[Experimental study of vibrio parahaemolyticus (biotype 2) transfer from water and sediments to benthic marine food chain organisms]. Transfer of Vibrio parahaemolyticus (biotype 2) from sediments to water and from water to benthic marine organisms was studied experimentally using a streptomycin-resistant strain. Transmission by trophic pathways was also studied using reconstituted marine food chains (Mytilus edulis, Nereis diversicolor, Carcinus maenas, Scorpaena porcus, Mus musculus). Water colonization by sediments could be observed only at temperatures above 16 degrees C. Sediments could well constitute a disseminating reservoir for these germs, their cycle in water being dependent of the cycle followed in the sediments. Contamination of animal organisms is essentially effected by a direct mean, either water or sediments; transfer by trophic pathways being negligible. Infection of land consumers (mice) is linked quantitatively to the nature of the last marine organism of the food chain since bacteria can flourish in the digestive tract of certain animals (Carcinus maenas).


Trypsin-uncoupled synthesis and secretion of yeast invertase: implications for the mechanism of secretion. The subcellular distribution of invertase was examined after synthesis and secretion by sphaeroplasts had been uncoupled by the addition of 30 microgram mL-1 trypsin. Sphaeroplasts secreted only the high molecular weight invertase during uncoupling by trypsin. The level of low molecular weight, 'small' invertase in the soluble internal pool was found to be elevated by over fivefold, and the membrane-associated pool was found to contain low molecular weight invertase in addition to intermediate molecular weight invertase, after 1.5 h of trypsin treatment. Purified plasma membranes from trypsin-treated sphaeroplasts had no detectable mannan synthetase activity. On the basis of these and previous findings, a working hypothesis wherein invertase is synthesized on the internal surface of the plasma membrane and glycosylated during its transit to the external surface is presented.


Aquarium pets as a source of antibiotic-resistant salmonellae. Thirteen serotypes of Salmonella isolated from imported ornamental aquarium frogs, snails, and their waters were shown to be multi-drug-resistant. Among the resistances exhibited were resistance to gentamicin, sulfamethoxazole-trimethoprim, cephalothin, and nalidixic acid. Frog isolates displayed eight different patterns and snails isolates had two different resistance patterns. The most common serotype, Salmonella typhimurium, was resistant to 18 antibacterials while other salmonellae were resistant to 9 to 16 antibacterials. Resistances in S. typhimurium and S. bovis-morbificans were conjugative and a number of R plasmids participated in the resistance. The plasmid-mediated resistance in S. typhimurium was stable and the levels of resistance conferred were markedly higher than in the other salmonellae tested. Resistance of other serotypes was non-conjugative and resistance to the beta-lactam antibiotics was unstable.


Evidence for chemotaxis during sexual development in Dictyostelium discoideum. Amoebae in mated cultures of Dictyostelium discoideum show oriented movement towards young aggregates, suggesting that cemotaxis is involved in macrocyst development. Amoebae also show directional movement towards midendocyte stages, indicating that as the macrocyst develops it continues to be a source of chemoattractant. These data are discussed in terms of our current knowledge about mating in the cellular slime moulds.


The effects of partial chronic denervation on forearm metabolism. Effects of chronic denervation upon in vivo forearm metabolism were studied in six patients and six controls. The diagnosis was amyotrophic lateral sclerosis in four patients, the neuronal form of Charcot-Marie Tooth disease in one patient, and an unclassified chronic disease of the lower motor neurons in one patient. In all cases the forearm muscles showed clinical weakness and electrical evidence of denervation, while muscle biopsy from a proximal muscle of the upper limb showed typical denervation atrophy. At rest there was increased oxygen utilization and lactate output as well as a tendency for increased uptake of glucose and long chain fatty acids from arterial blood per 100 ml of forearm tissue. During exercise the abnormally high lactate output increased further. An increased arterial lactate concentration was present during rest and exercise. Oxidation of fatty acids was not impaired. It is suggested that these abnormalities are consistent with an augmented utilization of blood borne fuels at rest by denervated muscles. A concurrent regional ischemia of muscles during rest and exercise, possibly due to defective autoregulation of skeletal muscle blood flow, may explain the abnormally high lactate generation.


Cerebellar form of progressive multifocal leukoencephalopathy (PML). A case of progressive multifocal leukoencephalopathy (PML) with selective involvement of cerebellum and brain stem is compared with nine other published cases. Recognition of PML presenting with ataxia before cerebral manifestations is stressed especially, since promising results with some antiviral drugs have been claimed.


[Criteria of the diagnosis and treatment of carotid atheromatosis]. This retrospective study concerning 102 patients was undertaken to study the therapeutic decisions in these patients when they presented with symptoms of cerebral vascular insufficiency, mostly from the territory of the carotid artery, either transient or accompanied by a deficit. The current literature on the subject is also mentioned. The clinical outcome with regard to the quality of life, seems to have been better in patients who were subjected to carotid endarterectomies than in those who received medical treatment.


Melanin containing neurofibroma: case report with evidence of Schwann cell origin of melanin. This case report describes a melanin-containing neurofibroma involving a spinal nerve root. Electron microscopy of the tumor shows that neoplastic Schwann cells are capable of melanogenesis. Although this capability is suggested in the literature, few reports provide ultrastructural confirmation. The likely identity between reported "cellular blue nevi of spinal nerve roots" and nerve sheath tumors is discussed. It is possible that pigmented nerve sheath tumors behave more aggressively than nonpigmented ones, although it is debatable.


Cardiovascular evaluation of obligate heterozygotes in Friedreich's ataxia. A study of 17 parents (obligate heterozygotes) of children with Friedreich's ataxia was carried out. In addition to medical histories and physical examinations, a standard 12 lead ECG tracing was obtained. In the age group below 50, there was no significant evidence of ischaemic or primary cardiomyopathy. Older subjects had more frequent risk factors for arteriosclerotic heart disease.


Evolution of cardio-pulmonary involvement in Friedreich's ataxia. The evolution of 15 patients initially evaluated during Phase One of the Quebec Cooperative Study of Friedreich's ataxia has been studied approximately three years later. It is concluded that the deterioration of cardio-pulmonary function in Friedreich's ataxia is multifactorial. The neuromyopathy (or the underlying metabolic or cellular defect) appears to be the main contributing factor to the deterioration of cardio-pulmonary function, which is exacerbated by the scoliosis and varying severity of the cardiomyopathy.


Regulation of respiration in Friedreich's ataxia. Friedreich's Ataxia (F.A.) is a degenerative disease which commonly leads to premature death of cardiorespiratory origin. To explain the early death of these patients, previous investigations have established the existence of 1) a cardiomyopathy in nearly 100% of cases, 2) a restrictive pulmonary syndrome of scoliotic origin and 3) a mild hypoxemia associated with slight respiratory alkalosis and a normal oxyhemoglobin dissociation curve. To further assess the cause of early death in patients with such neuromyopathy, we evaluated, in eleven F.A. patients, the sensitivity of the respiratory centers to hypercapnia, hypoxia, and hyperoxia. Ventilatory (VE, VT, F, VT/Ti) and occlusion pressure (P0.1) responses were taken as indices of the respiratory centers output during progressive hypercapnia (Read's method) and isocarbic hypoxia (Weil's method). We studied 11 Friedreich's Ataxia patients and 11 age, sex, and armspan matched controls. The responses of patients to hypercapnia were significantly greater than controls but their responses to hypoxia were similar to controls. Our study establishes that the respiratory centers are functioning adequately in early Friedreich's Ataxia and do not contribute to cardio-respiratory insufficiency in such neuromyopathy.


Oculomotor abnormalities in Friedreich's ataxia. A clinical neuro-ophthalmological and electro-oculographic study was made on fourteen patients with Friedreich's ataxia. None had evidence of optic nerve dysfunction. No patient complained of oscillopsia although all had ocular motor deficits of varying degrees, which appeared to be related to the severity of the general manifestations of the disease. The defects comprised square wave jerks, jerky pursuit with inability to maintain eccentric gaze resulting in gaze paretic nystagmus and rebound nystagmus. There was failure to suppress by fixation the vestibulo-ocular reflex. The slow phase velocity of caloric nystagmus was always of reduced velocity. There was inability to augment the slow phase velocity of optokinetic nystagmus with increasing stimulus velocity. Abnormalities of the saccadic system were manifest particularly as hypermetria. These signs in combination are suggestive of disease involving the cerebellar flocculus and vermis or their brain stem connections. No abnormalities were found in 17 parents or siblings.


Brain lesions in Friedreich's ataxia.

Brain lesions in Friedreich's ataxia. An estimate is given of the frequency of pathological changes (assessed by cell populations and from myelin staining) in the brains of 15 cases of Friedreich's ataxia. Mention is made of the special problem of distinguishing primary degenerative lesions from those due to circulatory disturbances arising from the patients cardiac disease.


Oculomotor and vestibular findings in autosomal recessive spastic ataxia of Charlevoix-Saguenay. Electronystagmographic recordings were made of oculomotor and vestibular function in 11 patients with autosomal recessive spastic ataxia of Charlevoix-Saguenay. All had horizontal gaze nystagmus, marked impairment of smooth ocular pursuit and optokinetic nystagmus, and defective fixation suppression of caloric nystagmus. Many had saccadic dysmetria, but saccade velocity was probably unaffected. Abnormalities pointing to brainstem disturbance were sparse. The findings are thought to indicate mainly diffuse cerebellar disease, with particular involvement of vermis and vestibulo-cerebellum.


Electromyography and nerve conduction studies in Friedreich's ataxia and autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). Twenty four ataxic patients were investigated with electromyography and nerve conduction studies. They were divided in two groups according to the area they came from, the evolution of the disease, and the clinical signs. Group I patients from the Rimouski area displayed all the clinical and electrophysiological signs of Friedreich's ataxia. Group II comprised patients who presented with a new syndrome known as the autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). Although the clinical evolution was better in the latter, there were more electromyographic signs of denervation and the motor conduction velocities were slower. Both groups showed identical and important abnormalities in sensory nerve conduction. The results of electrophysiological studies in spastic ataxia have not been reported to our knowledge. They underline the place of spastic ataxia as distinct from Friedreich's ataxia, spastic paraplegia, and the known familial neuropathies.


Electroencephalographic findings in Friedreich's ataxia and autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). Electroencephalographic studies have been done in two groups of hereditary ataxia: a group bearing the classical features of Friedreich's ataxia and a group clinically different described as autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). The qualitative anomalies observed in the two groups were similar and were comparable with the data reported in the literature. However, the main difference between the two groups is the greater incidence of EEG abnormalities in the ARSACS group, which suggests more involvement of the cortical and subcortical structures. This is reinforced by the lower I.Q. performance in the latter patients. Some comments are made about focal EEG findings, behavior and I.Q. In general, EEG was not considered a valuable instrument for diagnosis since no qualitative electric pattern could be identified. With regard to prognosis, EEG cannot be used as a criterion, since there is no relation between the degree of anomalies and the severity of the disease and since EEG does not worsen with the progression of the disease.


Computed tomography of posterior fossa in hereditary ataxias. Nine cases of Friedreich's ataxia and seven cases of autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) were submitted to neuroradiological procedures to determine the extent of atrophic processes in the central nervous system. All cases had a computerized cerebral tomography and five were studied with pneumoencephalography. The results show a correlation between the two tests and the comparison between Friedreich's ataxia and ARSACS. In Friedreich's ataxia, the radiological signs are variable and discrete in most of the cases. In ARSACS there are constant signs of cerebellar atrophy almost limited to the superior parts of the vermis and anterior lobes.


The neuropathy of Charlevoix-Saguenay ataxia: an electrophysiological and pathological study. Two female patients aged 30 and 40 years with the Charlevoix-Saguenay ataxia were studied. Both had absent sensory action potentials in upper and lower extremities but, unlike typical cases of Friedreich's ataxia, they displayed a marked slowing of motor conduction velocities. Sural nerve biopsies taken from calf and ankle revealed a severe loss of large myelinated axons contrasting with a normal myelinated fiber density. Evidence for active axonal degeneration was scarce, with no indication of axonal regeneration. Teased myelinated fibers revealed an increased variability of internodal length but no evidence for myelin breakdown. These findings support, as a primary defect, a developmental abnormality of peripheral nerve, namely a lack of maturation of large myelinated axons and possibly a faulty myelination of nerve fibers. We think it is unlikely to represent a progressive axonal atrophic or dystrophic process, as suggested in Friedreich's ataxia.


A cluster of Friedreich's ataxia in Rimouski, Québec. We described a cluster of 8 independent sibships of Friedreich's ataxia in the St-Fabien parish of Rimouski and have shown that they are all related within 6 generations. The study of this geographic and genetic isolate permitted the investigation of certain unusual features of the disease such as constant myopia, delayed reaction times to pain, flexor spasms, and a rapid evolution.


Measurement of ataxia and related neurological signs in the laboratory rat. The purpose of the present study was to design a standard battery of tests capable of quantitatively characterizing ataxia and concomitant neurological signs in the rat. In addition to a systematic analysis of the walking gait of animals, tests for activity, catalepsy, rigidity, and various reflexive responses were included in the battery. The standardization and validation of the test system was performed by determining and comparing profiles of neurobehavioral effects produced by 3-acetyl pyridine, acrylamide, pyrithiamine, and thiamine deficiency, four experimental treatments reported to induce ataxia in animals. Results indicate that profiles of neurobehavioral disturbances accompanying ataxia in animals varied distinctively with each experimental treatment.


Amino acid changes in thiamine-deficient encephalopathy: some implications for the pathogenesis of Friedreich's ataxia. Thiamine-deficient encephalopathy in the rat is characterized by ataxic gait, loss of righting reflex and curvature of the spine. Neurochemical changes include a diminished activity of cerebral pyruvate decarboxylase leading to abnormal pyruvate oxidation. The present study shows that this defective pyruvate oxidation produces a significant depletion of three important amino acid neurotransmitters, namely gamma aminobutyric acid (GABA), glutamic acid, and aspartic acid. Such changes could lead to severe neuronal dysfunction and the observed neurological symptoms of thiamine deficiency. Some implications for the pathogenesis of Friedreich's ataxia are discussed.


Erythrocyte protoporphyrin levels in patients with Friedreich's and other ataxias. Of 13 patients with Friedreich's ataxia (Type Ia) and 17 with type IIa recessive ataxias, all were found to have levels of "free erythrocyte protoporphyrin" (FEP) above the normal range. The rise in FEP in Friedreich's ataxia correlated well with the age of the individual and thus appears to be related to the course of the disease. Subjects with olivo-ponto-cerebellar atrophy, Charlevoix syndrome, Duchenne muscular dystrophy, and Parkinson's disease were also found to have significantly elevated FEP, although the distribution overlapped with the normal range. The finding of elevated FEP may indicate a relative heme deficiency in ataxia due to inhibition of ferrochelatase leading to a state of ineffective, persistent erythropoiesis. The possibility of a prostaglandin abnormality being related to this defect and to the pathogenesis of ataxia is considered.


Glucose tolerance and erythrocyte insulin receptors in Friedreich's ataxia. Detailed in vivo and in vitro studies of glucose and insulin metabolism in Friedreich's ataxia patients and unaffected family members have further defined the extent of the abnormalities in carbohydrate metabolism. The high incidence of glucose intolerance and a hyperinsulinemic response to a glucose challenge in a high percentage of Friedreich's ataxia patients has been confirmed. An increased incidence of glucose intolerance among heterozygotes is suggested, while the siblings show a more normal distribution of diabetes and a nearly normal insulin response to the glucose tolerance test. Human growth hormone patterns are normal for all groups. Preliminary studies of insulin binding to erythrocytes suggest a difference in the binding characteristics among diabetic Friedreich's ataxia patients, while the binding in the non-diabetic Friedreich's ataxia group is similar to that of non-diabetic controls. Results from a small group of non-diabetic siblings suggest a normal insulin binding, while a tendency toward increased binding at low insulin concentrations among diabetic family members is noted.


Pyruvate dehydrogenase, lipoamide dehydrogenase and citrate synthase activity in fibroblasts from patients with Friedreich's and Charlevoix-Saguenay ataxia. The activity of lipoamide dehydrogenase and two closely related enzymes was studied simultaneously in early, mild, and late passage fibroblast cultures. Friedreich's ataxia fibroblasts tended to lose pyruvate dehydrogenase and citrate synthase activities, while lipoamide dehydrogenase activity remained constant with aging of the cells. Mean pyruvate dehydrogenase activity was lower over-all in fibroblasts from ataxics. Mean citrate synthase activity was higher in ataxic fibroblasts. Present tissue culture media do not represent the best conditions in which to reproduce cofactor binding defects such as those found in other genetic diseases with structural enzyme mutations.


Pre- and postsynaptic effects of taurine and GABA in the cockroach central nervous system. Taurine resembles GABA in its synaptic effects in the cockroach cercal nerve giant fiber synapse where it exerts a depressant action upon synaptic transmission. Both taurine and GABA produce an increased conductance of pre- and postsynaptic membranes through changes in the permeability of chloride ions.


Regional distribution of amino acids in Friedreich's ataxia brains. The distribution of amino acids in two Friedreich's ataxia brains is compared to 4 control brains. Glutamate and GABA were decreased in the cerebellar hemispheres and/or in the vermis. Taurine concentrations were uniformly elevated throughout the areas studied. Taurine/glutamate and taurine/GABA ratios were consistently elevated in Friedreich's ataxia brains, whereas glutamate/glutamine ratios were consistently decreased (with normal glutamine concentrations).


Dicarboxylic amino acid uptake in normal, Friedreich's ataxia, and dicarboxylic aminoaciduria fibroblasts. Glutamic and aspartic acid uptake was measured in skin fibroblasts from patients with Friedreich's Ataxia, dicarboxylic aminoaciduria, and normal individuals. The results showed no difference in uptake kinetics of either dicarboxylic amino acids between Friedreich's Ataxia and normal cells, but reduced uptake velocities in dicarboxylic aminoaciduria fibroblasts. Friedreich's Ataxia fibroblasts were, however, less calcium-dependent and more magnesium and phosphate-dependent than controls in glucose-free incubation mixture. This difference might be related to some degree of glucose intolerance by Friedreich's Ataxia fibroblasts in culture.


Pilot studies on membranes and some transport mechanisms in Friedreich's ataxia. The observed anomalies in high density lipoproteins in Friedreich's ataxia led us to investigate the state of cellular membranes in this illness. As a preliminary screening program, we studied the shape of erythrocytes; the phospholipid content of platelets and the transport properties of these membranes as indirectly reflected in the absorption of Vit E and the renal handling of orally injected taurine. All these investigations were normal, except for a tendency towards more echinocytes in Friedreich's ataxia and the insignificant increase in taurine urinary excretion after an oral load. We concluded that the possible membrane abnormalities are not major and will have to be searched for with more subtle and specific tests.


Friedreich's ataxia 1979: an overview.

Friedreich's ataxia 1979: an overview. This overview summarizes the investigations carried out during the second part of Phase Two of the Quebec Cooperative Study of Friedreich's Ataxia. These investigations outline in more details the fundamental role played by an abnormality in the fatty acid composition (deficient linoleic acid, 18:2) of the cholesterol esters of high density lipoproteins (HDL) in the phenotypic expression of the disease. They postulate a defective incorporation of linoleic acid to surface phosphatidylcholine of chylomicrons and consequent relative and absolute decreases in lipoprotein protein components because of overpacking with defective cholesteryl esters. Secondarily to these changes, the postulated lack of activation of the lipoamide dehydrogenase (LAD) of the pyruvate dehydrogenase (PDH) complex could result in slow pyruvate oxidation, glucose intolerance, deficient synthesis of acetylcholine, and depletion of glutamic and aspartic acid pools. In parallel, abnormal phosphatidyl-choline molecules could be incorporated to membranes, resulting in specific defects in some functions of these membranes, including transport of calcium and/or taurine and myelinization. The framework of an understanding of Friedreich's ataxia is now available, but much fundamental and clinical work remains to be done to fill in and prove each one of these postulated steps.


Erythrocyte membrane lipids in Friedreich's ataxia. In a study of the lipid composition of erythrocyte membranes in Friedreich's ataxia, the concentration of the major membrane components (phospholipids, cholesterol and protein) in ataxic patients, family members, and control subjects were found to be the same. The total fatty acid distribution was also normal. However, an altered distribution of phospholipid classes in erythrocytes was noted (an increase of PI + PS and a decrease of PE in Friedreich's ataxia patients).


Spinal epidural infection.

Spinal epidural infection. Thirty cases of spinal epidural abscess are reviewed with particular emphasis on mode of presentation and results of treatment. In spite of repeated exhortations in the literature for earlier diagnosis, the results remain unsatisfactory because many patients have progressed to severe or complete paralysis before the correct diagnosis is made and surgical treatment carried out.


[Brain tumors in children in a French Canadian environment]. Between 1964 and 1976, we have seen 197 cases of cerebral tumors in children. We have studied the frequency of each histological group of tumors, their localization, the results of the clinical investigation, their clinical manifestations and the prognosis for each group. This study has confirmed that in children brain tumors are more frequently localized in the posterior fossa (56.4%). As in other series, tumors derived from the glia represent nearly 80% of the total. Clinically, increased intro-cranial pressure is the most frequent manifestation of posterior fossa lesion (75% of cases) while cerebellar involvement was seen in 60% of these children. Brain lesions and supratentorial tumors are more insidious in their presentation and their clinical manifestations more diversified. The EEG appeared useful in the investigation of brain tumors and showed irregularities in 78% of our patients. However, a more specific diagnosis requirelography. As in previous series, the mortality rate remained high in the children we have followed, particularly for some groups of tumors (glioblastoma, medulloblastoma, brain stem lesions). It is to be hoped that with the introduction of the CT Scan, the improvement of neurosurgical techniques and the use of immuno and chemotherapy, the prognosis may be improved.


Epilepsy and pregnancy.

Epilepsy and pregnancy. The management of the pregnant epileptic requires close cooperation between the neurologist and obstetrician. To prevent complications, knowledge is required about the natural history of epilepsy during pregnancy, the possible teratogenic effects of antiepileptic drugs, and changes in their absorption, biotransformation, and excretion. Close plasma antiepileptic drug monitoring is required because of the change in the handling of antiepileptic drugs during pregnancy. The treatment of status epilepticus with intravenous phenytoin is effective. Drug interactions which may lead to toxic plasma levels of some drugs and subtherapeutic plasma levels of others should be anticipated. The risk of problems resulting from antiepileptic drug therapy during pregnancy appears to be minor, provided that proper medical supervision is available. Newer antiepileptic drugs should not be administered to the pregnant epileptic until their safety in pregnancy is fully established.


Decrease in the rate of protein synthesis by polysomes from cultured fibroblasts of patients and carriers with Duchenne muscular dystrophy. Polysomes extracted from cultured fibroblast cells isolated from patients with Duchenne muscular dystrophy (DMD), carriers of the disease, and normal controls were used for in vitro measurement of protein synthesis in a wheat germ extract system. It was observed that polysomes from patients and carriers (seven of each aged 17 years or older) exhibited a 3-fold and a 1.5-fold decrease in the rate of protein synthesis, respectively, as compared with controls. These results are discussed with a view to developing a sensitive and easily available assay for the detection of DMD carriers.


Painful tonic seizures in multiple sclerosis: localization of a lesion. The history of a patient with painful tonic seizures in association with multiple sclerosis is related. These seizures have been thought by most authors to be spinal in origin. This case is reported because of the localization of a supratentorial lesion, clinically and on CT scan.


Cold induced rhabdomyolysis in carnitine palmyityl transferase deficiency. A case of carnitine palmityl transferase deficiency in skeletal muscle is described. The usual symptoms associated with this disease (recurrent muscle cramps or pain and pigmenturia) were observed but sudden exposure to cold precipitate rhabdomyolysis in this patient.


Human cysticercosis: a probable case of cerebral cysticercosis with generalized subcutaneous nodular lesions. A case is reported in Montreal of human cysticercosis in a 44-year-old man who emigrated from Italy in 1956. Numerous subcutaneous nodules were found throughout his body. X-ray of his thighs and chest showed oblong calcific densities measuring 1 x 0.5 cm in size. Examination of an excised nodule from the right biceps revealed a cysticercus larva morphologically similar to Cysticercus cellulosae although the scolex lacked hooks. On the basis of the intensity of infection, focal and generalized epileptic seizures, changes in the CSF, and well demarcated lucencies observed in brain scan, cerebral cysticercosis was considered the most likely diagnosis.


The analysis of a case of dysmorfophobia. A case history is presented of a 16 year old adopted girl, diagnosed as having dysmorfophobia and successfully treated by psychoanalytically-oriented psychotherapy, during which time much material for discussion and interpretation was provided by the patient's dreams. The psychodynamics of the case are explored. In this case, dysmorfophobia is seen as a facade covering up the patient's unconscious urge to yield to sexual temptation. Clinically, the case may be seen and classified as follows: It may be a syndrome or a cluster of symptoms that do not currently exist in the standard psychiatric nomenclature. The diagnosis of a personality trait disorder in a not yet fully structured personality might be a second alternative diagnosis. The author, however, is inclined to consider the case as "transitional" or "potential" emotional disturbance, in accordance with Edward Glover's views (4).


On knowing what you are not supposed to know and feeling what you are not supposed to feel. Much psychopathology stems from "impressions, scenes, and experiences" of childhood having, apparently, been forgotten yet continuing to influence thought, feeling and action. The problem of how best to conceptualize the processes responsible for shutting memories away is eased by drawing on the findings and concepts of cognitive psychology. In explaining both the nature of the material shut away and the causes of its being so, attention is called to the role that a child's parents play, wittingly or unwittingly. Children not infrequently observe scenes their parents would prefer they did not observe; they form impressions their parents would prefer they did not form; and they have experiences their parents would like to believe they have not had. Examples are given of parents who seek to disconfirm their child's observations of events, to disapprove or condemn their natural emotional responses to distressing situations, and who discourage their children from registering aspects of their (the parents') personalities and behaviour. Pressure exerted on the children to conform to their parents' wishes can be crude or subtle, but its effectiveness depends always on the child's insistent desire to be loved and protected.


Geropsychiatry in Indian culture.

Geropsychiatry in Indian culture. Geriatric psychiatry will be increasingly important in years to come as the care of the elderly becomes a health problem in India. Those aged 60 and over contribute to 6% of the country's population at present. The life expectancy of an average Indian has increased from 24 years in 1900 to 53 in 1971. Improved health care promises longevity, but social and economic conditions like poverty, breakup of the joint family system and poor services, specifically for the aged, pose a psychiatric threat to them. Organic diseases and effective disorders form the bulk of psychiatric illness in the aged. Suggestions for research in areas such as social, cultural and changing attitudes, and national economics, have been suggested as a promising field for preventive geriatric services. Adding life to years is more important than adding years to life. The paper offers some references to the studies on geriatric psychiatry in India and discusses cultural factors affecting the aged.


Depression, witchcraft beliefs and super-ego development in pre-literate societies. When guilt feelings and self-accusations made their first appearance as symptoms of depression in Europe and Africa, as noted in a previous paper, this followed a period of heightened witchcraft beliefs in both locations and was sometimes first noticed in the form of voluntary witchcraft confessions, raising the question of a possible connection between the two types of change. Using the concepts of "group ego" and "group super-ego" to which Eric Wittkower has contributed, it is suggested that the heightened witchcraft beliefs were a defence against an individualizing change which would eventually lead to the inward turning to aggression and reproach and hence to the symptoms mentioned.


Psychosomatic illness concept and psychotherapy among the Akan of Ghana. The example of the Akan in Ghana shows that western medicine has no psychotherapeutic alternative to offer the so-called "developing countries". The traditional healing methods existing in such countries must be preserved and researched in order to maintain them at least at their present standard (9). This task, as well as that of developing these methods over the coming decades to keep pace with the cultural development process, is one that devolves upon the young scientists and doctors of such countries. This in turn requires further study of socialization values and norms, the potential resultant conflicts, the psychotherapeutic conflict-solving processes designed to obviate them and the forces at work in such psychotherapy.


The influence of the supervision of psychotherapy upon being therapeutic. I: Introduction and background to the supervisory relationship. In individual psychotherapy which derives from psychoanalysis, the most important teaching tool is individual supervision. This is in keeping with the fact that close person-toperson contact between student and teacher is the most effective mode of teaching in a university. The supervisor's first task is to transmit a body of knowledge, about psychotherapy, to the student. His second task is to give the student the benefit of his experience around clinical problems or questions. His third task is to assist the student in the development of certain attitudes which are valuable and even essential for a psychotherapist. This latter task is accomplished largely via "reality identification".


The influence of the supervision of psychotherapy upon being therapeutic. II: Modes of influence of the supervisory relationship. Through supervision, the student develops those innate personal characteristics which are highly important in being therapeutic. In making conscious use of "reality identification" by the student with his teacher, we must take care to avoid certain pitfalls. What is not wanted is transference identification. To help avoid this, we must select appropriate teachers as supervisors. The student should also have more than one supervisor, as this tends to protect against the development of overidealization on the part of the student, of omnipotence on the part of the teacher. Personal characteristics of both students and supervisors are extremely important. A good supervisory experience is the most likely vehicle for developing those qualities in the student which will, in time, lead him to function most therapeutically.


Patient management in disulfiram implant therapy. Data from 100 disulfiram implant, placebo, and no-implant control patients demonstrate the effectiveness of the disulfiram implant in keeping the alcoholic dry. However, the superiority of the disulfiram implant group over the placebo group is interpreted as evidence of a pharmacological component to the procedure operating independent of the disulfiram-ethanol reaction (DER). Hypotheses involving inhibition of aldehyde dehydrogenase or inhibition of dopamine-beta-hydroxylase are offered as mechanisms by which the pharmacological effect may be mediated. Finally, in view of the low (approximately 0.5) probability with which a DER follows ingestion of alcohol by a disulfiram implant patient, it is suggested that the approach to patient management should be changed to maximize the effectiveness of the disulfiram implant procedure. Guidelines are given.


The mother tongue in psychotherapy.

The mother tongue in psychotherapy. The psychotherapy of three women with neurotic and adaptational problems was conducted using their mother tongue, German, and emphasis is placed on the facilitation of the therapeutic process by this method. It is felt that transference may be readily formed, there is less resistance to examining conflict areas, and the use of the acquired language as a defense against anxiety can be avoided. Several other authors have noted similar effects of therapy in the mother tongue. Various aspects of the literature are discussed, particularly focusing on the affective and cognitive differences between the primary and acquired languages as they may influence the psychotherapy.


A note on counter-transference and anti-Semitism. After a brief introduction where the meaning of racism is alluded to, a clinical vignette is presented. A patient who has suppressed her antisemitic feelings is being treated by a Jewish psychiatrist. The therapist's possible counter-transference motives in treating the patient are explored, and a workable solution is offered.


The incubus syndrome. A variant of erotomania. The term "incubus syndrome" is proposed to describe patients suffering from the delusion that they have been sexually approached at night by an unseen lover. Two cases characterized by co-existence of erotomania and schizophrenic sexual delusions are described. The patient's behaviour secondary to the defusion is discussed from the point of view of social significance as well as potential dangerousness.


Some determinants of affective symptoms in epileptics. Forty-two epileptics were given a psychiatric interview and completed five questionnaires. Current affective symptoms were significantly associated with a past history of neurotic disorder but not with temporal lobe epilepsy.


The psychoanalytic theory of depression. Part II--The major themes. In this second part of a review of the psychoanalytic theory of depression the major themes of the theory, as they appear in the works of the major contributors, are discussed. It is difficult to approach the complexities and ambiguities of psychoanalytic theory in general, and the theory of depression in particular, without an historical perspective. Accordingly, the author decided to group the major themes of the theory under three headings: Instinct Theory, Structural Theory, Object Relations Theory. The themes included under Instinct Theory are constitutional factors, aggression and orality. Under the heading of Structural Theory those themes associated with the ego, with the concepts of narcissism and the self, and finally those associated with the superego are discussed. It is of note that under narcissism the work of both Kohut and Kernberg is considered, including its relevance to any investigation of depression. The concepts of object loss and object failure are discussed under the heading of Object Relations Theory. It is suggested that a psychoanalytic approach has much to offer both the clinician and the researcher in their attempts to develop a comprehensive theory to explain the protean manifestations of human depression.


A serological survey of Leptospira interrogans serotype pomona in Saskatchewan horses. Leptospira interrogans serotype pomona antibody titres of 1:100 or greater were detected in 12.8% of 408 adult horses from seven of eight sampled herds in Saskatchewan. The geographical distribution of the seropositive horses was widespread throughout the agricultural area of the province. The geographical distribution and the cumulative increase in prevalence with age suggested that serotype pomona is enzootic in the equine population of Saskatchewan.


The effect of retained placenta and metritis complex on reproductive performance in dairy cattle -- a case control study. A study of the computer stored records of 293 dairy cows and 652 calvings reveals the effects of retained placenta and metritis complex on reproductive performance. The overall incidence rate of retained placenta was 11.2%. Retained placenta was 4.6 times more likely to occur following twin births than following single births. Most cases of retained placenta occurred during the fall. Forty-five percent of that seasonal increase was explained by an increased number of calvings. Metritis complex was diagnosed following 54.8% of retained placenta cases. Retained placenta alone did not significantly impair reproductive performance. Metritis complex, in the presence or absence of retained placenta, caused a significant (P</=0.05) increase in days open, services per conception, calving to first heat intervals and days from calving to first service. There is an indication (interaction P</=0.1) that cows with both retained placenta and metritis complex are more severely affected than cows with either retained placenta or metritis complex alone. The influence of retained placenta on fertility appears to depend on the proportion of cows with retained placenta that have metritis complex.


Prevalence and treatment of tapeworms in horses. A study was initiated to determine the prevalence of tapeworms in horses in Southern Ontario and to investigate the efficacy of pyrantel pamoate, niclosamide and mebendazole. Fecal samples were taken from 580 horses of various breeds, ages and sexes in 24 locations and Anoplocephala perfoliata was found in 13.6%. This was regarded as a minimum, the true rate being probably significantly higher and the reasons for this are discussed. A brief review of the life cycle and effects of tapeworms in horses and a comparison of two flotation techniques for the diagnosis of A. perfoliata eggs in feces is given. Pyrantel pamoate, niclosamide and mebendazole were compared for efficacy in field and critical trials. In field trials, pyrantel base and niclosamide at 6.6 and 50 mg/kg respectively were found to be effective, but in critical trials their efficacy was poor, 15 and 5.6% respectively. These anthelmintics at these dose rates caused only an elimination of the terminal egg bearing segments and were without significant effect on the entire tapeworm. When pyrantel base was administered at 13.2 and 19.8 mg/kg (twice and three times the therapeutic dose rate for nematodes respectively) the efficacy was 97.8 and 100%. It would appear that pyrantel pamoate administered at 13.2 mg pyrantel base/kg is an effective therapeutic dose for tapeworms in horses. Further dose titration studies are needed for niclosamide. Mebendazole was without effect at up to four (35.2 mg/kg) times the therapeutic dose for nematodes.


Atypical interstitial pneumonia in cattle. Atypical interstitial pneumonia is described as two clinical syndromes in young cattle. One syndrome occurs in animals which have clinical evidence of pneumonic pasteurellosis, responds initially to treatment for one to two days and then develops acute signs of atypical interstitial pneumonia. The second syndrome involves acute respiratory distress in young calves due to atypical interstitial pneumonia with antecedents of enzootic pneumonia. The postmortem lesions are described along with discussion of the possible pathogenesis of the condition and treatment.


Structure of the water-insoluble alpha-D-glucan of Streptococcus salivarius HHT. Water-insoluble, non-adherent alpha-D-glucans have been obtained from Streptococcus salivarius HHT under two sets of conditions: from a growing culture, or synthesized enzymically by using a glucosyltransferase. In the former case, the glucan ([alpha]D + 197 degrees) was shown by methylation analysis to have a slightly branched structure containing a relatively high proportion (80%) of (1 leads to 3)-alpha-D-glucosidic linkages, together with small proportions of (1 leads to 6)- and (1 leads to 4)-alpha-D-glucosidic linkages. The enzymically synthesized glucan had a much less-branched structure, containing 88% of (1 leads to 3)-alpha-D-glucosidic linkages. Both glucans, on Smith degradation (sequential periodate oxidation, borohydride reduction, and mild acid hydrolysis), gave linear, (1 leads to 3)-alpha-D-glucosidic polysaccharides (yields, 82--90%) that constitute the backbone chains. The presence of small proportions of glycerol, erythritol, 1-O-alpha-D-glucosyl-D-glycerol, and also 2-O-alpha-D-glucosyl-D-erythritol in the products of Smith degradation suggests that the short side-chains are attached to the backbone chain by (1 leads to 4)-, (1 leads to 6)-, and (1 leads to 3)-alpha-D-glucosidic linkages.


Structural studies on the capsular polysaccharide from Klebsiella serotype K64. Partial hydrolysis with acid, methylation analysis (including uronic acid degradation), Smith degradation, and p.m.r. spectroscopy have been used to determine the primary structure of the capsular polysaccharide of Klebsiella serotype K64. The hexasaccharide repeating-unit, which also contains one O-acetyl substituent, comprises a 4)-alpha-D-GlcpA-(1 leads to 3)-alpha-D-Manp-(1 leads to 3)-beta-D-Glcp-(1 leads to 4)-alpha-D-Manp-(1 leads to chain with a 4,6-O-(1-carboxyethylidene)-beta-D-glucopyranosyl and an L-rhamnosyl group attached to the 4-linked D-mannosyl residue at 0-2 and 0-3, respectively.


A method for the determination of the chemical structure of glycolipids biosynthesized in vitro and the specificity and activity of glycosyltransferases. A very sensitive method for the qualitative and quantitative investigation of the biosynthesis of the oligosaccharide chains of glycolipids in such tissues as cultured cells, biopsies, or cell organelles, is described. It permits the determination, on an ultramicro-scale, of the specificity of glycosyltransferases in terms of the exact chemical structure of the products that are synthesized from known labeled glycolipid precursors, and defines without ambiguity the precursor-to-product relationship in biosynthetic incubations in vitro.


Spin-labelling of sialic acid in soluble and cell-surface glycoproteins. A new, mild method is described for spin-labelling sialic acid residues in situ. The procedure involves the formation of C-1 sialamides and has been applied to a serum glycoprotein, a mucin, tissue sections from human colon, and erythrocyte membrane components. The selectivity of the method and its possible applicability to other types of labelling are discussed.


Purification and characterisation of two endo-(1 linked to 3)-beta-D-glucanases from Telescopium telescopium. The crystalline style of the gastropod Telescopium telescopium contains two (1 linked to 3)-beta-D-glucanases and a beta-D-glucosidase. The two glucanases (I and II) have been purified and shown to be endo-enzymes. Both enzymes attack laminarin, carboxymethylpachyman, and lichenin, but have no action towards carboxymethyl-cellulose. The main products of hydrolysis of laminarin are D-glucose and beta-(1 linked to 3)-linked oligosaccharides of d.p. 2, 3, and 4. Glucanases I and II are similar to each other, although they differ in molecular weight and kinetic properties.


Radioactive particle imaging of coronary blood flow distribution. The intracoronary injection of radionuclide-labeled macroaggregated albumin particles has been shown to be safe and to provide excellent myocardial imaging. When performed in the resting state, it is more sensitive than either the ECG or ventriculogram in identifying areas of scarring and fibrosis due to previous myocardial infarction. Combined with contrast induced coronary hyperemia, intracoronary MAA particles are useful in identifying stenoses of moderate severity that do not alter resting coronary blood flow. Particle studies are likely more sensitive than the rest-exercise 210T1 myocardial scan in identifying patients with significant coronary artery disease. Resting perfusion abnormalities are more closely related to improved or unimproved left ventricular function after surgery than are the ECG or resting left ventriculogram. While the long-range clinical utility of the particle technique is uncertain, its most useful application currently is identification of significant stenoses undetected by 201T1 and of questionable significance by arteriography.


Scintigraphic evaluation of left ventricular function. Scintigraphic studies, performed with a scintillation camera and a small computer, can provide information concerning total and regional left ventricular function (Table 1). Of the two types of studies (first-pass and gated blood pool) the gated blood study is more appropriate for studies of regional function than is the first-pass method. Ejection fraction, an index of global ventricular function, is measureable from first-pass or gated blood pool studies. Gated blood pool studies allow visual assessment of net ventricular function as well as the local functional status of the myocardium. Multiple gated blood pool studies allow computation of ventricular volume curves, from which ejection fraction and ejection rate may be determined. There are several areas of application for these relatively inexpensive and virtually noninvasive studies. In patients with recent myocardial infarction, visual assessment of regional ventricular wall motion and quantitative measurement of ejection fraction provide additional prognostic information, especially when measured serially. In patients with coronary artery disease, the development of regional ventricular wall motion abnormalities may indicate local myocardial ischemia. Consequently, scintigraphic imaging may add significantly to the usefulness of exercise stress testing.


Physiology and physics of nuclear cardiology. This chapter is a primer on the physics of radionuclide detection, flow physiology, and methods of in vivo evaluation of myocardial metabolism and intercavitary flow by noninvasive methods of intravenous isotope injection. This summary presents key concepts for the application of currently available instrumentation as well as future directions of nuclear cardiology. 1. Quantitative information is obtained in nuclear cardiology at the cost of high resolution imaging for two reasons: (a) the intrinsic resolution of the detecting systems is limited by available technology, and (b) the statistics required to achieve a high resolution image necessitate doses and imaging times far in excess of those which can be tolerated. Image resolution for both projection images as well as transverse sections are limited to the range of 5 to 20 mm, depending upon the configuration and instrument involved. 2. The second important concept is the fact that nuclear cardiology gives quantitative information regarding the amount of radiopharmaceutical which has accumulated in or is flowing through the cardiovascular system. This information allows one to deduce the dynamics of flow as well as actual metabolic rates. 3. The major emphasis for future work might well lie in the multiple transverse section imaging of the myocardium using both rotating and static devices. The key feature of this approach is the fact that the volume of interest can be localized and actual concentrations of radiopharmaceuticals can be measured by external detection using reconstruction tomography images. 4. Quantitative data on the distribution of a metabolite which accumulates in the myocardium is of little value if regional blood flow is not also known. 5. Finally, it is shown in this chapter that specific volume flow can be evaluated using short half-life isotopes and equations derived from the principle of conservation of mass. In principle it is now possible to obtain quantitative values delineating endo- and epicardial flow for the heart of man without invasive catheterization or high radiation doses. These procedures involve constant inhalation of carbon dioxide labeled with 15O which converts to labeled water and can be used for evaluating myocardial perfusion; bolus injection of 82Rb, a short half-life analogue of potassium, for repeated (every 5 min) imaging of the evolution of myocardial infarction size; evaluation of the accumulation of labeled fatty acids, amino acids, and sugars in the myocarium; presentation of images which reflect the magnitude of ejection fraction; and noninvasive evaluation of cardiac shunts. It is now possible to perform on the same patient during a few hours the following studies of myocardium: cation perfusion evaluation; water perfusion; uptake of fatty acids, amino acids, and glucose; oxygen utilization of the myocardium; and even measurement of the quantity of lung water. We now have the tools and methods to evaluate the in vivo biochemistry of the ischemic, 128 infarcting, repairing, and hypertrophic myocardium.


The effect of myocardial force on coronary transmural flow distribution. The role of myocardial force as a determinant of transmural coronary flow distribution was examined in the presence and absence of autoregulation by infusing calcium chloride into a segment of the left coronary system. The concentration of calcium used was adequate to increase force but did not alter coronary pressure or endoventricular pressure. No alterations in transmural gradients of flow were observed following increased regional force. These results suggest that increases in regional force are not of importance as a determinant of transmural blood flow.


Acute voltage, charge, and energy thresholds as functions of electrode size for electrical stimulation of the canine heart. This paper analyses the relationships between electrode size and charge, voltage, and energy thresholds in acute animal experiments. Cathodal stimuli of 1 ms duration are applied to canine hearts by using epicardial disc electrodes. Threshold charge in constant current and in constant voltage stimulation proves to be proportional to the electrode radius (a) to the power 1.5 for a greater than 0.4 mm and to be independent of electrode size for a less than 0.2 mm. Voltage and energy thresholds  are proportional to square root a and a2 respectively for a greater than 1 mm. Voltage thresholds show a minimum at a radius of about 0.5 mm, energy thresholds at about 0.3 mm. These results are explained by using two principles. The first is that the charge applied to the heart determines the response of the tissue to a stimulus and the second, that electrode impedance may be described by an RC-series circuit in these experiments. The resistance in this circuit is inversely proportional to electrode radius, in agreement with calculation of the electric field around the electrode. Electrode capacity depends linearly on electrode surface area. Stimulation is most efficient under the circumstances mentioned above for an electrode radius of about 0.3 mm.


Effect of increases in afterload before and after coronary occlusion in awake dogs. Ventricular function curves relating stroke work and left ventricular end-diastolic pressure were generated in awake dogs during increases in preload produced by infusion of fluid and during increases in afterload produced by administration of phenylephrine. The ventricular function curves produced by preloading were steeply upsloping whereas those produced by afterloading were essentially horizontal. Coronary occlusion produced downward displacement of these horizontal curves, but no change in slope. This increases in afterload did not help to demonstrate the functional impairment produced by coronary occlusion.


Myocardial anaerobic metabolism during isoprenaline infusion in a cyanotic animal model: possible cause of myocardial dysfunction in cyanotic congential heart disease. Mongrel dogs were made acutely cyanotic by anastomosis of the inferior vena cava to the left atrium and measurements of high fidelity left ventricular pressure, arterial pressure, blood gases, and myocardial lactate arteriovenous differences were determined before pacing, with atrial pacing at a rate of approximately 240 per minute, and during an infusion of isoprenaline to increase myocardial oxygen demands. The animals were divided into two groups on the basis of the arterial PO2 during isoprenaline: acyanotic or control dogs (n = 4, PO2 greater than or equal to 6.7 kPa [50 mmHg], mean = 52) and cyanotic dogs (n = 5, PO2 less than or equal to 4.7 kPa (35 mmHg), mean = 32). Myocardial lactate arterio-venous difference showed no significant changes in the control dogs with pacing or isoprenaline, but myocardial lactate production occurred in all five cyanotic dogs with isoprenaline infusion. These studies demonstrate that myocardial anaerobic metabolism can be produced during times of stress with isoprenaline infusion in a cyanotic animal model at systemic oxygen levels that can occur clinically.


Coronary artery pressure development and wave transmission characteristics in the horse. Measurements of the pressure waveform development and the wave transmission characteristics in the left extramural coronary arteries of the horse have been carried out. Near the ostium the left coronary pressure waveforms are seen to be virtually identical to the corresponding aortic root waveforms; however, the present of low frequency, relatively large amplitude pressure oscillations (on the order of 5 to 10 Hz) gradually become the dominant diastolic feature as one proceeds distally from the left ostium, and these eventually completely mask the incisura. In a limited number of experiments, these oscillations have been simultaneously observed on both centerline velocity and phasic flow signals. These are felt to be primarily due to wave reflection phenomena, but may represent a combined effect of wave reflections and the natural oscillatory motion of the heart mass. Peak systolic pressures were found to remain relatively unchanged as one proceeds distally; however, the end-diastolic pressures were found to decrease steadily, thus giving rise to an increasing pulse pressure and a gradually decreasing mean pressure. Wave speeds in the coronary arteries were found to range between 4 and 11 m.s-1, and the data obtained indicate the wave speed to be highly dependent on both local intralumenal pressure and spatial location.


Isoprenaline-induced myocardial infarction in spontaneously hypertensive rats. Spontaneously hypertensive rats were subjected to massive myocardial infarction. The pathophysiological changes were similar to those of normotensive rats but the spontaneously hypertensive rats developed congestive heart failure during myocardial repair rather than during the necrosis phase and survived in superior numbers. Blood pressure fell despite maximally increased corticosterone levels. Atrial and ventricular thromboses and left ventricular aneurysm formation were frequent.


Myocardial blood flow and O2-supply following dextran-haemodilution and methaemoglobinaemia in the dog. The adequacy of oxygen-supply to the left ventricular myocardium was compared in anaesthetised dogs following: a) isovolaemic haemodilution with Dextran 70 (to haematocrit = 20 +/- 2%), b) the acute induction of methaemoglobinaemia (to methaemoglobin-concentration = 53 +/- 7%), bu subjecting them to an exchange-transfusion with methaemoglobin-containing erythrocytes in dextran) and c) a control exchange-transfusion with normal homologous erythrocytes in dextran. Myocardial oxygen-supply was assessed by the measurement of myocardial blood flow (using 15 +/- 5 micron microspheres) and of the PO2 in coronary sinus blood. In dextran-haemodiluted dogs, mean myocardial blood flow was 92% greater than in the control group, allowing the maintenance of normal coronary sinus PO2. In the methaemoglobinaemic group, flow was only 15% greater than in the control group; because oxygen-capacity was halved in this group, myocardial oxygen supply was impaired and coronary sinus PO2 fell. Infusions of isoproterenol (0.1 microgram . kg-1 . min-1) produced similar myocardial flow-increments in the haemodiluted and control groups with similar transmural distribution. In the methaemoglobinaemic group, however, the subendocardial flow-increment was reduced, in association with a further reduction in coronary sinus PO2 and an attenuated contractile response to the drug. These findings suggest that the rheological effects of haemodilution play an important role in the maintenance of myocardial oxygen-supply, but in significant methaemoglobinaemia, the oxygen supply of the myocardium may be severely curtailed.


Pulmonary and systemic vascular responses to hypoxia after chemical sympathectomy. Mongrel dogs were anesthetised and exposed to acute hypoxia (8% or 10% O2 for 10 min) before and again either 2 or 12 days after 6-hydroxydopamine (6-OHDA, 80 mg . kg-1) pretreatment. Under normoxic conditions, systemic arterial pressure and systemic vascular resistance were reduced 2 days post 6-OHDA, but only systemic resistance was reduced 12 days post 6-OHDA. Pulmonary vascular haemodynamics were unchanged by 6-OHDA under normoxic conditions. No changes in the cardiac output, pulmonary, and systemic haemodynamic or ventilatory responses to hypoxia were observed 2 days post 6-OHDA, although the heart rate response was reduced. Similarly, 12 days post 6-OHDA, reponses to hypoxia were unchanged except for a reduced systemic pressor response. A significant transient fall in systemic arterial pressure was observed at the start of the hypoxic exposure 2 days post 6-OHDA. The ventilatory responses to hypoxia appeared to be influenced very little by the sympathetic nervous system. The results indicate that pulmonary vascular resistance is under little sympathetic influence, and that hypoxic pulmonary vasoconstriction is not mediated by the sympathetic nervous system.


Demonstration of dissimilar acute haemodynamic effects of ethanol and acetaldehyde. To determine whether the acute cardiac depressant effects of ethanol could be attributed to its metabolite (acetaldehyde), either ethanol or acetaldehyde was intravenously infused into pentobarbital anaesthetised, closed-chest dogs. At a venous blood ethanol level of 199 +/- 43 (SE) mg . dl-1, ejection fraction had decreased from 35 +/- 2 to 30 +/-2%, P less than 0.05, max dP/dt/end-diastolic volume from 14.0 +/- 2.1 to 8.6 +/- 1.1 kPa . s-1 . cm-3 (105 +/- 16 to 65 +/- 8 mmHg . s-1 . cm-3), P less than 0.02, whereas end-diastolic volume (P less than 0.005), myocardial oxygen consumption (P less than 0.05) and coronary blood flow (P less than 0.005) had increased. Higher ethanol levels exaggerated these changes when peak arterial acetaldehyde was 20.2 +/- mumol . litre-1. By contrast, infusion of acetaldehyde to a peak blood level comparable with that produced by ethanol increased cardiac output from 2.4 +/- 0.2 to 2.8 +/- 0.2 litre-1 . min-1 P less than 0.01), coronary sinus oxygen saturation from 46 +/- 4 to 55 +/- 3% (P less than 0.25) and reduced systemic resistance from 8.0 +/- 0.7 to 6.3 +/- 0.5 kPa . litre-1 . min-1 (60 +/- 5 to 47 +/- 4 mmHg . litre-1 . min-1) (P less than 0.001). High dosage of acetaldehyde to a level of 129 +/- 23 mumol . litre-1 produced elevation of cardiac output (P less than 0.001), ejection fraction (P less than 0.01), coronary blood flow (P less than 0.02), whereas systemic resistance (P less than 0.001), heart rate (P less than 0.05) and myocardial oxygen consumption (P less than 0.05) decreased. Discontinuation of acetaldehyde infusion significantly reversed these changes. Max dP/dt/left ventricular end-diastolic volume and left ventricular end-diastolic volume were not significantly altered by acetaldehyde. Thus, ethanol depresses cardiac performance and increases myocardial oxygen consumption. By contrast, acetaldehyde at levels produced by ethanol metabolism improves cardiac performance, consequent to afterload reduction, and reduces myocardial oxygen consumption.


Studies of isolated and enriched rat antral mucosa gastrin cells. A technique has been developed to obtain viable, isolated and enriched populations of gastrin cells (G-cells) from the rat stomach. Restricted tissue samples from a small area of the pyloric antrum known to be particularly rich in G-cells, were sequentially digested with pronase followed by mechanical agitation, to remove the epithelial cells. This technique resulted in a significant enrichment of G-cells (3-4 fold) since the surface epithelial cells and upper portions of the glands were discarded before the initial G-cell fraction was collected. These cells in suspension were then isolated from each other by gentle pipetting in a DNase containing solution and designated the crude preparation (CP). The G-cells were then purified further by separating the cells according to size by velocity sedimentation. The greatest concentration of G-cells (15-25%) was found in the fraction containing cells with diameters of 10 to 12 micrometer. The effectiveness of the technique was evaluated by counting G-cells as identified by electron microscopy and immunofluorescence and assessing gastrin activity by radioimmunoassay. All three methods indicated that cell separation by gravity velocity sedimentation enriched the G-cell population 15-20 fold over their concentration in the CP. The combined techniques of selective pronase digestion followed by gravity velocity sedimentation resulted in an isolated cell preparation containing a 50-100 fold increase of G-cells over their normal distribution in the intact gastric mucosa. Since these isolated G-cells retain features indicating viability, their usefulness for in vitro studies is suggested.


Immunoreactive pancreatic polypeptide (PP) occurs in the central and peripheral nervous system: preliminary immunocytochemical observations. Pancreatic polypeptide (PP) is a candidate hormone of unknown physiological significance. It is produced by a population of endocrine cells in the pancreas. In the present study a PP-like peptide was found to occur in the mammalian and avian central andperipheral nervous systems. Immunoreactive nerve fibres and nerve cell bodies were widely distributed in the brain. Dense accumulations of nerve fibres occurred in the following areas: nucleus accumbens, interstitial nucleus of the stria terminalis, para- and periventricular hypothalamic nuclei, and medical preoptic area. In addition, nerve fibres were regularly seen in cortical areas. Immunoreactive perikarya were observed in the following regions: cortex, nucleus accumbens, neostriatum and septum. In the gut, immunoreactive nerve fibers were distributed in the myenteric plexus, in smooth muscle, around blood vessels, and in the core of the villi. Immunoreactive perikarya occurred in the submucosal and myenteric plexus, suggesting that PP immunonal PP-like peptide could be demonstrated with an antiserum raised against avian PP, but not with those raised against bovine or human PP. Thus, neuronal PP is distinct from the PP that occurs in pancreatic endocrine cells.


Immunofluorescent localization of insulin-like material in the median neurosecretory cells of the blowfly, Calliphora vomitoria (Diptera). Immunocytochemical staining has shown that the median neurosecretory cells (MNC) of the brain of the blowfly, Calliphora vomitoria, contain an insulin-like material which cross reacts with antibodies to bovine insulin. There are 24-26 paraldehyde fuchsin-positive MNC of which only 6-8 show the specific insulin-like immunoreactivity.


Functional morphology of the midgut of Aedes aegypti L. (Insecta, Diptera) during blood digestion. Morphometric analysis of the epithelial lining of the stomach of A. aegypti suggests that digestion of the first blood meal in the stomach of this species can be viewed as a series of phases that can be correlated with physiological data from the literature. In phase Ia (0-10 h after blood meal [abm]) the whorls of the rough endoplasmic reticulum unfold, the Golgi zones increase, and the basal labyrinth is enlarged. This coincides with processes of synthesis and secretion (e.g., peritrophic membrane, esterases and lipases) and transport by the stomach epithelium. In phase Ib (10-20 habm) the cellular parameters measured further increase, indicating high synthetic and secretory activities (e.g., digestive enzymes). In phase Ic (20-30 habm) cell structures involved in synthesis and secretion still exhibit high values coinciding with maximal activity of proteases in the gut. Enhanced surface area of microvilli, prominent lipid inclusions, and appearance of glycogen deposits in the gut epithelium suggest increased absorption, storage, and transport functions of the stomach cells. In phase II (30-36 habm) structural alteration points to a gradual shift from synthesis and secretion to absorption, partial storage, and transport of nutrients. In phase III (36-72 habm) the cellular apparatus is reduced concomitant with the ending of the digestive cycle. Lipid inclusions and glycogen deposits disappear from the stomach epithelium.


New observations on the innervation of striated ducts in submandibular glands of cats, including possible peptidergic nerves. The presence of hypolemmal axons between striated duct cells in submandibular glands of cats has been established electron microscopically. Axons were found between "light" cells, between "light" and "dark" cells and between "light" and basal cells. Hypolemmal axons were observed most frequently in the junctional region between striated and intercalary ducts. They were often more common in younger animals. "Dark" cells with numerous processes sometimes appeared to have a special relationship with hypolemmal axons. Most of the hypolemmal axons in striated ducts contained characteristic agranular vesicles of the cholinergic type, about 40 nm in diameter; many of these axons also contained large dense cored vesicles of the peptidergic type, about 100 nm in diameter and possessing a more clear outer halo. No adrenergic axons have been observed beneath the basal lamina of striated ducts, even after use of 5-OHDA. The possibility that some of the hypolemmal axons in striated ducts are peptidergic and their possible functions are discussed. Apart from other activities these axons may have a role in supplying special trophic factors to the cells, helping them in their developmental specialisation and maintaining them in normal condition. An absence of such factors after parasympathetic decentralisation may be responsible for the dramatic atrophic changes in striated duct cells, especially since the atrophy in the gland is not solely due to an absence of acetylcholine activation.


Retention of hemopoiesis in tail vertebrae of newborn rats. In newborn rats, the marrow cavity of tail vertebrae is hemopoietic and contains no adipose tissue. The latter develops soon after birth to replace the hemopoietic tissue within the nonexpansile volume of the marrow cavity. By transposing the tail into the warmer environment of the abdomen, hemopoiesis was retained, and the development of adipose tissue was prevented in the transposed segment, when the operation was done in preweanling but not in adult animals. Systemic stimuli of erythropoiesis (phlebotomy, induced hemolysis) acted synergistically with the temperature increment to retain hemopoiesis. The findings support the concept that adipose cells in the yellow marrow are relatively stable and once developed, they are not readily mobilized. The findings may also explain the discrepancies in the results obtained by rat tail transposition.


Immunocytochemical localization of vasotocin and mesotocin in the hypothalamus of lacertilian reptiles. The hypothalamic magnocellular neurosecretory system of lizards was studied with the unlabeled antibody peroxidase-antiperoxidase complex (PAP) technique at the light microscopic level. It was shown that vasotocin and mesotocin are synthesized in separate neurons. The vasotocinergic as well as the mesotocinergic perikarya are of different sizes. Both cell types occur in close juxtaposition, but without a distinct pattern of distribution. The external zone of the lacertilian median eminence contains numerous immunoreactive vasotocinergic fibers and only few immunoreactive mesotocinergic fibers. The general organization of the hypothalamic magnocellular neurosecretory system of lizards, as revealed by immunocytochemistry, is essentially similar to that revealed with unspecific staining methods.


Effect of cyproterone acetate, levonorgestrel and progesterone on adrenal glands and reproductive organs in the beagle bitch. The effects of short-term (8 weeks) treatment with different doses of cyproterone acetate (CPA), levonorgestrel (LN) and progesterone (PRO) on the adrenal gland, ovary, uterus and vagina were studied in cycle-synchronised beagle bitches (first anoestrus). The same organs from non-treated primiparous beagle bitches at the 6th and 9th weeks of pregnancy were also included. In the animals treated with the highest doses of CPA (4.0 mg/kg/day orally) and PRO (42.5 mg/kg/day subcutaneously), as well as in pregnant bitches (9th week of pregnancy), a decrease in adrenal weight and cortex width and also an apparent loss of cells in the zona fasciculata and zona reticularis were observed. A marked increase in ovarian weight was recorded only in pregnant bitches (6th week of pregnancy). This was reflected by the presence of multiple well-developed corpora lutea. The ovaries of virgin control and progestagen-treated bitches revealed ovarian atrophy. Progestagen treatment caused marked stimulation of the uterus, resulting in dose-related oedematous and hyperplastic changes. Comparable findings were also observed during pregnancy. The vaginal epithelium of the progestagen-treated and pregnant bitches showed marked mucification as compared with control bitches. These structural responses indicate that progestagen treatment stimulates a pseudopregnancy-like condition in the adrenal glands, uterus and vagina of the beagle bitch.


Freeze-fracture study of taste bud pores in the foliate papillae of the rabbit. In freeze-fractured specimens of taste buds from the foliate papillae of rabbits, the intercellular spaces are separated from the pore of the taste bud by zonulae occludentes of the "tight-type". Below these tight junctions numerous desmosomes are found at irregular intervals. The epithelial cells adjacent to the pore are also joined by single strands of fusion. The microvilli arising from the neck of the type I cells have a high particle density. The microvilli of type II cells and especially the short microvilli of peripherally situated cells have a lower intramembranous particle density. The single microvillus of type III cells has a very large diameter and is longer than the other microvilli. It contains a few larger intramembranous particles and vesicle-like protrusions of the membrane facing the cytoplasm. Transverse fracturing reveals a filamentous fine structure in all microvilli. The physiological implications of these observations are discussed.


A stereological ultrastructural study of stimulated peritoneal macrophages in the germ-free mouse. Peritoneal macrophage ultrastructure was analysed stereologically in germ-free mice given a single intraperitoneal injection of sterile, pyrogen-free saline. Thus the stimulant was non-particulate, non-antigenic and inorganic, and effects of immune reactions were minimal. Macrophages were recovered 1, 6, 24 and 72 h after stimulation. A sequence of structural alterations is reported which may be fundamental to macrophage activation. The plasma membrane and nuclear envelope increased in area within only 1 h of saline injection. During the next 5 h loss of plasma membrane, probably by pinocytosis, caused cellular "rounding" and clear-cut alteration in surface configuration. At the same time lysosome-like granules enlarged but decreased in number. By 24 h most cellular structures and compartments (including the plasma membrane) were enlarged. Morphological evidence of nuclear activation accompanied a rather modest enlargement of the nucleus at this stage. The RER hypertrophied last and must, therefore, be judged sufficient in resident macrophages to support the initial growth response which results after stimulation. Thus hypertrophy was observed eventually in every structure examined. Even the minimally activated macrophages resident in the peritoneum of germ-free mice respond readily to stimulation.


Autoradiographic localization of 3H-glucocorticoids and 3H-cortexolone in mouse pituitary. Autoradiograms of mouse pituitaries were prepared 30 min after injection of 3H-dexamethasone (3HDM), 3H-corticosterone (3HB) and 3H-cortexolone (3HS) either alone or in the presence of competing unlabelled steroids. 3H-dexamethasone accumulated in cell nuclei of both the pars distalis and the pars nervosa but not in those of the pars intermedia. This preferential accumulation (nuclear/cytoplasmic grain density, 4 : 1) was abolished by the concurrent administration of excess dexamethasone. 3H-corticosterone, to a much less marked extent than 3H-dexamethasone, accumulated in cell nuclei of the pars distalis but not in those of the pars intermedia and the pars nervosa. Excess unlabelled corticosterone diminished nuclear grain density in the pars distalis. After 3-h-cortexolone injection, preferential nuclear uptake was not observed. In a second series of experiments, excess dexamethasone (10 x, 100 x), corticosterone (100 x, 300 x) and cortexolone (100 x, 300 x) administered with 3H-dexamethasone were without effect on cytoplasmic grain density but totally abolished preferential nuclear accumulation. Parallel biochemical studies on kidney cytoplasmic preparations from the same animals showed no differences in total cytoplasmic radioactivity between treatments but marked differences in cytoplasmic bound 3H-dexamethasone. The results demonstrate: i) that dexamethasone binds specifically to cell nuclei of the pars distalis and the pars nervosa and that this nuclear concentration is abolished by competing corticosterone and cortexolone as well as dexamethasone; ii) that corticosterone localizes in cell nuclei of the pars distalis but much less markedly than dexamethasone; iii) that cortexolone fullfils the criteria of a glucocorticoid antagonist at the pituitary cell level.


The subcommissural organ of Lacerta s. sicula Raf.: functional studies. The secretory activity of the subcommissural organ (SCO) is affected by adrenalectomy, adrenalectomy + castration, and by an increase in ambient temperature in adrenalectomized and adrenalectomized + castrated animals. Adrenalectomy inhibits the activity of the SCO. After adrenalectomy + castration the decrease in the secretory activity of the SCO is more rapid. In contrast, an increase in the ambient temperature in adrenalectomized animals induces a recrudescence of the activity of the SCO. The increase in temperature in castrated + adrenalectomized lizards does not affect the inhibition produced by this type of surgical treatment. The histological changes are discussed on the basis of results obtained in the present study and in previous experiments.


Are there specialized junctions in the pars maculata of the distal tubule? In the present study the tight junctions at the macula densa were compared to those of the adjacent straight and convoluted segments of the distal tubule using freeze fracturing and thin sectioning techniques. Only insignificant differences were found in the number of strands and the apico-basal depth of the tight junctions in the three distal tubular segments of rat, dog and tree shrew. In experiments with horseradish peroxidase on mice and tree shrews, the tracer did not penetrate the apical junctions in any of the distal tubular segments. Our findings do not support the concept of considerably higher permeability of the tight junctions at the macula densa, as previously reported. Gap junctions were never observed in the distal nephron. The present results suggest that the glomerulo-tubular feedback is more likely to be mediated by transcellular resorption of solutes than by passive diffusion through a leaky paracellular shunt pathway.


The first optic ganglion of the bee. III. Regional comparison of the morphology of photoreceptor-cell axons. The nine receptor cells in each ommatidium of the worker bee end as six short visual fibres in the lamina and as three long visual fibres in the medulla. Behavioural and physiological evidence for regional variation in spectral sensitivity prompted observations on the morphology of the visual units. The distribution, branching pattern, diameter and the arrangement of axonal protusions of the characteristic receptor-cell axons were studied in various regions of the lamina. The six short visual fibres and two of the long visual fibres in each laminar cartridge are uniform over the total eye surface. Only the receptor axons of the ninth cell a UV and polarised light-sensitive cell, show obvious regional variation. In view of the regional constancy in morphology of eight of the nine receptor-cell axons, the regional variations in spectral sensitivity demand either functional subdivision of morphologically indistinguishable photoreceptors (e.g., content of different visual pigments) or a highly complex connectivity pattern of their axons in the first optic ganglion.


Localization of pancreatic polypeptide cells in a limited lobe of the human neonate pancreas: remnant of the ventral primordium? The localization of pancreatic polypeptide (PP) cells was studied in the pancreas of four human neonates by specific immunocytochemical techniques. PP cells were detected in all parts of the pancreas. However, examination at low magnification showed that they were considerably more numerous in a small lobe, located at the posterior-inferior part of the head region. It is suggested that this lobe corresponds to the part of the pancreas that is derived from the ventral primordium. Both in the lobe rich in PP cells and in the remainder of the pancreas, approximately 75% of PP cells were present in the islets and 25% distributed among acini and ducts.


Fine structure of the receptor-free epithelium in the vomeronasal organ of the rat. The topography and distribution of the epithelia of the vomeronasal organ were investigated in the adult male rat. Special attention was given to the light and transmission electron microscopic structure of the area that is known to be free of receptor cells. In contrast to several brief descriptions in which many cell types have been reported, only one cell type is presently described in different functional phases. In the rat, this epithelium does not show the typical features of a respiratory or, in more general terms, non-sensory epithelium. The authors propose to call this epithelium as "receptor-free" rather than respiratory, non-sensory or ciliated. The importance of the vomeronasal organ in the maintenance of olfacto-endocrine mechanisms and reproductive behavior is discussed.


Ultrastructural investigation on the cell membranes of the vomeronasal organ in the rat: a freeze-etching study. The free surfaces and cell contacts in the epithelia of the vomeronasal organ of the rat were investigated by freeze-etching. The microvilli of receptor cells show a lower density of intramembranous particles (IMP) than the microvilli in the receptor-free epithelium. The ratio between the IMP on P- and E-face is approximately 11 : 1 in the receptor terminals, and 3.5 : 1 in the cilia and microvilli of the receptor-free epithelium. Although atypical in length and only poorly equipped with rootlet fibers, the cilia of the receptor-free epithelium are furnished with typical ciliary necklace structures of up to 10 rows of membrane particles. Differences in the density of IMP on the P-faces of different cilia are probably due to continual ciliogenesis and also due to the different age of cilia in the receptor-free epithelium. Zonulae occludentes show different configurations in the neuroepithelium and in the receptor-free epithelium. In the former, they show a tendency to cross-link and form facet-like patterns, reflecting a constant morphology and relative stability for this apical region. In the receptor-free epithelium the junctional rows of zonulae occludentes display only loosely interconnected networks and a tendency to orient parallel to each other and to the free surface. In addition to zonulae occludentes, typical square aggregations of IMP are observed in the receptor-free epithelium. They are not exclusively restricted to the zone of intensive cell contacts by means of fine interdigitating cell processes, and their function has yet to be identified experimentally.


Classification of human placental villi. I. Histology. The classification of human placental villi was reviewed on the basis of material prepared by means of special methods. The material from in situ normal-term placentae was biopsied by aspiration into glutaraldehyde. The classification was made on the basis of light-microscopic observations of semithin sections, reconstructions from serial sections, and scanning-electron micrographs. The peripheral villous tree is roughly divided into stem (ramuli), intermediate and terminal villi. The intermediate villi may be further subdivided as mature and immature types, which are found between the stem and terminal villi. Some of the terminal villi possess a local specialization described as the neck region. The histological characteristics and the branching pattern of each type are described, and the basis of the proposed classification is discussed.


Classification of human placental villi. II. Morphometry. Villi of placental tissue obtained from normal term placentae at Caesarean section were embedded in Epon. Semithin sections were subjected to morphometry. The villi were first grouped according to the modified classification proposed in the foregoing paper. The parameters examined include villous numbers, size, vascularity, volume of trophoblast and connective tissue. The measured values differ markedly from those obtained from paraffin sections. Statistically significant differences exist between the different types of villi in various parameters, providing further evidence supporting the validity of the structural classification suggested.


Demonstration of acid phosphatase activity induced by 20-hydroxyecdysone in the fat body of Calliphora. In the larval fat body of Calliphora erythrocephala, protein accumulation and autophagic activity occur prior to the onset of puparium formation. The involvement of the lysosomal system in the degradation of sequestered protein and cell organelles can be demonstrated by the electron-microscopical cytochemical localization of the lysosomal marker enzyme acid phosphatase in so-called protein granules. These granules contain not only newly synthetized or absorbed protein but also remnants of cell organelles such as mitochondria and endoplasmic reticulum. Ligation of the larvae behind the brain-ring gland complex prevents the appearance of these acid phosphatase-positive granules. They can be induced in ligated larvae by the injection of 20-hydroxyecdysone into the abdomen. These findings are briefly discussed in relation to the role of moulting hormones in normal development, especially with regard to the induction of autophagic activity.


Separation of non-proliferating from proliferating thymic lymphocytes based on light scatter analysis. Two populations of thymic lymphocytes from eight-week-old mice were separated based on the light scatter intensity they generated while passing through a flow cell analyser. The two populations were subsequently studied morphologically and analysed for the relative amount of DNA present in each cell. Cells having a low light scatter intensity had a high nuclear:cytoplasmic ratio, a heterochromatic nucleus, and a proliferative index (S + G2 + M) of only 23%. Cells with a high light scatter intensity had a low nuclear:cytoplasmic ratio, dispersed chromatin, frequently a uropod with budding microvilli and a proliferative index of 71%. The low light scatter cells resemble small cortical thymocytes or lymphocytes from the thoracic duct described by others. The highest light scatter cells resemble medium lymphocytes shown by others to be proliferative.


Larval adhesive organs and metamorphosis in ascidians. II. The mechanism of eversion of the papillae of Distaplia occidentalis. The cup-shaped adhesive papillae of Distaplia occidentalis evert at the onset of metamorphosis and each transforms into a hyperboloidal configuration. The rate of transformation is a function of temperature. At 14 degrees C complete eversion takes about 30 seconds. Myoepithelial cells that extend from the rim to the base on the cup contract. Simultaneously the central part of the papilla advances 60--70 micrometers. During the last phases of eversion, collocytes (cells that secrete adhesives) on the inner wall of the cup and on the sides of the axial protrusion flow outward and form a collar-like structure. The myoepithelial cells contain arrays of thick and thin filaments. These become compacted during contraction. The surfaces of these cells become extensively folded as they shorten to about 1/3 of rest length. According to the proposed model the myoepithelial cells are the driving force in papillary eversion. Immediately after eversion is completed the papillae begin to retract. Eversion of the papillae is not inhibited by cytochalasin B, but the process of retraction is reversibly inhibited. Some histological characteristics of five types of everting papillae in four families of ascidians are compared.


An electron microscopic study of lipid absorption in the pyloric caeca of rainbow trout (Salmo gairdnerii) fed wax ester--rich zooplankton. Rainbow trout were killed 4 and 18 h after being fed wax ester-rich marine zooplankton and the absorptive epithelium of the pyloric caeca examined by electron microscopy. Numerous osmiophilic drops were seen in the lamina propria underlying the epithelium of fish killed at both times, but these drops were only abundant within columnar epithelial cells of fish killed 4 h after feeding. Pinocytotic profiles were not common at the luminal plasma membranes, nor were osmiophilic droplets seen in the terminal web area between the luminal plasma membrane and the extensive smooth endoplasmic reticulum. Numerous osmiophilic droplets, 30--100 nm in diameter, were present in the cisternae of the smooth endoplasmic reticulum with up to five separate droplets per individual cisterna. Columnar epithelial cells also contained up to 100 large osmiophilic drops ("conglomerates") which tended to be concentrated in the supranuclear (Golgi) regions. The conglomerates were 250--1200 nm in diameter and were themselves made up of smaller droplets 30--400 nm in diameter. Conglomerates were present both within intracellular membranes and free in the cytoplasm. Osmiophilic droplets in the intercellular spaces and lamina propria were similar in size to individual droplets within conglomerates. We conclude that triacylglycerols are elaborated in the smooth endoplasmic reticulum, transferred to and processed in the Golgi region and finally discharged serosally as chylomicron-like particles of not greater than 400 nm diameter.


In vitro recalcification of the demineralized shell-repair membrane of the snail, Helix pomatia L. The role of the amoebocytes in the calcification process of the shell-repair membrane of the snail, Helix pomatia, was investigated in vitro. The shell-repair membranes were demineralized with 0.5 M EDTA at pH 7.4. For the recalcification of the demineralized membranes two substrates were chosen: (i) Tris-buffered Helix pomatia-saline, pH 7.4, and (ii) Helix pomatia-saline supplemented with 5 mM CaCl2 and 5mM NaHCO3. The membranes were incubated in 2 ml substrate at 37 degrees C and examined after 2 h, 24 h, and 3, 5 and 7 days. Calcium deposition and crystal formation were observed within the membranes incubated in the salt-supplemented substrate. The control membranes were either heat-inactivated or deprived of lipids. No calcium precipitation was observed in control membranes. The experiments show that the recalcification of the shell-repair membrane is under strict cellular control and that the granules released from the amoebocytes serve as sites for calcium deposition. The role of phospholipids in the calcification process is discussed.


The effect of supine rotation on left ventricular dimensions in man: a study using radio-opaque epicardial markers. It has been reported that patient rotation into the left lateral decubitus position (30 degrees rao) produces significant changes in the regression equations used for left ventricular volume determination and that normal values for echocardiographic left ventricular dimensions obtained from supine patients differ from those obtained after rotation. The purpose of this study was to establish whether patient rotation is associated with changes in left ventricular size and systolic function. The distances between left ventricular epicardial markers attached at the time of cardiac surgery were measured using biplane cineradiography in 14 patients in order to determine left ventricular dimensions before and after rotation. Supine epicardial left ventricular dimensions were not significantly different from those obtained with the patient rotated 30 degrees rao. These results suggest that reported changes in invasive and noninvasive measurements of left ventricular function associated with patient rotation are not primarily due to changes in left ventricular size.


Intracardiac M-mode echocardiography for continuous left ventricular monitoring: method and potential application. Because no accurate and readily applied method exists for continuous recording of left ventricular cavity dimensions and wall motion in man, we designed a catheter-mounted echocardiographic probe. The purpose of this report is to describe the instrumentation, technique, limitations, complications and preliminary observations employing the probe in humans. The echo transducer built into a cardiac allowed positioning in the right heart under fluoroscopy. The echo signals permitted continuous left ventricular cavity measurements at rest and during maneuvers. Our results suggest that intracardiac echo may be able to provide clear definition of motion patterns of the mitral valve and left ventricular walls. The ultrasonic catheter is an instrument that potentially offers a new technique for continuous monitoring of left ventricular size and motion.


Aortic vasa vasorum in cyanotic congenital heart disease. Three cases for longstanding untreated cyanotic congenital heart disease are presented. In addition to collateral circulation from bronchial, intercostal, and inferior phrenic arteries, thoracic aortic vasa vasorum were visualized. We believe this may represent an additional collateral pathway to the lungs. The angiography of these cases is presented.


Massive hemoptysis secondary to flow-directed thermodilution catheters. Hemoptysis is an unusual complication of flow-directed (Swan-Ganz) catheters. Over-inflation of the balloon with a shearing-induced rupture of a small pulmonary artery, and the spear effect of the catheter tip appear to be the mechanisms in the two cases presented. Diligent care to avoid overinflation of the balloon in the pulmonary capillary wedge position by observation of the pressure waveform is critical. The spear effect that is frequently seen during insertion may be eliminated by deflating the balloon at the first appearance of the pulmonary artery waveform and gradual advancement of the catheter five to eight cm, when the balloon is then reinflated to obtain the wedge.


Coronary artery-left ventricular communications: a report of two cases and review of the literature. Two patients with chest pain had angiographically-demonstrated communications between the three coronary arteries and the left ventricular chamber. Communications between coronary arteries and the left ventricle are unusual and communications between all three coronary arteries and the left ventricle are rare. These anomalies are, however, commonly associated with symptoms of chest pain. The presence of left ventricular hypertrophy and a widened pulse pressure may suggest a greater hemodynamic effect of the shunt flow than often suspected angiographically.


Percutaneous preformed single catheter coronary arteriography and its complications--10,000 cases. The single preformed catheter has offered an alternative to the conventional approaches to study of the coronary circulation and ventriculography. It has the advantages of being introduced percutaneouly without multiple changes for routine study or for provocative drug testing such as for spasm with Ergonovine maleate or muscular bridges with nitroglycerine. It requires no arteriotomy and has been associated with a low complication rate.


Quantitative coronary arteriography using 105-MM photospot angiography and an optical magnifying device. A quantitative coronary arteriographic technique is described utilizing 105-mm photospot angiography and a hand-held optical magnifying device. This technique is rapid, accurate, and reproducible. We feel this technique has potential in evaluating coronary responses to acute interventions and in the long term evaluation of progression or regression of atherosclerotic disease.


Inexpensive radiation protective glasses. Using the services of a local optical supply house, fabrication and testing of eyeglasses of a high lead content that could be used to protect the eye from the hazards of radiation were evaluated. Two separate types of eyeglasses were manufactured (a prototype followed by a second pair), and these were tested against a commercially available pair of radiation protective glasses. The protection offered by the locally manufactured pair of glasses exceeded the commercial pair and the cost savings are significant.