[Topographic correlations between the Chinese craniopuncture zones and the cerebral gyri]. Scalp acupuncture being a new chinese therapy in some nervous diseases, the authors establish here topographic relations between its areas and cerebral gyri. These areas are bordered by two main lines: the first is a medial antero-posterior line, the second is a transversal line joining the middle of the brow to the external occipital tuberosity. Brain extraction was possible after congelation. The sulci were injected by three different methods (aluminium wire, red lead and thick barium). Radiological research showed a close relationship between stimulation areas used in scalp acupuncture and neurological knowledge.


[Morphologic and biometric data on the constitution of the brachial plexus in man]. The authors relate the results of the examination of 172 human brachial plexuses from 89 leukoderma subjects native from the Parisian area. The origin of the plexus, with a participation of the fourth cervical nerve root in 41 p.c. of the plexuses, and its distribution, with three primary trunks in 90 p.c. of the plexuses were correctly described by classic authors. The secondary ventro medial trunk receives fibers from the middle primary trunk in 10 p.c. of the plexuses. The biometric study shows that the seventh cervical root is the largest on both sides and that secondary trunks are longer than the primary.


[Effect of the spatial environment on the mitotic activity, size and protein content of Paramecium tetraurelia]. Cell proliferation, cell volume, protein components of paramecia and chemical analysis of culture medium were studied in Paramecium tetraurelia cultures placed in space environment. The space flight resulted in a marked stimulation of cell proliferation, an increase of cell volume, a decrease of mean protein components and changes of electrolytes in the culture medium.


[Morphometry of the femoral head in the rabbit. Surface appearance of the acetabulum after femoral prosthesis]. An anatomical study has been achieved on 42 upper extremities of adult rabbit's thigh bones. Three types of prostheses have been perfected in order to analyse the reactions of the cartilage and of the subchondral bone when confronted with these implants. The animals were sacrificed at different intervals. The state of the acetabulum surface has been studied according to macroscopic and microscopic criteria. Three methods converge and agree in showing an arthrosis type of reaction with regard to the non operated controlateral articulation.


The flow volume curve: normal standards in young subjects. During epidemiological survey, satisfactory flow-volume data were obtained from 438 young Italian Boy-Scouts. Data from 302 non-smoking subjects (170 males and 132 females, ranging in age from 10 to 20 years) free of symptoms or history of cardiorespiratory disease were used in determining "normal" prediction equations and nomograms for peak expiratory flow (PEF), maximal expiratory flow at 75 percent (V 75%), 50 percent (V 50%), 25 percent (V 25%) of the forced vital capacity. The flow-volume curve showed for the same height and age evident intersubject variability. The prediction equations and nomograms give mean values but no information on scatter.


[Clinical and therapeutic considerations on bochdalek's congenital posterolateral diaphragmatic hernia (author's transl)]. The Authors describe 5 cases of Bochdalek's posterolateral diaphragmatic hernia in terms of their clinical, diagnostic, and therapeutic aspects. They also explain their criteria in the choice of surgical approaches and describe reconstruction methods used in the repair of large hernias. Finally, they propose a special schedule of postoperative management to be used in connection with neonatal surgery, where surgical mortality is still high.


[The diaphragmatic relaxatio (author's transl)]. The Authors briefly describe two cases of diaphragmatic relaxatio that they have seen and studied; then they make a revision of the literature about this uncommon disease. They speak about embryogenesis of the diaphragm and about nosology, etiopathogenesis, frequency (ages and sex) and phatological anatomy of this disease. In conclusion the Authors discuss in detail signs and symptoms, diagnosis and surgical treatment of diaphragmatic relaxatio.


[Gastroduodenal perforation due to peptic ulcers: a statistical contribution (author's transl)]. The authors offer a review of their ten-year (1968-1978) experiences at the First Institute of Clinical Surgery, University of Catania. In particular, they report on the low morbidity (12.9%) and mortality (4.5%) observed in a series of 240 patients with gastric or duodenal perforation due to peptic ulcers treated surgically by simple suture of the perforation.


[Enterovesical fistula (author's transl)]. The authors get a starting point from describing a case with undecided etio-pathogenesis, to focalize the entero-vesical fistulas that represent the most frequent variety of entero-urinary fistulas. Particularly they stop a little on manifold aspects of etio-pathogenetic and classificative order, refer anamnestic, clinical, instrumental and radiological data which allow to get an undoubted diagnosis, emphasize the high rates of complete recoveries in relation to the timely application of adequate surgery.


[Penetrating heart wounds: four cases (author's transl)]. The authors describe four cases of penetrating heart wounds: two from slash and puncture injuries and two from gunshot. Hearth lesions involved the left ventricle and pericardium in two cases, the right ventricle in one case, and only the diaphragmatic pericardium in one case. After a review of the literature, the authors discuss clinical and diagnostic problems relative to penetrating chest wounds and particularly those of the heart, stressing the need for very prompt diagnosis; as for actual treatment, they conclude that this can be carried out without any special problems in any Department of general emergency surgery.


[Complications of primitive tumors of the small gut: personal observations in nine cases (author's transl)]. The authors describe 9 cases of primitive tumors of the small gut (3 adenocarcinomas, 2 lymphosarcomas, 1 fibroma, 1 angioma, and 2 leiomyosarcomas, one being the cause of active hemorrhage). In all cases the tumors were diagnosed only at operation, which was invariably necessitated by complications. Seven patients underwent emergency surgery for intestinal obstruction; one underwent an exploratory laparotomy for recurrent intestinal bleeding caused by an angioma of the ileum; and the last of this series (exceptional enough to warrant separate reporting elsewhere) was operated upon as an emergency case when the tumor, precisely a leiomyosarcoma, was perforated and actively bleeding.


[Intestinal obstruction and incomplete obstruction from mesenteric cyst formation in children (author's transl)]. In the light of three cases of their own observation, of children with mesenteric cysts causing complete or incomplete intestinal obstruction, the authors review the existing literature on the subject, discuss the etiology, clinical aspects, and therapeutic methods for the correction of such pathology, and conclude by calling attention to mesenteric cysts as possible causes of intestinal transit disorders in the pediatric age group.


[Elastic ligature in the treatment of hemorrhoids (author's transl)]. The authors report their experience with 57 patients suffering from first, second, and third-degree hemorrhoids. Elastic ligature of internal hemorrhoid nodules was done ambulatorily with good results and no important complications. From these results, and considering the ease of the procedure, the authors agree with other experts that this method of treating hemorrhoids may become more and more popular.


[Transverse colon atresia. Case presentation (author's transl)]. The Authors report about a case of colonic atresia localized on the transverse colon a few cms after the right flexure curd by one time resection and end-to-end anastomosis. The pathology of the lesion is atypical since features of Bland-Sutton and Louw's classification types II and III were mixed together at the atresia site while the radiological features were those typical of type II.


[Criteria of choice and long-term results of surgery for plain goiter (author's transl)]. The Authors review their criteria of choice in 95 operations for plain goiter. The explain the parameters used in the evaluation of the various surgical procedures represented in this series, and give an account of long-term results in patients completing the followup period.


[Peripheral vascular trauma (author's transl)]. The authors review several existing classifications of traumatic events affecting the peripheral blood vessels; after discussing the symptoms of such events and diagnostic guidelines, they outline therapeutic approaches and emphasize above all the need for prompt surgery with the least possible delay after the injury. They review of cases of their own observation, and conclude by highlighting the basic concepts of modern surgery in this field of pathology.


[Assay of antithrombin III and soluble fibrin complexes in the study of blood thrombophilia (author's transl)]. The authors conducted a series of experiments concerning the condition of hypercoagulability of patients with a history of thrombosis, in view of determining whether or not the risk of thrombosis could be assessed by laboratory tests. To that end they assayed antithrombin iii activity and soluble fibrin complexes in their test subjects. Antithrombin activity was assayed by a chromogenic method; soluble fibrin complexes by the hemoagglutination test. The activity of antithrombon III was significantly reduced in patients with venous thrombosis, not so in arterial thrombosis. Testing for soluble fibrin complexes was invariably unrewarding, probably because the thrombosis episodes under investigation were of too long standing.


[Pre- and post-operative evaluation of biologic parameters in patients with scoliosis (author's transl)]. The authors had studied biological parameters of respiratory and muscle function in patients effected by scoliosis before and after surgical treatment according to Harrington method, in order to evaluate a correlation with the anatomical deviations. The study has been led by spirometric and electromyographic tests, which have show a real correspondence between the anatomical situation and the considered parameters before and after surgical treatment, and emphasizing an improvement of respiratory and muscle function.


[Intrafascicular neurolysis in carpal tunnel syndrome recurrences]. The authors view intrafascicular neurolysis of the median nerve as the only therapeutic solution for recurrencies of the carpal canal syndrome. The procedure should be carried out as early as as possible in order to obtain not only the control of pain but also the restoration of good trophic conditions of the tenar eminence.


[Reasons for treatment failures in carpal scaphoid fractures]. Are taken into examination the principal causes of mechanical, biological, anatomical order, of incorrect treatment to whom to give the evolution in pseudoarthrosis of scaphoid fractures and of unsuccess for their bloody treatment. Cases of insuccesses is presented for whom is tried to give to each one of them an etiopathogenetical explanation and the most recent techniques adopted are shown.


[Indications for and the validity of the traditional electrodiagnostic and electromyographic examinations in orthopedics and traumatology]. Electrodiagnosis and E.M.G. are two neurophysiological primers able to study muscle and nerve problems related to the electroanalisis. This two primers are dissected in this text either in relation to their use or to their opportuneness for the diagnosis of some important disease of orthopedic interest.


[Unusual trauma of atlas. (Jefferson's double fracture with a fracture of right lateral mass). Clinical note (author's transl)]. Reporting a study of theirs about a Jefferson bilateral fracture combined with a dislocated fracture of the atlas vertebra on its right side, the Authors inquire into the traumathology of the cervical spine giving account of the result study.


[Medical and surgical problems of old patients in orthopedics (author's transl)]. The world-wide medical researches are agreed to point up the importance of all the problems concerning the old age. Considering that, the authors of the text deal with the new therapeutic methods for the old, according to their peculiar orthopaedic studies.


[Considerations on the treatment of fractures of the proximal end of the tibia (author's transl)]. The authors discuss the treatment of fractures of the proximal end of the tibia with special attention to the relative merits and limitations of nonsurgical versus surgical procedures. In this respect the clinical material accumulated at the Istituto Ortopedico G. Pini of Milan affords a fruitful comparison of the two therapeutic approaches. More precisely, while the differences are not so dramatic as to favor one approach over the other in all cases, it appears evident that surgical aggression by suitable methods and in properly selected cases affords markedly shorter periods of immobilization and more rapid functional recovery.


[Clinical statistical remarks about osteoarticular tuberculosis in some hospitals in Milan from 1975 to 1978 (author's transl)]. The Authors have examined some patients (164 at all) accepted with specific osteoarthritis, among 7 Milan's hospitals. They have inferred clinical evaluations in connection to articular locations, their frequency and their development, to the connection with social and economic condition and to the management.


[Particular aspects of painful symptomatology in orthopedic-traumatologic pathology (author's transl)]. Medicine and surgery are able to resolve almost the whole painful symptomatology now, but they are not allowed to understand and explain the original essence of the pain itself. In this work the authors aim to emphasize the physio-pathological features of the pain considering such a problem as a psychosomatic question.


[Treatment of delayed or defective consolidation in posttraumatic double fractures]. The authors have analyzed a numerous case material of leg and antebrachium open fractures slowly evoluted or bad stiffened. After a classification of the various types of slow and defective knitting, according to their mechanical and biological etiology. The authors have examined the specific surgical cares, with particular attention about external fixator Hoffman-Vidal, Judet.


[Problems in fractures of the tibial plateau]. Subject of the work is the fracture of the tibial condyle. Their classification is based on two main principles: their site and their pathologic anatomy. Many and different theories about their treatment are carefully analized after.


[Carpal tunnel syndrome: the causes of recurrence]. The authors discuss the possible causes of recurrency in patients with the carpal canal syndrome treated surgically by splitting of the transverse carpal ligament. With reference to possible technical errors in the surgical procedure, they explain the correct way to obviate not only the extrinsic compression of the nerve but also the intrinsic pressure exerted upon the axons.


[Lesions of the extensor apparatus of the distal phalanx of fingers in children (author's transl)]. The authors discuss their experience in the treatment of lesions of the extensor apparatus of the distal phalanx of fingers in children. The discussion touches upon diagnostic and therapeutic aspects of the problem and includes a detailed description of the surgical procedure adopted by the authors, which proves adequate to obviate the well-known morphological and functional alterations often following such lesions.


[Neurogenic arthropathies].

[Neurogenic arthropathies]. Are taken in examination the various causes of the neurogenic arthropathy. Are described the three main diseases which provoke a neurogenic arthropathy, that is the tabes, the hydrosyringomyelia, the diabetic neuritis. Are described arthropathy above all on the shoulder, on the Knee, and on the Foot. Are described five points for the precocious diagnosis of the disease.


[General considerations and modern views on the surgical treatment of recurrent dislocation of the shoulder (author's transl)]. The authors discuss the treatment of recurrent dislocation of the shoulder joint in a synthetic review of methods so far proposed and tried out; the they offer a critical description of the method currently representing the best one available according to their experience made at Milan's Istituto Ortopedico G. Pini.


The estimation of mutation rates when premeiotic events are involved. When mutation or recombination events occur premeiotically, the distribution of exceptional individuals among the offspring will be "clustered" as opposed to binomial. Even though the exact nature of the clustering is usually unknown, unbiased methods for measuring mutation rate and determining the precision of these measurements are given to replace a biased method now frequently used. When clustering is pronounced, the unweighted average mutation rate is found to be a more efficient estimator than the usual average weighted by family size. Methods of statistical inference and optimal experimental design in the absence of specific knowledge of the mechanism of clustering are also discussed.


Mutagens in a river heavily polluted with paper recycling wastes: results of field and laboratory mutagen assays. Paper recycling industries generate considerable quantities of waterborne wastes, and thus water pollution constitutes the greatest environmental problem associated with this industrial activity [Hunt and Franklin, 1973]. Generally the impact of this water pollution is considered in terms of aesthetic blight and deterioration of water quality. We present data that document another aspect of this pollution, the environmental contamination of an aquatic ecosystem with mutagenic materials. A natural population of the fern Osmunda regalis growing in a river heavily polluted with paper recycling wastes had a high incidence of chromosome mutations. This population was monitored for four years for the frequency of two-break chromosome mutations. These mutations were postzygotic in origin and suggested the presence of mutagens in the river water. The fern population is downstream from the outfalls of a paper recycling mill, which was discharging 13.3 X 10(6) liters of untreated paper recycling waste per day. In 1977 a waste-water-treatment facility was constructed to remove the solid waste previously discharged into the river. This facility generates 69,300 kg of solid waste daily, which is taken to a landfill. Periodic samples of this solid waste were collected from the waste-treatment facility in the summer of 1978, extracted with various solvents, and the extracts tested for mutagenic activity with the Salmonella/mammalian microsome mutagenicity test [Ames et al, 1975]. A majority of the solid waste samples contained mutagenic materials, but in all cases S-9 activation was required for mutagenic activity. The samples also were assayed with the soybean mitotic crossing-over assay [Vig, 1975]. Four out of six samples were positive. These results document the presence of mutagens in the solid waste generated by a paper recycling industry and the genetic impact of these mutagens on the local biota.


Cytogenetic effects of busulfan in vivo on bone marrow cells and oocytes of adult mice and liver cells of transplacentally exposed embryos. Adult female mice were twice treated orally with 15, 30, or 60 mg busulfan per kg of body weight. In bone marrow, a dose-dependent linear increase in the frequency of chromosome aberrations was observed. Similar to the effects of other alkylating agents, busulfan induced all types of aberrations, including exchanges. In metaphase II oocytes, only a few chromosome aberrations were observed. An intervening round of DNA-replication seems to be necessary to translate busulfan-induced lesions in oocytes into chromosome aberrations. In embryonic liver cells of transplacentally exposed mice, chromosome aberrations were induced.


Cytogenetic investigation on leukocytes of workers exposed to metallic mercury. A cytogenetic analysis was performed in 28 mercury-exposed subjects as well as eight control subjects from the same chloralkali plant and in 12 healthy controls from the "general population." No chromosomal effects could be demonstrated in the mercury-exposed population in comparison with both control groups. Also no effect of smoking was observed. From the study it seems obvious that mercury, although it is capable of producing chromosomal damage even at low exposure levels, will not be harmful in this respect when adequate protection measures are taken.


Prevention of the mutagenic activation of an antischistosomal isothiocyanate in primates by an antibiotic. Administration of 4 nitro-4' isothiocyano-diphenylamine (CGP 4540, amoscanate) to two nonhuman primates, Macaca mulatta and Cebus apella, resulted in the appearance of mutagenic material in the urines of these animals. Mutagenic metabolites of this drug could also be detected in the urines when the drug was administered to primates infected with Schistosoma mansoni and Schistosoma japonicum. As observed previously in mice, the mutagenic activation of amoscanate can be prevented in primates by coadministration of a single oral dose of erythromycin with no concomitant reduction in antischistosomal activity. The protective effect of erythromycin was confirmed in several crossover experiments. This dissociation of mutagenic from chemotherapeutic effects provides an opportunity to reduce serious potential long-term risks of this antischistosomal drug.


Ethylene oxide: evidence of human chromosomal effects. Ethylene oxide is a known mutagen as indicated by short-term testing in vitro and in vivo. Occupational exposure can occur during ethylene oxide gas sterilization of materials for hospital and other use. To study the problem in a hospital sterilization facility where occupational exposure was suspected, epidemiologic, analytic and bioassay tools were employed. All persons whose work activities involved some aspect of the sterilization process were considered exposed to the gas. Within this group of symptomatic and asymptomatic individuals, chronic and incidental exposure was documented by clinical history. Sister chromatid exchanges were studied in lymphocytes cultured from exposed individuals as well as comparable controls. Four chronically exposed persons who reported upper respiratory and neurologic symptoms were studied in some detail. This group showed significantly increased sister chromatid exchange at three weeks and again at eight weeks after the last known exposure. Another group of eight persons with fewer complaints studied as late as the ninth week showed significantly increased exchanges. Incidental exposure may also increase sister chromatid exchange. The measured maximum concentration of ethylene oxide in the sterilizer room was 36 ppm (within standards set by the Occupational Safety and Health Administration).


The effect of 2,4-diaminotoluene and isomers of dinitrotoluene on unscheduled DNA synthesis in primary rat hepatocytes. The important industrial chemicals 2,4-dinitrotoluene (DNT) and 2,4-diaminotoluene (DAT) are hepatocarcinogens in rats. Technical grade DNT contains approximately 76% 2,4-DNT, 19% 2,6-DNT, and lesser amounts of the other isomers. The ability of 2,4-DAT, technical grade 2,4-DNT, and the purified isomers 2,3-DNT, 2,4-DNT, 2,5-DNT, 2,6-DNT, 3,4-DNT and 3,5-DNT to damage the DNA of primary rat hepatocytes was examined. Male Fischer-344 rats were perfused in situ, single cell suspensions were obtained after liver dissociation, and cultures of these cells were treated in the presence of 3H-thymidine. Autoradiography was employed to visualize label incorporation following repair of DNA. At the nontoxic (as judged by cell morphology) doses of 1 x 10(-4) M and below, only 2,4-DAT induced a significant response (ie an average greater than 5 grains net/nucleus). The activity seen with 2,4-DAT suggests that damage to the DNA of the hepatocytes may play a role in its carcinogenic activity and is consistent with the proposal that the induction of DNA repair in primary hepatocytes is of value in predicting the activity of aromatic amino compounds. However, the carcinogenic activity of the dinitrotoluenes was not reflected as DNA repair in the isolated hepatocyte, indicating that additional factors involving the whole animal also play a role in the mechanism of action of DNT.


QSAR of the inhibition of glyoxalase by S-substituted glutathiones. A quantitative structure-activity relationship (QSAR) has been formulated for the inhibition of glyoxalase I from yeast by 37 S-substituted glutathiones: log 1/C = 1.23 pi' + 1.20 MR4 - 0.67 I1 - 0.14 pi'2 + 1.85 C in this expression is the molar concentration of inhibitor producing 50% inhibition, pi' is the usual hydrophobic parameter modified for certain substituents, MR4 is the molar refractivity of certain p-phenyl substituents, and I1 is an indicator variable for those congeners with an acetylated alpha-amino group. This equation should be of help in the design of more effective inhibitors which may be of value in cancer chemotherapy.


[N-Alkyl-2-(5-methyl-4-imidazolyl)ethylamines. Synthesis and effect on gastric secretion]. Synthesis of some 5-methylhistamines alkylated on the amino group (form. I) together with a new method (C) of obtaining them via 5-methylhistaminol, are described. Both the agonistic and antagonistic pharmacological activities of these methylhistamines were studied in vivo on gastric secretion of different animal species (conscious dogs and cats and anaesthetized rats). The potency of the compounds, as far as the H2-receptor stimulant effect is concerned, was very remarkable in the first members of the series and decreased by increasing the degree of substitution. Independently from their "potency" some members of the series showed an "efficacy" which was actually greater than that of histamine. All the compounds tested were completely devoid of any antagonistic activity against gastric hypersecretion induced by histamine.


[Chemical and pharmacological research on pyran derivatives. XII. Bis-(beta-chloroethyl)amino-substituted chromones and benzochromones]. By the reaction of phenols or naphthols with N,N-bis-(beta-methoxyethyl)ethoxycarbonylacetamide in the presence of phosphorus oxychloride the preparation of bis-(beta-methoxyethyl)amino substituted chromones or benzochromones was achieved. Treatment of these compounds with hydriodic acid at 95 degrees and then with thionyl chloride gave rise to the formation of the corresponding bis-(beta-chloroethyl)amino derivatives. When beta-naphthols reacted with N-ethoxycarbonylacetylmorpholine 1-oxo-3-morpholino-1H-naphtho[2,1-b]pyrans were obtained. These compounds as well as the corresponding 3-bis-(beta-methoxyethyl)amino derivatives afforded 1-oxo-3-bis-(beta-iodoethyl)amino-1H-naphtho[2,1-b]pyrans by treatment with hydriodic acid at reflux. The latter compounds were also easily transformed into 3-bis-(beta-chloroethyl)amino derivatives by reaction with phosphorus oxychloride in N,N-dimethylformamide. Pharmacological screening of some of the compounds described indicated no tumor-inhibiting activity.


[1,5-Benzodiazepines. III. Synthesis of 2,4-bisdialkylamino-3H-1,5-benzodiazepines]. Treatment of 2,3-dihydro-2-oxo-4-dialkylamino-1H-1,5-benzodiazepines with phosphorus pentasulfide afforded 2-thio derivatives which in turn gave the corresponding methylmercapto derivatives by reaction with sodium hydride and methyl iodide. By treating these compounds with dialkylamines the formation of 2,4-bisdialkylamino-3H-1,5-benzodiazepines was achieved. Pharmacological screening of some of the products indicated that the introduction of a second dialkylamino substituent into the 1,5-benzodiazepine molecule gave the compounds CNS excitant properties, while the initial monodialkylamino derivatives containing sulfur showed a CNS depressant activity.


[Unexpected anti-inflammatory activity of rigid structures derived from 6-arylpyridazinone antihypertensive agents. II. Synthesis and activity of 5H-indeno(1,2-c)pyridazine and 5H-indeno(1,2-c)pyridazin-3-one]. The synthesis of 5H-indeno[1,2-c]pyridazine (V) and of some derivatives were reported. The compounds synthesised generally retained the antiinflammatory activity exhibited by the 4,4a-dihydro derivatives of this class, previously tested. Moreover (V) showed analgesic and antipyretic properties higher than those of acetylsalicylic acid.


[Antimicrobial effect of derivatives of 1,2,4-benzothiadiazin-1,1-dioxide. VII]. Series of alkyl derivatives of the following have been prepared: 5,7-dichloro- [compounds (II leads to V)], 6-methyl- [compounds (VI leads to IX)] and 6-methoxy-3-mercapto-1,2,4-benzothiadiazine-1,1-dioxide [compounds (X leads to XIII)]. The products were tested for antimicrobial activity. Studies were also made of the corresponding 3-mercapto precursors (XIV, XV, XVI) and the relative 3-picolinium salts (XVII, XVIII, XIX) and also of the 3-picolinium salts of 6-chloro-, 7-chloro- and 6,7-dichloro-3-mercapto-1,2,4-benzothiadiazine-1,1-dioxide (XX, XXI, XXII). Some of the 3-alkylmercapto compounds, and especially the 5,7-dichloro derivative, inhibited various strains of Gram-positive bacteria of the genus Staphylococcus, while the same substances proved much less effective against the genera Streptococcus and Diplococcus. Antimicrobial activity appeared to be influenced by the length of the alkyl chain as well as by the nature and position of the substituents on the benzene ring. The compounds proved inactive against the Gram-negative schizomycetes (Salmonella, Shigella, Escherichia, Proteus, Pseudomonas. Enterobacter, Klebsiella, Serratia, Yersinia, Providencia) and against yeasts (Candida) with the exception of compound (V) which showed slight bacteriostatic action against three strains of Candida albicans.


Synthesis of 7-acylamidodesacetoxycephalosporanic acids and corresponding pivaloyloxymethyl esters. Chemical and microbiological properties. A series of 7-acylamidodesacetoxycephalosporanic acids and analogous pivaloyloxymethyl esters have been prepared and tested in vitro for antibacterial activity. Those acids which exhibited a significant in vitro activity, were also studied in vivo and compared with the corresponding esters. Experiments performed on laboratory animals showed that, after oral administration, the esters were absorbed more efficiently than the corresponding acids.


The anticonvulsant and CNS activity of N-butyryl-N-butylurea in mice. As a further extension of our studies related to CNS activity of substituted butylureas, a number of derivatives of butylurea were synthesized. Among these a derivative of n-butylurea, N-butyryl-N-butylurea (NBNB) was prepared by acylation of n-butylurea with butyryl chloride in pyridine. The compound was found to possess considerable sedative-hypnotic action. Sleeping time of pentobarbital and barbital was significantly potentiated by NBNB. The compound also exhibited moderate anti-tremorine action and produced significant reduction in the activity ratio for Treadmill experiments. Significant anticonvulsive activity of NBNB was observed against strychnine, pentetrazole and supramaximal electroshock-induced convulsions. In addition to protection against tonic convulsions, the animals were also protected against strychnine and pentetrazole lethality.


Synthesis and pharmacological activity of derivatives of exo-trimethylenenorbornane. II. By reaction of secondary amines with 3-hydroxymethylene-exo-5,6-trimethylenenorbornan-2-one, synthesized from exo-5,6-trimethylenenorbornan-2-one and sodium/ethyl formate, a series of N,N-disubstituted 3-aminomethylene-exo-5,6-trimethylenenorbornan-2-ones has been obtained. These compounds gave N,N-disubstituted 3-aminomethyl-exo-5,6-trimethylenenorbornan-2-ones by LiAlH4 or catalytic reduction. Starting from the same alpha-hydroxymethyleneketone, pyrazole derivatives (V) and (VI) have been also synthesized; the former showed anticonvulsant activity in mice.


Synthesis and pharmacological activity of derivatives of exo-trimethylenenorbornane. III. Two synthetic routes to (exo-5,6-trimethylenenorbornan-2-ylidene)acetonitrile starting from exo-5,6-trimethylenenorbornan-2-one are described. From the above-mentioned nitrile, 2-(exo-5,6-trimethylenenorbornan-2-ylidene)ethanamine and 2-(exo-5,6-trimethylenenorbornan-2-yl)ethanamine, as well as N,N-dimethyl and N,N-diethyl derivatives of the latter, were prepared.


[Bile acid derivatives with antimicrobial activity]. A series of condensation products of cholic and dehydrocholic acids with (L)-aminoacids was prepared and tested in vitro for antimicrobial activity. The derivatives of cholic acid with basic aminoacids showed significant activity, especially marked when (L)-arginine was the condensed aminoacid.


[Synthesis and biological activity of 7-(2-nitroimidazoles and 7-(2-aminoimidazole) methyleneamino cephalosporin and their derivatives]. The synthesis of 7-[[(1-methyl-2-nitro-1H-imidazol-5-yl)methylene]amino] and 7-[[(2-amino-1-methyl-1H-imidazol-5-yl)methyle-ne]amino]cephalosporanic acids and of some derivatives is described. Their physico-chemical characteristics are reported. The compounds show no appreciable antibacterial activity in vitro. They show no synergy with cephaloridine against Enterobacter cloacae 214 (producer of class I beta-lactamase) and therefore have no anti-beta-lactamase activity.


Study on compounds with potential antitumor activity. III. Hydrazone derivatives of 5-substituted 2-chloro-3-formyl-6-methylindole. The synthesis of 5-methoxy- (IX) and 5-hydroxy- (X) 2-chloro-3-formyl-6-methylindole is reported: three hydrazonic derivatives were prepared from each compound. Preliminary results on the activity of the six derivatives against P388 leukemia in mice are reported.


Synthesis and neuropharmacology of cyclobutanecarbonylureas. Ten urea derivatives of cyclobutanecarboxylic acid were synthesized and examined for general CNS depressant properties, barbiturate potentiation, myorelaxant, antitremorine and anticonvulsant potencies. Water solubility seems to play an important part in the activity of these compounds. However, lipid solubility also plays a part as activity determinant. 1-Cyclo-butanecarbonyl-3-ethylthiourea appears to be the most active CNS depressant, whereas the parent compound, cyclobutanecarbonylurea, is the most active barbiturate potentiator. Cyclobutanecarbonylurea, 1-cyclobutanecarbonyl-3-n-butylurea and 1-cyclobutanecarbonyl-3-(2,4-xylyl)urea appear to be the most active myorelaxants, while 1-cyclobutanecarbonyl-3-n-butylurea and 1-cyclobutanecarbonyl-3-(1-adamantyl)urea are the most active against pentylenetetrazole-induced convulsions. Cyclobutanecarbonylurea, 1-cyclobutane-carbonyl-3-n-butylurea, 1-cyclobutancarbonyl-3-cyanoacetylurea, 1-cyclobuta-necarbonyl-3-(1-adamantyl)urea and 1-cyclobutanecarbonyl-3-(2,4-xylyl)urea are also slightly active oxotremorine antagonists. None of the compounds possess significant analgesic activity.


[3-Hydrazinepyridazine derivatives. III. Synthesis and anti-hypertensive activity of new 3-(2-acylhydrazine)-pyridazine-6-alkylamino substitutes]. The synthesis of 2-(6-dialkylamino-3-pyridazinyl)hydrazinecarboxylates (II) and hydrazides (V) from the corresponding 3-chloro-6-dialkylaminopyridazines (I) is described. The 6-substituted derivatives of 2,3-dihydro-1,2,4-triazolo[4,3-b]pyridazine-3-ones (III) and 1,2,4-triazolo[4,3-b)pyridazines (VI) were obtained by thermal cyclization of (II) and (V), respectively. The new acyl derivatives were evaluated together with todralazine and budralazine as antihypertensive agents in comparison with propildazine and hydralazine. The ethoxycarbonyl compound [(II g), ISF 2469] exhibits good antihypertensive activity particularly via oral administration. Its interesting pharmacodynamic properties, including slow onset and long-lasting action, qualify it for further pharmacological and clinical studies.


Synthesis and anti-inflammatory properties of some pyrrolo(1H,3H)[3,4-d]pyrimidin-2-ones and pyrrolo(1H,6H)[3,4-d]pyrimidin-2-ones. The unequivocal synthesis of some terms belonging to the two isomeric classes of the pyrrolo(1H,3H)[3,4-d]pyrimidin-2-ones and of the pyrrolo(1H,6H)[3,4-d]pyrimidin-2-ones is reported. Some of these compounds are active in inhibiting the development of the carrageenin edema, of the granuloma cotton pellet and of the adjuvant arthritis in the rat when administered orally.


Derivatives of 1,2,3,3-tetramethyl-2-azabicyclo[2.2.2]octan-5-endo-ol with antiarrhythmic and other activities. I. A synthesis of esters from 1,2,3,3-tetramethyl-2-azabicyclo[2.2.2]octan-5-endo-ol lithium slat and acyl chlorides is described. A number of these compounds showed strong antiarrhythmic, local anesthetic and hypotensive activities.


Studies on the inhibitory effects of zinc heptanoate on microorganisms. Inhibitory effect of zinc heptanoate was observed on different cultures of bacteria and fungi. Growth of all the bacteria was inhibited by the compound. Greatest inhibition was seen in the case of Staphylococcus albus, Streptococcus pyogenes, Shigella dysenteriae, Shigella sonnei, Shigella flexneri, Salmonella typhi, S. paratyphi A, S. paratyphi B, Vibrio cholerae, Corynebacterium diphtheriae, and E. coli whereas least inhibition was found in the case of Staphylococcus aureus. In triethanolamine: water (1:1) solution minimum inhibitory concentration (MIC) was least for Klebsiella pneumoniae (800 p.p.m.) while in the case of Staph. aureus and Bacillus subtilis it was 200 p.p.m. Among yeasts and fungi greatest inhibition was found with Trichophyton schoenleini, T. rubrum, T. gourvili, Microsporum adouini, M. vanbreuseghemi and least in the case of Candida albicans. In triethanolamine: water (1:1) solution the MIC for T. schoenleini and T. gourvili and T. violaceum was as low as 900 p.p.m. whereas in the case of Aspergillus oryzae it was highest--3500 p.p.m. The effect of the compound on glucose consumption of Aspergillus niger and Bacillus subtilis was also seen.


[Genetic control of spontaneous resistance to murine adenocarcinoma (ADK-lt)]. The genetic control of spontaneous resistance by virgin mice towards a mammary adenocarcinoma of BALB/c mice origin was studied in F1 hybrid mice produced by crossing BALB/c females with males of different haplotype from BALB, A, or B10 strain. The findings obtained show that the intensity of natural resistance in vivo is not under an unigenic control but is the result of multiple interactions among genes located both inside or outside the major histocompatibility complex.


[Candida albicans infection: in vitro immunity aspects]. The authors have investigated the chemotactic ability of C. albicans toward macrophages and polymorphonuclears. Experiments, carried out by modified Boyden chamber, lead to isolate a chemotactic agent, considered either a moderate cytotaxin, or an excellent cytotaxigen.


[VCG analysis of the delta wave in WPW syndrome: its relevance for localization of pre-excitation areas (author's transl)]. Electrocardiograms of 27 patients with the Wolff-Parkinson-White syndrome (12 A Rosenbaum and 15 B Rosenbaum type) were studied. Planimetrically it was determined mean polarity of the delta were on both frontal (DI and DIII bipolar leads) and horizontal (V1 and V3 precordial leads) planes. In order to identify anatomical site of pre-excitation, all data were statistically analyzed. It was allowed to distinguish 5 delta wave groups and 5 relative anatomical sites of pre-excitation: posterior paraseptal, left ventricle free wall, right ventricle free wall, left ventricle posterior wall and dorsal portion of the interventricular septum.


[Anti-toxoplasma antibody titers and immunoglobulins]. 285 sera from parturient patients have been tested for the presence of anti-toxoplasma antibodies by the direct Agglutination test and for Immunoglobulins by the immunochemical turbidimetric determination. 17 sera showed a significant increase in the titre of anti-toxoplasma antibodies; 5 of these 17 presented a simultaneous IgM level increase, subsequently confirmed by a 2 Mercaptoethanol pretreatment, this fact suggesting the presence of active infectious disease. The authors think it can be useful in the diagnostic assessment of active toxoplasmic infectious disease the simultaneous screening of sera by the two described methods: the direct Agglutination test and the immunochemical turbidimetric determination.


[Echocardiographic aspects of prosthetic porcine valves. Observations on 125 personal cases (author's transl)]. Echocardiograms were performed on 111 prosthetic porcine valves in mitral position and 25 in aortic position. Satisfactory tracings were obtained in 68% of the mitral and in 80% of the aortic prosthesis. The characteristic appearance of the porcine prosthesis consists of two lines parallel to each other which represent the stent; the valve cusps reflect much thinner echoes with a box-like pattern similar to that of the normal aortic valve. The distance between the cusps varied from 12 to 17 for the mitral prosthesis and from 11 to 15 for the aortic prosthesis. The range of these values as well as the range of other parameters which were measured varies widely. We suggest therefore that a post-operative echocardiogram should be performed to get a baseline pattern useful for comparison with following controls.


[Salmonellae isolated in Gela in 1976/78 and their antibiotic sensitivity]. Authors take into account the Salmonellae isolated at Gela in the microbiology's laboratory that is connected at the Division of infectious diseases of The Hospital V. Em. III of Gela, during period of two years. They notice how S. Wien is most diffuse and it presents some characteristic like the S. Wien isolated in Algeria. They suppose, so, the possibility that S. Wien is arrived to Gela from Algeria, because of the intense trade exchanges that this town has with North Africa. They argue, for an efficacious work of prophylaxis of the Salmonellosis, that in all hospitals rise some Microbiology's laboratories and that they can arrive, always, at the serologic classification of the Salmonellae.


[Echocardiographic study of bioprostheses in the mitral position (author's transl)]. Eighteen patients, with a Hancock heterograft in the mitral position, were analyzed by means of phonocardiography and echocardiography. Phonocardiography examination failed to show any pathologic data; by echocardiography the Authors succeeded in pointing out one case of malfunctioning prosthesis (verified by autopsy) and two cases suspected of malfunctioning prosthesis. The AA. conclude by confirming validity and perspectives of echocardiography in this field, to get even beginning deteriorations of bioprosthesis function.


[Polygraphic indices of wearers of Hancock bioprostheses normally functioning in the aortic position]. A phonomecanocardiographic study in 33 patients who had undergone aortic valve replacement with a glutaraldehyde-preserved Hancock bioprosthesis, has been carried out 6 to 42 months after surgery. All xenografts were considered well functioning on the basis of clinical, electrocardiographic and radiographic evaluation. Typical phonocardiographic features of a well functioning porcine heterograft in aortic position were considered 1) an opening snap of variable intensity recorded in about 50% of the patients; 2) a normal closing sound; 3) a protosystolic ejection murmur which was always present and whose intensity was inversely related to the prosthesis size; and 4) the absence of a diastolic murmur. The anatomical and functional characteristics of the aortic valve of the pig are suggested to explain both the absence of a diastolic murmur and the pattern of the closing sound, which is undistinguishable from that of a normal aortic valve. Moreover, the reduced pliability of the right coronary cusp of the porcine valve, due to the muscular shelf at its base, with consequent limitation of the effective prosthetic orifice and relative stenosis of the device correlates well with both the opening snap and the sytolic ejection murmur.


[Left ventricular volume measurement; the accuracy of the measurement]. Volume angiography is a widely diffused technique in hemodynamic laboratories despite several factors which limit the validity of the method. We have evaluated three of these factors: a) indefiniteness in the identification of the contour of the left ventricular cavity on the projected image; b) indefiniteness due to the reproducibility in tracing the contour of the left ventricular cavity by the same operator; c) indefiniteness related to the geometrical assumption (ellipsoid of revolution). The indefiniteness, given as per cent variation from the mean value, has been determined  for the diastolic as well as systolic phase. The maximal possible indefiniteness, for diastole and systole, in contours identification in 15 cases has been found to be +/- 11.3% and +/- 24% of the mean volume. Intra observer reproducibility evaluated outlining 30 times the left ventricular contour has been equal to a mean difference from the mean volume of +/- 1.2% for diastole and +/- 4% for systole. The mean difference of the mean volume calculated with the area-lenght method (ellipsoid geometry) from the volume calculated with the Simpson rule has been, on 15 cases, equal to 4% in diastole and 11% in systole. This high level of indefiniteness, mainly for the systolic phase, must be considered before giving a value excessively precise to the volume data obtained with angiography. On the other hand, the method retains an orientative meaning extremely useful in clinical evaluation.


[Echocardiographic size of the left atrium and pulmonary "capillary" pressure in different cardiopathies]. In order to investigate the relationship between left atrial pressure and volume, left atrial echograms and mean pulmonary wedge pressure were obtained on 64 patients with various cardiac diseases. A statistically significant relationship was found in the whole group (r = 0.67, p < 0.01), but there was a considerable degree of dispersion around the regression line. A good correlation was present in 6 patients with hypertrophic cardiomyopathy (r = 0.97, p < 0.01) and in 13 patients with long standing mitral valve disease (r = 0.85, p < 0.01). There was no correlation in coronary artery disease patients.


[Cefamandole: in vitro and in vivo activity]. Among the cephalosporin antibiotics, a relatively new derivative of Cefamandole has been studied, the sodium salt of its formyl ester, Cefamandole nafate. It has shown a broad spectrum of antibiotic activity against a wide variety of Gram-positive and Gram-negative Bacteria (127 strains); the susceptibility was good even with beta-lactamase-producing bacteria. Good protective doses (PD50) were found after mice infections with Staphylococcus aureus and Salmonella wien. The pharmacokinetics of Cefamandole carried out comparatively in 5 human volunteers and in laboratory animals exhibited high levels, especially in the urines.


[Balloon catheter atrial septostomy via the umbilical vein]. The feasibility of atrial septostomy through the ombelical vein is discussed. The advantages and the pitfalls of this technique are examined. On the basis of our experience with 8 cases thus treated in the last year, it is concluded that a careful use of this technique in patients under six days of age is indicated.


[Iatrogenic ostial stenosis of the left coronary artery. Report of a case with Starr-Edwards aortic prosthesis (author's transl)]. A case of a 41 years-old-man, who had undergone surgical intervention ten years previously for aortic valve replacement in ECC with the coronary perfusion technique, is reported. This patient was studied because of the appearance of angina pectoris three months after the intervention and its progressive development. Selective left coronary angiography showed an ostial subocclusive stenosis; the run-off from the right coronary artery provided distal blood supply to the left coronary artery. A venous bypass was implanted between the aorta and the left anterior descending branch; the prosthesis was substituted because it was altered and caused hemolysis' problems. In accordance with most Authors late ostial coronary stenosis is a complication of the coronary perfusion technique, which is adopted for myocardial protection during surgical interventions for aortic valve replacement.


Congenital elevation of the scapula (a review of 69 cases). The author have reviewed sixty nine cases of congenital elevation of scapula on whom scapuloplexy was performed. The degree of elevation was classified according to Rigault's criteria (1976). This operation gave excellent or good results in 68 per cent of cases, the improvement being slightly better from the aesthetic than from the functional point of view. The factors adversely influencing the results were: the degree of elevation, scoliosis, "pagoda" deformity, and insufficient surgical lowering. Osteotomy of the clavicle is necessary in the presence of neurological complications. In cases with scoliosis or "pagoda" deformity of the scapula it is desirable also to resect the supero-medial angle. The operation should be carried out before the patient reaches the age of ten years.


Long stem femoral components for total hip replacement. Certain special problems in reconstruction of the arthritis hip in the adult require the use of a femoral component that has a long stem. A long stem component is essential if a major defect exists in the cortex of the proximal portion of the femur. Examples of such defects are windows cut in the femur to remove cement or to remove a broken femoral stem. Another example is the hole made by penetration of a femoral stem through the cortex. Standard long stem components are used for these cases. A new device in the long stem family, called the calcar replacement long stem component, is designed to restore leg length in those cases in which the femoral calcar has been removed or resorbed. It is also being used in certain cases of heterotopic ossification. In certain cases of primary or secondary malignant disease the entire proximal portion of the femur is excised and the proximal femoral replacement long stem component is inserted. The use of these long stem femoral components is illustrated and the limitations and pitfalls are discussed.


Syndesmomyolysis in early osteoarthrosis of the knee. The authors present a new operative procedure for the early stages of osteoarthrosis of the knee associated with varus or valgus axial deviations. This is based on biomechanical considerations related to the articular equilibrium of the knee, and on pathogenetic interpretations of arthrotic disease in this particular joint. After reviewing the capsular, muscular and ligamentous systems of the medial and lateral compartments of the knee, they consider the active forces capable of opposing the eccentric thrusts of load and gravity in disequilibrium due to axial deviation. Clinical investigations have been carried out which reveal that under these pathological conditions, cicatricial retraction occurs on the concave side and stretching on the convex side of the axial deviation. For the former they have devised the operation of "syndesmomyolysis", which must be preceded by preoperative muscular reinforcement on the convex side. The objective of this procedure is to restore the equilibrium of the forces acting on the articular axis.


Grice-Green's extra-articular subtalar arthrodesis. 1. Notes on the operative technique. Although Grice's operation has been used all over the world, no systematic account of it has been found in the literature (including publications dealing with technique), which presents it in terms related to the basic "classical" principles on which the operation was conceived. The present description of the authors' special technique is presented with these basic principles in mind. If executed with precision, it appears to be reliable and to conform to these basic requirements. The various stages are illustrated and a typical case is shown which supports the validity of the concept.


Interilioabdominal amputation.

Interilioabdominal amputation. Thirty two consecutive cases of interilioabdominal amputation are reported. They were performed for malignant tumours of the hip and the proximal end of the femur and thigh. This operation is rather more frequently indicated than disarticulation of the hip and involves less trauma.


Lumbar spondylolisthesis. Surgical reduction and stabilization by Harrington's technique. The author discusses the reduction and stabilization of lumbar spondylolisthesis by the posterior route according to Harrington's technique based on ten years experience since his first communication. The case histories, technique, and results are reported in eighteen cases treated during the ten years 1968-1977 at the Istituto Ortopedico Toscano, Florence, with some illustrative examples.


Plasmocytoma (a study of 222 cases).

Plasmocytoma (a study of 222 cases). In a review of 222 cases of plasmocytoma, the author demonstrates that solitary plasmocytoma is not rare and has a different localization in bone as compared with the multiple type. The prognosis is influenced by the number of lesions, the level of the anemia, calcemia and hypoalbuminaemia, and the type and level of the paraproteins. In solitary plasmocytoma, the prognosis is also conditioned by the sex of the patient and the site of the primary localization. Proteinaemia was increased in only 40 per cent of cases and electrophoresis was negative in 20 per cent. The treatment of choice for plasmocytoma is radiotherapy associated with Malphalan.


Chondromas and chondromatosis (a study of 265 cases, 200 with long term follow up). 265 cases of solitary chondroma, multiple chondromas and chondromatosis were analysed. Two hundred cases had a long term follow up of 1-50 years (average ten years). Recurrence after surgical removal is rare. It is exceptional for malignancy to develop in chondromas of the hand. Malignant degeneration (chondrosarcoma, fibrosarcoma, etc.) was found in 12 per cent of the solitary chondromas and in 32 per cent of the multiple chondromas and chondromatosis involving the bones elsewhere than in the hand. The first of these figures is probably excessive, since many of the solitary chondromas elsewhere than in the hand remain asymptomatic and unrecognised; but the second figure is probably too low, since the risk of sarcomatous degeneration remains present throughout the patient's life.


Ewing's sarcoma with diffuse involvement of the bone marrow (report of two cases). The author reports two cases of Ewing's sarcoma with diffuse neoplastic invasion of the bone marrow causing panmyelopoietic failure. This condition must be differentiated from the medullary aplasia which may occur as a complication of treatment of antitumoral chemotherapy in patients affected by Ewing's sarcoma.


Osteoblastoma associated with osteomalacia (presentation of a case and review of the literature). An exceptional case is presented in which osteoblastoma was associated with osteomalacia. The clinical and pathogenetic aspects are discussed in the light of a review of the literature.


Surgery of liver tumors.

Surgery of liver tumors. Hepatic neoplasms, primary and metastatic, are best treated with surgery. The present report summarizes the results of various surgical procedures used during the last eight years in the management of 310 patients with liver neoplasms. Exploratory laparotomy was the ultimate diagnostic test, determining resectability of the lesion. Percutaneous liver biopsy was discouraged and was used only in the presence of obvious distant metastasis. Primary and metastatic neoplasms confined to the liver were managed with lobectomy, hepatic trisegmentectomy, or left lateral segmentectomy whether they were solitary or multifocal; the choice of procedure depended on their location. Tumors invading major vascular structures were resected using a new method of hepatic isolation/hypothermic perfusion. Neoplasms involving the entire liver were managed with intrahepatic infusion chemotherapy administered directly into the hepatic circulation through percutaneous catheters. Selected individuals with unresectable lesions were treated with vascular isolation and perfusion of the liver with chemotherapeutic agents. Budd-Chiari syndrome caused by malignant obstruction of hepatic outflow was managed either with isolation/hypothermic perfusion and resection or with hepatic artery ligation and infusion of chemotherapeutic agents. Total hepatectomy with orthotopic liver transplantation was reserved for a few highly selected individuals. The results obtained with these procedures were encouraging. Major hepatic resection was performed with a 9% operative mortality and resulted in an 81% 3-year actuarial survival if the disease was limited to the liver. Palliative major resection in a 31% 3-year actuarial survival. Intrahepatic infusion of chemotherapeutic agents was effective when the dosage was adequate and proved superior to peripheral intravenous treatment. Isolation perfusion of the liver permitted resection of lesions which could not have been managed by conventional procedures. The effectiveness of isolation chemotherapy perfusion of the liver was tempered by leakage of Actinomycin-D into the systemic circulation. The results is this series of patients encourage the judicious use of these procedures in the management of the patient with liver cancer. A pessimistic attitude often based on preoperative evaluation alone without the benefit of exploratory laparotomy ought to be discouraged.


Increased resistance and impaired maximal vasodilation in normotensive vascular beds of rats with coarctation hypertension. To study the resistance of normotensive vascular beds in coarctation hypertension, we measured perfusion pressures of pump-perfused (blood), innervated, isolated hindlimbs of 12 rats (Group A) with 4 weeks of hypertension due to partial contriction of the abdominal aorta above the renal arteries, and of three control groups: 11 normotensive rats (Group B) with aorta sham-constricted, nine normotensive rats (Group C) with slight (5%) hindquarters atrophy due to partial constriction of the abdominal aorta below the renal arteries, and six rats with two-kidney, one clip Goldblatt hypertension (Group D). After aortic constriction, measured femoral arterial pressures in Group A rats remained normotensive. In hypertensive rats of Groups A and D, compared to normotensive Group B or C rats, hindlimb pressure-flow curves were displaced toward the pressure axis (p < 0.05). Compared to normotensive rats, drop in hindlimb resistance after acute local nerve section was increased in rats with coarctation hypertension. Residual resistance after maximal vasodilation with intraarterial sodium nitroprusside remained elevated in hypertensive rats of Groups A and D (p < 0.05), as compared to normotensive Group B or C rats; compared to Group B rats, this residual resistance in the coarcted rats of Group A was increased by 9%. Thus, in normotensive vascular beds of rats with chronic hypertension caused by aortic coarctation, resistance is elevated. The neurogenic component contributes to this high resistance, and structural vascular changes, indicated by impaired maximal vasodilation, may also contribute to the elevated resistance. It is most unlikely that these resistance changes are attributable to elevated hindlimb intravascular pressures.


Essential hypertension: an approach to clinical data by the use of models. A new approach, based on animal circulatory models, was proposed for the study of clinical data in hypertension. Clinical data were identified with steady states in models. From the study of models, possible impairments, susceptible to account for the observed derivations of steady states in men, were analyzed. To be specific, the 1967-Guyton-Coleman model was confronted with a set of data on essential hypertension. The approach afforded a physiological interpretation for statistical results performed on clinical data.


High dosage tobramycin treatment of children with cystic fibrosis. Bacteriological effect and clinical ototoxicity. The bacteriological effect of chemotherapy against mucoid strains of Pseudominas aeruginosa in the lower respiratory tract of patients with cystic fibrosis is reported. A comparison of the effect of high doses of tobramycin (10 mg/kg/24 h) given alone or in combination with carbenicillin showed a significant difference in favour of the combination therapy. In 74.5% of the initially successful courses the patients were recolonized within one month. Fifty-three patients were examined by audiometric and vestibular tests. Only in one patient was it possible to register a transient, high tone hearing impairment at 8000 Hz bilaterally, that might be attributed to the tobramycin treatment. It is concluded that high dose tobramycin treatment in children and adolescents with normal kidney function implies only a minimal clinical risk of adverse ototoxic effects, even after repeated courses of treatment. No nephrotoxic side-effects were found in this material.


Audiometric evaluation of infants 12-18 months of age. Behavioral observation audiometry in conjunction with acoustic impedance studies have infrequently been evaluated in the 12-18 month infant population. Seventy-three infants from the neonatal registry had audiological evaluations performed consisting of speech detection and hearing threshold levels, as well as acoustic impedance studies. Complete audiometric results were obtained from 75% (55) of infants during the initial audiologic evaluation; 73% (53) provided binaural tympanograms. Only 50% of the patients cooperated for all four frequencies attempted on acoustic reflex studies with a 4% incidence of absent reflexes. Impedance studies confirmed audiometric findings in 77% of the infants evaluated.


Congenital laryngeal defects.

Congenital laryngeal defects. Embryologic disorders of the larynx are rare. The main symptoms are stridor and hoarseness, symptoms which in the newborn always necessitate further investigation. Both the laryngotracheo-esophageal cleft and the congenital laryngeal web are discussed in relation to the embryologic development of the larynx and to diagnosis and therapy. The use of the operating microscope is stressed.


Woakes' syndrome: the problems of infantile nasal polyps. Usually, nasal polyposis in early childhood (children aged less than 5 years) is caused by cystic fibrosis of Kartagener's syndrome. In later age groups, recurrent sinus infections, allergy and ASA disease (asthma, aspirin intolerance and nasal polyps) have to be taken into consideration. Four cases of early childhood polyposis are reported which fit into none of these etiological groups. This newly defined Woakes' syndrome comprises recurrent nasal polyposis with broadening of the nose, frontal sinus aplasia, bronchiectasis, and dyscrinia (production of highly viscous mucus). The disease seems to be hereditary. The possible origins of the disease are discussed.


Effect of middle-ear dysfunction and disease on hearing and language in high-risks infants. The effect of middle-ear dysfunction and disease on hearing and language development at one year of age was evaluated for 143 high-risk infants. These infants were categorized as normal or abnormal based on otologic history, otoscopic examinations, and on tympanometric examinations. Language was significantly related to gestational age, being delayed by approximately the amount of prematurity. Language scores were therefore adjusted for gestational age. Speech-detection threshold was not related to gestational age, and was used as the measure of hearing. Hearing levels were negatively correlated with adjusted language quotients. Infants with abnormal otologic histories reported were not different from infants with normal histories in either hearing or language development. Infants with bilateral otoscopic abnormalities had significantly higher speech-detection thresholds, but did not differ in language development from those with bilaterally normal otoscopy. Infants who were abnormal bilaterally by tympanometric examination had significantly higher speech-detection thresholds as well as significantly delayed language development. A significant effect on both hearing and language was found among those infants bilaterally abnormal by tympanometry for whom evidence of middle-ear disease was not visualized by otoscopic examination. Implications of these findings are discussed.


The effects of chronic middle ear effusion on speech and language development -- a descriptive study. In this study, the speech and language skills of children with histories of chronic middle ear effusion were analyzed. Forty-seven children between the ages of one year eleven months and five years five months were given a battery of speech and language tests in the course of a diagnostic evaluation. All the children had been referred to speech pathology by a physician because of a suspected communication disorder. All subjects had histories of three or more episodes of middle era effusion, with the first episode occurring prior to 18 months of age. All medical records were checked and in-depth case histories were obtained in order to rule out other possible complicating factors that might have contributed to a speech and language delay. The results of this study revealed essentially age-appropriate receptive language skills in this group of children. Expressive language and articulatory skills were significantly below chronological age level expectation, indicating the possible serious effects of chronic middle ear effusion on speech and language development.


Wegener's granulomatosis in childhood. A clinical report based on 3 cases. Wegener's granulomatosis is a very rare disease in children; only 10 cases have been reported in the literature. The present report describes 3 cases where Wegener's granulomatosis developed at an early stage, beginning with upper respiratory tract symptoms. All the 3 children have been successfully treated with a combination of azathioprine and corticosteroids.


The effect of early onset of otitis media on educational achievement. One hundred and forty-four patients from three different pediatric practices were compared using the Science Research Associates (SRA) tests for academic achievement. First, the patients were divided into those who had had three or more attacks of otitis media and those who had had no attacks of otitis media during the first 18 months of life as recorded by their pediatricians. Matched pairs by sex, birth date, occupation of father, school attended and year of testing were made for comparison purposes. Using the one-tailed t-test, a significant difference in the composite score was found favoring the group with no recorded otitis media in the first 18 months of life. All patients were treated with antibiotics.


The evolution of the vestibular apparatus according to the age of the infant. In 56 full-tem A.G.A. infants and in 27 infants of a minimal age of 15 days with a neurological "risk" (full-term small for gestational age, S.G.A.), the nystagmic response to vestibular stimulation (rotatory and torsion swing test) was examined. A delay in the appearance of a response to the labyrinthic stimulus and a persistence of the prevalence of the slow phase of the nystagmus appeared clearly higher in the "risk" infants. The statistical difference of the response between the two groups was highly significant. This allowed us to conclude that the vestibular test appears to the one of the most useful in evaluating the sensorial maturation of S.G.A. infants.


Intractable paroxysmal sneezing: a conversion reaction of adolescence. A case of recurrent paroxysmal sneezing in an adolescent girl is reported with a review of the literature. The mechanisms of sneezing are described. Most cases appear to have a psychogenic etiology. We postulate that this is a conversion symptom in which the patient received secondary gain and probably represents a pre-oedipal conflict.


Surgical treatment of late radiodermatitis (a four year experience with 53 cases). The authors report their experience with the surgical treatment of 57 radiation lesions (53 patients). The clinical and pathological findings in late radiodermatitis are reported and proper surgical techniques are discussed in view of the various reconstructive difficulties encountered.


Comparison between lymphographic findings and clinical follow-up in malignant melanoma. The clinical developments in 23 patients with stage I melanoma of the lower limbs were followed over a 2 year period. The subjects were divided into two groups based on lymphographic findings (14 negative, 9 positive or dubious). All underwent excision of the primary tumor, but none underwent prophylactic lymphadenectomy. At the end of the 2 year period there were no significant differences in the clinical developments in the two groups.


A simple method for quantitative estimation of collagen type III to type I ratio in soft tissues. In the present paper a relatively rapid and simple method for estimating the ratio of collagen type III to type I in soft tissues is proposed. The ratio Gly/Ala is determined in pure collagen samples obtained from pepsin digests of the tissues. Since this ratio varies linearly depending on the composition of the mixtures of the two collagen types, it is shown that the percentage content of the two collagen types is easily calculated.


Urinary excretion of hydroxyproline and hydroxylysyl glycosides in adjuvant-induced arthritis. The effect of adjuvant-induced arthritis on the urinary excretion of hydroxyproline and hydroxylysyl glycosides (glc-gal-hyl and gal-hyl) was investigated in male Sprague-Dawley rats up to 70 days after the injection of Freund's complete adjuvant. In comparison with control animals the total urinary hydroxyproline is significantly increased in the arthritic rats at one day after injection, returns to normal level at one week and is further significantly increased between the 2nd to 7th week. The excretion of total glycosides in urine parallels the excretion of total hydroxyproline. However, the low ratio of glc-gal-hyl/gal-hyl provides circumstantial evidence in favour of the hypothesis of bone collagen degradation in the acute stage of adjuvant-induced arthritis in rats (between 2 and 3 weeks), while high absolute values but normal ratios of glc-gal-hyl/gal-hyl suggest degradation of both bone and skin collagen in equal amounts between the 4th and 7th week. No significant differences are found between control and arthritic groups in the later part of the experiment.


Phospholipid composition of photosynthetic membranes of Rhodopseudomonas capsulata. The phospholipids and the fatty acids present in membranes of cells of Rhodopseudomonas capsulata, grown photosynthetically in anaerobiosis, were analyzed by thin layer chromatography and gas chromatography-mass spectrometry. The three phospholipids detected, phosphatidylcholine, phosphatidylethanolamine and phosphatidylglycerol, contained about 80% of a single monounsaturated C18 fatty acid, cis-vaccenic acid. These membranes offer therefore a naturally occurring model system endowed with an extremely simplified phospholipid complement. The data indicate moreover that the biosynthetic pathway of unsaturated fatty acids present in these facultative aerobic bacteria proceeds only via the 3-hydroxydecanoyl acyl carrier protein dehydratase (E.C. 4.2.1.60).


Survival and quality of recovery of patients with pertrochanteric fractures of the femur. The authors have reviewed two consecutive groups of 100 patients with pertrochanteric fractures of the femur. The first were treated conservatively and the second surgically. The subsequent results were subjected to statistical analysis. There was a statistically significant difference between the mortality rates in relation to treatment in the two groups but not in relation to age. A history of previous pathological disorders was found to exert a negative influence only in the conservatively treated cases. Fifty four per cent of the cases treated conservatively and 70 per cent of those treated by operation were able to lead completely independent lives. This was unfavourably affected by the age and preoperative pathological state of the patients only in the cases treated conservatively.


Femoro-patellar arthrosis. Pathogenesis and surgical treatment. The writers examine the anatomical and functional basis of pain in the knee due to imbalance of femoro-patellar pressures which cause arthrotic changes in the patella. The symptoms of this knee condition require very accurate assessment in view of its complex pathogenesis in order to arrive at the correct surgical treatment.


High tibial osteotomy for arthrosis of the knee: general considerations and surgical technique. High osteotomy of the tibia is now internationally recognised as the treatment of choice in most cases of osteoarthrosis of the knee in which surgery is indicated. It has been favourably reviewed in the recent specialist literature. The author describes two techniques in current use at the Orthopaedic Clinic at Trieste which have proved both reliable and rewarding.


Minor changes in the sodium dodecyl sulphate-gel electrophoresis periodic acid-Schiff-staining profiles of erythrocyte membranes in beta-thalassemia major. The sialic acid content of the human erythrocyte membrane is higher in homozygous beta-thalassemia than in heterozygous and healthy donors. Analysis of the difference by means of polyacrylamide gel electrophoresis in 1% sodium dodecyl sulphate and PAS staining failed to reveal significant variations in mobility and relative staining intensity of the main glycoprotein components, PAS-1, PAS-2 and PAS-3. The minor, although highly significant, changes which were recognized in the PAS pattern of beta-thalassemia patients compared with normal controls concerned the PAS-4 region and a shoulder trailing band PAS-2, which both increased in staining intensity relatively to the main sialocomponent PAS-1. Moreover, the shoulder was found to be more prominent in profiles from erythrocytes of blood group 0, in both normal and thalassemic subjects. The experimental data are discussed in the light of the presence of blood group ABH specific macroglycolipids in human erythrocytes (Dejter-Juszynski et al. 1978).


Total prostheses without cement in osteoarthritis of the hip joint. (2nd paper). (24 cases: Mittelmeier's arthroprosthesis). In this second paper on total prostheses of the hip without cement, we analyse the results of twenty four cases (one of them bilateral) in which Mittelmeier's prosthesis without cement was used. The results are considered encouraging. The indications are discussed and the advantages and disadvantages of this type of arthroprosthesis are assessed.


Functional state of rat liver RNA polymerase IA and IB. Phosphocellulose chromatography has been employed to characterize RNA polymerase I present in two different functional states in rat liver cells. The actively transcribing enzyme solubilized from nuclei appears to belong both to the IA and IB classes, whereas the non-transcribing enzyme present in the cytoplasmic fraction has been found to belong only to the IA class. Indirect and direct evidence indicates, however, that in isolated nuclei only the IB form is to be regarded as the physiological form of the enzyme, the IA form arising as a procedural artefact during the extraction process. It may, therefore, be concluded that rat liver IA and IB RNA polymerase are to be strictly regarded as the non-transcribing and transcribing form of the enzyme, respectively.


The treatment of trochanteric fractures of the neck of the femur by Ender's nail. The authors report the clinical and radiographic results obtained in the treatment of 138 patients with pertrochanteric fractures of the neck of the femur by Ender's elastic nail. This extremely simple method of treatment, which is within the scope of all surgeons, permits early recovery of function in the elderly patient and, even more important, early mobilisation in the upright stance, thereby preventing many of the surgical complications that can affect elderly patients.


The primary structure of mitochondrial aspartate aminotransferase from pig heart: peptides obtained by cleavage with thermolysin and chymotrypsin. The production, purification and analysis of peptide derived by digestion of mitochondrial aspartate aminotransferase with thermolysin and chymotrypsin are described. Despite the complexity of the peptide mixture obtained and the relative shortness of the fragments produced, these digests proved to be very useful for the completion of the primary structure determination of the enzyme. In fact, information for 87% of the total structure was contributed by thermolytic peptides, and for 89% by the chymotryptic ones. Moreover some of these peptides were essential for elucidating controversial points of the sequence.


Eosinophil granuloma of the scapula.

Eosinophil granuloma of the scapula. The writers present a case of eosinophil granuloma of the scapula. This is extremely rare at this site. They describe the clinical course, the unusual radiographic appearances, and the complete functional recovery following local resection.


The surgical treatment of lumbo-sacral coccygeal agenesis. Vertebro-pelvic instability and deformities of the lower limbs are the main therapeutic problems in lumbo-sacral agenesis. The first of these can be solved conservatively with the aid of an orthopaedic corset; patients treated in this way have never reported visceral compression disturbances. In regard to the deformities of the lower limbs it is possible and preferable to perform corrective surgery rather than amputation. However, this is complicated by the possibility of ischaemic attacks as a result of stretching of the neurovascular bundle. Surgical treatment should be commenced at an early stage and be performed in the following order: knees, hips, feet. If the deformity is not long-established, extension of the knees can be achieved by simple posterior capsulotomy and tenotomy of the flexors followed by slow, gradual trans-skeletal traction applied over a period of approximately one month. Relapses, however, must be treated by double osteotomy (supracondylar of the femur and metaphyseal of the tibia) with removal of anterior wedges. Flexion relapses of the knees are common and require further surgery. Correction of the hip deformities is easy and we have never observed relapses of this deformity. When the deformities have been corrected and static function restored to the lower limbs, the patients can walk with elbow crutches and orthopaedic calipers by oscillating the trunk.


A new type of distractor for the surgical correction of scoliosis and spondylolisthesis. A distractor for the surgical correction of scoliosis is described. It comprises a threaded rod that runs inside a cannula. The distraction is achieved with special distraction forceps. Fixation is then secured by screwing a nut along the rod until it is in contact with the opening of the cannula. This distractor is not as simple as the Harrington device but it has a number of advantages. It is easier to apply in difficult surgical situations. The fixation mechanism is infallible. The lengthening is achieved more gradually. Slackening and removal are simple and always possible, and it is never necessary to section the rod with cutting shears.


Rigid fixation and early weight bearing in the treatment of pertrochanteric fractures of the femur. The authors review eighty cases of pertrochanteric and subtrochanteric fractures of the femur treated surgically with the vitallium Jewett nail-plate between May 1975 and November 1977. They draw attention to the possibility offered by this fixation device of starting weight bearing at an early stage, a factor that is unanimously regarded as essential for rapid recovery in the elderly fracture patient. In fact, fifty-six patients commenced independent walking with some support within two weeks of operation. The fairly low incidence of complications (six in eighty operations), and the relative simplicity of the surgical technique, support the Jewett nail-plate as a suitable device for rigid fixation of trochanteric fractures of the neck of the femur.


External fixation devices in fractures of the leg. External fixation devices, of which there are many types, represent a new and extremely effective method of fixation in fractures of the leg. These are extremely common, frequently severe and often complicated by a variety of other lesions. The usefulness of this method lies in the fact that they can be applied immediately with minimal additional trauma, and the fracture can be immobilised whilst leaving the damaged area uncovered and thus available to carry out repairs and reconstruction of the soft tissues. Mobilisation of the patient is not impeded, and they can be replaced by other more traditional methods as and when these may become more appropriate. The author presents his own views based on some ten years experience with external fixation devices in traumatology, with special reference to fractures of the tibia.


Fat embolism as a cause of idiopathic necrosis of the head of the femur. Review of forty five cases of post traumatic fat embolism. It has been postulated in recent years that idiopathic necrosis of the head of the femur may possibly be caused by arteriolar obstruction by fat emboli emanating from a fatty liver, which would act as a reservoir, due to various causes such as alcoholism and prolonged steroid therapy. A similar situation has been found in human pathology in post traumatic fat embolism. The writers have reviewed forty five cases of post traumatic fat embolism which had passed the pulmonary filter. All the cases were reviewed after a minimum of two years, since this is considered the minimum time within which necrosis can manifest itself radiologically. In none of these cases was there any evidence of necrosis of the head of the femur. These findings, supported by other critical considerations. do not lend support to the theory of fat embolism as a case of idiopathic bone necrosis.


Dedifferentiated chondrosarcomas.

Dedifferentiated chondrosarcomas. The authors report twenty five cases of dedifferentiated chondrosarcoma, illustrating the principal clinical, radiographic and histological features. The prognosis is particularly grave in this neoplasm: the only correct therapy is radical removal of the tumour by amputation or disarticulation.


Histiocytic fibroma of bone (a study of 170 cases). This study is based on 170 cases of histiocytic fibroma of bone. This is a metaphyseal hamartoma composed of histio-fibroblasts; it is completely benign, and affects children and adolescents. Because of their benign nature and characteristic radiographic appearance, which is almost always diagnostic, these tumours do not require surgery, except in rare forms that give rise to symptoms, or in which tthe radiographic appearances are atypical and clarification of the diagnosis is called for.


Somatosensory evoked potentials (S.E.P.) in slow pathological compression of the spinal cord. Somatosensory evoked potentials (S.E.P.) were used to examine twelve patients who had slow compressive lesions of the spinal cord (ten cases of spondylotic myelopathy, one neurinoma, one metastasis of a vertebral body). 73 per cent of the recordings were found to be abnormally reduced in amplitude, and/or showed prolonged latency times aa regards the primary and secondary complex. Patients with a clinical lesion of the dorsal column showed a clear reduction in amplitude in the recordings (sometimes coupled with slowed latency), especially in the primary complex. Patients with symptoms indicative of an injury to the ventrolateral region of the spinal cord showed tracings with alterations most of all related to the secondary complex. In 76 per cent of cases, the somatosensory evoked potentials were in accordance with the level of the compression, the degree of invalidity, and the clinical picture.


Microprocessor, self-recording and manual audiometry. AC HTLs were measured on 12 normal-hearing young adults by (a) standardized manual, (b) self-recording (Bekesy), and (c) microprocessor audiometry stimulating standard manual procedure, to determine how threshold measurements would be affected by the 3 methods of testing when utilized in industrial hearing conservation programs for compliance with federal agency recommendations. Self-recording audiometry resulted in mean thresholds lower than standard manual audiometry by from 1-9 db; microprocessor audiometry resulted in thresholds higher than standard manual audiometry by from 0.2-4.4 db except at 4 kc/s where the microprocessor mean threshold was 3.8 db lower. Thus microprocessor audiometry more closely approximated audiometry by standard manual procedure. All 3 methods required 7-8 min per S for a 7-frequency audiogram on both ears.


A comparison of clinical behavioral audiometry and autoregression analysis of EEG and heart rate in hearing-impaired children. Autoregressive analysis, a statistical technique for detecting changes in electroencephalic (EEG) and heart rate (HR) data was compared with clinical behavioral audiometric results on 10 hearing-impaired children in schools for the hard of hearing and deaf. EEG and HR data were collected in a screening paradigm involving tones of .5, 1, and 4 kc/s at 80 db SPL in a free field. An index of reliability, or acceptable level of agreement, was set at 70%. This criterion was met 5 out of 6 times. For the EEG, agreements exceeded 70% at 1 and at 4 kc/s, and for HR at all 3 frequencies. Results suggest that the autoregressive approach yields data very similar to behavioral audiometry in this population. Continued exploration of autoregressive analysis of electrophysiologic indices in determining reactivity to tones is warranted, particularly since the statistical method can be used with younger infants.


Some published data on auditory localization reanalyzed within the framework of a model proposed by Searle, Braida, Davis, and Colburn. The model for auditory localization proposed by Searle et al (J. Acoust. Soc. Am., 1976, 60, 1164-1175) was predicated on several assumptions and on data from restricted sound source loci. For example, only those studies were included using frontal-median plane sources and Ss with restrained head movements. The authors noted, however, that the model's generality needed to be tested by use of paradigms that gathered data from positions all around the S, and with data in which variables other than those accounted for by the model were utilized. Two studies (Gatehouse and Cox, J. Audit. Res., 1972, 12, 179-183, Gatehouse, J. Audit. Res., 1976, 16, 265-273) had required Ss to identify the position of a loudspeaker in both azimuth and elevation stimultaneously from a matrix of as many as 60 loci, but data had been reported only in per cent correct. The present paper offers a reanalysis of these data using average error in the spherical coordinates system of the model. Average-error analysis proved to be a relatively powerful tool, confirming the model to that extent. For example, a significant superiority of binaural over monaural performance in vertical plane localization was extracted from the data. Again, it could be shown that broadband noise, as compared with pure tones, provides useful binaural information in both the horizontal and vertical planes. Use of the model in studies of complex localization tasks may answer some unresolved issues and inconsistencies found in the general localization literature.


Reflex modulation and loudness recruitment. Eyeblink reflexes to airpuffs to the orbit are inhibited by preliminary tones even of low intensity, and the amount of inhibition  or "reflex modulation" (RM) is correlated with tone loudness. Brief pure tones were presented 100 msec prior to an airpuff to the eye and eyeblink amplitude was recorded in 7 normal-hearing adults. Tones of several levels were either in quiet or in a white noise of 73.5 dbC. As tones increased in intensity, RM increased faster to stimulation in the masked than in the unmasked ear, simulating the classical "pseudo-recruitment" in the noise-masked ear. In addition, very rapid growth of RM was found at 4 kc/s in a patient with sensorineural impairment of 70 db at that frequency as compared with the RM from a frequency with normal HTL. These data confirm the potential of RM in the objective quantification of loudness recruitment.


The Preyer reflex audiogram of several rodents, and its relation to the "absolute" audiogram in the rat. Careful examination under a hand lens of the Preyer reflex in 7b mice, 4 voles, and 10 rats established thresholds from 4 up to 60 kc/s using an ionophone loudspeaker. Thresholds wre reliable, and the location of prounced species-specific sensitivity peaks agreed with those establised in the literature by conditioning and by electrophysiologic techniques. It would appear that such peaks coincide with frequency peaks in the vocalizations of these species. In 3 of the rats, conditioned (lever-pressing) audiograms were collected. These exhibited relatively greater sensitivity below 20 kc/s than has previously been reported, declining from 20 to 4 kc/s at only about 3 db/octave. From maximum at 20 kc/s to 40 kc/s sensitivity declined at about 12 db/octave, and from 40-60 kc/s at about 46 db/octave. At 4 and 10 kc/s the difference between the Preyer and the conditioned thresholds was constant (the Preyer about 80 db less sensitive), but at 20 kc/s and above, the reflex threshold appeared relatively and progressively higher. While the Preyer reflex is thus not necessarily a good predictor of the conditioned-response audiogram, it may come to be a useful index of loudness sensitivity.


[OEstradiol and progesterone steroid hormone receptors in cancer of the endometrium. The significance of the progesterone receptor (author's transl)]. It would seem that the satisfactory way for the clinician to orientate the treatment by hormones in cancers of the endometrium lies in the presence at the same time of oestrogen and progesterone receptors and in particular of the latter. This applies when treating cancers of the endometrium with hormones in a way that is directed by chemical determination of hormone susceptibility.


[Screening for fetal growth abnormalities by measuring the skull and thoracic perimeters using real-time ultra-sound (author's transl)]. The object of this work is to demonstrate a new rapid method of working out the thoracic and skull perimeters iK the fetus using real time ultra-sound. Normal growth curves have been established as a result of 1955 measurements of the perimeters of the thorax and 729 measurements of the perimeters of the skull in 1344 patients pregnant with a single fetus. the gestational age had been checked by an ultra-sound examination between the 12th and the 20th week of the pregnancy. 43 newborn were light in weight below the 10th percentile on Lubchenco's curve. An analysis of these results shows that the diagnosis of growth abnormalities is made most efficiently by using the perimeter of the thorax. It is suggested that systematic and repeated use of this measurement in the third trimester of pregnancy is of value.


[An allometric study of the relative growth of the head and the body of the fetus and of the new born (author's transl)]. An allometric study of the relative growth of the head and the body of the fetus and of the newborn shows that there is a more rapid growth of the head in relationship to the length of the fetus before the 30th week of pregnancy and then there is a slowing down between the 30th and the 40th weeks, followed by a re-acceleration after birth for full term infants. This phenomenon is not shown in premature babies born before the 30th week of pregnancy who continue their head growth with the same speed after birth and slow down only for a short time near their theoretical term. These results led to a hypothesis being formed that cephalic growth is slowed down in the uterus because of steric (molecular) congestion, a slow-down that is slightly demonstrated in breech presentations and much later in very premature babies. This opens the way to a discussion on the final results of this phenomenon on the brain.


[The obstetrical future of women who have been operated on for uterine synechiae. 107 cases operated on (author's transl)]. The authors undertake to show that the obstetric future of women who have been operated on for uterine synechiae is not as poor as would appear from previous publications. 59 p. 100 of 75 women who wanted to become pregnant did so and 46 p. 100 went on to have at least one living child. If one only takes into account those women who were able to be followed up, 71 p. 100 became pregnant and 55 p. 100 had pregnancies with a viable child. When women with only uterine synechiae and without an associated lesion were considered, 81 p. 100 of them became pregnant and 67 p. 100 had a viable child. From this it is important to screen for an associated lesion by laparoscopy. The authors also write about the value of hysteroscopy carried out to find synechiae more easily and to control the treatment.


["In utero" diagnosis of congenital fragilitas ossium (osteogenesis imperfecta) (author's transl)]. The authors report a case of congenital fragilitas ossium diagnosed "in utero". The radiography of the fetus in the uterus showed bony abnormalities suggestive of Porak and Durante's disease. This early diagnosis is often useful because it will help to prevent trauma before and during delivery which is a principal cause of fetal death.


[The induction of labour by acupunctural electrostimulation. A new technique and one that is thirty centuries old; a preliminary study (author's transl)]. Ten patients had their labours induced by acupunctural electrostimulation. This method was successful in starting labour each time. Eight women delivered normally vaginally. One had a caesarean and had uterine contractions without dilatation of the cervix. Electrostimulation has also allowed us to perform acceleration of labour.


[Listeria infection of a twin pregnancy (author's transl)]. A Listeria infection of a twin pregnancy had induced a partus immaturus at 23 weeks. One foetus died in utero of a widespread foeto-placental granulomatosis, while the other one, dying sub-partu, showed only retroplacental abcesses. The unequal extent of the infection in the two placentas -- of diamniotic, dichorionic type -- is interpreted as different stages of the same disease; it could be due to a different resistance to the germ between the two dizygotic foetuses.


The transfer of fatty acids across the sheep placenta. Maternal and fetal plasma concentrations of free fatty acids, triacylglycerols and phospholipids and the profile of their fatty acids were measured in three catheterized and unanaesthetized sheep. Fetal concentrations of all three lipid fractions were low and did not correlate with maternal concentrations. There were no measurable umbilical venous-arterial differences. Linoleic acid concentrations were low in both mother and fetus. The fatty acid composition of fetal adipose tissue, liver, lung and cerebellum of five animals was analysed. Again linoleic acid levels were very low, but phospholipids contained 2-8% arachidonic acid. [14C] linoleic acid and [3H] palmitic acid were infused intravenously into three ewes. Only trace amounts of labelled fatty acids were found in fetal plasma and these were confined to the free fatty acids. 14C-label was incorporated into fetal tissue lipids, but most of this probably was due to fetal lipid synthesis from [14C] acetate or other water-soluble products of maternal [14C] linoleic acid catabolism. It is concluded that only trace amounts of fatty acids cross the sheep placenta. They are derived mainly from the maternal plasma free fatty acids and might just be sufficient to be the source of the small amounts of essential fatty acids found in the lamb fetus, but are insignificant in terms of energy supply or lipid storage.


Diffusion permeability and ultrafiltration-reflection-coefficients of Narand Cl- in the near-term placenta of the sheep. Experiments were performed on unanaesthetized ewes in the last third of pregnancy. Fetuses and ewes had indwelling vascular catheters. In some of the experiments fetal urine was drained to the exterior by means of an indwelling vesicular catheter. Placental diffusion permeabilities were measured with 22Na+ and 36Cl- injected into eight fetuses. Volumes of distribution of Na+ and Cl- in the conceptus were Na+: 548 +/- 24, Cl-: 760 +/- 51 (ml/kg fetal wt +/- SEM). Diffusion permeabilities were Na+: 5.2 X 10(-3) +/- 0.3 X 10(-3), Cl-: 9.8 X 10(-3) +/- 0.9 X 10(-3) (ml.s-1.kg-1 +/- SEM). Ultrafiltration-reflection-coefficients of Na+ and Cl- in the placental exchange barrier were measured 17 times in seven fetuses with vesicular catheters. The transplacental e.m.f. was estimated from these results, on the assumption that the individual reflection-coefficients of Na+ should correlate with those of Cl-. The best estimate was -1.0 mV (fetus negative), and the best estimates of the placental reflection-coefficients were Na+: 0.83 and Cl-: 0.79. There was a reliable negative correlation (P < 0.01) between the calculated reflection-coefficients and the osmolality of the urine secreted by the fetus. This suggested that the concentration of vasopressin in fetal plasma affects the membrane characteristics of the placenta. The mean total osmotic force across the placental barrier of the sheep in these experiments was calculated to be 260 Pa (2 mmHg).