoxic effect leading to a decrease of DNA synthesizing cells. High concentrations of city smog extract induced cell necrosis and suppressed DNA synthesis completely. Moderate doses of extract caused a dose-dependent, but temporary cessation of DNA synthesis. Cells resumed DNA synthesis after a certain delay. Low concentrations of city smog extract induced no detectable effects. Inhibition of DNA synthesis was evident already one hour after addition of extract. Therefore a direct effect on DNA metabolism could be supposed. Furthermore, exposed cultures demonstrated a delay in entrance of new cells into the DNA synthesis. Alterations in DNA synthesis could be of great importance for carcinogenesis, especially if we take in consideration the content of carcinogens in city smog extract.


[Field tests carried out to determine the occupational exposure to vanadium (author's transl)]. In a metallurgic plant we analysed blood samples, urine and finger-nails of 54 workers exposed to vanadium. On the basis of orientating dust measurements it can be assumed that the results obtained were, as a rule, clearly lower than the MAC values for vanadium pentoxide dust. The median vanadium concentration in whole-blood was 2.9 micrograms/l. This indicates that the exposed persons differ significantly from the control group. The median vanadium concentration measured in urine was 37.8 micrograms/l. This means that there is a significant difference in comparison with the control group (0.8 micrograms/l). In order to obtain values of greater reliability, the vanadium concentration resulting from the analysis of spontaneous urine samples was to be referred to the creatinine content. Conversion yields a medium vanadium concentration of 33.9 and 0.6 micrograms/g creatinine for the exposed workers and normal persons respectively. The cystine content found in the finger-nails of persons occupationally exposed to vanadium was significantly reduced with respect to the comparative group (8.9 against 9.9 mg cystine per 100 mg finger-nails). Within the groups of persons examined no correlation is found to exist between the cystine content of the finger-nails and the age of the persons, nor between the vanadium concentrations in blood and urine. After a weekend without exposure the vanadium concentrations in blood and urine dropped. In general, this drop was the more pronounced the higher the initial value was. Roughly two to four days after the occupational exposure had ceased, the values dropped to the half of the initial value. Based on the test results available, the vanadium concentrations in blood and urine reflect the extent of an occupational vanadium exposure and are suitable indicators for estimating the potential threat caused by this heavy metal.


[Rhizospheric organism under the influence of environmental pollution. II. Physiologic efficiency of the microbial biocenosis in fungicide containing soil (author's transl)]. Measuring the potential soil respiration according to the incubator method allows the physiological performance of the celluloytic microflora to be determined. Laboratory tests were carried out to analyse catabolic processes after soil samples had been enriched with native cellulose + fungides. As the temporary capacity of mineralization primarily induced by the substrate invariably gives rise to a substrate-specific "change in position" in the microbial biocenosis, the measured values cannot furnish a parameter for microbiological comparisons of the soil content. Preliminary analyses provided information on the processes of depolymerisation of various C-sources and characterized the celluloysis as well as the order of respiration of its monomer. The rising respiration curve markedly drops off after 12 days, because with the CO2 development at its maximum, total and partial respiration alternate, a phenomenon that was verified in soils incubated with glucose 14C (Keefer and Mortensen, 1963; Macura, 1963; Simonart and Mayaudon, 1958). The test results obtained with fungicide-treated soils (dithiocarbamine acid derivatives) allow the conclusion that the fungicides exercise a varying influence: in the cellulolysis the activity of the cellulase systems is reduced depending on the active substance and concentration, but what is surprising is that respiration is stimulated; this applies to amounts of pesticides being 0.75 and 1.5 times the practical quantity applied. Nor have the "dissociation tests" with cellobiose, which is supposed to be the final link of celluloysis, shown any inhibition of the 1.4--glucodimerase or high respiration values comparable with the glucose metabolism. Tests with cellulases (Cx with dimerase function, Messrs. Roehm and Haas, Darmstadt), which are at present being carried out, are expected to support these observations experimentally. Investigations intended to clarify whether an additional administration of Mn2+ and Fe3+ in the presence of Maneb and Ferbam permits interference with possible adsorption and exchange processes have not yet yielded any generally valid results. The results of the open-field investigations also tend to indicate that the mentioned dithio-carbamates determine the magnitude and the extent of the physiological and CO2-ecological processes to a varying degree; it can be seen that a remarkable "capacity fo compensation" is discernible in the succession of the investigated phases of soil-physiological processes which we tried to clarify.


[Studies to investigate the ecological importance of the mass development of Hydrodictyon reticulatum in infiltration basins for drinking water. I. Metabolic products and their effect on various types of bacteria (author's transl)]. Cells of the green freshwater alga H. reticulatum, harvested from their natural habitat, were found to have antibacterial activity. The active substances seem to be lipophilic, because ethanol extracts were more effective, especially against Bac. subtilis, than water extracts (Table 4). The different effects of water extracts, which were tested after various dilution steps (Table 1--3) presume, that there must be a second active substance. We suppose, that it is correlated with chlorophyll derivatives. Culture filtrate from a strain, grown under laboratory conditions, was tested in the same way. Concentrated tenfold it was active against several grampositive strains of bacteria.


[Microbial settlement of paint- and building-materials in the sphere of drinking water. 3. Macrocolonies on the joint in a drinking-water-reservoir covered with tile (author's transl)]. The microbial growth in form of macrocolonies on the joint of a drinking-water-reservoir covered with tile could be observed repeatedly. The slime was examined microbiologically. The origin of the carbon sources was determined by radiocarbon test.


[Metastases in the hypophysis].

[Metastases in the hypophysis]. Among 1521 malignant extracranial tumours, 64 metastases (4.2%) were found in the pituitary. The most frequent occurrence was found for carcinomas of the breast (21.4%) and for bronchial malignomas (5.9%). A statistically significant difference with regard to the location in the anterior and the posterior lobe was not found in our own patients. A remarkable fact is the high degree of affection of the pituitary gland in case of malignant melanomas.


[Retinal blindness as a complication of carotid angiography]. Aortography and subsequent angiography of the A. carotis communis (Seldinger technique) was carried out in a 51-year-old man suffering from cerebrovascular insufficiency (transitory hemiparesis, disturbances in word finding). Complete interna occlusion from the carotid fork, no formation of collaterals in the ophthalmic artery region. After the last administration of the contrast medium loss of sight on the side of the carotid angiography (right side). Reappearing of retinal circulation only on the following day. Treatment with Radecol, Prednisolut, amyl nitrite. No return of slight, --Discussion of the two releasing possibilities; washing-in of embolic material and arterial spasms. A survey in the form of tables is given of nine similar complications which were found in the literature. Comprehensive bibliography.


[Intervertebral disk displacement in children and young adults]. A report is given on 10 children and adolescents who were surgically treated because of prolapses of lumbar intervertebral discs. Besides a detailed anamnesis, the preoperative diagnosis was mainly based on general medical and neurological findings as well as X-ray pictures of the lumbar vertebral column. In case of the absence of radicular neurological failures and pecularities in the X-ray picture, e.g. signs of a spinal process of displacement, destructive changes in the osseous structures of the vertebral column, assimilation disturbances in the lumbosacral transition region, there is the indication for Dimer-X myelography. For all patients, histologically distinct to high-degree degenerative changes in the withdrawn vertebral disk material were found. Reliable signs of a traumatic genesis of the intervertebral disk prolapse were not seen.


[Neurosurgical aspects of the apallic problem]. In the period from 1965 to 1974, 77 patients with an apallic syndrome were observed at the Surgical University Clinic of Innsbruck. Main cause was cerebral contusion (35 patients) followed by open fracture of the skull (7), acute subdural haematoma (7), aneurysm (7), epidural haematoma (6), cerebral tumours (4), perforating skull lesion and traumatic intracerebral haematoma (2 each). 43 patients died, 5 showed spontaneous healing and 9 a rehabilitation effect. Defect healings occurred 12 times. For 23 patients, the survival times were up to 3 months and for 4 patients one year. Patients with healed defects were followed up for more than 10 years. The calculation of the nursing costs as compared to a simple surgical case showed an eight times higher value. However, the financial expenditure for drugs and laboratory findings decreased considerably from about the forth week. The large amount of nursing means and the high cost for personnel remained. Of the 285 patients of the years 1965 to 1974, who were unconscious during a period of up to one week, 59 became apallic. Of these, 27 survival, three were healed, 8 in rehabilitation, 5 as permanent nursing cases and 2 as defect healing. No clinical or intrumental methods can be found by means of which a prediction is possible whether the patient will be healed or become will develop an apallic syndrome.


[Fusiform arterial dilations of the vessels of the posterior cranial fossa]. In a 28-year-old woman with symptomatic cerebral convulsions, vertebral angiography showed two spindle-like dilatations which are probably located in the vascular province of the A. cerebelli superior. The EEG showed convulsive activities, the PEG a beginning hydrocephalus. Neurological findings and fundoscopy were normal. Lues could be ruled out. Differentiation from a cerebral phlebectasia, which is also rare, was reliably possible. An association between the vascular dilatations and the convulsions is not assumed.


[Therapy problems in sphenoethmoidal meningoceles]. After a brief survey of the forms of cranial meningoencephaloceles, the current opinions on their development, symptoms and surgical therapy, a report is given on the case of a five-year-old boy suffering from a sphenoethmoidal meningocele of the size 3 x 3 x 4 cm. There was at the same time a wide median palate cleft, obviously a consequence of the meningoencephalocele. A further finding presented by the boy was a neuroradiologically diagnosed agenesis of the Corpus callosum and a median cheiloschisis. This suggests a central development disturbance as a primary cause. The attempt to perform an intracranial occlusion of the defect of the base, which was repeated twice, was not successful. It was only by a transpalatinal-transnasal extradural intervention (reposition of the meningocele after removing the epipharyngeal mucosa, blocking of the bony defect with a perforated tantalum plate) that the removal of the meningocele was successful. The closure of the palate cleft was then made by the oral surgeon. This surgical intervention may also be considered for the treatment of the transsphenoidal meningoencephalocele, which also presents many problems.


[Treatment and prognosis of the therapeutic effect of L-DOPA in dystonia musculorum deformans]. Clinico-biochemical examinations of 55 patients suffering from various clinical forms of deforming myodystonia were performed. L-DOPA was used in 47 cases. A correlation between the therapeutic effect and the level of phenylacetylglutamine excretion was revealed. The increase of the phenylacetylglutamine excretion was an evidence of a positive result of the treatment that was noted in 36 patients (77%). A resistance to the drug was observed in cases when the phenylacetylglutamine excretion did not exceed its normal level. The quantitative determination of phenylacetylglutamine in the daily portion of the urine can be used as a prognostic test of the therapeutic efficacy of L-DOPA in patients with deforming myodystonia.


[Correction of the hormonal activity of the thyroid gland as a method of pathogenetic therapy in the complex treatment of temporal lobe epilepsy]. Corrective therapy (by thyroidin, di-iodo-thyrosine) of disturbed hormonal activity of the thyroid gland was carried out in 30 patients with temporal epilepsy. There was a favourable immediate (1,5 years) therapeutical effect: the epileptic paroxysms either disappeared or their frequency was reduced, significant normalization of the EEG and iodine metabolism, and improvement in the mental state of the patients were shown. It is recommended to include hormonal correction of the activity of the thyroid gland in the comprehensive treatment of patients with temporal epilepsy.


[Differentiated methods of treating atherosclerotic patients at the Kislovodsk health resort at early periods after transient cerebral circulatory disorders]. A dynamic examination of 135 patients with transient disorders of cerebral circulation (TDCC) was conducted in conditions of a sanatorium-resort treatment in Kislovodsk in early stages following the last attack (from 2-3 months). The method of a phasic examination and treatment was accomplished according to the following principle: polyclinic -- hospital -- resort -- polyclinic. Apart from the clinical dynamic examinations such methods as EEG, REG studies of blood coagulation and basic metabolism, and if necessary angio- and dopplerosonography were used. During their stay at the resort diadynamic currents werer used according to the method of a weak effect on the projection of spinal arteries, sinusoidal modulated currents on the cervical sympathetic nodes and plexus, carbon dioxide Narzan baths, and terrain cure. A significant improvement was seen in 10, improvement in 115, insignificant improvement in 9 patients. One patient showed no changes.


[Experience with the prognosis of strokes]. Results of using discriminant analysis for forecasting ischemic and hemorrhagic strokes are presented. Use was made of clinical data obtained from groups consisting of 400 patients with a history of ischemic strokes, 50 patients with a history of hemorrhagic strokes and 100 healthy individuals. Each observation in these groups was analyzed from 120 parameters and features. As a result of mathematical processing of these data 15 risk factors found to be the most informative for forecasting ischemic strokes, and 16 factors for forecasting hemorrhagic strokes were selected. The reliability of the identification capacity of the prognostic system was evaluated from generalized Machalanobis distance. The correctness of forecasting ischemic strokes was confirmed in 83% and of hemorrhagic strokes in 94.7% of the cases.


[Clinical picture of vibration disease caused by an overall low-frequency jerky vibration and problems involved in sanatorium treatment]. On the basis of complex clinico-physiological examinations of 102 patients suffering from vibration disease caused by general low-frequency push-type vibration the following leading symptomocomplexes were determined: vegetative polyneuritis (53%), peripheral polyneuritis (20.5%), cerebral polyneuritis (13.7%), angiodystonic syndromes and lumbosacral radiculitis (12.7%). The patients were treated with two balneopelotherapeutic complexes, such as nitrogen thermal and bromoiodine baths plus mud applications. The dynamics of the disease symptoms and of the results of additional instrumental examinations has demonstrated the efficacy of the balneopelotherapy given in sanatorium conditions, this efficacy being dependent on the disease stage, prevailing syndrome, and the therapeutic complex used.


[Functional role of several groups of neurons in oculomotor nerve nuclei (experimental study)]. The localization and functional significance of some groups of neurons in the main nuclei of the cat aculomotor nerve were studied with the aid of the method of retrograde degeneration. The topography of the oculomotor nerve nuclei in some representatives of the order of rodents, hare-like and predatory animals was specified. The conducted study demonstrated that the cell groups in the main nuclei of the oculomotor nerve were situated rostro-caudally in the following order: for the superior straight, internal straight and inferior straight muscles. In the middle and caudal sections of the nuclei there is a semidecussation.


[Problem of progression in schizophrenia. I. Problem of progression of attack-like forms]. A total of 552 patients with attack-like schizophrenia, who attained old age were examined clinically. It was established that the development of negative changes in such patients occurs predominantly during the first half of life. Subsequently not all patients demonstrate a progressive development of the disease and even if it does occur it is seen in the form of more frequent or longer attacks and a complication of psychopathological disorders. At the same time there is a certain correlation between the clinical picture of the attacks and the severity of deficitary changes. A reverse development of some personality changes in long-term remissions in old age are described.


[Prevalence and chief variants of the course of schizophrenia with a predominance of delusional and hallucinatory-delusional disorders throughout the course of the disease (clinico-epidemiologic study)]. A nonselective group of 971 schizophrenic patients was studied. The development of the disease in these patients was characterized by the prevalence of hallucinative disorders during the whole duration of the disease. This group totalled 19.1% of the whole population of patients. The cases with continuous paranoid schizophrenia totalled 42.4% of the studied group (8.1% of the population). The rest observations formed the continual range between paranoid and attack-like schizophrenia.


[Variants of the course of schizoaffective psychoses]. The clinical and follow-up studies of 107 patients with 2-10 attacks of schizoaffective psychoses permiteed one to distinguish the main variants of development: cyclothymolike, typical schizoaffective and a variant nearer to shiftlike schizophrenia. In a cyclothymolike variant, the attacks resemble phases of a cyclothymic psychoses, but the development of the disease becomes atypical dissociated. The remissions are characterized by disthymical and somatopsychic disorders and personality changes. Typical schizoaffective variants have a development with attacks, mainly of the "acute schizophrenia" type. Following the attacks there is a stabilization of the process with minimal personality changes. In variants nearer to shiftlike schizophrenia, the affective disorders in the framework of the attack gradually lose their intensity, while the hallucinatory delusional symptomatology acquires a tendency towards a systematization. The remissions are short with more marked personality changes.


[Nosologic features of depression (clinico-statistical study)]. A clinico-statistical analysis of depressions with different nozological entities (125 cases) demonstrated that the nozological boundaries of endogenous and psychogenic depressions are quite obvious (if not considering the degree of the affect). Regarding the depth of affective disorders, the depressive symptomatology reflects mainly the general pathological regularities (the state of severity) and not so much the nozological traits of the disease.


[Certain principles for differential utilization of metabolic treatment preparations in the complex therapy of mental disorders]. A study of 246 patients (with schizophrenia, manic depressive psychoses and psychoorganic syndrome) treated by some drugs of a metabolic action (encephalotropic", "nootropic" drugs, piracetam, piriditol and pantogam) permitted one to determine the place of these preparations in a comprehensive treatment of mental disorders. On the basis of clinical studies of the above-mentioned preparations, the conclusion is made about desirability (and in some cases about necessity) of including them into pharmacotherapy. During such studies certain traits of the clinical effect in each of these drugs was examined, permitting the comparative spectra of the pharmacological activity of piracetam, piriditol and pantogam to be determined. The clinical studies of these patients indicate the necessity of a differentiated use of the mentioned drugs having in view the state of the patient and detected clinical profile of the drugs.


[Neurologic disorders in the late period following terminal states]. The dynamics of the psychoneurological status f 70 patients who had experienced clinical death (17 patients), massive blood loss with prolonged hypotension (30 patients), and terminal eclampsia (23 patients) was studied. In 71% of the patients various late psychoneurological disorders were revealed. Distribution of these disorders according to the WHO classification is presented. It has been found that the psychoneurological disorders of this kind may either: a) gradually disappear, b) stabilize, or c) progress. In 42% of the patients new psychoneurological disorders appeared in the late period: such a deterioration became manifest 3 to 5 months after the terminal state sustained. The discovered incompleteness of the compensation processes points to a necessity of developing a rehabilitation program.


[Morphologic changes in an artery feeding an arteriovenous aneurysm over a long period following its embolization]. Different materials are used in operations for embolization of arteriovenous aneurysms on which radical operation cannot be performed. A case is described with successful embolization by means of silicon-tantulum balls of vessels supplying a giant arteriovenous aneurysm. The patient died 6 years after operation from recurrent massive hemorrhage with escape of blood into the ventricles. Morphological examination of the artery revealed neither necrotic or inflammatory changes in its walls at the site of the embolism.


[Anatomo-experimental basis for tentorial-sinus autoplasty]. The histotoprographical features of the upper and lower sheets of the cerebellar tentorium are determined and the anatomical characteristic of their neurovascular structures is given. A method for separating the sheets of the cerebellar tentorium and forming from its upper sheet rectangular pedicled autografts facing the transverse or straight sinus, the superior petrosal sinus and the sinus drain was elaborated on human cadavers. Optimum dimensions of the temporal graft were calculated according to age and individual range of variability of the size of each half of the cerebellar tentorium. Three methods of tentorial autoplasty of the transverse sinus were used in the experiment: monograft, bigraft and total plastics of the resected sinus segment.


[Study of the strength of the adherence of the dura mater to the bones of the skull]. The strength of the fixation of the dura mater to the bones of the cranial portion and base of the skull was studied with regard to their resistance to separation. Specimens taken from individuals who had died at the age of 3 months to 4 years and from 25 to 58 years were examined. These specimens were not treated with preservatives. It was established that the strength of fixation of dura mater to the cranial bones depends on the age and individual anatomical features and is 30--1800 g/cm. The topography of the fields of minimum and maximum strength of fixation of the dura mater was determined which explains some regular features of epidural hematoma formation.


[Traumatic pneumocephalus].

[Traumatic pneumocephalus]. Five patients with traumatic pneumocephalus are reported. A case with traumatic ventricular and subarachnoidal pneumocephalus resulting from damage to the sphenoidal sinus is described. Treatment of traumatic pneumocephalus is nonoperative is nonoperative in most cases.


Estriol serum levels, neonatal vitality and stromal villous edema in diabetic pregnancies. Estriol serum levels, neonatal vitality and stromal villous edema were studied in diabetic pregnancies. The average serum estriol levels in diabetic patients whose placentas had villous edema was 26.45 +/- 9.16 ng/ml. This value was significantly lower than that of the diabetic patients without villous edema (59.26 +/- 12.06 ng/ml). The average serum estriol levels in diabetic patients who gave birth to depressed newborns was 25.68 +/- 9.73 ng/ml. In diabetic women who gave birth to vigorous newborns this value was 56.57 +/- 14.10 ng/ml. The difference was statistically significant. These results and similar findings from other authors are discussed.


Effect of alloxan diabetes on some aspects of lipid metabolism in albino rats. Administration of alloxan (40 mg/kg i.v.) caused a marked decrease in the lipolytic and esterolytic activities of rat aorta. This effect was completely reversed when the diabetic rats were treated with low doses of insulin (2-3 U/die) for 3 days. The insulin-dependence of esterolysis and lipolysis in rat aorta and the role of hydrolases in atherogenesis in experimental diabetes have been discussed.


Glucose-insulin interaction in obese individuals with asymptomatic reactive hypoglycemia. The interrelationship of glucose and insulin was investigated in obese nondiabetic subjects with asymptomatic reactive hypoglycemia. Results were compared to those obtained from obese control subjects and normal individuals. The diagnostic criteria for asymptomatic reactive hypoglycemia were the appearance of blood glucose values of 40 mg/dl and below during the postabsorptive phase of a 6-h OGTT and the absence of related symptoms. The blood glucose nadir occurred earlier in obese hypoglycemics than in obese controls. Maximum insulin response was similar in both obese groups, but occurred significantly later in obese hypoglycemics than in obese subjects without hypoglycemia and normal subjects. In obese hypoglycemics the blood glucose nadir was inversely proportional to the time of the insulin peak (i.e. the later the insulin peak the lower the blood glucose nadir) but correlated poorly to maximum insulin values. Delayed insulin response was found to be the major abnormality in asymptomatic reactive hypoglycemia and a probable cause of the decreased ability to maintain post-hyperglycemic glucose homeostasis. Decreased glucose tolerance in some obese hypoglycemics pre-treated with prednisolone suggests that asymptomatic reactive hypoglycemia could be the manifestation of an early diabetic stage.


Abnormal steroid sulfate in plasma of women with intrahepatic cholestasis of pregnancy. Concentrations of numerous sulfate steroids were checked in the plasma of 10 women in normal pregnancy (NP), 21 women with intrahepatic cholestasis of pregnancy (ICP) and 10 pregnant women suffering from viral hepatitis with jaundice (VHP). A considerable increase in 5 alpha pregnane and 5 beta pregnane 3 alpha, 20 alpha diols, mono- and disulfates and in 5 alpha pregnane 3 beta, 20 alpha diols disulfates was observed only in ICP and not in VHP. This observation permits us to hypothesize that these hormone changes can have a causative role in the pathogenesis of ICP.


Effect of somatostatin (SRIF) on plasma glucose and insulin response to glucagon in liver cirrhosis. The present study was performed in order to evaluate the plasma glucose pattern in cirrhotic patients who, in the course of a continuous somatostatin infusion (500 microgram/h), were given pulses of glucagon (1 mg i.v.). In normal as well as in cirrhotic subjects somatostatin infusion provoked a marked reduction of the IRI plasma level and this was uninfluenced by subsequent glucagon administration. The rise in plasma glucose level in response to i.v. glucagon administration during somatostatin infusion was less marked in cirrhotics compared to normal subjects. This can be attributed to a variety of factors such as reduced number of liver cells or quantitative or qualitative changes of the liver cell glucagon receptors. Glucagon does not seem to contribute to the pathogenesis of carbohydrate intolerance in liver cirrhosis.


Diverticular disease of the colon and gallstones in New Zealand and England. The clinical presentation and subsequent treatment of 160 consecutive patients with proven diverticular disease of the colon from the Auckland Hospital, New Zealand were compared with 182 consecutive patients admitted to St. Bartholomew's Hospital, London. There were significant differences in sex incidence, in the ages of the male patients at presentation, patient symptoms, extent of disease and methods of surgical treatment. These probably reflect differences in the types of National Health Services of the two countries, rather than differences in the natural history of diverticular disease of the colon. Overall, the 342 patients studied show a very good correlation with other large series published over the last 10 years. This study confirms the previously reported association between diverticular disease of the colon and gallstones. It confirms that gallstones are more common in female patients with or without diverticular disease. It suggests that Auckland patients with gallstones are more likely to have had a cholecystectomy than London patients. The possible role of dietary fiber in the aetiology of both gallstones and diverticular disease of the colon is discussed.


Effects of fat mass reduction by dieting and by lipectomy on carbohydrate metabolism in obese patients. The interrelation of enlarged body fat mass (BFM) with reduced carbohydrate tolerance and hyperinsulinemia was studied in obese subjects with chemical diabetes. These patients were subjected to lipectomy following weight loss induced by a low-calorie, low-carbohydrate diet. An improvement in glucose tolerance and in insulin sensitivity and a reduction in insulin release during OGTT was observed after a diet-induced BFM loss of 9.9 +/-1.2 kg. Subsequent surgical reduction of BFM by 6.0 +/- 0.5 kg had no further effect upon carbohydrate tolerance, insulin release or insulin sensitivity though a marked decrease in basal plasma FFA values was observed. These findings suggest that fat mass enlargement per se has no effect on blood glucose homeostasis after oral or i.v. loading. The improvement in carbohydrate tolerance and in insulin resistance usually observed following diet-induced loss of BFM seems to be due to the reduction in calorie and carbohydrate intake rather than to decrease of BFM.


Investigation of cholecystokinin-octapeptide splitting enzyme in dog kidney. In vitro experiments were carried out to examine the enzymatic activity in various organ homogenates of the dog, which inactivates the biological activity of the synthetic cholecystokinin-octapeptide (CCK-OP). The highest splitting activity was found in the renal cortex; substantially lower activities were registered in the lung, pancreas and small intestine. It seems interesting that neither the gallbladder nor the saliva and the serum contained measurable amount of the CCK-OP splitting activity. An effort was made to characterize the CCK-OP inactivating principle found in the renal cortex. It was ascertained that the CCK-OP was inactivated by a peptidase which is heat sensitive, has a pH optimum of 7,4 and could be inhibited by chelating agents (EDTA) and epsilon-aminocaproic acid. The fact that most of the enzyme function is associated with the sediment obtained at 12 000 g speaks in favour of its mitochondrial origin.


On the mechanism of the insulin-glucose interactions. Analysis of the course of D-glucose binding to insulin has shown that the mechanism of glucose-insulin interaction is a cooperative process. Binding of D-glucose molecules to insulin is facilitated by the dissociation of insulin aggregates caused by insulin-glucose interaction. Thus, insulin behaves as a system with strong positive cooperativity. The results have been treated in accordance with theories for interactions coupled to association equilibria. The data obtained support the idea that insulin monomers are the active species responsible for insulin action.


Phasic and tonic types of smooth muscle activity in lower oesophageal sphincter and stomach of the dog. Mechanical activity of isolated circular muscle strips from the lower oesophageal sphincter (LES), fundus, corpus and antrum of canine stomach was recorded. Nifedipine (10(-6) mol/l) selectively suppressed the phasic components of spontaneous, acetylcholine (ACh)- and noradrenaline (NA)-induced activity of gastric strips. The nifedipine-resistant tonic components of gastric strips were suppressed by nitroprusside sodium (NP) (10(-5) mol/l). LES strips exhibited only weak spontaneous activity. Their ACh-induced activation was nearly completely suppressed by nifedipine. Only NA was able to elicit a strong nifedipine-resistant activation which was, in contrast to the activation of fundus strips, not suppressed by NP.


Kinetics of insulin secretion following glucose infusion in patients with atherosclerotic peripheral vascular disease. Kinetics of insulin secretion following an i.v. glucose infusion, according to the protocol described by Cerasi and Luft, were studied in 19 patients with angiographically documented atherosclerotic peripheral vascular disease and in a group of appropriate controls without clinical signs of disease. No significant differences were noted between patients and controls in plasma cholesterol levels and in the K value following a standard i.v. glucose tolerance test. Blood glucose levels were significantly lower in the patients, whereas mean plasma insulin and triglyceride levels were significantly higher. Analysis of the glucose and insulin responses to the glucose infusion test indicated that 31.6% of the patients had a delayed and sluggish insulin response to the glucose load, fitting the criteria suggested for the diagnosis of prediabetes, versus 10% of the appropriate controls. In particular, simulation of the plasma insulin responses by a square-wave glucose stimulus, confirmed that in a significantly higher number of patients the early insulin peak was below normal limits. The results of this study suggest that increased insulin secretion is not present in patients with atherosclerotic vascular disease, in contrast to reports by other authors, and that inefficient insulin secretory mechanisms may be observed in these patients, thus possibly contributing to the development of the atherosclerotic disease.


Effect of gastric distension on human pancreatic secretion. The effect of gastric distension on pancreatic secretion of bicarbonate and trypsin was studied in 10 individuals in the basal state or during stimulation with low and high doses of secretin or secretin plus cholecystokinin (CCK). Gastric distension augmented the pancreatic response to secretin but had no consistent effect on the pancreatic response to combination of secretin and CCK. We conclude that gastropancratic reflexes do not have much functional significance in man.


Lipid metabolism by muscle of diabetic rats. This study was undertaken to ascertain whether enhanced oxidation of intracellular lipids could explain the impaired carbohydrate metabolism of diabetes. Pieces of diaphragms removed from diabetic (60--75 mg/kg streptozotocin i.v.) and control rats were incubated for 1 h with palmitate-1-14C. Tissue lipids from one piece were separated on silicic acid columns and the amount and specific activity of free fatty acids (FFA), triglycerides (TG) and phospholipids (PL) were measured. 14CO2 production was also assessed in some experiments. The other pieces of tissue were incubated for a subsequent hour (without radioactivity) at which time measurements of tissue lipid content and specific activity and 14CO2 production were again performed. FFA incorporation into CO2, tissue TG and PL was normal. TG content was moderately and PL content was slightly reduced in diabetic tissue. Changes in diaphragm TG and PL content and specific activity during the 2nd h of incubation strongly suggested that most of the 14CO2 produced during this period was derived from TG. Approximately 25% of tissue TG in both control and diabetic muscle was oxidized to CO2 during the 2nd h of incubation. In diaphragms from diabetic rats, (+)-octanoylcarnitine (an inhibitor of FFA oxidation) decreased TG oxidation considerably but had no effect on the impaired glucose uptake. Thus, these data do not support the hypothesis that the glucose-fatty acid cycle (utilizing either extra- or intracellular lipids) may account for the altered carbohydrate metabolism of diabetic muscle.


Gastric stump carcinoma -- carcinogenic factors and possible preventive measures. Cancer in the resected stomach has a very poor prognosis unless it is detected at the "early gastric cancer" stage. The development of gastric stump carcinoma is probably dependent on the procedure chosen for primary surgery (resection). Local irritation accompanying the execution of anastomosis is also discussed as a possible cause of malignant transformation. Surgical precautions should include the choice of methods avoiding reflux, and the use of resorbable suture material for performing an exact and well-matched anastomosis. Periodic postoperative control is essential; in addition to radiological methods, endoscopy and biopsy are indicated for adequate identification of local abnormalities and mucosal changes. Patients whose high risk was stated in previous examinations, must be re-examined at shorter intervals. Identification of changes at the early cancer stage requires close cooperation of surgeon and pathologist.


Hereditary pancreatitis: morphological pictures (ERCP) in the youngest member of a family. Endoscopic retrograde cholangiopancreatography (ERCP) pictures of the pancreatic duct and of the biliary tract are described in the youngest member of a family with hereditary pancreatitis. The endoscopic changes are very similar to those usually observed in patients affected by chronic relapsing pancreatitis. Morphological changes were particularly marked in the body and tail of the pancreas. However, no abnormal changes were observed in the biliary tract.


Peak expiratory flow during a passive exhalation: an index of expiratory resistance during anesthesia. During a passive exhalation performed between (FRC + VT) and FRC, peak expiratory flow (VmaxE) varies as a function of the respiratory system expiratory resistance, RT, with the following relationship: VmaxE = VT/(RT . CT), where Cr is the total respiratory system compliance (static). This expression assumes: (1) a laminar flow regimen during expiration, and (2) a constant CT value over the range of VT. Both these conditions are usually attained during controlled ventilation in the apneic patient. VmaxE can be monitored continuously with relative ease, and may represent a simple and useful index of the mechanical properties of the respiratory system in the anesthetized patient.


Long- and short-term mortality rates in patients who primarily survive cardiac arrest compared with a normal population. This is a follow-up study of 180 survivors after cardiac arrest outside intensive care and coronary care units. The follow-up extended over 0.5 to 8.5 years (averaged 4.3 years) after the primary cardiac arrest. Of the patients, 72 (40%) were discharged from hospital, 13 with anoxic brain damage. Thirty-ourred in 43% after 2 years, and in 50% after 3 years. After that time, the mortality was similar to that of a comparable normal population. At the end of the study, 34 patients were still alive, including eight with neurological sequelae. Their present cardiac function was satisfactory in the majority (59%) of the patients falling into group I or II of the American Heart Association classification. Their social situation, however, left much to be desired, as only 50% had fully or partly regained their previous level of activity.


Studies on muscle relaxants during haemodialysis. Signs of neuromuscular block were evident more than 20 hours after the administration of alcuronium to an anuric patient. Complete recovery occurred during haemodialysis. We therefore decided to study the dialysance of three radioactive non-depolarising relaxants during haemodialysis of four patients with chronic renal failure. Although dimethyl tubocurarine and alcuronium were equal as regards dialysance, the concentration of the former, in plasma, falls faster than does alcuronium. It is believed that a larger volume of distribution occurs with dimethyl tubocurarine. In spite of the fact that the dialysance of muscle relaxants is small, haemodialysis might lower the concentration of these substances in the plasma to a level below the critical point which produces paralysis.


Importance of using proper techniques to teach cardiopulmonary resuscitation to laymen. Immediate attempts to resuscitate patients with cardiac arrest by lay bystanders distinctly increase the chances of survival in such patients. In the present study we investigated possibilities of intensifying the cardiopulmonary resuscitation (CPR) training of laymen. A group of 46 young conscripts (test group) was given 2 hours of CPR instruction in what was considered the most efficient way. The procedures included showing a film on the theory and practice of CPR, a discussion of the film, and then 3 to 5 min instructed individual practice with a recording manikin. Another 56 conscripts participated in a 1-h illustrated lecture on CPR, which was followed by group training with a non-recording manikin; they served as a reference group. The performance of the subjects in CPR was measured with a recording manikin before and 2 months after the training. Before training, none of the subjects passed the surprise resuscitation test. After training, the skills of 62% of the subjects in the test group were acceptable according to original criteria for lay public, and 28% passed the test according to the strict criteria for medical personnel. The less intensive training given to the reference group did not improve the acceptability of resuscitation. It is concluded that CPR training for laymen may lead to failure to attain an adequate level of skill. Proper training techniques and equipment are important, but even their use does not guarantee that an adequate level of CPR performance will be attained by all laymen if their skills are not later refreshed.


Regional lung function following hip arthroplasty and preoperative normovolemic hemodilution. The effect of preoperative normovolemic hemodilution with dextran 70 as dilutional agent on postoperative regional lung function was evaluated in patients undergoing hip arthroplasty in the lateral decubitus position. The major part of the surgical blood loss of these patients was replaced with the received autologous blood. The results obtained were compared to changes in a group of patients in whom the operative bleeding was replaced with bank blood. Regional lung function, as studied with Xe133 radiospirometry, is not negatively influenced by the hemodilution technique. In both groups a reduction in perfusion, ventilation and volume of ventilated alveoli was revealed postoperatively in the lung that was dependent during surgery, probably caused by impaired ventilation of this lung and peroperatively induced microembolism. A more rapid normalization was found in the preoperatively hemodiluted patients. The reduced volume of bank blood transfused to these patients and/or a protective effect of the preoperatively infused dextran on the microembolism evoked by the surgical trauma might explain this difference between the groups studied.


Influence of general anaesthesia on portal pressure in liver cirrhosis and portal hypertension. In 19 patients with cirrhosis of the liver and portal hypertension, a catheter was inserted into the portal vein using a percutaneous transhepatic technique. The portal pressure was measured during general anaesthesia with and without halothane, and in the awake state. Addition of halothane to the N2O:O2 anaesthesia did not change portal venous pressure, in spite of a significant fall in arterial blood pressure. Portal venous pressure under general anaesthesia with complete muscle relaxation did not differ from the pressure in the resting, awake patient.


Epidural analgesia inhibits the renin and aldosterone response to surgery. Renin activity and aldosterone concentration in plasma and excretion of sodium and potassium in urine were measured during a period of 24 hours in 12 patients undergoing hysterectomy under general anaesthesia or epidural analgesia. Analgesia extended from T4 to S5 and was effective throughout the study. The normal stress-induced increase in plasma renin activity and aldosterone was inhibited by epidural analgesia. Urinary excretion of potassium was significantly lower in the epidural group, but sodium and water retention showed no difference between groups. It is concluded that neurogenic stimuli from the surgical area are important release mechanisms of the renin-aldosterone response to surgery. The results suggest that post-operative sodium retention is caused by factors other than the mineralocorticoid system.


Increased serum concentrations of lactic, pyruvic and uric acid and bilibubin after postoperative xylitol infusion. Xylitol has been suggested as a more advantageous calory source for intravenous administration than glucose in certain clinical situation, but the general suitability of intravenous xylitol infusion has not been confirmed. Thirty-middle-aged women were infused with 100 g of xylitol as postoperative fluid therapy after gynaecological laparotomy and general anaesthesia. Another 10 women received 50 g of glucose in a similar manner and served as a reference group. Infusion of xylitol both at the rate of 0.25 g/kg/h (1000 ml 10% xylitol in approx. 8 h) and 0.5 g/kg/h (1000 ml 10% xylitol in approx. 4 h) caused a distinct increase in the serum concentrations of lactic acid, pyruvic acid, and uric acid; such an increase was not seen with glucose infusion. The faster infusion of xylitol also distinctly increased serum bilirubin concentrations. Because of the possibility of lactic acidosis and urate deposits in kidneys, infusion of 100 g or more of xylitol at a rate of 0.25 g/kg/h or faster is not safe for postoperative fluid therapy in routine clinical work.


Effect of different anesthetics on the pharmacokinetics and pharmacodynamics of pancuronium in the cat. To investigate the effect of different anesthetics on the pharmacokinetics and pharmacodynamics of pancuronium, 120 microgram/kg i.v., cats were anesthetized with either pentobarbital (N = 4), ketamine (N = 4), enflurane (N = 5), or halothane (N = 5). A longer onset time and duration of neuromuscular blockade occurred during enflurane and halothane anesthesia. The apparent elimination half-life was longer and the total voluem of distribution at steady state larger during halothane anesthesia. The plasma concentration of pancuronium required for neuromuscular blockades was less during enflurane than during the other three anesthetics. We conclude that inhalation anesthetics may prolong a neuromuscular blockade by altering both the pharmacokinetics and pharmacodynamics of pancuronium.


Studies on intrapulmonary gas distribution in the normal subject. Influence of anaesthesia and artificial ventilation. Intrapulmonary gas distribution, assessed by a multiple breath, nitrogen washout technique and expressed by the Fowler index NWOD, was studied in subjects with healthy lungs during spontaneous breathing while awake, and during mechanical ventilation under halothane anaesthesia. The distribution index rose from a mean of 32% awake to 56% during anaesthesia. An attempt was also made to differentiate between the contribution of gravitational (airway closure) and non-gravitational (diffuse airway obstruction) inhomogeneity of ventilation. This was accomplished by measurement of the slope of the alveolar plateau during a sinle breath nitrogen washout. The slope was similar awake and anaesthetized, and it increased equally under both conditions, when preinspiratory lung volume was stepped up from RV to CC, CC being the lung volume at which airways begin to close during expiration. NWOD was significantly correlated to the degree of airway closure, expressed as FRC-CC, and, less so, to inspiratory resistance. It is suggested that a less efficient ventilation distribution in anaesthetized normal subjects, as measured by NWOD, is caused rather by airway closure (gravitational inhomogeneity) than by diffuse airway obstruction (non-gravitational inhomogeneity of ventilation).


Pancuronium bromide precurarisation. II An evaluation of clinical aspects in patients of female sex. The authors have studied the effects of precurarisation by means of pancuronium on 120 female patients by using three multiple doses of pancuronium bromide. The authors have demonstrated that the dose of pancuronium, capable of abolishing almost completely fasciculations and postoperative succinylcholine myalgias, corresponds to 0.009 mg/kg. This dose has proved to be most efficient in causing a considerable increase in subjective precurarisation symptoms (Heavy eye-lids, blurred vision etc.). Such symptoms have never caused even the least discomfort to the patients. The authors have finally demonstrated that the doses of pancuronium employed cause a decrease in V.C. within limits that do not, however, compromise ventilation.


Asymptomatic myasthenia gravis manifested after removal of mediastinal tumors. Report of two cases. Asymptomatic myasthenia gravis firstly manifested as total paralysis in patients submitted to a surgical procedure should be considered extremely rare. Two cases of latent myasthenia gravis manifested after thoracotomy for removal of mediastinal tumor are reported. Prolonged apnoea and need for postoperative mechanical support of respiration was most likely due to non-depolarizing relaxants administration. In both cases edrophonium test was positive and the histology of the tumor showed thymoma. The further recovery after pyridostigmine treatment was uneventful for both patients.


A premature referral to the mortuary. Cerebral recovery with barbiturate therapy. The authors report a patient in circulatory arrest with unusual spontaneous cardiopulmonary recovery in the mortuary. Cerebral outcome and clinical evaluation of various therapeutic modalities in postischemic encephalopathy are discussed briefly.


[Hematolymphatic transport in skin, subcutaneous tissue and superficial lamina of the fascia of the lower leg in varicose veins]. The lymphatic bed of the skin and subcutaneous tissues of the lower leg from 20 operated patients was studied by light and electron microscopy and by phlebographic methods. Three stages of development of the disease were examined: without complicated form of varicose veins, complicated form, and postthrombophlebitic syndrome. Morphological features of the state of the lymphatic bed of the skin, subcutaneous connective tissue and fascia of the lower leg in the initial stage of disease show the fine structure changes of lymphatic vessels and capillary walls interpreted as a compensation phenomenon. It seems that the structure alterations of endotheliocytes of lymphatic capillaries and the connective tissue surrounding them found in this study in the complicated form of the disease and the postthrombophlebitic syndrome are the basis of the mechanism of transport-resorption insufficiency of the lymph vessels' terminal flow paths.


[Anterior falcate artery in adults: histology of the relation of superior sagittal sinus, dural vein and the arachnoid granulations]. The anterior falcate artery, which is the continuation of the anterior ethmoidal, supplies the dura mater in the region of the superior sagittal sinus as far almost as the coronal suture. Graphic reconstructions show its relationships to the veins, the sinus, and the arachnoid granulations. Histological studies of the artery emphasize its adaptation to longitudinal stretching. The complexity of its relationships suggests a functional significance beyond that of nourishing the dura.


Anatomical closure of the ductus arteriosus in the dog (Canis familiaris). The ductus arteriosus was studied in 138 dogs (80 female and 58 male) aged from 6 h to 21 days. This experiment led us to conclude that the anatomical closure of the d. arteriosus starts within 96 h and is obliterated after 6 days in 100% of the animals studied. We have also evidenced that the closure starts in the medial part of the d. arteriosus and progresses to the pulmonary artery and aorta.


Cellular thorn-like projections in human endocervical epithelium. Preliminary scanning electron-microscopic study. By means of scanning electron-microscopic investigations, thorn-like projections (TLP) were observed in the cilio-secretory epithelium of the ventral surface of the human endocervix. These projections, which seem to be characteristic of a new cell type, were seen at different stages of the menstrual cycle (days 8, 14 and 21) in 4 apparently healthy fertile women. Striking differences in length, with a maximum size at midcycle, suggest an evolutive process throughout the menstrual cycle. The origin and possible physiological role of TLP in the reproductive process are discussed.


Aging in retinas and optic nerves of 2.5- to 9-month-old mice. Aging of the retina and optic nerve was studied in 2.5- to 9-month-old albino mice. A change was found in the number of visual cells and in the distribution of large versus small optic nerve fibers. No significant change was found in the number of retinal phagosomes and in the total number of optic nerve fibers.


Delayed maturation of the male cerebral cortex in rats. 45 male and female Wistar rats were given a single injection of 3H-thymidine (10 mu Ci/g body weight) on day 1, 7, 14 or 21. All animals survived until 60 days of age when they were perfused with 10% neutral formalin and the brains were removed and prepared for autoradiography. The sagittal section of the cortex (L980 micron) was 6.8% larger in the males (p less than 0.05) but the packing density of the cortical cells was 5.9% higher in the females (p less than 0.01), thus bringing the total number of cells to the male levels. The diameter of the female cortical cells was 3.8% smaller than those of the males (p less than 0.05). The greatest difference was among the smaller cells (3-9 micron). The rate of postnatal acquisition of cortical cells was indicated by the number of radioactive-labelled cells. Males had more labeled cells after each injection; it was most pronounced (32% difference) on day 7 (p less than 0.05). This may reflect a delayed acquisition rate of cells formed before birth, since more cells could be labeled by the postnatal injection.


Interneuronal synapses in the local ganglia of the cat urinary bladder. The interneuronal synapses of the urinary bladder in the cat were studied by electron microscopy. The great majority of the fibres containing vesicles are found within the ganglia occurring in the trigonum area. Morphologically differentiated synaptic contacts could be observed on the surface of the local neurons and between the different nerve processes. The presynaptic terminals can be divided into three types based on a combination of synaptic vesicles. Type I terminals, presumably cholinergic synaptic terminals, contain only small clear vesicles of 40-50 nm in diameter. Type II terminals, presumably adrenergic terminals, are characterized by small granulated vesicles of 40-60 nm in diameter. Type III terminals, probably of local origin, contain a variable number of large granulated vesicles of 80-140 nm in diameter. Occasionally, a single nerve fibre contacted several (two or four) other nerve processes forming a typical synapse. In other cases, on one nerve cell soma or on other nerve processes there are two or three different-type nerve terminals establishing synapses. It might be inferred from these observations that convergence and divergence can occur in the local ganglia and that cholinergic and adrenergic synaptic terminals can modulate the ganglionic activity. However, a local circuit also can play an important role in coordinating the function of the bladder.


Asymmetry in the skull.

Asymmetry in the skull. Various linear and angular measurements were taken in 118 normal skulls of adult humans. The two halves of the skulls were found to be symmetrical. The phenomenon of asymmetry of various parts of the body, in relation to cerebral dominance and specific skills has been discussed in view of the findings of the study and in the light of the available literature.


Absence of the mental foramen in dry human mandibles. The absence of the mental foramen was investigated in 1,435 dry human mandibles (2,870 sides). The foramen was absent twice in the right side (0.06%) and once in the left side (0.03%). The meaning of this anatomical variation was commented.


Teratogenic effects of a single oral administration of methylmercuric chloride in mice. The teratogenic effects of methylmercuric chloride (MMC) given orally as a single dose to pregnant ICR mice on day 10 of gestation were examined. The doses tested were 25, 20, 15 and 10 mg/kg. Controls received distilled water orally. Each group consisted of 20 females. Fetuses were taken on day 18 of gestation for teratological study. The number of resorbed or dead embryos was moderately increased in the 25 mg/kg group. Fetuses from dams given 25, 20 and 15 mg/kg MMC weighed significantly less than those in the control group. Many fetuses with malformations were observed in the treated groups; cleft palate occurred in 100, 58.6 and 28.0% of fetuses from dams given 25, 20 and 15 mg/kg MMC, respectively (statistically significant). Hydronephrosis appeared in 23.8 and 18.5% of fetuses from dams given 25 and 20 mg/kg MMC, respectively (statistically significant). Skeletal variations, incomplete ossification of sternebrae, for example, were also observed in the treated groups. These results indicate that MMC is teratogenic so far as cleft palate is concerned and embryotoxic in ICR mice.


"Semi-open" muscle biopsy technique. A simple outpatient procedure. An easy and safe method for muscle biopsy is described. The biopsy instrument is an alligator forceps (Weil-Bladesley's conchotome). With this method an adequate amount of muscle tissue can be obtained for both chemical and morphological studies. The method combines the advantage of the "open-surgical" method - sufficient quantity of material - with the advantages of the needle methods - easy to perform, not incapacitating and only slightly uncomfortable for the patient. Out of 959 consecutive biopsies with this method only 19 were impossible to evaluate because of too much artefact or too little tissue.


Visual evoked potential in patients with cerebral asthenopia. Cerebral asthenopia is often overlooked as a symptom in diffuse brain lesion. An objective correlate of this symptom has so far never been demonstrated. Averaged visual evoked potential (VEP) in 10 patients with asthenopia was compared with 20 normal subjects. Both eyes and each eye alone were stimulated using bipolar recording in the midline and over each of the occipital lobes. There was no difference of latency of the VEPs in the two groups, but the amplitude of the most prominent component was significantly reduced in the patients. There was also a difference in the two groups regarding habituation and lateralisation. No amplitude difference could be found in the somatosensory evoked potential. The amplitude difference in VEP, as an objective correlate of asthenopia, is probably modal specific and suggests involvement of the visual cortex. VEP is unsuitable as a diagnostic tool due to the great overlap between amplitudes in asthenopic patients and control subjects.


[Early histogenesis in the cerebral cortex of the mouse: a Golgi analysis (author's transl)]. By the application of the rapid Golgi method to embryonic telencephalon, three stages can be distinguished in the early developmznt of the neocortex. Stage 1 is characterized by a neuroepithelium containing a continuously proliferating cell population. Stage 2 corresponds to the primordial cortical organization; the first neuronal (post-mitotic) cells appear in the external part of the neural tube and are differentiated in a predominantly horizontal pattern. Stage 3 begins when the cortical plate appears. This structure will give rise to the major part of the adult cortex. The cells of the cortical plate assume a typical radial orientation and their axons (afferent fibers) are well individualized. The afferent fibers however, are not easily analyzed by the technique employed. Those morphological findings are discussed in relation to various data from the literature in developmental neurology.


Pigmentary degeneration of the retina in heredodegenerative neurological diseases. Frequency of pigmentary degeneration of the retina (PDR) among patients with degenerative and heredodegenerative neurological diseases (HDNDs) was estimated based on the hospital statistics. PDR was detected in 3% of 176 inpatients with HDNDs by careful ophthalmologic examination. On the other hand, out of 30 consecutive cases of PDR seen in our Department of Neurology, 15 patients were associated with some form of HDNDs. Atypical PDR were more frequently associated with HDNDs than typical PDR. Among neurological manifestations in those 15 cases of PDR associated with HDNDs, mental deficiency, hearing disturbance, spasticity, progressive ophthalmoplegia and ataxia were most frequently encountered. Four cases with unusual symptomatology were presented. Clinical analysis of cases of PDR associated with HDNDs in the present series as well as in the relevant literature revealed an extreme variety of clinical manifestations and underlying metabolic disorders, suggesting a possible participation of multiple factors in the pathogenesis of PDR. Importance of careful ophthalmologic examination in HDNDs was stressed from the prognostic point of view.


[Semiology of bismuth encephalopathy. Comparison with seven personal cases (author's transl)]. The authors analyze 99 well-described cases of bismuth encephalopathy and suggest a clinical syndrome according to three stages of the disease (before, during and after the acute period) and three clinical domains (psychiatry, neurology and neuropsychology). A particular attention concerns the presence of sequellar clinical signs (mnesic functions), sometimes observed one year after interruption of bismuth ingestion.


Fenestrated blood vessels in human skeletal muscle. In a fine structural study of 32 skeletal muscle biopsies, rare examples of fenestrated blood vessels (FV) were found in three cases. In view of similar observations reported in a case of Duchenne muscular dystrophy, it is suggested that FV albeit rare may occur in skeletal muscle at least under pathologic conditions. These aberrant FV may be derived from adjacent dermis and/or epineurium which are known to contain occasional FV. Alternatively, the occurrence of fenestrae may reflect a nonspecific alteration in pre-existing continuous endothelium. The significance, if any, of their presence in skeletal muscle is unknown.