Group treatment of single males with erectile dysfunction. Nine men with chronic erectile dysfunction (three primary, six secondary) who had no regular sexual partner were treated in two 12-session all-male psychoeducational therapy groups. Treatment intervention addressed specific factors which inhibited adequate sexual function with a focus on coping skills to overcome those factors. Pre, post, and follow-up behavioral self-report data and responses on a goal attainment scale questionnaire indicated that the treatment groups were successful for five men with secondary and one man with primary erectile dysfunction. Subjective report and pre- and posttreatment fantasy productions to TAT cards for the first group indicated that all men significantly improved their attitudes about sexuality and their sexual self-concept. The results suggest that this is a viable, cost-effective treatment for secondary erectile dysfunction, but not for primary erectile dysfunction unless supplementary individual therapy is provided.


Coital and contraceptive behavior of female adolescents. Structural interviews conducted with 532 female clients of a teen contraceptive clinic revealed a moderate level of coital activity i(in terms of both frequency of intercourse and number of partners) which typically began at age 15. Prior use of contraception was sporadic and almost exclusively confined to nonprescription methods. Primary reasons for nonuse of birth control included fear of lessening the pleasure of intercourse and lack of access to contraception. The data indicate that a combination of comprehensive sex education and ready access to birth control is necessary to prevent unintended adolescent pregnancy.


Sexual response in spinal cord injured adults: a review of the literature. The literature on sexual response in spinal cord injured (SCI) adults is reviewed and criticized. Principal characteristics of spinal cord injury are reviewed, and variables usually taken into account in studying sexual behavior in the SCI population are specified. Target behaviors of erection, ejaculation, attempts at intercourse, and male and female orgasm are isolated, and relevant data are reported. Attention is given to conceptual and methodological shortcomings of past research. Literature relevant to remediation of sexual problems in the SCI population is reported, and outcomes are noted. Future directions for research are indicated with particular emphasis placed on the appropriate utilization of psychophysiological techniques.


Experimental studies of the etiology of genital exhibitionism. Several studies are reported which examine the critical stimuli and responses as well as personality factors important in genital exhibitionism. Using penile volume measurement, sex history questionnaires, personality tests, and behavioral observations, it was found that (1) exhibitionists responded most to mature females and were comparable to normals in reactions to children and men; (2) while exhibitionists indicated narcissistic desires in exposing, in a laboratory study they did not differ from controls in reactions to exposing with various reactions of the female, from sexual arousal and admiration to fear and anger; (3) the only strong features distinguishing exhibitionists from controls and other sexually anomalous subjects were peeping associated with orgasm and outdoor solitary masturbation; (4) exhibitionists seemed to be less assertive and less feminine than controls, but results were weak and inconsistent; (5) exhibitionists and controls did not differ in separation and divorce or marital satisfaction; (6) blood testosterone and penile reactivity of exhibitionists were within normal limits. Overall, the results suggest that most major theories of genital exhibitionism are wanting. It is suggested that narcissism and pedophilia be examined further in connection with exhibitionism.


Klinefelter's syndrome: sexual development and activity. Determination of plasma testosterone in 105 patients with Klinefelter's syndrome 16--45 years of age revealed that at each 5-year age interval values of male hormone were lower than in a control group of 25 normal adolescents and 85 fertile and potent men. Analysis of heterosexual development by means of the HTDM Questionnaire in 110 patients with Klinefelter's syndrome age 21--40 years, who were examined mainly for sterility and signs of imperfect somatosexual development, revealed a distinct retardation of sociosexual development compared to that of 325 normozoospermic men from sterile marriages. For eight out of 12 items on the HTDM Questionnaire the differences were statistically significant. Examination by means of the SAM Questionnaire in these two groups revealed that the sexual activity of examinees with Klinefelter's syndrome was significantly weaker than that of fertile and potent men. For 15 out of 18 items on the SAM Questionnaire the differences were statistically significant.


Ego development and sex attitudes in heterosexual and homosexual men and women. A comparison was made of heterosexual and homosexual men and women utilizing Loevinger's concept of ego development and focusing on the relationships among ego levels and attitudes toward homosexuality and on personal sex guilt and other sociosexual variables. Previous comparative studies were critically analyzed with respect to the adequacy of definition and description of sampling procedures, and the appropriateness of research question. A pilot study reported here concerns the development of a measure of "attitudes toward homosexuality." The major study utilized 200 subjects who completed an anonymous and lengthy questionnaire. This sample was relatively young, well-educated, white, and Protestant. Self-ratings on the two Kinsey-type scales clearly differentiated the self-identified primarily heterosexual and homosexual groups. In this study there were no significant differences in ego levels between the heterosexual and the homosexual groups, suggesting that ego development and sexual orientation development are independent phenomena. Among both homosexual and heterosexual subjects there were low but significant correlations between higher levels of ego development and more positive attitudes toward homosexuality. More negative attitudes toward homosexuality were correlated with higher levels of personal sex guilt for heterosexual and homosexual men and for heterosexual women. Our measure of sex guilt proved to be related to ego level only for heterosexual males, although the measure of this construct requires additional research and refinement. Other correlates of these variables are also reported.


Vaginal photoplethysmography: methodological considerations. Methodological considerations related to the use of vaginal photoplethysmography in the experimental investigation of physiological sexual arousal in women are discussed. Specific topics covered include the operation and use of the device, methods of data reduction and analysis, and the role of vaginal photoplethysmography in the study of female sexual arousal. A review of the literature focusing on methodological issues is also included.


The intelligence of rapists: new data.

The intelligence of rapists: new data. IQs of violent sexual offenders (rapists) were compared to those of alleged nonviolent sexual offenders, nonsexual violent offenders, and nonsexual nonviolent offenders. Data were gathered from defendants referred to the medical coauthor for pretrial psychiatric evaluation. Rapists scored lower in the IQ test, but this difference did not appear to be significant in the pairwise X2 comparisons. This held true after controlling for the race of the defendant.


Exorcism as psychiatric treatment: a homosexual case study. A case of exorcism as apparently successful treatment of transsexualism has previously been reported. The actual procedure in a similar case of exorcism by a psychiatrist is reported, together with details of the outcome and a discussion of theoretical, applied, and ethical aspects of the case.


[Influence of native crude fibers on the true digestibility of nitrogen and the amino acids]. In several test series with rats, the influence of native crude fibres (straw meal and pea hulls) on the amount of metabolic fecal nitrogen (MFN) was tested. It could be ascertained that native crude fibres increase MFN. The influence of the increased MFN on the true digestibility of nitrogen and the amino acids was investigated in test series with casein diets. The casein diets were supplemented with native crude fibres. Generalising, we can state that native crude fibres--due to their structure (lignin)--fix amino acids and thus withhold them from absorption. They do not, however, increase the MFN by mechanical action (increase of the scraping off of intestinal epithelium).


[Food value of straw meal in the nutrition of pigs. 1. Digestibility of the nutrients and N-balance after feeding with partially hydrolized straw meal]. Straw Meal was mixed with concentrated HCl at a mass proportion of approximately 10 : 1. After a one-hour duration of action the mixture was diluted with water (in proporation to the added HCl volume the double amount of water) and steamed in an electric steaming caldron for one hour. The partially hydrolised final product was neutralised with calcium hydroxide (3,5 kg per 10 kg HCl). In a digestibility experiment 4 pigs were fed according to the differential method with barley (supplemented with lysine and methionine) without straw meal resp. with straw meal (717 g barley dry matter+386 g straw meal dry matter per animal and day for pigs with an average live weight of 64.3 kg). In this test 21.0% of the organic matter of partially hydrolised straw meal, 0.5% of the crude fibre and 42.3% of the N-free extractives were digestible. When the animals were fed with barley exclusively (1045 g dry matter per day and animal of an average body weight of 61,4 kg), 17,1% of the 26,0 t N per animal and day were excreted in feces. After the feeding with straw meal admixtures, 34,5% of the 20,9 g N per animal and day were excreted in feces. When the feed consisted of 1,99 kg barley, 220 g fish meal and 565 g straw meal (dry matter in each case) per animal and day for the same pigs with an average body weight of 97,1 kg a digestibility of the organic matter of the partially hydrolised straw meal of 24,6% was achieved. 24.3% of the nitrogen consumed (72.9 g) by each animal per day were excreted in feces. After slaughtering, the pH-value in the caecum sould be ascertained as 6.0 to 6.5. The conclusion of this is that partially hydrolised straw meal contains approximately 20% utilisable carbohydrates and has a positive dietic effect in the digestive tract.


[Metabolism of colostomized laying hens with 15N-labeled wheat. 2. Incorporation of the labeled nitrogen into fractions of the egg]. The colostomised hens received 15N-labelled wheat. For a period of 8 days the incorporation of the 15N excess (15N') into the albumen, the yolk and the egg-shell was measured. In addition to that, the values for atom-percent of 15N' in the amino acids lysine, histidien and arginine of the albumen and the yolk were ascertained. The egg-shell and the albumen were labelled shortly after the beginning of the experiment. In both fractions the atom-per cent of 15N' rises more quickly than in the yolk. After the withdrawal of the labelled feed the decrease in the yolk was slower than in the egg-shell and the albumen. Concerning the atom-per cent of 15N' there is hardly a difference between the total N and the amino acids. Despite the different supply with amino acids, the relation of histidine 15N' : lysine 15N' : arginine-15N' in the yolk and the albumen remains largely constant. It is 1 : 2 : 3 and corresponds to the quantitative relation of the N content of the three amino acids in the egg protein. The utilisation of 14N and 15N' of the wheat lysin for the egg synthesis amounts to approximately 50%. There are considerable differences between the utilisation of 15N' of the histidine and 15N' of the arginine and the 14N of the two dietary amino acids.


[Utilization of feed energy by growing pigs. 3. Energy requirement for the growth and fattening of pigs]. The test series for the investigation of the energy consumption of growing pigs of the breeds large white and improved land race pig as well as cross breeds of the two breeds in a total of 369 metabolism periods (as described in the first two pieces of information of this publication series -- Hoffmann and others, 1977 and Jentsch and Hoffmann, 1977) were statistically analysed for the purpose of the derivation of the energy requirement for maintenance and the partial energy requirement for growth in order to test the possibilities of the factorial analysis for the derivation of energy requirement values of growing pigs. The dependence of the maintenance requirement of growing pigs (investigations in the live weight range of 10 to 40 kg -- see 1st information--were made with boars those in the live weight range of 30 to 120 kg were made with gelded boars, 2nd information) on the live weight can best be characterised by applying a power exponent of 0,61 or 0,62 for the live weight. A definition is offered to be discussed for the energetic maintenance requirement of productive live stock and laboratory animals as a conventional value. The energy requirement values derived from the doubly-factorial statistical analysis show a satisfactory adaptation to the measured values as such concerning energy intake and observed growth performance of the test animals. The conclusion is drawn that the factorial analysis of the energy requirement (maintenance plus partial performances) results in a better estimate of the requirement of growing animals than the assessment according only to live weight and live weight increase without characterising the energy requirement for partial performances. This is important for the further working on and more exact definition of requirement norms.


Molecular mechanism of 1,1-dichloroethylene toxicity: excreted metabolites reveal different pathways of reactive intermediates. The excretion and biotransformation of [14C] 1,1-dichloroethylene (vinylidene chloride, VDC) after administration of a single oral dose has been investigated in female rats. Seventy-two hours after a dose of 0.5, 5.0, and 50.0 mg/kg, 1.26, 9.70, 16.47%, respectively, are exhaled as unchanged VDC, and 13.64, 11.35, 6.13% as 14CO2. The main pathway of elimination is through renal excretion with 43.55, 53.88, 42.11% of the administered radioactivity. Through the biliary system, 15.74, 14.54, 7.65% of the activity are eliminated. The isolation of the main metabolites of VDC from 24 h urine is accomplished through the combined application of solvent extraction, ion exchange chromatography and thin layer chromatography. Then gas chromatography and mass spectrometry are used for their identification. Three metabolites have been identified: thiodiglycolic acid, N-acetyl-S-(2-carboxymethyl)cysteine and methyl-thio-acetylaminoethanol. In addition, three smaller unidentified radioactive peaks have been found. Thiodiglycolic acid is the main metabolite in VDC metabolism. The simultaneous formation of an ethanolamine- and a cysteine-conjugation product points to different reaction pathways of the postulated intermediate reactive epoxide; ethanolamine probably originates from membrane lipids, which react with VDC-epoxide and/or its derivatives. This pathway could explain, in part, the parenchyma damaging effect of VDC.


Induction of dominant lethal mutations in male mice by fosfestrol. Using the dominant lethal assay, the ability of fosfestrol, a diethylstilboestrol derivate, to induce mutations in male mice was tested and confirmed. Up to 300 mg/kg of fosfestrol the induction of mutations occurs exclusively in spermatozoa. A dose of 600 mg/kg of fosfestrol induces dominant lethal mutations up to 10 days posttreatment. The majority of induced dominant lethal mutations in all dose groups are expressed as loss after implantation.


The effects of aspirin on the development of the mouse third molar. A potential screening system for weak teratogens. Aspirin is teratogenic at high doses in rodents. A dose related effect is shown at much lower levels in an animal testing system which permits subthreshold effects on development to be measured. This system, which depends on changes in tooth size in the mouse, has advantages in assessing weak or cumulative teratogens.


Effects of dichlorvos (DDVP) inhalation on the activity of acetylcholinesterase in the bronchial tissue of rats. The experiments presented here deal with the effects of the inhalation of dichlorvos [dimethyl-(2,2 dichlorvinyl)-phosphate, DDVP] vapor on acetylcholinesterase (ACHE) activity in rat bronchial tissue. Exposure to DDVP concentrations of 0.8 and 1.8 micrograms/l for 3 days reduced ACHE activity in the bronchial tissue (62.8 +/- 0.8 and 51.6 +/- 1.6% of the control), but did not elicit any changes in blood ACHE activity (101 +/- 4.5% of the control each). Higher concentrations (4.3 micrograms/l) induced a decline in ACHE activity also in the blood (38.2 +/- 1.1% of the control). In the histochemical preparations used to demonstrate ACHE activity in bronchial tissue (thiolacetic acid method), a staining of the bronchial glands and smooth muscles characteristic of the enzyme activity was strongly reduced after exposure of the animals to even the lowest dose applied (0.2 microgram/l). The question of whether localized inhibition of ACHE in the bronchial tissue might cause increases in airway resistance due to activation of a broncho-bronchial reflex is discussed. This efferent cholinergic mechanism has been found to be at least partly responsible for maintenance of bronchospasm and hypersecretion in chronic obstructive diseases of the respiratory system.


Spontaneous activity of autonomic functions in coma due to drug overdose. Spontaneous heart rate, respiration rate and electrodermal activity were studied in 32 patients with different grades of severe poisoning by ingestion of various drugs. The degree of their behavioural impairment was determined with the Munich Coma Scale (MCS) which measures stimulus evoked somatomotor responses. There was a significant reduction of spontaneous variations of heart rate and respiration rate with increasing severity of coma. Spontaneous electrodermal fluctuations were present only at the least severe grades of impairment. Thus, cardiorespiratory and electrodermal activity can provide significant information on the level of behavioural impairment in severe poisoning.


The influence of 2-/o-cresyl/-4 H-1 : 3 : 2-benzodioxa-phosphorin-2-oxide (CBDP) on organophosphate poisoning and its therapy. The aim of the experiments was to obtain more information on the toxicity of organophosphates and protection against them. Pretreatment of mice with CBDP increased the s.c. toxicity of soman 19.1-fold, and its i.p. toxicity 17.8-fold. The protective effect of atropine and the oximes HS-3, HS-6 and HI-6 in soman poisoning was much greater in CBDP pretreated than in control animals. Atropine + HI-6 raised the s.c. LD50 of soman in the CBDP pretreated animals from 6.8 micrograms/kg to 166 micrograms/kg (PI = 24.3), but in control animals the i.p. LD50 was only raised from 370 micrograms/kg to 608 micrograms/kg (PI = 0.6). CBDP inhibited blood and brain AChE activity, but had no effect on aliesterase (AE) activity in plasma, liver and brain of mice in vivo. CBDP increased s.d. toxicities of sarin 11-fold, of tabun 5-fold and of VX 0.24-fold. The protective index of atropine + HS-3 in sarin poisoning, as in the case of soman poisoning, was much higher in CBDP pretreated than in control animals (20.1 : 13.6), only slightly higher in tabun poisoning (4.3 : 3.4) and in the case of VX poisoning lower in CBDP pretreated than in control animals (32 : 47). The results indicate that CBDP potentiates soman, sarin and tabun toxicities mainly by blocking their binding to non-specific sites in the body.


[On the effect of cadmium on tissue respiration and gluconeogenesis in rat kidney cortex (author's transl)]. Oxygen consumption (QO2), respiratory quotient (RQ) and gluconeogenesis of rat kidney cortex slices were determined (Warburg technique). QO2 was not influenced by 0.01 mM CdCl2 in the incubation medium (no exogenous substrate added), 0.1 mM, 1mM and 10 mM, respectively, reduced QO2 by 43%, 45% and 68%. In the presence of 8 mM glucose, 10 mM acetate or 5 mM butyrate, 1 mM Cd resulted in a decrease in QO2 by about 50% each. Addition of 20 g/l albumine to the medium abolished this effect of cadmium. RQ was not influenced by a mM Cd, both without and with 8 mM glucose in the medium. Glucose production from 7 mM pyruvate or 5 mM glutaminate in slices from fed and starving rats was reduced by 1 mM Cd to half the value found in controls.


[Hernia hiatal. Detection of gastroesophageal reflux with the telemetric Heidelberg capsule]. 120 patients with upper gastrointestinal symptoms were studied and submitted to gastric secretory tests, upper gastrointestinal X-rays and endoscopy. Gastroesophageal reflux was assessed by means of a Heidelberg telemetric capsule. 60 patients had hiatal hernia. Gastroesophageal reflux was present in 63.33%. 76% of the patients with hiatal hernia had gastroesophageal reflux, especially on those with small hernias and on the 5th and 6th decade of life. Gastric hiperacidity facilitates the incidence and presence of reflux. X-rays and endoscopy allowed us to diagnose diseases at the gastroesophageal junction. The correlation between these 2 methods and the presence or not of reflux, allowed differentiation between patients with organic diseases and patients with "functional" symptoms.


Radiological routine examination of the stomach and duodenum by means of double contrast method. The double contrast radiologic examination performed routinely allows us to improve the study of the mucosal relief, thus increasing the diagnosis of gastric ulcers, polyps and gastric cancer. In the operated stomach one can obtain better results with this technique than with the conventional examinations.


Serum immunoglobulins in patients with schistosomiasis mansoni. The authors evaluated immunglobulins IgA, IgC and IgM in two groups of schistosomiasis patients, 20 presenting the hepato-intestinal form (HI) and 20 the hepatosplenic form (HS). The results indicated abnormalities in the following proportions: IgA: HI = 55% HS = 45% IgC: HI = 85% HS = 95% IgM: HI = 75% HS = 85% The authors compare the values of each immunoglobulin in the two groups of patients and evaluate their results.


[South American blastomycosis. Diagnosis by colonoscopy]. Two cases of South American Blastomycosis are presented; the disease is not frequent in our country; the cases are a segmentary and difuse type primitive localized in the colon. In both of them the colonoscopy was a very important aid in the diagnosis.


[Salivary amylase in kwashiorkor. III. Investigative study of salivary concentration and secretion in 4 patients presenting complications during nutritional recovery]. In four kwashiorkor children with ages between 20 and 36 months, the salivary volume (ml), the amylase concentration (U/ml) and secretion (U/Kg/5 min.) was studied, since the first day in the hospital until the discharge. These children had same diseases during the nutritional recuperation. The control group had eighteen children of the same age and eutrophic. The salivary secretion during 5 minutes was taken by special technic and in the same moment in each day. In one patient with serious kwashiorkor the level of the salivary secretion was slow while the nutritional state was bad. The levels of the salivary amylase secretion and concentration was slow while the disease was present making difficult the nutritional recuperation in each patient.


[Articular manifestations of intestinal diseases]. The articular manifestations of the intestinal diseases can be quite variable affecting primarily either the pripheral joints, or sacroiliac areas and the spine. The presence of the haplotype HLA-B27 is associated in the majority of cases with the presence of spinal involvement. The treatment of the arthritis does not usually follow the natural history of the inflammatory bowel disease.


Familial tapetoretinal degeneration and epilepsy. Tapetoretinal degeneration is described in two siblings in association with generalized major motor seizures and intellectual impairment. Neither of these patients have the characteristic dysmorphic features or biochemical abnormalities seen in previously described cases, which are reviewed. Inheritance was probably autosomal recessive.


Histologic findings in motor neuron disease. Relation to clinically determined activity, duration, and severity of disease. Correlation of 18 histologic variables with age and sex of 24 patients with motor neuron disease (MND), and the duration, severity, and activity of their disease, showed that high density of atrophic fibers correlated with degree of muscle weakness and the worst prognosis and that type I grouping correlated with the best prognosis. Although both type I and type II fibers are involved in the majority of patients with MND, the data suggest that involvement of type I fibers is more important in relation to activity of the disease.


Chiasmal syndrome due to metastasis.

Chiasmal syndrome due to metastasis. We examined three patients with a chiasmal syndrome due to metastasis and were able to find only two additional cases in the literature. The characteristic presentation consisted of progressive impairment of vision without headache or abnormal plain skull x-ray films in patients with weight loss or diabetes insipidus. In three of the five patients, the primary malignant neoplasm was occult when symptoms and signs of chiasmal dysfunction were seen. Four patients responded well to irradiation. The chiasm may be compromised by suprasellar extension of pituitary metastasis, by infiltration from an infundicular or hypothalamic metastasis, or by hematogenous spread of tumor.


Familial periodic ataxia.

Familial periodic ataxia. Two members of a family suffer from recurrent attacks of either vertigo or cerebellar incoordination. The occurrence of these two distinct types of attack in the same patient may reconcile the disparate features of previously reported cases of familial periodic ataxia. The finding of downbeating nystagmus suggests a medullary disturbance. As in a previously reported family, the attacks were relieved by acetazolamide.


Eaton-Lambert syndrome in a 9-year-old girl. A girl with Eaton-Lambert syndrome had symptoms beginning at the age of 9 years. An extensive search for underlying neoplasm or definable autoimmune disease gave negative findings.


[Angiographic anatomy of the cecal artery]. After studying the angiographic anatomy of the cecal artery in 80 post--mortem examinations we have demonstrated the following: -The common cecal trunk (76,2% of the cases) had its origin from the right colic artery in 12 (15%) and from the ileal artery in 49 (61,2%) observations. -The anterior and posterior cecal arteries had a separate origin in 19 observations (23,7%). In 7 of these observations (8,7%) the anterior cecal artery had its origin from the right colic artery and, the posterior cecal artery originated directly from the ileal artery. In 11 observations (13,8%) both cecal arteries, originated directly from the ileal artery and, in one case (1,2%) the anterior cecal artery originated from the right colic artery and the posterior cecal artery from the ileocolic artery.


Micromyoclonic seizures of sleep.

Micromyoclonic seizures of sleep. A patient with primary generalized epilepsy had convulsive seizures refractory to anticonvulsant therapy. Several waking EEGs failed to show paroxysmal activity, but a sleep recording revealed polyspike EEG discharges associated with individual electromyographic discharges localized to the chin. The discharges occurred with a 90- to 100-minute period during the night. An increased frequency and duration of the EEG discharges on the last night of recording preceded a marked increase in the number of convulsions the following day.


Value of second lumbar puncture in confirming a diagnosis of aseptic meningitis. A prospective study. In patients with viral meningitis, polymorphonuclear leukocytes sometimes predominate in the CSF on initial examination. In a prospective analysis of this phenomenon, 16 consecutive patients with viral meningitis were followed up with serial CSF studies. The percentage of polymorphonuclear leukocytes showed a significant fall between initial and second examinations (41.75 +/- 27.0 to 8.6 +/- 8.78 [mean +/- 2 SD], P less than .001), while total WBC counts and the protein and sugar content levels remained unchanged. Based mainly upon this "polymorph shift," antibiotic therapy was correctly withheld from 100% of patients reexamined. On subsequent examinations, the percentage of polymorphonuclear cells remained low. All patients recovered completely without any specific treatment. In otherwise healthy subjects with the aseptic meningitis syndrome, antibiotic therapy can be withheld even when polymorphonuclear cells predominate on initial CSF examination. If suspicion arises regarding the diagnosis, another examination will demonstrate a significant fall in polymorphonuclear cells if the initial impression was correct.


Necrotizing myelopathy complicating Hodgkin's disease. A case of necrotizing myelopathy is presented as a complication of Hodgkin's disease. The distinctive pathologic feature of this case was severe acute vasculitis involving only the vessels of the spinal cord that was considered to have been the cause of the segmental necrosis.


Does gastrectomy predispose to amyotrophic lateral sclerosis? Some authors have suggested that amyotrophic lateral sclerosis (ALS) may be precipitated by a "deficiency factor" following gastrectomy. Methods to establish a statistical association of the disease with gastrectomy include a case-control study. Two such studies have been made in Japan, one involving 712 and the other 158 cases of the diseases. No statistically significant association between gastrectomy and the subsequent occurrence of ALS was found, indicating it is unlikely that the operation predisposes to ALS. None of many other factors studied except mechanical injury showed a statistically significant association in either study.


Electromyographic abnormalities following myelography. Electromyographic (EMG) abnormalities were found in 13 of 32 patients with previously normal studies following myelography. These abnormalities usually developed by the first day after myelography and resolved by the fourth day. The changes were evenly divided between those restricted to a single paraspinal muscle level, thus mimicking the frequent findings in radioculopathy, and those present bilaterally and at multiple levels. We were unable to correlate these EMG changes with the clinical status of the patient or with events occurring at myelography. Thus, the performance of EMG within four days following myelography can lead to false-positive results if paraspinal muscle EMG abnormalities are used as the diagnostic criteria.


'Agenesis' of the temporal lobe. A case report with autopsy findings. The temporal lobe agenesis syndrome is a rare congenital abnormality. In previous case reports, this syndrome has been described in association with arachnoid cysts or abnormal collections of CSF. An autopsy performed in the case of our 25-year-old patient revealed agenesis of frontal and temporal lobes without an anatomic cyst. During life the patient had no neurologic abnormalities that could be related to the lesion.


Presenile dementia with motor neuron disease in Japan. A new entity? A 61-year-old woman suffered the gradual onset of difficulty with memory, concentration, and cognition at age 58. Progressively more severe dementia was accompanied by muscle wasting and fasciculation prominent in hand and bulbar muscles. An electromyogram and a muscle biopsy specimen demonstrated denervation patterns, and a computerized tomographic scan showed considerable cerebral atrophy. This report reviews cases of presenile dementia with motor neuron disease reported in Japan and discusses the possibility of a new clinicopathologic entity.


Tear osmolarity and ocular surface disease in keratoconjunctivitis sicca. Tear osmolarity and Rose Bengal staining were studied in a group of patients with keratoconjunctivitis sicca (KCS) before and after treatment with isotonic and one-half isotonic saline to compare treatment with these two solutions and to ascertain whether tear film osmolarity could be correlated with ocular surface disease. When 20 KCS eyes were treated with isotonic saline drops every three hours for one week, the average (+/-SD) tear osmolarity decreased from 365 +/- 77 mOsm/L to 329 +/- 47 mOsm/L, and the average (+/-SD) Rose Bengal staining score decreased from 4.1 +/- 3.1 to 3.6 +/- 3.3. There was no objective difference between treatment with isotonic and one-half isotonic solutions, in a double-masked comparison, however, four of five patients with diagnostically significant Rose Bengal staining preferred the half isotonic solution. There was a significant positive correlation between tear film osmolarity and Rose Bengal staining.


Specular microscopy of traumatic posterior annular keratopathy. Specular microscopic studies in two patients with traumatic posterior annular keratopathy demonstrated that the endothelial rings consist of disrupted and swollen endothelial cells. The damaged cells were still evident many days after the rings had disappeared. The amount of endothelial cell loss depends on the severity of the injury, and a measurable decrease in cell density occurs only in the more severely injured patients. A physical explanation for the occurrence of these endothelial rings is discussed.


Germinating seed in anterior chamber. Report of an unusual case. A seed introduced into the eye of an 8-year-old boy through a penetrating corneal wound became embedded in the iris. Many months later it germinated. The germinating seed was successfully removed from the iris and anterior chamber with retention of excellent visual acuity. The seed was identified as a dicotyledonous seedling of the family Compositae.


Lacrimal function tests.

Lacrimal function tests. A comparative study of lacrimal function tests was undertaken. The primary Jones fluorescein test, the fluorescein dye disappearance (FDD) test, the Hornblass saccharin taste test and the Schirmer secretory test were tested for their reliability and effectiveness in 60 lacrimal systems with no known pathologic history or physical findings. Schirmer test values diminish with advancing age. The correlation between the FDD test, the Jones fluorescein test, and the saccharin taste test was low. The FDD test is an unsatisfactory test. The saccharin taste test time was shorter in patients with a positive Jones fluorescein test and longer in patients with a negative Jones fluorescein test. Forty-eight percent or 31/60 lacrimal systems had a negative Jones fluorescein test. This is higher than previously reported. The saccharin taste test was found to be the most practical and reliable of all lacrimal excretory function tests despite its subjectivity.


Congenital mucocele of the lacrimal sac. Two infants had congenital mucocele of the lacrimal sac. The diagnosis of this condition was aided by ultrasound. Congenital mucocele is one of the few indications for immediate lacrimal system probing in the neonatal period. Probing in both patients was successful.


Blepharophimosis, ptosis, epicanthus inversus, and primary amenorrhea. A dominant trait. The syndrome of blepharophimosis, ptosis, and epicanthus inversus is a rare but well-documented autosomal dominant disorder. Although autosomal dominant inheritance has been repeatedly confirmed, several observers have noted that transmission of the trait is predominantly through an affected male parent. To our knowledge, no published observations have accounted for this unusual differential transmission. Described here is a family with typical features of this disorder and in addition primary amenorrhea in the affected women. The primary amenorrhea, which has not been previously documented in this disorder, does account for differential transmission in this family and possibly in other families. Since affected individuals are treated by ophthalmologists, the possible occurrence of this extraocular manifestation should be recognized in the management of patients and their families.


Pigmentary dispersion and glaucoma. A new theory. A new theory states that mechanical rubbing between anterior packets of zonules and the peripheral iris in predisposed eyes is the cause of the loss of iris pigment in pigmentary glaucoma and in the pigmentary dispersion syndrome. The peripheral radial defects were in close approximation to anterior packets. The total number of iris defects in advanced cases correlated with the average number of anterior packets. Histologic study showed a groove in the stroma of the iris as well as loss of the pigmented neuroepithelium and was compatible with mechanical damage. The theory explains why the disease predominates in young myopic men, why it decreases in incidence with age, and why, in some cases, it regresses. Treatment with an alpha-adrenergic blocking agent may be advantageous in this condition.


Saccadic intrusions in strabismus.

Saccadic intrusions in strabismus. Fixational eye movements were studied to determine the presence of and to quantify saccadic intrusions under monocular and binocular viewing conditions in subjects with intermittent strabismus, amblyopia without stabismus, or constant strabismus amblyopia. Saccadic intrusions were present under most test conditions in intermittent strabismus, were rarely observed in amblyopia without strabismus, and were prominent during monocular fixation with the amblyopic eye in constant strabismus anblyopia. This suggests that the presence of saccadic intrusions was related to strabismus and not amblyopia. There was no relationship between saccadic intrusion amplitude and visual acuity. Two possible mechanisms for producing intrusions are abnormally rapid regional visual adaptation and strabismus-induced fixation degradation.


Balloon cell melanomas of the ciliary body. In spite of the fact that balloon cell change has been recognized ophthalmoscopically and histologically in certain posterior choroidal melanomas, the nature and importance of this observation remain controversial. This article provides a clinicopathologic correlation in two cases of ciliary body melanoma with almost total balloon cell transformation. On the basis of special stains and electron microscopic observations, we have concluded that balloon cells in such cases represent spindle melanoma cells that have undergoing extensive cytoplasmic lipid metamorphosis. The possible mechanisms for this change are considered. Melanomas containing an abundant number of balloon cells are probably comparatively dormant and benign tumors that offer a relatively good prognosis. Although clinical recognition may be difficult, the use of needle biopsy coupled with cytologic diagnosis in selected ciliary body tumors may disclose balloon cell change and help to direct therapy.


Intraocular penetration of miconazole in rabbits. Data from this in vivo albino rabbit study suggest that miconazole nitrate may penetrate the ocular compartments better than either natamycin or amphotericin B after intravenous, subconjunctival, or topical administration. The concentrations of miconazole in cornea and in aqueous humor after either topical or subconjunctival administration were very high, and a further threefold increase in the levels was seen if the corneal epithelium had been removed prior to drug therapy. Miconazole was found in the vitreous in some animals after subconjunctival injections of the drug. Intravenous administration produced high concentrations of miconazole in the aqueous humor, which rapidly fell over eight hours. No signs of toxicity or adverse reactions were found in these short-term experiments. Miconazole may be a useful addition in our methods of treating keratomycosis and oculomycosis.


Experimental vitreous fibroplasia following perforating ocular injuries. Biochemical data and histopathologic observations were made on an experimental model of vitreous fibroplasia in the rabbit eye, with comparisons between the change in vitreous collagen concentration and histologic characteristics 7, 14, and 30 days after injury. Prior to two weeks after injury there is a relatively small amount of new vitreous collagen formed, associated with an inflammatory and vascular reaction. At four weeks there is a marked increase in new vitreous collagen and dense fibrous sheets are noted. Vitreous hemorrhage accelerates collagen formation, and methylprednisolone sodium succinate does not decrease vitreous fibrosis. Our results suggest that the optimum time for vitrectomy, under the conditions of this experiment, is two weeks after primary repair. The efficacy of steroids in retarding vitreous fibroplasia is not supported.


Vitreous inhibition of tumor neovascularization. Cartilage has been reported to contain a factor that inhibits tumor neovascularization. Rabbit vitreous, another avascular tissue, has also been shown recently to have an inhibitory effect on tumor neovascularization. This report describes our results on the effects of bovine and human vitreous on tumor neovascularization with use of a rabbit cornea model. Inhibition of neovascularization was observed with both bovine and human vitreous in the form of reduced new blood vessel growth over and around the vitreous pellet and subsequent delayed exophytic tumor growth. Stimulation of neovascularization by bovine and human vitreous was also observed as an early, short-lived response.


Clinical specular microscopy. I. Optical principles. The clinical specular microscope yields a corneal endothelial image. Depending on the slit width of the illumination source, a typical endothelial photomicrograph contains three or four distinct zones. The appearance of the boundary between the endothelial cell pattern and the adjacent dark zone, called the dark boundary, reflects the configuration of the endothelial cell-aqueous humor interface and provides important information about the posterior corneal surface.


Clinical specular microscopy. II. Qualitative evaluation of corneal endothelial photomicrographs. The clinical specular microscope shows the morphological appearance of the endothelium in normal and abnormal corneas. This instrument resolves the endothelial mosaic of the normal cornea into a quasiregular pattern of contiguous cells having well-defined cell boundaries. Cell size varies over a wide range in a number of disorders, and endothelial cells may assume shapes that are substantially different from their usual hexagonal appearance. Cell boundaries are dark and most commonly appear as a straight, narrow line. However, other types of cell boundaries, collectively referred to as doubled boundaries, have been encountered. Cell boundaries normally intersect in a manner that results in three angles of intersection, each approximately 60 degrees, but variations from this pattern are seen. A number of noncellular structures also can be seen in the endothelial zone.


Auditory potentials of cochlear nerve and brain stem in multiple sclerosis. Auditory evoked potentials of the cochlear nerve and the brain stem were recorded in ten patients with multiple sclerosis (MS) and four patients thought to possibly have MS. A characteristic pattern materialized, with a prolonged N1-P4 conduction time and absent or small N2 and/or N5 waves. We discuss possible clinical implications.


Delineating the cleft in upper blepharoplasty. The subject of the esthetic qualities of the upper eyelid-eyebrow complex is discussed and how the cosmetic surgeon should diagnostically evaluate the problems occurring in this area. Emphasis is put on the other contributing factors that may contribute to blepharochalasis of the upper lid other than redundant skin limited to the upper lid space. A blepharoplasty technique with an incision at the supratarsal fold and evaluation of a skin muscle flap is discussed briefly.


Hearing aid selection. An analysis and point of view. Hearing aid selection and hearing aid evaluation are related, but separate, processes. Adequate selection must precede evaluation, which can only be applied to a few of the limitless amplification possibilities. I discuss the theoretical principles of aid selection and illustrate their application by reference to aid selection procedures developed in the National Acoustic Laboratories, Australia. Unless selection is arbitrary, a theoretical method is being used even if not recognized or applied consistently. It is argued that casual methods cannot be adequate and should be replaced by the adoption of theoretical procedures that are explicit, systematic, comprehensive, and subject to critical examination and refinement.


The retroconchal space of the lateral nasal wall. The retroconchal space is defined in this article as the posterior part of the lateral wall of the nasal fossa. Considerable variations in the size and shape of this retroconchal space exist, these in turn depending on the variations of the middle and inferior conchae. The retroconchal space can be defined in plain radiographs or in nasopharyngograms. This would be of help in pinpointing the site of a neoplasm.


Transmastoid decompression of the facial nerve in Bell's palsy. We describe the technique of decompression of the facial nerve from the geniculate ganglion to the stylomastoid foramen. The decompression was made on 51 patients with Bell's palsy, and the results of follow-up study were compared with those of 77 patients in whom the pyramidal and vertical segments were decompressed. The decompressions were indicated when a severe denervation of the nerve was confirmed by electrodiagnostic examinations. Incidences of notable residual palsy and of pronounced sequelae were always lower in the former group of patients regardless of the operational timing. In either group, a more desirable result was obtained by the decompression within 30 days, but a favorable effect of the decompression was recognizable even when the surgery was performed between 31 and 90 days after the onset.


Surgical management of drooling.

Surgical management of drooling. The presence of drooling is an indication of an upset in the coordinated mechanism of facial, tongue, and palate muscles. This upset is particularly common in children with cerebral palsy. After extensive investigation and the establishment of the relative significance of the drooling and the degree of cerebral palsy, positive treatment with physiotherapy is then commenced. Those patients whose conditions fail to improve adequately with positive physiotherapy can be helped by staging surgery. Surgery treatment is carried out as a planned procedure. The submandibular ducts are transposed. Submucosal dissection and redirection of salivary flow from the submandibular glands excludes the necessity for extirpation of the salivary glands.


Effect of urea on osmolality of perilymph. Blood osmolality was altered in chinchillas by intravenous administration of urea. Serum osmolality peaked rapidly at 30 minutes after administration and decreased slightly to a plateau for 180 minutes. Perilymph and CSF osmolality lagged substantially behind the increase in serum osmolality and equaled serum osmolality only after one hour. Perilymph osmolality followed changes in the serum up to 60 minutes with a definite time lag. This phenomenon suggests the existence of a selective blood-labyrinth barrier that is permeable to urea and water. However, the time lag due to the barrier may permit the reduction of hydrostatic pressure in the labyrinth. The results of the present study seem to render partial explanation of improved hearing in patients with Meniere's disease who were treated with urea.


Clinical evaluation of nasal obstruction. A study of 1,000 patients. Nasal airway resistance was evaluated in 1,000 patients who were seen at the Mayo Clinic between 1971 and 1977 for rhinologic complaints. Nasal obstruction was reported as the major symptom in 863 patients. Nasal airway resistance correlated well with the side and the severity of the obstructive symptoms. Symptoms of nasal obstruction typically occurred with a total nasal resistance greater than 3 cm H2O/L/s. Rhinoscopic evidence of nasal deformity could not be used to predict an increase in nasal resistance since many patients with rhinoscopically abnormal noses had "normal" nasal resistances. We conclude that the calculation of nasal airway resistance is a useful technique in the clinical evaluation of nasal obstruction. Nasal airway resistance data provide objective values that can substantiate and quantitate the symptoms of nasal obstruction.


Osteonecrosis of hyoid bone and thyroid cartilage. A 55-year-old man with carcinoma of the right pyriform fossa was treated with cobalt therapy. Subsequently, osteonecrosis of the right greater horn and the right superior horn of the thyroid cartilage developed, followed by pathologic fractures of the processes and spontaneous expulsion of the sequestrae.


Reversible compression neuropathy of the eighth cranial nerve from a large jugular foramen schwannoma. Jugular foramen schwannomas are unusual tumors occasionally resulting in neural hearing losses. Two previously reported cases document preservation of hearing following removal of a jugular foramen schwannoma. I report the third such case, in which there was progressive auditory and vestibular dysfunction seen on serial preoperative auditory tests and recovery of function seen on postoperative auditory and vestibular tests. The presumed pathophysiologic feature sub-serving this observation is compression neuropathy. I discuss experiences with compression neuropathy in animals and man under other circumstances.


An electron microscopic study on the lining mucosa of developing rat vocal cords. To explain the developmental process of epithelial cells of true vocal cords, larynges obtained from 42 fetal and 36 developing young rats were examined using scanning and transmission electron microscopies. Although the membranous portion was indistinguishable from the arytenoid portion in the prenatal stage, there was no squamous cell epithelium on the glottis. The lining epithelium of vocal cords in 15, 16, and 17 day fetal rats was composed of cuboidal and columnar cells which had a primary cilium. Immediately after birth the membranous portion of vocal cords became recognizable, and ciliated cells present on vocal cords retrogressed rapidly while nonciliated squamous cells grew and extended. Results of the present study show that epithelial cells of ciliated columnar type covering vocal cords change remarkably to nonciliated squamous cells between prenatal and postnatal stages.


Nerve supply to the inner sensory cells in a human cochlea. A choclear apical turn taken from a 66-year-old woman showed an area with marked decrease in number of the inner sensory cells. After observation by scanning electron microscope, the same specimen was thin-sectioned tangentially to the osseous spiral lamina. Numbers of myelinated nerve fibers were counted and the thickness of the fiber was measured by computed measuring equipment. Compared to the area with inner sensory cells intact, the area without inner sensory cells showed a 70% decrease in number of myelinated fibers. These degenerated fibers might have had intimate relationship with the inner sensory cells, probably being the afferent nerve supply to the inner sensory cells.


[On the interpretation of Békésy audiograms (author's transl)]. A group of 112 subjects with sensorineural hearing loss was checked by an audiological test battery consisting of: pure tone audiometry, SISI Test, tone decay test and fixed frequency Békésy audiometry. Classification of Békésy tracings by two audiologists showes good agreement when introducing a hybrid type I/II, which completes Jerger's classification system of types I--IV. The results of our investigation exhibit no significant differences of manual pure tone threshold and automatic tracing contrary to some other authors. Finally the correlation of diagnosis and type of Békésy audiogram is discussed.


DC potential and K+ activity in experimental endolymphatic hydrops. No alteration in K+ activity of endolymph and perilymph was seen during development of endolymphatic hydrops in guinea pigs. The DC-potential was not changed during enlargement of endolymphatic space.


Early auditory-evoked responses in the cat: rate effects. The brain-stem electric responses (BSER) of the cat have been evoked with a 4-kHz tone burst at three stimulus intensity levels, and at interstimulus intervals (ISI) varying fromm 500 to 20 ms. Response amplitude and latency have also been compared in different post-natal age groups, and in bilaterally hearing and unilaterally deaf animals. Increasing reptition rates produce greater latency changes in the youngest animals, whilst all age groups show amplitude decrement at shorter ISI, apart from wave III which increases in amplitude, particularly in bilaterally hearing cats at higher stimulus intensity levels. Wave I shows greater amplitude reduction than do the succeeding waves, which may indicate that the primary cochlear nuclei contribute to later waves of the BSER.


Two-tone masking and auditory critical bandwidths. Two-tone masking of 1,000-Hz signals was investigated in 5 normally-hearing listerners. The results indicate a consistent increase in critical bandwidth with level of the two masking tones (approximately 3%/dB). Irregularities in the individual two-tone masking functions led to further investigations with a single listener. For subcritical frequency separations between masking tones, -10 dB/decade masking slopes were demonstrated along with large dips or notches in the two-tone masking functions. Both the -10 dB/decade masking slopes and the large notches were replicated in detail when only the lower-frequency tones of the two-tone masking pairs were employed as maskers. Separate masking bands were then introduced that eliminated the -10 dB/decade masking slope and the large notch. It is concluded that the two-tone masking experiment is really a single-tone experiment, and that the detection of beats, roughness, and combination tones determines the form of single-tone and two-tone masking functions. If critical bnadwidth estimates are to be obtained from these experiments, it is most appropriate to refer to those estimates as "critical bandwidths for tonal interaction".


Two experiments on subtle mid-frequency hearing loss and its influence on word discrimination in noise-exposed listeners. The present study consisted of two experiments. Experiment I was directed toward the detection of subtle mid-frequency cochlear dysfunction and the determination of word discrimination in noise for persons with noise-induced hearing loss. The presence of significantly elevated aural-overload thresholds, consistent with the presence of cochlear pathology in regions of normal pure-tone sensitivity, confirmed previous findings obtained with this subject population by other investigators. In addition, a marked reduction in word discrimination was observed in the presence of a background of competing noise. For experiment II, normal hearers listened to consonant-nucleus-consonant monosyllables filtered to match the mean audiometric configuration of the noise-exposed subjects in experiment I. Results showed significantly better performance with these filtered words by the normally hearing subjects than that by the noise-exposed group for unfiltered materials. The results of the second experiment were interpreted as providing further support for the presence of subtle auditory dysfunction in the mid-frequencies despite normal threshold sensitivity in this same frequency region.


Age effect in hearing - a comparative analysis of published threshold data. Numerical data from the literature on presbyacusis, in the form of pure-tone hearing threshold levels as a function of age, are subjected to critical evaluation and analysis. A formula is derived for predicting the age effect for otologically screened groups of males and females. Further, the complete distribution of hearing levels for each audiometric frequency in the range 0.125-12 kHz and at any age can be estimated with the aid of tabulated coefficients and some simple rules. The study was undertaken in connection with the work of ISO on standardization of normative audiometric data.


Physical and subjective correlates of earmould occlusion. Physical and subjective aspects of earmould occlusion are examined and related. In particular, measurements made in an ear-like coupler for various venting arrangements are compared with those obtained subjectively by a loudness balance procedure. The results demonstrate the effectiveness of an open (completely non-occluding) earmould at low-frequency sound reduction but indicate some of the factors which make its individual effect difficult to predict. It is further seen the group of hearing-impaired persons was less able to make systematic judgements on sound quality than was the control group of normally hearing persons.


Enhancement of nitroblue tetrazolium dye reduction by leucocytes exposed to a factor released from sensitised lymphocytes. Leucocytes from purified protein derivative (PPD) skin test positive individuals, after exposure to PPD in vitro, show a significant increase in nitroblue tetrazolium (NBT) dye reduction when compared to leucocytes from PPD negative donors. The active principle was shown to be soluble, and was released from lymphocytes after a rapid, immunologically specific interaction with the sensitising antigen.


Production of tremorgenic toxins by Penicillium janthinellum Biourge: a possible aetiological factor in ryegrass staggers. Topsoil, herbage and faeces collected during an outbreak of ryegrass staggers in sheep were examined for tremorgenic penicillia. No such fungi were recovered from the plant material, but they were found among the predominant fungi in the soil and faecal samples. The commonest species of Penicillium, and almost the only tremorgenic species encountered, was Penicillium janthinellum Biourge. When fed to sheep, the mycelium of this fungus evoked a number of the clinical signs seen in field cases of ryegrass staggers. Two tremorgenic toxins were isolated from the mycelial felts and available evidence indicates that they are verruculogen and fumitremorgin A. P. janthinellum also produced these tremorgens when cultured in moist, autoclaved soil, but not in unheated soil. The results obtained from this study are in accord with the hypothesis that ryegrass staggers is caused by tremorgenic mycotoxins.


A method for the analysis of sigmoid stimulus-response curves. This paper describes a method, using an interactive computer programme, for fitting a curve to data which is expected to assume a sigmoid form. The programme is specifically designed to generate best estimates of the limits and maximum slope of stimulus-response curves for the carotid sinus baroreceptor reflex, but is applicable to curve-fitting tasks in other fields such as immunology, pharmacology, biochemistry and neurophysiology.


The binding of urate by plasma proteins. Protein binding of urate may have some pertinence to the pathogenesis of gout. However, binding studies have been hampered by problems with in vitro methodology and by the problem of relating the results of in vitro studies to the physiological situation. In the present study urate binding was determined by an ultrafiltration procedure. All manipulations were performed anaerobically and at 37 degrees in order to maintain the sample under physiological conditions. Normal urate bound was 15 +/- 7.5% in males and 10 +/- 6.6% in females. Urate binding did not correlate significantly with either the albumin or total urate concentration. It is suggested that the interaction between protein and urate is influenced by a number of factors other than the concentrations of free urate and binding protein. Some possible ones are discussed. The techniques described might usefully be applied to a study of urate binding in various pathological states.


A comparison of methods for measuring intestinal antibodies against Vibrio cholerae in mice. A re-evaluation was made of the efficiency with which some of the commonly used assays would detect intestinal antibodies. The data indicate that the most sensitive assays for the detection of intestinal antibodies are the baby mouse protection test and the radioimmunoassay. The reasons for the lack of sensitivity with other assay methods are discussed.


Intestinal antibody to Vibrio cholerae in immunised mice. The immune response of the mouse to priming and booster doses of V. cholerae was studied to establish whether serum antibody could be used as a correlate of local immunity. Serum antibody titres following oral boosting of orally-primed animals were shown to reflect the state of local intestinal immunity. This was not the case when the same oral booster dose was given to parenterally-primed animals. These results were discussed in relation to the human endemic situation. The highest titres of intestinal protective antibodies were found following combination of the oral and parenteral routes of immunisation. Various killed or extracted preparations of V. cholerae were used as oral vaccines to test their ability to induce protective antibodies in the gut. Only Boivin antigen was capable of inducing as good an intestinal antibody response as would the living organism.


Lymphocyte sensitization in sheep inoculated with extracts of spontaneously occurring malignant lymphomas. A macrophage migration inhibition test showed that the blood lymphocytes of 15 of 27 sheep inoculated in utero or at birth with disrupted cells from ovine malignant lymphomas responded in culture to antigens derived from three other lymphomas. A close association was seen between animals whose lymphocytes were antigen-sensitive and those which developed lymphocytosis. This association and the specificity of reaction between the various tumour antigens employed in the tests is interpreted as further evidence toward a viral aetiology in ovine malignant lymphoma.


Radioimmunoassay of secretin in serum.

Radioimmunoassay of secretin in serum. A radioimmunoassay for the measurement of immunoreactive secretin has been developed. The assay is specific and sensitive so that 2.8 fmol/ml can be measured. Basal secretin levels in man are generally undetectable and a protein-rich meal does not elicit a secretin response. However, the intraduodenal instillation of HCl leads to a prompt rise in circulating immunoreactive secretin and exogenous secretin administered intravenously is easily and accurately measured.


Presumptive 1/29 autosomal translocation in Australian cattle. A cytogenetical study was made of 9 descendants of a Charolais bull, heterozygous for a presumptive 1/29 translocation, three of the dams of some of these descendants, and three unrelated bulls which were mated to some of the descendants. Photographic karyotypes of Giemsa stained and C-banded chromosomes were prepared for each animal. The dams of the progeny showed no chromosomal abnormalities indicating that translocations were inherited from the sire. Three daughters of the Charolais bull and two of his grand daughters were heterozygous for the translocation, with a modal chromosomal number of 59, while the remaining three daughters and their progeny possessed normal karyotypes. No phenotypic abnormalities were observed in the animals examined. Measurements of the arms of the chromosomes suggested that the translocation chromosome (a large submetacentric) contained chromosomes 1 and 29. The submetacentric translocation chromosome had a single C-band, the two submetacentric X chromosomes showed no C-bands and each acrocentric autosome had a single C-band. All cattle heterozygous for the translocation showed normal fertility.


Distribution of Cysticercus bovis in lightly infected young cattle. Sixty-seven young cattle grazed on a sewage farm since birth were slaughtered and the carcases finely dissected in search of Cysticercus bovis. Forty-seven (70%) were infected, but only 49% of infected cattle had cysts in tissues considered to be sites of predilection and only 19.8% of all cysts found were located in these sites. Most of the remaining cysts were distributed randomly throughout the masculature.


Diagnosis of Johne's disease in cattle using mesenteric lymph node biopsy: accuracy in clinical suspects. Histopathological examination of biopsies of mesenteric lymph node obtained from the region of the terminal ileum proved to be a very accurate method of diagnosing Johne's disease in the living animal. Identical conclusions were reached in 100 clinical suspects following examination of either mesenteric lymph nodes alone, or a wider range of routine specimens including ileum, caecum, colon and ileocaecal lymph nodes. A method of obtaining biopsy specimens from mesenteric lymph nodes is described and is recommended when an early definitive diagnosis is required.


Bromosulphophthalein clearance rates in sheep with pyrrolizidine liver damage. Sheep fed a ration containing 50% of dried Heliotropium europaeum showed a marked decline in bromosulphophthalein (BSP) fractional clearance rate during the first 3 months feeding. Thereafter, the response of individual animals varied widely on a time basis, although 3 groups could be identified. In the terminal stages, mean clearance rates were below 20% of initial values, with some sheep showing a decline in excess of 90%. Loss of liver functional capacity was generally much greater than indicated by the degree of damage revealed by histopathology. Thus, a suitably modified test could have considerable prognostic value in the field. In this investigation, all sheep with clearance rates below 0.15 died when exposed to a further period of H. europaeum feeding.


Resistance to thiabendazole in a field population of Ostertagia circumcincta from sheep. A population of Ostertagia circumcincta from sheep has been found which, in field and laboratory trials, showed a lack of response to the recommended dose (44 mg/kg) of thiabendazole, suggesting that a degree of resistance exists to this anthelmintic. Preliminary experiments indicated a less than expected response to levamisole. This was not confirmed in a laboratory trial and therefore resistance to this anthelmintic has not been shown conclusively.


Efficacy of oxfendazole against inhibited Ostertagia ostertagi in naturally infected cattle. Oxfendazole was administered to pregnant cows at 2.5 and 5 mg/kg body weight to determine the anthelmintic efficacy against naturally acquired larvae which became inhibited at the early 4th stage. The experimental design included three groups of orally-treated cows, that is, 10 placebo treated control cows, 11 cows treated with 2.5 mg/kg of oxfendazole and 10 cows treated with 5.0 mg/kg of oxfendazole. Oxfendazole at 2.5 mg/kg body weight was 82 and 94% effective against EL-4 and adult O. ostertagi, respectively. At 5 mg/kg, Oxfendazole was 95 and 99% effective against EL-4 And adult O. ostertagi, respectively. The results suggested the use of a field dosage level of 5 mg/kg body weight oxfendazole where inhibited larvae may be encountered.


Effect of adding superphosphate to the drinking water on the fertility of dairy cows. Mean serum inorganic phosphorus concentrations of cows in an infertile dairy herd of 170 cows in the Hunter Valley increased from less than 4.5 mg/100 ml to greater than 5.8 mg/100 ml after defluorinated superphosphate was added to their drinking water at the rate of 2.5 kg/450 1 once weekly from September, 1976. The first service pregnancy rate increased from 36.5% to 63.2%, the mean calving to conception interval decreased from 109 days to 85 days and the number of cows culled each year for infertility fell from 15 to 5. The pasture fed to the milking cows contained on average greater than 17% crude protein, greater than or equal to 0.39% phosphorus, greater than or equal to 9 ppm copper and 38--46 ppm manganese according to the dominant species. The Ca/P ratio ranged from 2 to 5.5:1. Of these, only the Ca/P ratio and the manganese concentrations appeared to be abnormal.


Activity against Ostertagia ostertagi of low doses of oxfendazole continuously released from intraruminal capsules in cattle. Slow release from intraruminal capsules of 0.48 mg/kg oxfendazole per day for 5.5 days gave percentage efficiencies of 99 +/- 0.6, 86.6 +/- 6.3 and 93.1 +/- 4.5 for the removal of adult worms, developing 4th stages and inhibited larvae of Ostertagia ostertagi respectively. These efficiencies were not significantly different from those obtained from a single oral dose of 2.5 mg/kg. Peak plasma levels of oxfendazole were similar for the 2 types of administration but high levels were maintained longer in cattle given capsules.


Aircrew helmet protection against potential cerebral concussion in low-magnitude impacts. The response of the Gentex DH-151 (contact type) and Gentex 411 (suspension type) aircrew helmets to low-magnitude impacts, such as those sometimes encountered during cockpit buffeting, in ejection, and in parachute landings, was studied to augment the data base on helmet performance. The helmets, mounted on a Hodgson headform, were dropped on the crown and rear at impact velocities up to 4.97 m/s. Acceleration time histories were tape recorded and digitized and Gadd Severity Indices (GSI), among others, were calculated from the resultant acceleration curve. Both helmets kept the GSI below predicted concussion thresholds at 4.97 m/s and were considered to perform well on initial impacts. On second impacts, the GSI rose considerably because the shell and liner of the DH-151 cracked and the suspension of the "141" stretched during the first blow. Improvement of the multiple impact performance of both helmets appears desirable, although the suspension helmet performed slightly better than the contact helmet with respect to the criterion used.


Physiological effects of a military training program on male and female cadets. Tested at the beginning and the end of the 6-week training program which all incoming cadets (plebes) undergo upon entering the U.S. Military Academy were 29 males and 26 females (17-21 years old). The aerobic training consisted of running for 30 min 5-6 d/week at varied speeds depending upon performance in an initial 1.5-mile run test. Females responded to training with a significant increase (p is less than 0.001) in VO2 max from 46.0 +/- 1.0 to 49.7 +/- 0.8 ml/kg.min (7.9%). Males did not increase their initial VO2 max (59.4 +/- 1.1 ml/kg.min) significantly. Both groups significantly reduced HRmax and percent body fat. Their initial VO2 max values and activity history accounted for the lack of a significant increase in this highly-fit population of males. Blood lactates were significantly decreased (p is less than 0.05) at the same two submaximal workloads after training. The initial difference in aerobic power between males and females was reduced from 22% to 18%.


Doppler detection of thresholds for decompression-induced venous gas emboli in the awake rat. Awake, unrestrained rats with chronic implants of a Doppler probe on the vena cava, were saturated in a small plexiglass chamber at a maximum pressure (P1), rapidly decompressed to a predetermined pressure (P2) and then monitored for the presence of intravascular bubbles. If there were no indication of bubbles within 1 h, the decompression was considered bubble free. For each saturation pressure, an increasing pressure difference (deltaP = P1 - P2) was tried on each exposure until the threshold for bubble detection was found. The relationship deltaP = a P1 + b, where a and b are constants defining the threshold for bubble detection, was experimentally determined at pressures from 3-10 ATA. The depth-dependent linear relationship deltaP = 0.38P, + 1.29 (r = 0.97, P is less than 0.001) was found for first exposures and deltaP = 0.62 P1 + 0.16 (r = 0.99, p is less than 0.001) for repeat exposures. The chronic Doppler preparation allows a more sensitive threshold determination than past methods for small animals and also allows repeat pressure exposures without the effects of a severe decompression stress.


Psychiatric aspects of adaptation to long submarine missions. The case histories of 261 submarines disqualified psychiatrically for further submarine duty revealed that the major symptomatology was emotional in nature, with character pathology second in frequency. The latter pathology resulted in disqualification much earlier than the former, a fact indicative of effective neurotic defenses. The submariners who show these slow-developing neurotic symptoms appear to be reacting maladaptively to the stresses of the 60-d submarine patrols. Some etiological factors appear to be related to the role of man occupies within the crew, to the nature of the mission itself and, perhaps, to the length of the submarine patrols.


Effect of diet on dichlorovinyl dimethyl phosphate toxicity in rats. Young male albino rats (120+/-5 g) were kept for 30 d on the following synthetic diets--High Protein Diet (HPD): 59% casein; Low Protein Diet (LPD): 5% casein; High Fat Diet (HFD): 51% fat; and Standard Diet (SD); 19% casein, 11% fat, and 60% sucrose. Composition of diet per se did not significantly affect plasma and RBC cholinesterase (ChE) activity, Mortality of animals on different diets, due to administration of DDVP (Vapona, dichlorovos) 50 mg/kg i.p. was: SD: 37%; HPD: 26.5%, LPD: 53%; and HFD: 44%. Plasma ChE inhibition after 24 h of DDVP administration (in surviving animals) was SD: 42%; HPD: 52%; LPD: 55%; and HFD: 47%. Erythrocyte ChE inhibition was 40% in SD, HPD, and HFD and 60% in the LPD rats. Five days following DDVP administration, plasma ChE was normal and erythrocyte ChE was still significantly increased and erythrocyte ChE was normal.


Effect of induced cyclic changes of deep body temperature on task performances. Performance of three tests was studied during induced cycles of deep body temperature between limits of 37.8 degrees C and 38.9 degrees C. During heating phases skin temperature was 38.8 degrees C and during cooling it was 36.1 degrees C. A verbal transformation test, performed at the midpoint of each temperature cycle, showed no significant effect from the large differences in skin temperature and subjective comfort between heating and cooling. The test was considered to be insufficiently difficult. A pursuit rotor test and a colour/word interference test, performed at the end of the heating and cooling phases, showed mean decrements in performance of 15% and 4%, respectively. These results are related to the measured levels of deep body and skin temperature and to subjective assessments of comfort.


Regional heat loss in resting man during immersion in 25.2 degrees C water. Five male subjects having a wide range of relative body fat, 9.2-20.2%, were studied during total body immersion in water at 25.2 degrees C. The regional surface area of each subject was calculated from anthropometric data utilizing a segmental geometric model. Skin temperatures (Tsk) and regional skin heat loss were measured prior to and during 30 min immersion at 13 sites. During immersion, mean Tsk was 25.9 degrees C and remained significantly higher than the water temperature. A measurable temperature gradient for heat flow was observed from all body segments. Segimental temperature in water ranged from 26.7-25.4 degrees C, being warmest at the neck and coolest at the foot. Heat the flow per regional area was highest in the neck, 187 W/m2, and least at the foot, 12 W/m2. Heat flow from each body region was dependent on regional Tsk. Skinfold thickness was a minor factor in altering regional heat flow in the foot, hand, lower arm, upper arm, thigh, and calf; in the torso, neck, and head regions it was of major importance in detering heat loss.


Human tilt perception in a dynamic environment. This study examines the perception of tilt and linear acceleration as sensed through the utricular otolith of the vestibular system. Any sensation derived from the otolith is a consequence of the displacement of the otolith parallel to its own plane. This leads, naturally, to the definition of a sensation plane. A model is presented which defines this sensation plane. It assumes that the sacular otolith contribution is negligible, an assumption substantiated by correlation with experimental data by Schöne. Applying this model to perceived pitch angle, a simple equation is presented which relates the number of Gs and actual pitch angle to the perceived pitch angle. Experimental data are needed to develop perceived sensation curves for the sensation plane. The model implies that a state of confusion exists outside the realm of our prior experiences. Disorientation or motion sickness may be related to this confused state. In addition, new avenues of inquiry are introduced.


Thermal strain resulting from protective clothing of an armored vehicle crew in warm conditions. The purpose of the study is to define a method of evaluation of physiological strain resulting from protective garments worn in warm conditions by the armored vehicle crew. A technique is developed evaluating evaporative transfer through clothing by continuous weighing of the active man (accuracy +/- 3/g). An index is defined (Iw) as the ratio of steady-state evaporating rate in clothed conditions to steady-state evaporation of nude subject in the same conditions of work and heat stress. The Iw index is significantly related to physiological strain determined by increased body heat content and reduced tolerance time. The results are compared to other previous findings concerning evaporative transfer through clothing and physiological strain indexes. The technique shows that evaporation through heavy clothing is not negligible. It is suggested that usual static measurements using physical models underestimate the evaporative heat transfer through clothing layers.


Physiologic and performance measurements in simulated airborne combined stress environments. The Naval Air Development Center's Human Centrifuge was used to assess the effects of repeated exposures to a simulated Air Combat Maneuvering (ACM) environment on various measures of physiological function and psychomotor performance. The environment consisted of a realistic ACM profile that included associated noise, high speed/stall buffet conditions, and increased intra-cockpit temperatures. The effects of varying the subject's seatback angle, as a function of the environment, was also measured. Analysis of the various physiological and performance data revealed the following: 1) heart rate was negatively correlated with tracking accuracy under the combined stress conditions of this study, 2) test conditions that included acceleration and buffet resulted in a significant decrement in tracking accuracy, 3) the addition of increased intra-cocpit temperatures, when combined with acceleration and/or buffet, produced a significant decrease in tracking accuracy, 4) increasing the seatback angle from the vertical partially ameliorated the effects of the other stressors. Details of these findings, as well as results of various biochemical analyses, are discussed.


Investigation of a simple, retrospective test for in-flight hyperventilation. The experiment was designed to study the feasibility of using a single rebreathing estimate of mixed venous carbon dioxide tension (PvCO2) was a simple field test for hyperventilation in pilots. The results confirmed that the fall of end tidal carbon dioxide tension (P(ET)CO2) during hyperventilation and rise during recovery was exponential. The results also showed that the relationships between PvCO2 and P(ET)CO2 values during the unsteady states of carbon dioxide washout and accumulation may be described as a loop which encloses the theoretically derived line for the steady-state relationships. The deviation from the steady-state line appears on theoretical consideration to be directly proportional to carbon dioxide elimination rate, and indirectly proportional to cardiac output. Because of the exponential recovery, and because one value of PvCO2 could correspond to a range of values of P(ET)CO2, it is concluded that a field test for hyperventilation based on a single rebreathing estimate of PvCO2 would not be of value. The finding of a low value of PvCO2 would, however, be an indication that hyperventilation had taken place.


Motion sickness in cats: a symptom rating scale used in laboratory and flight tests. The cat is proposed as a model for the study of motion and space sickness. Development of a scale for rating the motion sickness severity in the cat is described. The scale is used to evaluate an antimotion sickness drug, d-amphetamine plus scopolamine, and to determine whether it is possible to predict sickness susceptibility during parabolic flight, including zero-G maneuvers, from scores obtained during ground based trials.


Psychiatric education in aerospace medicine. In order to facilitate curriculum design for psychiatric education in aerospace medicine, three groups of physicians were surveyed: experienced flight surgeons, student flight surgeons, and psychiatrists trained in aerospace medicine. Two measures were obtained: 1) an assessment of the usefulness of particular psychiatric skills and knowledge in the practice of aerospace medicine, and 2) a rating of the clinician's abilities in these areas. Results support the primary importance of interviewing and diagnostic skills. Student flight surgeons show deficiencies in the areas of administrative knowledge and in knowledge of the impact of the flyer's environment upon his mental status. These findings link psychiatry in aerospace medicine with the emphasis on understanding the man/environment interface and on the flight surgeon's organizational function of boundary control through decisions on fitness to fly.


Frequency analysis of heart rate variability under flight conditions. The factors causing heart rate variability (HRV) were investigated under various kinds of workloads and flight conditions. Frequency analysis of heart rate, and cross-correlation analysis with blood pressure and respiration, were performed by using the fast Fourier analyser. Consequently, the main frequency of HRV at rest consisted of 0.1 Hz and 0.25-0.3 Hz. These fluctuations disappeared under physical loads, but the value of 0.1 Hz at first increased under moderate mental load and thereafter decreased as the mental load increased. It was suggested that the behavior of the frequency 0.1 Hz under mental load was influenced partly by higher brain centers. For the actual flight, the frequency decreased under takeoff and landing, and remained as at rest during the gunnery and acrobatic training flight. It was concluded that the evaluation of workloads under flight conditions by using the analysis of the factors of HRV was very useful to improve a man-machine interface.


Concurrent loss of consciousness and sino-atrial block during +Gz stress. Current USAF fighter aircraft easily exceed human physiologic limits with their rapid onset of head-to-foot acceleration forces (+Gz). Sudden in-flight incapacitation caused by these increased +Gz forces could be disastrous with loss of materiel and human life. The physiologic mechanisms responsible for loss of consciousness (LOC) secondary to high +Gz must be fully understood so that maximum protection against it can be provided. An interesting case of an episode of LOC with concurrent sino-atrial block occurring during a relaxed rapid onset (1 G/s) centrifuge run is presented. The patient was undergoing flight medical evaluation for an episode of syncope, etiology unknown. An unusual characteristic of the patient was his high level of endurance training. The possibility of an excessive increase in vagal tone, developed by endurance training, is discussed as a probable etiology for this patient's prolonged time of incapacitation evidenced after +Gz-induced loss of consciousness.


Fighter index of thermal stress (FITS): guidance for hot-weather aircraft operations. Operation of fighter and trainer aircraft at low altitude in hot weather often involves significant heat stress on aircrews. Guidance for control of this stress and its adverse consequences has not heretofore been available. The Fighter Index of Thermal Stress (FITS) was derived from the Wet Bulb Globe Temperature (WBGT) using recent in-flight data on cockpit environments and assuming a fixed contribution from solar heating. The FITS table is entered with ground dry bulb temperature and dewpoint temperature, and yields an estimate of cockpit thermal stress. Caution and Danger Zones are designated on the table, based upon typical aircrew clothing, metabolic rate, and physiological status. Appropriate protective measures are recommended, including awareness of heat stress, limitations on ground operations, allowance of adequate recovery intervals, provision for fluid intake, and cancellation of flights under severe conditions. Possible applications of FITS are discussed together with its potential impact on flight operations at 30 USAF bases.


[An indirect proof of stretch-induced Ca++ release from the sarcoplasmic reticulum in glycerinated skeletal and heart muscle preparations (author's transl)]. The existence of still functioning vesicles of the sarcoplasmic reticulum (SR) in glycerinated rabbit psoas muscle fibers and cat myocardium is demonstrated by the use of activation (force development and shortening) of the contractile system as an indicator for "sarcoplasmic", free Ca++ concentration and by electron microscopic studies. Furthermore, the conditions for Ca++ release and uptake by the SR vesicles were analyzed. (1) As indicated by electron microscopic studies, glycerinated skeletal and heart muscle preparations contain SR vesicles (diameter 0.1--0.2 mu). Detergent treatment as used by Julian (1971) causes neither morphological change in the contractile system nor in the SR vesicles. (2) The delay in tension development of glycerinated preparations after an increase in free Ca++ concentration of the bathing medium is demonstrated to be caused at least partly by Ca++ uptake in these SR vesicles. (3) The SR vesicles of glycerinated preparations are able to accumulate Ca++ just at concentrations which are subthreshold for tension development. The accumulated Ca++ can be detected by a transient force development resulting from abolishment of the Ca++ storage capacity of the SR vesicles caused by high concentrations of detergents. (4) Ca++-induced Ca++ release is also demonstrated in glycerinated preparations. After Ca++ loading this release mechanism occurs at Ca++ concentrations in the bathing medium starting at about 10(-7,48) Mol/l both in skeletal and heart muscle preparations. (5) Quick stretch of Ca++-loaded, relaxed preparations caused local contractions of the myofibrils in both single fibers and fiber bundles of glycerinated rabbit psoas muscle. Skeletal fiber bundles and cat myocardium show a transient tension development parallel to these local contractions. These effects are demonstrated to be due to a stretch-induced Ca++ release from the SR vesicles. (6) Length-controlled quick stretches or quick releases of partly activated preparations cause sinusoidal tension oscillations superimposed on the well-known, delayed active tension development. In contrast, fully activated preparations do not show superimposed oscillations in tension. Force-controlled quick stretches or quick releases induce equivalent oscillations in length which are more distinct than the tension oscillations, however. These oscillations are also demonstrated to be due to stretch or release-induced changes in the Ca++ fluxes between SR vesicles and the "sarcoplasm". (7) This stretch induced release of Ca++ from the SR could be one reason for the multiple-phase course of active and passive isometric tension development in vivo following quick changes in length, and could also partly explain the prestretch dependence of tension development which cannot be explained from the degree of overlapping of the contractile filaments alone...


Effects of adaptation to high altitude hypoxia on the contractile function and adrenoreactivity of the heart. Effects of adaptation to mountain altitude of 3200 m on the contractile function and adrenoreactivity of the heart in rats have been investigated. It was shown that adaptation to altitude increased the contractile force and contraction and relaxation velocities of the left ventricle as compared to the controls. Simultaneously, a significant increase in cardiac response to noradrenaline developed in the course of adaptation. The increased response was accompanied by its more rapid disappearance. These changes may be explained by the increase in the activity of myocardial adenylate cyclase and phosphodiesterase. It was also shown that the decrease in cardiac function produced by cardiac denervation was less pronounced in adapted rats. This fact may be explained by increased effectiveness of cardiac autoregulatory mechanism. The comparison of these results with the data of other investigators suggests that in well adapted animals the strength of interaction between the levels of the regulatory hierarchy of the whole organism changes, i.e., the capacity of autoregulatory cell mechanisms and their reactivity to neurohumoral stimuli increase. As a result, control of the organism's reactions by higher levels of the regulatory system is more economical in adapted animals.


Experimental occlusion of two small coronary arteries in the same heart. A new validation method for infarct size manipulation. A method for the evaluation of interventions aimed at manipulation of infarct size is described. This method has 2 advantages over other methods: 1. Two small-to-medium sized coronary branches of the same heart are occluded and reperfused in sequence. Thereby a "control-infarct" can be compared with a "test-infarct", both within the same heart. 2. The amount of infarcted tissue in both areas is quantitated by using the p-NBT method. A condition of the method is that the areas of perfusion of both arteries are equal. Infarct size is always expressed as a percentage of the perfusion area of the occluded artery. Validation experiments with simultaneous occlusion and reperfusion of both arteries resulted in infarcts of equal size. Validation experiments with regard to the p-NBT method showed that reperfusion accelerates the washout of dehydrogenases from infarcted tissue which allows early and precise diagnosis of infarcts after relatively short occlusion- and reperfusion periods.


Myofibroblasts in subepicardium after local cold injury. Rat hearts were exposed and injured locally by direct cryoapplication. The hearts were examined 2, 4, 20 and 48 hours, 7 and 12 days later. In the first 48 hours mast cell and polymorphonuclear (mainly eosinophilic) granulocyte infiltration was followed by proliferation of mononuclear phagocytic and fibroblastic cells and new capillaries. The underlying muscle showed freeze-thaw-rigor damage, segmental intramyofiber necrosis, phagocytosis and focal regeneration. After 7 days numerous myofibroblasts appeared and they were intimately related to myofibers undergoing degeneration and repair. After 12 days there was increased fibrosis while mesothelial covering cells of the epicardium and myofibers returned to normal. It is suggested that amines released from mast cells are involved in the formation of myofibroblasts.


Experimental validation of methods for the measurement of coronary sinus blood flow in man. The measurement accuracy of clinically applicable methods for blood flow measurement in coronary sinus -- continuous local thermodilution (LTD), differential pressure (DP), ultrasonic Doppler (US) and the electromagnetic flow measurement method (EMF) -- was examined in 15 anaesthetized closed chest dogs with left ventricle weights between 150 and 200 g. The LTD, DP, US and the EMF were examined in each experiment in the two following arrangements. 1. In coronary sinus -- left jugular vein by-pass: This arrangement allowed four reference methods for measurement of coronary sinus blood flow (CBF). 2. In "clinical" position, without by-pass, which allowed two reference methods for CBF measurements. The results on the measurement accuracy of the LTD, DP and US are, depending on the measurement arrangement, contradictory. In the by-pass arrangement 1 there was observed a good agreement of the LTD, DP and US CBF values with the reference values. In the "clinical" position, without by-pass 2 the measurement accuracy of LTD was not sufficient for exact measurement of CBF and derived parameters. The examined velocity tip flow probes (US, DP) gave no correlation with the reference methods. US and DP are even for semiquantitative estimation of CBF unsuitable. The EMF tip flow probe was for the CBF measurement unsuitable, because of disturbance by the electrical activity of myocardium.


Coronary reactive hyperaemia and coronary dilator action of adenosine during intracoronary infusion of angiotensin II. Investigations were carried out in chloralose-anesthetized, thoracotomized dogs. The effects of an intracoronary infusion of angiotensin II (3 ng/ml coronary blood) on reactive hyperaemic blood flow and adenosine-induced coronary vasodilation were established. Coronary artery occlusions were performed over periods of 5, 10 and 25 heart beats and adenosine was injected intracoronarily at dosages of 2, 4, and 8 microgram/kg body weight. The vasodilator effect of adenosine and reactive hyperaemia after 10 and 25 heart beats were both significantly diminished by angiotensin II. By contrast, reactive hyperaemia after coronary artery occlusion lasting 5 heart beats remained unchanged. The present results obtained with angiotensin II further confirm that adenosine is only partially involved in mediating reactive hyperaemia and that this involvement takes place only after sufficiently long periods of coronary artery occlusion.


Vagal control of coronary blood flow in dogs. The experiments were performed on open-chest mongrel dogs, the hearts being paced at a constant rate. Both vagi were cut in the neck and the peripheral ends were stimulated with frequencies of 1, 5, 10, 15, 20, 25, 30, 35, 40 and 50 cycles per sec (30 sec, 8 V, 2 msec). Adrenergic beta-receptors were blocked with propranolol and adrenergic alpha-receptors with dihydroergotamine. Coronary flow was measured with electromagnetic flowmeters on the descending branch of the left coronary artery. A significant increase in coronary flow was observed with rising frequency of stimulation. This increase was 15 percent with 30 Hz and decreased with higher frequencies. The total coronary resistance reached its lowest level at the frequency of 30 cycles per sec. The results clearly indicate the parasympathetic control of myocardial blood flow.


Long term effects of the anorectic agent fenfluramine alone and in combination with aminorex on pulmonary and systemic circulation in the pig. We have investigated the effects of chronic oral administration of two anorectic substances, fenfluramine and aminorex, especially on the pulmonary circulation in young pigs with one ligated pulmonary artery. The pulmonary vascular reactivity was tested by alveolar hypoxia, alveolar hyperoxia and infusion of prostaglandin F2ALPHA. No elevation of pulmonary arterial pressures or resistances were found due to the intake of fenfluramine or aminorex over a three month period. The responses to the vasoconstrictor stimuli, hypoxia and prostaglandin F2alpha, and to the vasodilator stimulus, hyperoxia, were equal and not augmented in the drug groups. Fenfluramine or aminorex could therefore could therefore not be shown to have an adverse effect on the pulmonary circulation or on the reactivity of the pulmonary vascular bed in the pig, but fenfluramine elevated systemic arterial pressure.


[The adaptation of AV-nodal conduction time on gliding increase and decrease of atrial frequency before and after autonomic blockade (author's transl)]. In 19 patients with healthy AV-nodes the adaptation of the intranodal conduction time (A-H time) to gliding increase and decrease in atrial frequency and to the blockade of the autonomic nervous system was investigated using His bundle electrograms. The measurements were performed during right atrial stimulation with three frequencies, each with a duration of one minute, before and after blockade of the parasympathetic (8 pat.; 1 mg atropine i.v.) and the sympathetic (11 pat.; 0.4 mg Visken i.v.) nervous system. Gliding increase and decrease in atrial frequency results in a staircase pattern of A-H-adaptation in 18 of the patients. The height of the steps was identical in both phases of stimulation in each individual patient. One patient showed functional dissociation of intranodal conduction which was different during increase and decrease of atrial frequency. With parasympathetic blockade the staircase behavior of the A-H time basically remained unchanged with the exception of shorter A-H intervals resulting in lower steps. Atropine abolished the functional dissociation of intranodal conduction; thus the drug might prevent reentrytachycardias due to functional dissociation in the AV-node. Sympathetic blockade lengthens the intranodal conduction time; thus shifting the staircase pattern of the A-H time to higher levels. The results are discussed with respect to the electrophysiological characteristics of AV nodal cells as slow response fibers, and to the changes caused by atrial stimulation, acetylcholine and adrenaline.