[Need for participation of the legal physician in investigations on the spot]. The author points out the importance of the medico legal doctor's presence in the survey also in cases of mortal road accidents. In fact, only the previous knowledge of the problems and data concerning the case can consent the expert to give their value to general findings which thus become meaningful in order to solve the case. To this purpose he refers to a case he personally observed in which through the interpretation of a single skin and lower bone wound it was possible to identify the part of the vehicle which had produced it.


[Cimetidine and hyperprolactinemia].

[Cimetidine and hyperprolactinemia]. Plasma TSH was determined in 12 normal subjects before and after administration of mg 400 of cimetidine i.v., an H2-receptor antagonist. TSH concentration remained unchanged. In 7 normal subjects, pretreated with bromocriptine; variation of plasma prolactin were studied before and after administration of mg 400 and 800 of cimetidine. Bromocriptine inhibited the increase of prolactin secretion, induced by cimetidine. It can be assumed that: a) cimetidine doesn't release hypothalamic TRH in portal vessels; b) that drug has no direct effect on pituitary cells; c) hypothalamic H2-receptor blockade by cimetidine decreases dopamine release from hypothalamus to pituitary gland.


Effects of octylguanidine on the electrical and mechanical events of xenopus heart. The effects of octylguanide on the electrical and mechanical events of Xenopus heart perfused at the rate of 5 ml/m with oxigenated Ringer of ph 7,4 at 24 degrees C were studied. The early effects on the action potential resemble those of the tetrodotoxina, the later effects looks like instead as those observed with metabolic poisons. The cardiac preparations poisoned by octylguanidine still have a metabolic reserve available to furnish energy for the contractile process.


Radiation methods in agriculture.

Radiation methods in agriculture. On the basis of fundamental investigations in radiobiology, numerous methods of using ionizing radiations in agricultural practice have been proposed. The current status of the problem, on the basis of basic, semi-production and industrial-scale tests of the suggested methods, is described. We conclude that there is now a satisfactory, economically viable radiation-biology technology. For wide introduction of this technology into agricultural practice, governmental decisions concerning the production of specialized equipment, training of service personnel and overall organization of the work under production conditions are required.


Heat stress in microwave irradiation.

Heat stress in microwave irradiation. In experiments on 159 sexually mature dogs with an average weight of 6.5 + 0.71 kg, a study was made of the dynamics of physiological indices (rectal temperature, respiration and heart activity) of heat stress and various (%) effects of damage depending on power density (500, 300, 100 mV/cm2) and duration of microwave irradiation (2400 MHz). On the basis of the data obtained, it was established that the relationship between power density and duration of microwave irradiation with an equally probable (0.1%) effect of damage may be interpolated (100 < power density < 500) by an exponential equation of the type y = 1416 x-0.8156, where y = power density, mV/cm2, and x is the time of irradiation in minutes. The probability characteristic of adaptation possibilities of functionally critical values of damage not exceeding the indeterminate probability is obtained.


Functional genetic damages and their possible role in the aging of eukaryote cells. As a result of investigations of the functional acitivty of eukaryote cells damaged by ionizing radiation and alkylating mutagens under conditions of extreme loading, the authors have suggested that natural aging and aging accelerated by mutagens are based on a process of accumulation of functional genetic damages. The molecular nature of these damages differs from the mutational changes and repairable damages of DNA.


Teaching "street law" to the criminally insane. A course in "Street Law" was taught to forensic patients by law students, following a format used by Georgetown University Law Center. Although the course has been taught to high school students and inmates of correctional facilities, this was the first time it has been extended to mental patients found not guilty of crimes by reason of insanity. An outstanding feature of the course was marked enthusiasm shown by patients who, through long institutionalization, had become apathetic, indifferent, and despairing. Their readiness and ability to learn brought to mind a couple of old sayings often heard around mental hospitals, "I may be crazy but I'm not stupid," and "Sometimes you can't tell the patients from the staff." The staff of at least one ward has picked up "teaching and learning to use as a central theme in treatment of patients, not abandoning traditional methods, but shifting the emphasis from therapy to teaching as a way of getting the patient's interest in his own rehabilitation. Judges, reviewing cases for release, have looked quizzical when the patients' active participation in a "law course" has been used as evidence of satisfactory progress.


Kinetics of survival of patients with inoperable lung cancer and assessment of the efficacy of treatment. A general analysis of data on survival of patients with inoperable lung cancer obtained from 59 publications was undertaken by the linear regression method. It is suggested that the parameters reflecting the kinetics of survival of these patients be used as a "historical control" for assessment of the efficacy of new methods and treatment of lung cancer. It was shown with the aid of this control that antitumor chemotherapy increases the 6-month survival rate of patients with an immediate positive effect after chemotherapy.


Demonstration of the synthesis of hydrocarbons in animal tissues. Incubation of tissue of homogenates of peripheral nerves, liver, and subcutaneous adipose tissue of rabbits with [1-14C]palmitic acid and intraperitoneal injection of this preparation into rats, in a dose of 20 muCi per 100 g of weight of the animals, permitted establishment of the presence of enzyme systems of biosynthesis of n-alkanes in the tissues of higher animals. Evidence of the biosynthesis of n-alkanes in the animal organism represents a new aspect of our knowledge of the metabolism of this class of compounds in animal tissues.


Change in ATP and ADP content of fasting and feeding planarians (Polycelis nigra). The ATP and ADP content of planarians subjected to starvation for two weeks followed by feeding for the same period was investigated. The ATP and ADP content during fasting increased and then, after feeding, returned to normal. The ATP/ADP ratio varied in the same way, which is consistent with the view that the adenylic nucleotide pool is implicated in the regulation of the energy metabolism of the organism.


Life span of lymphocytes in cattle in the norm and during lymphatic leukemia. Comparison was made of the rate of in vivo elimination from blood and organs of cattle of lymphocytes labeled with 3H-thymidine in the course of seven days in the norm and during lymphatic leukemia. Significant delay in the elimination of labeled lymphocytes, and especially of lymphocyte precursors, from the blood, spleen, and lymph glands of the animal was established in the stage of lymphatic leukemia that was examined.


The anatomy of the brain of the bottlenose dolphin (Tursiops truncatus). Rhinic lobe (Rhinencephalon): The archicortex. The hippocampal formation or archicortical division of the rhinecephalon of the bottlenose dolphin, Tursiops truncatus, is described from the standpoint of its gross topographic relations and cytoarchitecture. A feature of the dolphin brain, which lacks olfactory bulbs and peduncles, is the striking reduction of the archicortical relative to the paleocortical formations. The small, poorly developed archicortex covered by massive epihippocampal portions of the hemispheres (parietal and temporal lobes), appears greatly reduced relative to the large, well developed olfactory lobes which are covered by small epistriatal portions of the hemispheres (orbital lobes). The archicortex exhibits three junctional zones with the paleocortex, two laterally in the unci and one anteriorly in the septal area. Despite the small size of the hippocampal formations, the general topographic disposition of its cytoarchitectonic areas and their cellular organization in Tursiops have many features that are similar to those in other placental mammals. The archicortex is subdivisible into four major sectors: temporal, retrosplenial, supracallosal and subcallosal. With the exception of the temporal sector, cytoarchitectonic areas of the other sectors are variously attenuated and poorly differentiated, particularly the dentate area and the hippocampal areas H5 and H4. Here, the dentate area and hippocampal areas H5 and H4 which are present along the paradentate bank of the hippocampal sulcus, extend to the level of the oblique sulcus of the parahippocampal gyrus and then disappear. Hippocampal areas H3, H2 and H1 are also clear in the floor and along the parahippocampal bank of the hippocampal sulcus in the temporal sector. These areas are less definable as they extend beyond the oblique sulcus into the retrosplenial sector and are difficult to recognize as distinct areas in the supracallosal and subcallosal sectors of the archicortex. The archicortex is demarcated bilaterally from limbic formations in the border of the hemisphere by segments of the rhinic cleft which are very clear. Equally clear is the cytoarchitectonic demarcation of the archicortex from the neocortex in the border (limbus) of each hemisphere, i.e., where the subiculum abuts against the presubiculum. The subicular area, best expressed in the temporal sector, extends anteriorly over the corpus callosum to the subcallosal gyrus and, throughout its extent from the uncal to the septal junction, is clearly demarcated from limbic neocortex by a transition zone characterized by archicortical cells merging with cells in the deep layer of the bordering neocortex. Overall, the archicortical formations of the dolphin and other whale brains we have examined exhibit many regional peculiarities that we have described, both grossly and architectonically, with emphasis on the comparative anatomical approach.


Validity of myocardial oxygen consumption parameters. The purpose of this study was to examine any reported indices for estimating myocardial oxygen consumption (MVO2) under uniform experimental conditions at maximal variation of hemodynamics and MVO2. One hundred sixty-two steady states were analyzed in 10 closed-chest dog experiments. Myocardial blood flow was directly measured by a different pressure catheter in the coronary sinus. The indirect values of MVO2 calculated from 24 indices were compared with directly measured MVO2. Throughout a wide range of hemodynamic states, the best correlate with MVO2 was found to be the additive parameter Et (r = 0.96). Any indices that do not incorporate potentially important changes of MVO2 related to both myocardial contractility and ventricular dimensions show unsatisfactory correlations with MVO2 at extreme changes of hemodynamics. Tension-time index (TTI) correlates poorly with MVO2 (r = 0.63). This result is due to the neglect of contractility. Pressure-heart rate product (P X HR) correlates with MVO2 with r = 0.86. Better results for TTI and P X HR, as reported in previous works, are reproducible by dividing our data into two groups of different inotropic states. At normal and moderate inotropic stimulation the correlation for TTI rises to r = 0.96, and for P X HR to r = 0.91. This augmentation is to be referred to the close relationship (r = 0.92) of peak ventricular pressure to maximum rate of pressure rise in this group. The additive parameter E1 is the best, both at moderate (r = 0.97) and at maximal inotropic stimulation (r = 0.87), and is to be preferred for indirect estimation of MVO2. Results are discussed with regard to the clinical application of MVO2 indices.


Cardiocirculatory adjustments during pregnancy -- an echocardiographic study. Adaptation of the circulation to pregnancy occurs via a complicated series of changes not yet completely understood. To define pertinent alterations, echocardiographic measurements of left ventricular function were performed every 4 weeks in 13 normal pregnant women. Six weeks postpartum each women was reexamined; thus each woman served as her own nonpregnant control. Left ventricular dimensions, left venticular wall thickness, shortening fraction, and rate of change of these measurements were recorded. As expected, cardiac output was increased throughout pregnancy. Up to 20 weeks gestation this occurred via an increased heart rate. After 20 weeks gestation stroke volume increased significantly, with 20% at 20--26 weeks up to 30% at term (p < 0.01). With the end-diastolic wall thickness remaining equal, myocardial hypertrophy occurred. This was corroborated by an increase in end-systolic left ventricular wall thickness towards term: from 13.8 mm (S.D. +/- 1.73) in early pregnancy to 16.6 mm (S.D. +/- 1.62) at term, with end-systolic left ventricular dimension unchanged. It was concluded that during pregnancy the mechanism to produce a higher cardiac output shifts from an increase in cardiac frequency to elevation of stroke volume with concomitant myocardial hypertrophy. Due to changes in heart rate and afterload, no conclusions could be drawn regarding myocardial contractility.


Noninvasive assessment of cardiac motion: comparison of the apexcardiogram and cardiokymorgram. The apexcardiogram (ACG) and cardiokymogram (CKG) (displacement cardiogram) tracings were compared in 45 patients with a variety of cardiac diseases and in 16 normal subjects. The ACG and CKG were generally comparable in waveform and timing of standard tracing intervals; however, on a case by case comparison frequent discrepancies between the ACG and CKG were observed. In 13 patients where no ACG could be recorded, an interpretable CKG tracing was obtained. However, the CKG produced frequent artifacts, mirror images, was very sensitive to probe position, and was judged to be of limited advantage over the ACG.


A comparison of mathematical models for estimating right ventricular volumes in animals and man. Volume of 19 right ventricular canine casts and 11 right ventricular human casts were obtained by water displacement and compared to three different mathematical models for estimating right ventricular volumes by biplane cineangiography. In the canine studies, significant linear correlation coefficients were obtained using the longest measured length method (r = 0.92), the triangular modification of Simpson's rule (r = 0.93), and the elliptical modification of Simpson's rule (r = 0.93). The human studies resulted in similar significant correlation coefficients of 0.96, 0.97, and 0.97, respectively. Although the highest correlation with the lowest standard error of estimate was obtained using the triangular model, all three mathematical models produced volume estimations that feel within acceptabe biological limits of accuracy.


Intra-aortic balloon pumping device for infants. The miniature components of an intra-aortic balloon pumping system (IABP) have been successfully developed in this laboratory and have been effectively tested both in vitro and in 32 in vivo experiments using small animals weighing 3.5--18 kg. It is reasonable to assume that IABP can be successfully employed for clinical use in infants and small children.


Isolated chronic tricuspid insufficiency due to closed chest trauma: report of a case with long-term follow-up. A case of isolated chronic tricuspid insufficiency due to closed chest trauma is described in this report. Studies for carcinoid syndrome were negative. At surgery the posterior leaflet of the tricuspid valve appeared to be torn and disrupted. The other leaflets were shortened and atrophic. The results of pre- and postoperative cardiac catheterization with long-term follow-up to the present, and the available literature on this rare entity has been briefly reviewed.


The effects of long term oral treatment with indapamide on the development of DOCA-salt hypertension in rats: vascular reactivity studies. The onset of DOCA-salt hypertension in male Sprague-Dawley rats was prevented during 11 weeks of oral treatment with indapamide (0.5, or 10.0 mg/kg) or propranolol (60 mg/kg) administered in the diet. The body weights of the indapamide treated groups were significantly (P < 0.01) greater, at weeks 4, 5, 6, 7 and 11, while the body weights and food intake of the propranolol treated group were significantly (P < 0.05) lower at week 11, than the control group. A significant reduction in heart wet weight (P < 0.001) was measured in the indapamide treated animals only. No significant diuresis nor natriuresis was measured in any group during week 11 of treatment. When all groups were subjected to an increased salt load, four weeks after cessation of drug treatment only the indapamide (10 mg/kg) treated animals failed to show an increased blood pressure. Vascular reactivity studies carried out six weeks after termination of drug treatment, indicated a significant (P < 0.01) reduction in pressor activity elicited by electrical stimulation of the entire sympathetic outflow in indapamide (10 mg/kg) treated pithed rats. No significant difference in the pressor activity elicited by noradrenaline (5 x 10(-8) - 5 x 10(-6) g/kg, i.v.) or tyramine (10(-5) - 5 x 10(-5) g/kg i.v.) was observed in any treatment group. In conclusion, chronic oral treatment with indapamide or propranolol, prevented the onset of DOCA-salt hypertension in rats. A long lasting antihypertensive action of indapamide involving the sympathetic nervous system is also indicated.


Differential development of salt-induced and renal hypertension in Dahl hypertension-sensitive rats after neonatal sympathectomy. Rats with a genetic susceptibility to salt hypertension were given repeated neonatal injections of guanethidine. Vascular reactivity and tissue catecholamine concentrations indicated that a peripheral sympathectomy had been produced. Chemically sympathectomized rats had lower blood pressure than controls while fed a diet containing 0.4% NaCl. Furthermore, the dramatic rise in blood pressure exhibited by control rats fed a diet containing 8.0% NaCl was completely absent in sympathectomized rats similarly fed. The absence of salt-induced hypertension was observed regardless of whether the animals were anesthetized with ether or pentobarbital or had the blood pressures determined in an unanesthetized state. Finally, two-kidney Goldblatt hypertension did develop in sympathectomized rats, but to a level below intact rats similarly treated.


Sequential method for combined screening antihypertensive and diuretic agents in the same spontaneously hypertensive rat (SHR). A combined method for detecting compounds with antihypertensive and diuretic activity simultaneously in the same spontaneously hypertensive (SH) rat is described. The present method, utilizing the advantages of sequential probability test analysis, the spontaneously hypertensive rats and the direct measurement of arterial blood pressure, proves to be feasible and efficient in detecting both activities. This ia s 3-stage sequential test requires one to three rats per compound. One adult SH rat was dosed by gavage with compound at 100 mg/kg, p.o. and loaded with 0.9% NaCl at 25 ml/kg, p.o. at 0-hr. The rat was put in a metabolism cage. The 0-5 hr. urine was collected and urinary Na+, K+ and CL- were determined. A second identical dose was given without NaCl loading at 24-hr. Mean arterial blood pressure (MABP) of conscious rats was measured directly by fermoral-iliac artery puncture at 28-hr. The criteria to accept, retest or reject a compound were based on the testing of known antihypertensives and diuretics. A 2nd and 3rd rat may be needed for a test compound depending on the outcome of the MABP and urinary electrolytes of the 1st rat. Based on MABP, guancydine, hydralazine, clonidine, reserpine, alpha-methyldopa, guanethidine and parglyine were accepted as active. Based on urinary sodium excretion, furosemide, quinethazone, acetazolamide, hydrochlorothiazide, metolazone, triamterene and clonidine were accepted as active.


Long-term measurement of total exchangable sodium in one- and two-kidney Golblatt rats. Total exchangeable sodium (Nae) was measured by wholebody counting of 22Na in 1- and 2-kidney Goldblatt rats before, and for 12 weeks after, renal artery clipping. In 1-kidney Goldblatt rats, Nae relative to body weight increased immediately after the clipping procedure and then fell though not to normal levels; from the 10th to the 12th week it again rose rapidly, probably secondary to vascular damage. In 2-kidney Goldblatt rats, Nae relative to body weight increased immediately after the clipping procedure but by the 5th day it was back to normal and remained normal thereafter. Consideration of the values for absolute Nae (i.e. expressed in mmol per rat) casts some doubt on the reality of the sodium 'retention', except in the 1-kidney Goldblatt rats in the later stages of their hypertension. Immediately after surgery temporary loss of weight (presumably mainly affecting fat stores and muscle) probably accounts for much of the rise in Nae relative to body weight.


Antibiody-facilitated digestion and its implications for infant nutrition. A model of digestion is proposed in which oligopeptides arriving at the small bowel epithelium are bound to secretory antibodies, which hold them in contact with proteases and thus facilitate their breakdown and utilization. "Immunity" and "digestion" are thus seen as two sides of the same coin. Absence of this pathway, predictably, would cause a degree of malabsorption, while partial deficiency (either quantitative or qualitative) would give rise to a coeliac-like illness. Breast-feeding with colostrum and then milk provides the infant gut with both immunity and "digestivity", and this could be adopted therapeutically for coeliac disease and other consequences of local immunodeficiency.


Paediatric preparation for multiple premature births. We describe the managment of 2 sets of pre-term quadruplets born to 2 women pregnant concurrently following the induction of ovulation with gonadotrophin. Careful antenatal planning was necessary to provide for each of the 8 pre-term infants a standard of neonatal medical and nursing care comparable to that normally available for singleton pre-term infants.


Hypertension during pregnancy, with and without specific hypotensive treatment. I. Perinatal factors and neonatal morbidity. In a prospective study, women who were hypertensive before the 28th wk of gestation were randomly allocated into two groups: those who received specific hypotensive therapy (Ht) and those who did not (Hu). The outcome was compared with a random sample of the hospital population (S) ascertained after delivery. In both hypertensive groups there was a higher incidence of clinical signs of possible fetal distress and instrumental delivery. Although there was no difference between the groups in the distribution of birthweight above and below the mean for gestational age, the treated hypertensive group had an excess of infants with relatively smaller head circumferences for their gestational age compared with both the untreated hypertensive group and the hospital sample. Tube-feeding was also more frequent in the treated hypertensive group. In the untreated hypertensive group there were more infants whose neurological status was categorized as questionable or abnormal in the neonatal period, compared with the sample. The different problems encountered by infants in the two hypertensive groups emphasized the need for further study of these babies. Their development during the first year of life will be examined in a subsequent paper.


Hypertension during pregnancy, with and without specific hypotensive treatment. II. The growth and development of the infant in the first year of life. The growth and development of three groups of infants were prospectively assessed from birth to 12 mth. In two groups the mothers had been hypertensive before the 28th wk of gestation; one group was randomly allocated to specific hypotensive therapy, the other group was allocated to no specific treatment. The third group was a sample of the hospital population. General health, and the incidence of sight and hearing problems did not differ. Infants in the treated hypertensive group had had more perinatal problems, and there was an excess of infants with relatively small heads for their gestational age at birth. At 6 mth their heads were still smaller than the hospital sample, but by the age of 1 yr the difference was no longer present. The neurological status of infants in the untreated hypertensive group was less favourable in the neonatal period, and there was still an excess of infants in this group rated questionable on neurological assessment at the age of 12 mth. In both hypertensive groups there was an excess of infants with delayed fine-motor function at 6 mth, and in the untreated group there was an excess with delayed gross-motor function at 12 mth compared with the hospital sample. Our varied findings draw attention to the dangers of assessing the effects of different pregnancy conditions in terms of neonatal mortality and morbidity alone. Our date indicate that follow-up should extend for longer than 12 mth when the effects of adverse pregnancy factors and their management are under consideration. Further evaluation will be made when these children are 4 yr old.


Acquisition of appetitional and palpebral conditioned reflexes by the same infants. The establishment of appetitional and palpebral conditioned reflexes was compared in three groups of 26 infants, 3--150 days old. The age range within each group at the beginning of conditioning was 0--20 days for both methods. The parameters compared were the time to reach equal criteria for the establishment of the conditioned response, and the nature of acquisition. The main results are as follows: (1) appetitional CR was established more quickly than palpebral CR; (2) the relative rates of conditioning in both methods were correlated in the same infants (r = 0.84; P<0.001); (3) the course of conditioning was in striking agreement in infants of the same age, both premature and full-term, for the two applied methods, but different for groups of infants of different ages. The results indicate that two quite different methods yield a picture of differences in the functional capacity of the CNS which are in close agreement with those for age.


Sudden unexpected death in infants of narcotic-dependent mothers. During the study years 1972--1974, 8 of 383 infants born to mothers with known narcotic dependency during pregnancy died unexpectedly within the first 4 mth of life; autopsies were compatible with the diagnosis of SIDS. This incidence of SIDS was 5.5 times that in our hospital populations (P < 0.001) and 8.7 times that of our borough within New York City (P < 0.001). Similar factors, such as sex ratio, age at time of death, and diurnal and seasonal variations suggest that narcotic-associated sudden death may be a relevant study model for sudden unexpected death in the general population. Intrauterine exposure to narcotics and its subsequent effect on central control of respiration in the young infant may be the underlying mechanism of drug related SIDS.


Induction of labour by different methods in primiparous women. I Some perinatal and postnatal problems. A personal prospective study was made of some perinatal and postnatal problems associated with induction of labour by three different methods in primiparous women with unripe cervices. The methods of induction were: (A) amniotomy followed by intravenous oxytocin [49], (B) amniotomy followed by intravenous prostaglandin E2 [39], (C) prostaglandin E2 by the extra-amniotic route [42]. A spontaneous group (D) comprising 54 mother--infant pairs was also studied. Length of gestation was between 37 and 42 wk in all but 2 cases. There was no perinatal mortality, and no infant had hyaline membrane disease. A close association was found between method of delivery and method (or absence) or induction. The caesarean section rate was highest in group C and lowest in group D. The spontaneous vaginal delivery rate was lowest in group C and highest in group D. More infants in the three induction groups were admitted to the Special Care Baby Unit (SCBU) than in the spontaneous group. No significant associations were found between the severity of the conditions leading to induction and caesarean section rates, low Apgar scores, admissions to SCBU, or the favourability of the cervix before induction. Among those who intended to breast feed fewer infants in the spontaneous group changed from breast to bottle while in hospital and after discharge from hospital than in the combined induction groups. Success in breast-feeding was not significantly associated with method of delivery or whether the infant was admitted to SCBU or not.


Induction of labour by different methods in primiparous women. II. Neuro-behavioural status of the infants. The infants of primiparous women in whom labour had been induced by three different methods were studied, together with a fourth group (D) who had laboured spontaneously. The methods of induction were: amniotomy followed by intravenous oxytocin (A), amniotomy followed by intravenous prostaglandin E2 (B), and prostaglandin E2 by the extra-amniotic route (C). Neurological assessments were made on the first day after birth, 4 days later, and at the age of 2 mth. No significant associations were found between method of delivery and neurological scores at any age. On day 1 infants with a lower Apgar score at 1 min had a lower neurological score than those with a high Apgar score (P < 0.05). On day 5 infants with a high serum bilirubin level (> 207 mumol/l) had a lower mean neurological score than those with a lower recorded serum bilirubin level (P < 0.05). By the age of 2 mth this difference had increased still further (P > 0.001). No differences were found in the mean neurological scores of infants in the four groups during the neonatal period, but at the age of 2 mth the mean score for infants in group A was significantly lower than that for infants in group C (P > 0.05) and D (P > 0.01). Among those children seen again at the age of 18 mth fine-motor adaptive performance was poorer for infants in group A than in groups B (P > 0.05), C (P > 0.005) and D (P > 0.01).


Swaddling, cradleboards and the development of children. The cross-cultural and historical use of techniques of infant restraint, swaddling with or without the use of a board or cradle, are described. Such techniques were used very widely in temperate latitudes but have declined since the 18th century. Laboratory experiments indicate that swaddled babies sleep more, have reduced levels of motor activity in response to stimulation, fewer startles and lower heart-rate variability. No clear long-term effects of swaddling have been demonstrated. Results are reported of an ethological study of cradleboard use among Navajo Indians. Time on cradleboard declined from about 16 h a day in the first 3 mth to less than 9 h by the first birthday. The extent of cradleboard use was determined by both infant and parental actions. As compared with European infants, Navajo babies spend much more time in actual or potential social contact with adults. It is suggested that swaddling and cradleboard might be used in western cultures to reduce the social iolation of infants, to reduce parental child tension with 'sleep problem' babies and in various paediatric situations.


The effect of perinatal factors on cord thyroxine concentration. Cord blood thyroxine (T4) concentrations were measured in 4,068 infants from 28 wk gestation to term. Each chart was reviewed for the following factors: delivery by cesarean section, prolonged rupture of membranes, neonatal asphyxia, meconium-stained amniotic fluid, maternal diabetes mellitus and twinning. Each neonate was evaluated for the Idiopathic Respiratory Distress Syndrome, and low (SGA) or high (LGA) birthweight for gestational age. Within each gestational age group, the mean cord T4 value was similar except for a significantly lower mean cord T4 concentration for the term SGA subgroup. Thus, inclusion of the infant with a complicated neonatal course or the infant born to a high-risk mother in mass screening programs for congenital hypothyroidism using cord serum will not increase the number of false-positive T4 values.


[Reflections on the problem of "discreteness" and "steady state" in living processes]. A survey is given over the different meaning of the dialectic pair of terms continuity and discontinuity in philosophy contrasting with sciences. In mathematics, the term continuum is defined by Cantor in set theory as the innumerable multitude of the real numbers especially in the interval [0, 1]. The discontinuum means in Cantor's definition the rational fractions in [0, 1] which in triadic development do not contain the figure 1 [written I). In a more general sense, continuum is used in the mechanics of continuous fluids and gases in physics as well as in physiology. Here, the use of this term neglects the reality of intermolecular spaces intentionally. To employ in the life sciences, the pair of terms steady state and discreteness is clearer. Processes of life mostly are steady in the sense of balanced proceedings but numbers of individuals, cells, molecules, sexes etc, are discrete only. For example, the difference or the dimorphism between males and females is a distinct one between two different conditions but cannot be projected on "discontinuity". Discreteness as a term comprehends Boole an variables as are male-female, living-dead, as well as crowds of measure points.


[The initial stages of formation of the bone centers and the construction of the skeletal organs. The metamorphosing cartilage: Part I]. In connection with the investigation of the ossification center we discussed the significance of the several sites of osteogenesis. In consideration also of anthropometric relations during growth we got the impression that among others the relations to the muscle- and nerve-system are important for development of bones. The insertions of muscles at the diaphysis are in square dimensions respectively linear, in which regions a tendineous osteogenesis occurs, so that muscle and bones may grow together. The organ of growth for diaphysis is the epiphyseal disk und represents real a diaphyseal disk. Above the epiphyseal disk there remains a part, which acts firstly as growing cartilage. Close to it and partly connected with the epiphysis are apophysis, the points of circumscripted insertions of muscles. In this part a metamorphosis takes place, which in connection of the formation of the cavity of the ossification center formate later on the osseal basis of joint cartilage. With retardation and finally the stop of length growth in epiphysis and metaphysis a new area of bone formation is built up in which the ultimate spongiosa becomes formed. During the formation of the cavity of the ossification center dominate degenerative changings of the cells and intercellular-substances. The chondrocyts accumulate in first easily dissolving carbohydrates. The original meandering endoplasmatic reticulum transforms to small vesicular structures and are fragmentated. The partly roundish and bizarre shaped nuclei shows signs of pyknosis. The cells become a longish dense shape with enclosed vesicles and dense structures, there structural elements cannot be more diagnosed. The fibrills originally arranged in a cross-system decrease in diameter and run now almost parallel. Finally they disintegrate to fragments which are mixed with MPS-granules.


[A morphological and functional analysis of the extent of cartilage coverage in the human hip joint]. The extension and the shape of the cartilage surface of 30 human femora and acetabula were measured. The results were considered and discussed as the response of the articular cartilage to the specific stress on this joint. 3 kinds of cartilage distribution were found on the femoral head; these shapes were understood as the consequence of the position and the dwelling time of the actual cartilage stimulating area. The largest extention of the cartilage was found in the ventrolateral direction and the smallest in medial direction. The cartilage margin of the "A" type was regulary curved. The "B" type has an inlet towards the fovea capitis. This inlet reaches in the "C" type to the fovea as an area free of cartilage. The acetabula could not be divided into types with different cartilage distribution because of the great similarity in shape. Therefore we computed an average acetabulum. The largest extension of the facies lunata was found 15 degrees in front of the roof of the acetabulas as seen in x-ray pictures. The cornu anterius is always narrower than the cornu posterius. The outer margin of the osseous acetabulum does not reach the equator, it lies on a latitude of 11.5 degrees. The incisura acetabuli is inclined against the vertical line with 18.3 degrees. The width of the facies lunata can be considered as a result of mechanical stress. The different extensions of the cartilage of both joint components in ventro-lateral direction seems to be the consequence of different extensions of movement. The area of movement of the caput femoris is larger than the area of the acetabulum.


A functional interpretation of the varanid dentition (Reptilia, Lacertilia, Varanidae). A cinéradiographic analysis of the feeding movements in Varanus bengalensis produced the following results. The mouth is opened by raising the head (upper jaw) rather than by lowering the lower jaw. Starting from the resting position, the muzzle unit is elevated around 9 degrees relative to the rest of the skull during jaw opening; the quadrate swings anteriorly around 21 degrees. During jaw closure, the snout is depressed around 15 degrees relative to the rest of the skull, hence 6 degrees beyond the resting position. The quadrate swings backwards around 27 degrees. Amphikinesis is interpreted as allowing a stronger posterior recurvature of the maxillary teeth in Varanus. This increases the holding effect of the teeth without increasing their length, an adaptation of Varanus to capture relatively large prey. The formation of plicidentine (dentine infolding) in the teeth of Varanus increases the surface of attachment of the teeth on the supporting bone. Moreover, the dentine lamellae take up tensile and compressive stresses along their long axes upon axial or vertical loading of the teeth. The slope of pleurodonty is modelled so as to minimalize shear stress on the surface of ankylosis upon axial or vertical loading of the teeth.


[Morphologic evolution of the musculi extensores digitorum and abductor pollicis longus in man. Part I: Introduction, methodology, M. extensor digitorum]. The author discusses first of all the theoretical principles of the evolutionary myology and gives a detailed explanation on the 3 types of studies included in this complex method. The investigated material is distributed into 3 groups, which correspond to the above mentioned 3 types of studies: 1. The variations of the muscles, object of research, are studied on 200 upper limbs of adults and cn 100 limbs of human fetuses. The crown to heel length of the latter and the number of the studied limbs could be seen on the Table on page 823. 2. The comparative-anatomic research is performed on 122 limbs of animals. The different species of animals as well as the number of the examined limbs are given on the table on page 824. 3. The organogenetic material includes 18 upper limbs of human embryos and fetuses, the age of which could be seen on the table on page 825. After expressing his gratitute to all, who have assisted him in his work the author gives the already known literature data related to the phylogenesis and ontogenesis of the muscles studied by him. His own investigations start with searching of m. extensor digitorum in man, as special attention is paid both to the muscles' bellies and their tendons and the connexus intertendinei.


Information system, data bases, and on-line services of the Japan Information Center of Science and Technology (JICST). The JICST information processing system consists of the data-base production system, authority file management system, bibliographic retrieval system, and printed issue compiling system. The bibliographic retrieval service based on the JICST On-line Information System (JOIS-I) has been available through leased line since 1976 and now also through dial-up line, which covers five data bases: the JICST bibliographic and on-going research information files, CA Condensates, MEDLARS, and TOXLINE files. The on-line output in Japanese kanji is also available. The newly revised JOIS-II system is now being developed.


Health and safety information for regulatory purposes--an industrial point of view. This article describes how one company (The Dow Chemical Company) is managing the issue of increasing demands by regulatory agencies for health and environmental information. Described are: an interdisciplinary organization linked by a resource and communication network; methods of evaluating information requests and establishing priorities for response; and problems in communicating with the regulators. The need for a responsive technical dialogue between government and industry is stressed.


On-line storage and retrieval of chemical information. I. Structure entry. An interactive program has been developed for entering, verifying, and storing chemical structures encoded in the Wiswesser Line Notation. The program calculates a molecular formula from the WLN for checking and then generates a bit string fragment code and connection table of the atoms in the structure. The encoding and entry of the WLN using a CRT has significantly improved the speed of the total compound registration process.


On-line storage and retrieval of chemical information. II. Substructure and biological activity searching. An improved interactive system for searching substructure and biological activity data has been developed. Features of the system include a two-level substructure search (fragment screen and atom by atom) and an expanded biological activity data base. The system operates on a file of about 150 000 compounds.


An evaluation of the leading patent equivalents services. Patent equivalent services are useful tools for identifying patent families. A patent family consists of a group of patents in various countries which cover the same invention. The patent equivalents services provided by the three leading suppliers--Chemical Abstracts Service, Derwent Publications Ltd., and INPADOC--have been tested and evaluated for coverage, recall, and accuracy. Results are reported for a test sample consisting of 75 pharmaceutical patent families.


Human globin chain separation by isoelectric focusing. Human globin chain separation, a key procedure in the study of hemoglobinopathies, is routinely performed by chromatography on carboxymethylcellulose. This method, though relatively easy and highly reliable, is expensive and time consuming. A new procedure, based on isoelectric focusing, is presented which allows the simultaneous separation of globin chains from multiple samples (at least 20 per gel slab). The method is rapid, inexpensive and can be easily carried out in clinical laboratories, and its high sensitivity allows the identification of radioactive bands even with minute amounts of labelled material. A new phenomenon, called the 'Nonidet P-40 effect', which greatly enhances the separation between gamma and beta chains by binding to these two chains and shifting their pI values in opposite directions, is described.


Fluorography of tritium-labelled proteins in immunoelectrophoresis. A method is described for detecting 3H-labelled proteins in immunoelectrophoretic systems performed on agarose gels. The method is based on the incorporation of a polyacrylamide gel into the agarose gel after the electrophoresis. This mixed gel has the characteristics of a polyacrylamide gel, making it possible to use fluorography as has been described for polyacrylamide gels. The applicability of the fluorography method is demonstrated by analyzing 3H-labelled human serum albumin and 3H-labelled pig intestinal brush border proteins by quantitative immunoelectrophoresis.


Heart synchronized gamma - camera gating: displaying two heart cycles on one screen. A method for the evaluation of the haemodynamic status of a patient with acute myocardial infarction is presented. Left ventricular ejection fraction has been considered to be an accurate indicator of haemodynamic status before and after therapy. A device for synchronising the R-wave, and controlling the recording oscilloscope during systole and diastole is described. The intention is to display both systole and diastole on one oscilloscope.


Antagonistic maternal immune reactions (rejection and facilitation) to the embryo in the urodele amphibian Salamandra salamandra lin. In vitro assays have been employed to demonstrate that pregnant salamanders mount an immune reaction against their embryos. Maternal spleen cells kill up to 85% of dissociated embryonic epidermal cells during a 48 h incubation period. The degree of killing depends upon the ratio of maternal to embryonic cells and on the number of embryos borne by the mother. The cytotoxicity shows considerable specificity for the embryos of a given mother although a weak degree of killing can occur with embryos from other mothers, presumably due to some form of cross-reactivity. The effect is inhibited by the addition of maternal serum to the cultures. The degree of protection is also a function of the number of embryos borne by the mother. Pre-incubation experiments indicate that the maternal serum has a protective action on the embryonic cells which is largely specific for the female's own embryos (and suggested to be antibody in nature) and an inhibitory action on the maternal spleen cells which occurs also with spleen cells of other females (and suggested to be either an immune complex or a nonimmunological substances). An increase in beta protein peaks is seen following electrophoresis of sera from pregnant (and also allografted) salamanders. These findings indicate that the pregnant salamander mounts a double immune reaction against her embryos, an aggressive (rejection) reaction and a protective (facilitation) reaction.


A low cost portable enuresis alarm.

A low cost portable enuresis alarm. The enuresis alarm described is a portable device designed for 'toilet training' of mentally sub-normal children. It weighs 70 gm with battery, has dimensions of 90 x 60 x 30 mm and conforms to DHSS recommendations. The battery life is over 1000 hours (6 weeks) in continuous use. Total component cost is is pounds 6.20 (in 1978), construction is simple and the circuit may be used as a conventional nocturnal enuresis alarm.


[Evidence for the developmental theory of myopia. 1. The role of accommodation in the development of myopia]. The causal part of weakened accommodation in the formation of myopia is linked with the visual activity at near-distance. Feeble accommodation can be caused by a morphological deficiency of the ciliary muscle and its insufficient training, also by a reduced blood-supply of the eye and by the influence of general diseases on the ciliary muscle. For the first time the thought is expressed to prevent myopia and its progression by influencing the accommodative apparatus of the eye.


[Blood circulation of the optic nerve with respect to the development of glaucomatous papilla excavation]. Recent research findings in microvascular anatomy enable the authors to make as new suggestion regarding the arrangement of the intraorbital vasculature of the optic nerve. In anatomical specimens three separate zones can be identified, sharply delimited and each with its own source of blood supply. After briefly describing the vasculature of the distal segment (neck) of the optic nerve the authors report several new theories concerning the pathogenesis of glaucomatous cupping of the optic disk.


[Various diagnostic methods in the examination of vascular exophthalmous]. The radiological examination results are reported form 13 cases of vascular exophthalmos in the presence of carotid-cavernous sinus fistels, carotid aneurysm and vascular malformations of the orbit. The results of the various methods of examination in the literature are discussed and proposals are suggested for a consequent diagnostic procedure.


[Prognosis of basal cell carcinoma of the eyelids in relation to histologic differentiation and thoroughness of resection]. As life expectancy increases the diagnosis and treatment of basal cell carcinoma of the lids is assuming ever greater importance. While there is still some debate as to whether conservative or surgical treatment is preferable, the emphasis in conservative treatment varies. Our own view is based on an analysis of 531 surgically treated patients. For histologic differentiation we used the data of Lever (1958). Considering that our recidivity rate was only 6.2%, we recommend primary surgical treatment. After localization of the tumor the inner canthus in particular should be kept under observation for recurrences. Histologic differentiation showed the sclerodermiform basal cell carcinoma to be especially dangerous.


[Leiomyoma of the ciliary body - misdiagnosis leading to an unconventional but successful surgical approach]. Report on a leiomyoma of the ciliary body in a 12-year-old girl. The clinical findings were misinterpreted as a traumatic ciliary body cyst because of the associated iridodialysis, the fact that the tumor could be transilluminated, because it appeared cystic on ultrasonography, and because there was a history of severe cranial trauma. In the course of an attempt to puncture the presumed cyst a cherry-sized ciliary body tumor was revealed. It proved possible to shell this out without performing an iridocyclectomy. An elective enucleation would have been performed had the true diagnosis been known preoperatively. Due to the misdiagnosis and the resulting unconventional approach the eye was preserved with some residual functions. the histological picture was that of a leiomyoma, a tumor rarely found in the ciliary body. The histological and electronmicroscopic appearance are described and compared with the few cases previously reported.


[Prospects for surgical treatment of retinal detachment (author's transl)]. In the light of experiences gathered in the surgical treatment of over 1500 cases of rhegmatogenous retinal detachment in a period of 12 years the authors believe that, despite advances in surgical technique and the prospects of further technical improvements outlined here our therapeutic capability will not be increased sufficiently to enable us to cure "malignant" detachments. Hence the authors think that there is a certain limit to the number of successful operations which will not be exceeded. This limit is 80-85% in unselected material and about 95% in cases with good prognosis.


[Dye-filling patterns in routine serial angiograms]. Rapid-sequence fluorescein angiograms of 127 healthy eyes with cilioretinal arteries were analyzed with regard to the time of dye entry into the central retinal artery, the cilioretinal artery and the choroid. In younger patients up to age 49) the cilioretinal artery filled simultaneously just as often as prior to the central retinal artery (42.9% and 41.4%, respectively); only rarely (15.7%) was a later filling noticed. In older persons (50 years of age and older) this filling pattern was reversed. The cilioretinal artery most frequently filled later than the central retinal artery (48.7%) and only rarely prior to it (15.8%). Similar results were obtained when comparing the filling time of the central retinal artery with the first choroidal fluorescein. With increasing age the circulation in the choroid and the cilioretinal arteries slows down in comparison to the central retinal artery, due to sclerotic vessel changes which have been shown to be much more pronounced in the choroidal vessels than in the retinal vessels. These findings are important for the understanding of age-related diseases of the optic nerve head, which derives almost all its blood supply from the choroidal circulation.


[Pharmacokinetics of mezlocillin in the rabbit eye]. Following intravenous injection of 50 mg/kg Mezlocillin into rabbit eyes the concentrations measured in the aqueous humor were of low-grade therapeutic efficacy. In the vitreous, this dose and form of application had no therapeutic effect. The transfer concentration in the aqueous humor after subconjunctival application of 20 mg Mezlocillin was comparably low. High therapeutic levels in the aqueous humor and even, in isolated cases, traces of Mezlocillin in the vitreous were found after subconjunctival injection of 100 mg.


[Absorption and distribution of cytoplasmic organ lysates (conjunctisan A eye drops) following intraconjunctival application (author's transl)]. The absorption and transport pathways of Conjunctisan A were determined, and its mode of action clarified, by means of radioactive labeling. A dose of 0.5 ml of this drug, labeled with I131, was applied to the conjunctival sacs of rats and rabbits. After six hours there was highly significant enrichment in the ocular tissues. The highest degree of enrichment was found in the uvea, i.e., the ciliary body, choroid and retina. However, there was also moderate enrichment in the lens and the vitreous. It was proved immunologically that the radioactivity was identical with the original Conjunctisan A molecule. In particular, it as demonstrated that the enriched Conjunctisan A in the aqueous humor precipitates with the specific antibody.


[Conservative management of senile cataract with conjunctisan A eye drops]. It seems to be a generally held view that there is no way of treating senile cataract successfully. However, this view is contradicted by the results of a long-term study carried out on 192 eyes treated with Conjunctisan A. According to these results lens opacities in senile cataract can indeed be influenced by therapy. Conjunctisan is a new therapeutic principle which exploits the effect of watersoluble protoplasmic elements, in particular proteins, ribonucleic and deoxyribonucleic acids, phospholipids, polysaccharides, lens-cell-specific nucleic acids and amino acid precursors from the lens, vitreous body, retina, optic nerve, cornea, conjunctiva and placenta. Over a period of observation of 5 years (1973-1978) Conjunctisan A eye drops were administered to the conjunctival sac twice or three times a day. Out of 192 eyes thus treated, lens opacification was halted in 36% and vision improved in 45%. These results concur with those of our earlier investigations on 74 eyes (1969-1973). It is also worth mentioning that opacification is slowed down much more than previously assumed on the basis of experience: this was demonstrated in a comparison with 75 cases of senile cataract that were not treated or treated only by conventional methods.


[Cataract extraction following glaucoma surgery]. This paper presents the results of cataract extraction in 124 patients who had previously undergone glaucoma surgery. The results were best when cataract extraction was combined with iridoplasty. With this method we were able to improve the patients' vision and preserve the filtration bleb. The technique of the operation is described.


[Results of aphakia correction with permanent silicone lenses]. Silicone contact lenses were fitted postoperatively to 114 aphakic eyes (55 children, 59 adults) and followed up for a maximum of 2 years. Provided they were fitted carefully the lenses were well tolerated for surprisingly long periods of time. Complications observed were superficial ulcer in 2 cases and circumscribed corneal infiltration in 3 cases and circumscribed corneal infiltration in 3 cases and circumscribed corneal infiltration in 3 cases. Corneal vascularization was not found. Postoperative vision was good, corneal astigmatism being reduced by 0.87 D on average. The main problems were deposition of organic material and in some cases poor hydrophilic properties of the lenses. Constant lens mobility is essential for long-term tolerance and avoidance of complications. At present it is recommended that the use of permanent-wear silicone lenses be restricted to special indications.


[Minor eye operations on infants under local anesthesia]. A procedure with local anesthesia is possible after premedication with Thalamonal and atropine in some special cases. The child is sufficiently sedated and remains co-operative. Four cases are reported in order to illustrate how such a procedure leads to satisfactory results.


[Pleomorphous adenoma of Moll's glands]. Description of a 70-year-old patient with a recurrent pleomorphic adenoma of the lower eyelid which originated form an adenoma of Moll's gland.


[Luetic papilledema].

[Luetic papilledema]. Although luetic ocular changes are rarely seen today they should not be neglected in differential diagnosis. Luetic papilledema is extremely rare and neurologic symptoms may be minor. A clinically observed case is described.


[Macula hole as a retinal complication of congenital malformation of optic disk and coloboma choroideae in the same eye (author's transl)]. Case report of a 24-year-old woman with combined ocular malformation: bilateral pits in the optic disc and coloboma of choroidea. Complication: macula hole in the colobom-eye. -- Within 3 years preexistent myopia increased 2 dpt in all. Possibly combination of unphysiological retinal traction by coloboma on the one side and axial myopia on the other side is cause of macula hole.


[The morning glory syndrome].

[The morning glory syndrome]. Two cases of hereditary Morning Glory Syndrome (MGS) with serious damage to the second eye are described. Besides MGS there is simultaneous shrinking of both kidneys, and chronic glomerulonephritis is suspected. A further member of the family suffers from a pseudoneuritis nervi optici, but not from kidney disease. Our findings are compared with cases of MGS which have already been described. The particular symptoms of MGS are compared with known anomalies. After analyzing the literature and our cases the following can be said of MGS: Refraction and sight can be normal. The size of the optic disk varies between too large and too small. Regarding the morphology, the prominent elevated annulus around the optic disk is possibly identical with that in the case of pseudoneuritis. The MGS can be hereditary, and there may be simultaneous, chronic and progressive kidney disease. The course of the kidney disease can have serious consequences for the patient.


[Endemic eye diseases in Samoa, 1910-1913]. In the years 1910/13 two endemic infections of the conjunctiva were found in Samoa in addition to ocular manifestations of filiariosis. One of these infections was obviously trachoma, the other an acute micrococcus catarrhalis conjunctivitis by diplococcus samoensis.


[A subjective contrast effect encountered daily by ophthalmologists]. After a brief review of psychophysical contrast effects an example of direct interest to ophthalmologists is illustrated.


[Cataract therapy: operation or not?].

[Cataract therapy: operation or not?]. Communication concerning an aid to vision for cataract patients who cannot undergo cataract surgery on schedule. Three possible ways of eliminating dazzling of the outer field are given. Experience has shown that a particularly simple and effective method is to stick black material or paper with an appropriate slit onto the lenses of reading glasses. This reduces the amount of stray light responsible for dazzling and thus improves visual acuity.


[Problems and developments in keratoprosthetics]. Problems and difficulties in Keratoprosthetics operations are described and methods of overcoming them discussed.


[Total orbitoplasty].

[Total orbitoplasty]. In injuries, removal of tumours and infections of the orbit the exenteration of the orbit may become necessary, sometimes even with sacrificing the eyelids. After healing of the orbital disorder the task of the orbitoplasty consists in rebuilding an orbit fit for a prosthesis; when the eyelids have to be reconstructed too, we speak of a total orbitoplasty. Further difficulties arise for the plastic surgeon, when the disorders or/and their treatment are followed by an open communication with the nasal hole and its paranasal sinuses. Mennig has called this complicated form of orbital reconstruction as total orbitoplasty of rhinosurgical type; its additional task is to close the open communications of the nasal hole and its paranasal sinuses with the orbit. Two selected clinical examples of total orbitoplasty demonstrate the procedure in such cases. The first case shows a total orbitoplasty with reconstruction of the eyelids after an injury to the right half of the face caused by high-tension current. The second case illustrates the rhinosurgical type of total orbitoplasty (Mennig), with closure of the fistulas between the orbit and the nasal cavity and paranasal sinuses as an additional reconstruction task.


Dialysance of acetate and bicarbonate: effect of ultrafiltration. The dialysance of acetate and bicarbonate measured using a 1.8 M2 hollow fiber artificial kidney was quantitated both in vivo and in vitro. The diffusional transfers of acetate and bicarbonate were similar as would be expected from their almost identical ionic weights. However, ultrafiltration increased bicarbonate loss and decreased acetate uptake and at a TMP of 300 mm Hg the dialysance of bicarbonate was significantly greater than the dialysance of acetate. Therefore, ultrafiltration reduces the transfer of net base to the patient which impairs the correction of acidosis, and may contribute to clinical problems associated with ultrafiltration during hemodialysis.


Leukocyte counts and arterial blood gases in nonrenal psoriatic patients treated with extracorporeal devices: Preliminary report. Four psoriatic patients with normal renal function were treated with RP-6 dialyzers. There was a significant decrease in the leukocyte counts at 5 mins of hemofiltration and it remained the same without rebound leukocytosis at 60 mins. Leukopenia was not accompanied by changes in PaO2 or PaCO2 and thus not accompanied by hypoxemia. C3 values were also unchanged, although a tendency to decrease was noted. Leukopenia and hypoxemia may not be related.


Characterization of erythroid inhibiting factors (EIF) in patients with anemia of chronic renal failure. Using the fetal mouse liver cell culture technique for evaluation of erythroid colony formation (CFU-E) sera of 15 patients with CRF and 10 normal subjects were investigated. When sera were removed immediately prior to the onset of regular hemodialysis from patients in a severe uremic state, they produced a significant inhibition of CFU-E formation when tested in the fetal mouse liver cell culture. In contrast, when the same sera after 48 hrs of in vitro dialysis were tested, inhibition of CFU-E formation was reversed to a large part. Inhibition was reversed in the same manner when sera removed from the same patients after 16--20 wks of regular hemodialysis therapy were tested in the fetal mouse liver cell culture. Thus, the EIF present in the serum of patients were severe uremia can be removed by in vivo and in vitro dialysis.


Bis(2-ethylhexyl) phthalate levels in nonuremic patients treated with extracorporeal devices. DEHP levels after treatment were studied in 6 nonuremic psoriatic patients undergoing extracorporeal therapy. Serum DEHP levels at the end of therapy of these patients were significantly lower than that of maintenance hemodialysis patients. DEHP and/or its metabolites were excreted by the normal kidneys, although the excretion of nonmetabolized DEHP by the kidneys was minimal. There was no correlation between serum DEHP levels of these nonuremic patients and the type of artificial kidney used or the mode of therapy employed.


Water soluble vitamins in patients with chronic renal failure and effect of B6 administration of immunological activity. Blood concentrations of water soluble vitamins were studied in 29 undialyzed and 35 dialyzed patients with CRF, and 36 healthy volunteers. Effects of B6 administration on immunological parameters were studied in dialyzed patients. In dialyzed patients, whole blood B1 decreased, while plasma B2, B6 and serum B12 and folic acid increased. In undialyzed patients with uremia, plasma B2, serum B12 and folic acid increased, while plasma C decreased in patients with moderate CRF. Oral administration of B6 for 4 wks was associated with improved tuberculin skin tests and PHA mitogen responses in dialyzed patients. Supplementation of B1 is required for patients with CRF while B6 and C may be considered.


Subclavian cannula for temporary hemodialysis. A new silastic and teflon cannula has been developed for temporary hemodialysis access. It is introduced through the subclavian vein by the Seldinger technique. The cannula which is quick and easy to insert, can be used repeatedly for weeks or months without limiting the patient's mobility and without the need for repeated vessel punctures. Complications are few and largely preventable. Since introduction of the subclavian hemodialysis cannula at the Toronto Western Hospital in September 1977 no patient with end-stage renal failure has required insertion of a silastic-teflon shunt or temporary peritoneal dialysis, nor has hemodialysis had to be postponed because of lack of an arteriovenous fistula.


Hypercoagulability: a cause of vascular access failure. In a group of 58 patients requiring tertiary vascular access procedures for maintenance of hemodialysis, 29 patients who thrombosed well-functioning fistulas were evaluated for both antithrombin deficiencies as well as platelet hyperaggreability. Thirteen of these 29 patients were found to have one or more coagulation defects. Following correction of the hypercoagulable state, tertiary vascular access procedures, using autologous tissues, were 100% successful in these 13 patients.


Ischemic heart disease in the hemodialysis population. We conclude that the incidence of IHD in men undergoing hemodialysis for end-stage renal disease was not greater than that seem in a nondialysis population of men with similar risk factors. In contrast, we found the rate of IHD in women with end-stage renal disease to be accelerated when compared to similar nondialysis subjects. Our data also suggest that during the 6 yrs of hemodialysis, ischemic heart disease did not represent a major mortality risk in patients who had not had symptoms of IHD prior to therapy although it dose pose a significant mortality risk in patients with evidence of established coronary artery disease prior to the onset of dialysis.


Evidence that acetate in dialysate does not stimulate lipid synthesis. Concern has been expressed that the acetate (Ac) used in dialysate may stimulate lipid synthesis and accelerate atherosclerosis. Tolchin, et al(10) calculated the fractional generation of bicarbonate from Ac, in order to estimate the amount of Ac entering the citric acid cycle. However, these calculations were based upon the assumption that the bicarbonate space was 60% of body weight. These investigators estimated that 91-93% of Ac was metabolized to bicarbonate; they suggested that 7-9% Ac may have been used for lipid synthesis. In the present experiments, 6 hemodialysis patients were infused with 2 mmoles Na bicarbonate/kg to measure directly the bicarbonate space for each patient. The bicarbonate space was 44 +/- 2% of body weight. On a separate day, the same patients were infused with 2 mmoles Na Ac/kg. Using the measured bicarbonate space, the calculated fractional generation of bicarbonate from Ac was 98 +/- 4%. Rabbit experiments were also performed with an atherogenic diet, supplemented with 10% Ac, 10% bicarbonate, or 10% glucose. After 8 mos of dietary treatment, there was no difference in serum triglycerides, cholesterol, or extent of atherosclerosis between groups. The human and animal experiments both provide evidence that Ac in dialysate does not stimulate lipid synthesis.


Effect of exercise on lipid metabolism and dietary intake in hemodialysis patients. In conclusion, a 10 wk exercise conditioning program in stable chronic hemodialysis patients resulted in improved exercise endurance without apparent adverse effects on nutritional status or lipid metabolism. Changes were observed suggesting a beneficial effect on carbohydrate and bone metabolism. The exercise-induced rise in serum creatinine may reflect an increase in muscle mass.


Effect of hemodialysis on myocardial function as assessed by postural stress testing. Myocardial performance, measured by systolic time intervals during passive postural stress, was evaluated in patients with end-stage renal disease before and after a single hemodialysis and compared with that of normal volunteers. Predialysis, the patients displayed a sluggish hemodynamic response to sudden postural changes. With tilting to 90 degrees, the patients' heart rate did not increase adequately and left ventricular ejection time (LVET) decreased only slightly in comparison to that of controls. Postdialysis, however, the response to sudden postural change in terms of increases in heart rate, decreases in LVET and decreases in calculated ejection fraction, were indistinguishable from those of control subjects. Since pre-ejection periods were not different from those of controls at any time during the test, we were unable to demonstrate a definite abnormality of myocaridal function before or after dialysis. The marked hemodynamic improvement in response to upright tilting, noted postdialysis, can be best attributed to a dialysis-related reduction in cardiac preload.


The production of prostaglandins in response to experimentally induced osteomyelitis in rabbits. Osteomyelitis was induced in the tibiae of rabbits by injection of staphylococcus aureus and sodium tetradecylsulphate (STD); additional rabbits were injected with STD alone. Confirmation of osteomyelitis was based on positive culture of the same phage type bacteria from the tibiae and on the characteristic radiographical and histological appearance of osteomyelitis. Only tibiae which proved to be infected by the above criteria showed significantly increased in vitro release and content of Prostaglandin E and Prostaglandin F2 alpha compared with tibiae injected with STD (P less than 0.05). After two weeks infection, infected tibiae released nine times more Prostaglandin E and five times more Prostaglandin F2 alpha than tibiae injected with STD alone. After four weeks infection, infected tibiae released less Prostaglandin E (P less than 0.05) than after two weeks infection but the release of Prostaglandin F2 alpha was similar. The production of large amounts of prostaglandins by bones in response to infection may be the cause of the rapid bone resorption and sequester formation observed in osteomyelitis.


Effects of onion (Allium cepa) extract on platelet aggregation and thromboxane synthesis. Oral administration of onion and garlic reportedly decreases platelet aggregation in both human and animal subjects. An oily chloroform extract of onion (Allium Cepa) was prepared and separated by column chromatography on silicic acid into six fractions by elution with solvents of increasing polarity. The least polar fraction contained most of the inhibitory activity towards platelet aggregation induced by either ADP or arachidonic acid. Further purification was afforded by thin-layer chromatography. The specific activity of this major active fraction (I50 per ml of PRP) was approximately 7 units per milligram. Platelets incubated in the presence of onion inhibitor and (1-14C)-arachidonic acid showed striking changes in the pattern of arachidonic acid metabolites formed. Thromboxane B2 synthesis was almost completely suppressed without significant decreases in total hydroxy fatty acid formation. It was concluded that the observed antiplatelet activity of onion relates to the presence of a non-polar, heat stable inhibitor of thromboxane synthesis. This appears to be the first demonstration of this type of inhibitor present in significant quantities in a common foodstuff.


Inhibition of ovulation and fertilization by indomethacin and effect of prostaglandin-F2 alpha on early pregnancy in the rabbit. Ovulation induced by HCG in rabbits was blocked by a single subcutaneous injection of 6 mg/kg indomethacin given 6 h after the insemination and HCG treatment. In addition, a time-dependent inhibition in the fertilization rate after indomethacin treatment was also recorded. This suggests that indomethacin, when given at a critical time and at an appropriate dose level, not only blocks ovulation but also interferes with fertilization. Treatment with graded amounts of prostaglandin-F2 alpha incorporated in a Silastic-polyvinylpyrrolidone-gel (PVP) had marginal to no effect after intravaginal placement on 4- or 6-day pregnancy. However, 5 mg PGF 2 alpha/ Silastic-PVP tube when placed intravaginally on Day-7 of pregnancy resulted in termination of pregnancy in 66% of the treated does. This implies that young corpora lutea are resistant of PGF2 alpha treatment and that pregnancy at the time of ovo-implantation can be terminated by PGF2 alpha incorporated in a Silastic-PVP tube.


The synthesis of dimethylphosphonoprostaglandin analogs. The synthesis of prostaglandin analogs incorporating the dimethylphosphono or dimethylphosphonomethyl moiety in place of the carboxylic acid moiety is described. These analogs exhibited only very low levels of smooth muscle activity during biological testing.


Relationship between concentration of prostaglandins E and F in the regulation of ovum transport in rabbits. Prostaglandin E and F levels were measured by a radioimmunoassay technique in different parts of the rabbit fallopian tube treated with indomethacin and in untreated rabbit at 0, 24, 48 and 72 hours after Human Chorionic Gonadotrophin (HCG) administration. The results indicate a significant rise in the levels of PGE and fall in the levels of PGF throughout the isthmus at 48 hours and in the distal isthmus at 72 hours in the untreated rabbits. In the indomethacin treated rabbits, PGF levels were reduced relatively more than PGE levels in different parts of the rabbit fallopian tube at various time intervals after HCG administration. Prostaglandins E and F may have a role in regulating ovum transport.


A new selective antagonist of prostaglandins: 20-methyl-13,14-didehydro-PGF2 alpha. 20-methyl-13,14-didehydro-PGF2 alpha has been assayed for antagonistic activity against PGF2 alpha and PGE2 on different smooth msucle preparations in vitro. This compound may be considered a selective and probably a competitive antagonist of PGF2 alpha on rat uterus in vitro.


Bronchodilator activity in vivo and in vitro of four 13,14-didehydro-PGE2 analogues. The bronchodilator activity of four analogues of PGE2: 13,14-didehydro-PGE2 (I), 20-methyl-13,14-didehydro-PGE2 (II), 16 S-methyl-13,14-didehydro-PGE2 (III) and 16 R-methyl-13,14-didehydro-PGE2 (IV) was studied in vivo and in vitro. The potency of III and IV when administered by aerosol to conscious guinea pigs was four times that of PGE2 in protecting against histamine-induced convulsion; I and II were less active. Compound III administered by aerosol to anaesthetized guinea pigs was six times more potent than PGE2 in protecting against i.v. histamine-induced increase of intractracheal pressure and the effect was longer-lasting. All the compounds caused relaxation of carbachol-induced tone in isolated guinea pig tracheal strips.


Urinary prostaglandins in kidney disease. Substances having the chromatographic behaviour and the bioassay properties of prostaglandins (PGE and PGF) were detected in the urine of 30 patients with kidney disease and 15 healthy subjects. The mean urinary PGE and PGF values in 15 patients with chronic glomerular disease or nephrosclerosis were significantly lower than those of 15 patients with chronic pyelonephritis and other forms of chronic interstitial nephritis, polycystic kidney disease, obstructive nephropathy or diuretic phase of acute renal failure, and of the mean PGE and PGF values found in the healthy subjects. It was suggested that in contrast to disease affecting primarily the renal medulla, chronic glomerular disease and nephrosclerosis are accompanied by a decrease of renal prostaglandin synthesis and/or release.


Differential regulation of the formation of prostaglandins and related substances from arachidonic acid and from dihomogammalinolenic acid. I. Effects of ethanol. Ethanol, over the concentration range 33 to 300 mg/100 ml (7.2-65.2 x 10-3 M) caused a dose dependent and highly significant enhancement of conversion of 14C-dihomogammalinolenic acid (DGLA) to prostaglandin (PG) El and to thromboxane (Tx) B1 by human platelets. Ethanol had no significant effect on conversion of 14C-arachidonic acid to PGE2 and TxB2. This concentration range is the one involved in human alcoholic intoxication. The effect could be related to enhanced transport of DGLA to the active site of the cyclo-oxygenase enzyme complex, to a modification of the enzyme complex which changes the way it metabolizes DGLA but not arachidonic acid or to two different enzymes. Whatever the mechanism it seems that it is possible to regulate selectively the formation of 1 and 2 series PGs probably at the cyclo-oxygenase level. The physiological and clinical implications of this are discussed.


Differential regulation of the formation of prostaglandins and related substances from arachidonic acid and from dihomogammalinolenic acid. II. Effects of vitamin C. Vitamin C over the concentration range 10 to 100 microgram/ml (5.7-57 x 10-5 M) caused a dose dependent and highly significant enhancement of conversion of 14C-dihomogammalinolenic acid (DGLA) to prostaglandin (PG) E1 and to thromboxane (Tx) B1 by human platelets. Vitamin C had no effect on conversion of 14C-arachidonic acid to PGE2 and TxB2. The concentration range is relevant to physiology: in some cells which concentrate the vitamin, such as polymorphonbuclear leucocytes and the adrenal cortex, vitamin C concentrations may be substantially higher than 100 microgram/ml. Vitamin C can therefore selectively enhance the formation of cyclo-oxygenase generated products from DGLA without changing formation of those from AA. This effect can account for a number of the known actions of vitamin C including its effect on the immune system. The implications of this finding are discussed.


Effects of indomethacin on pulmonary hemodynamics and extravascular lung water in sheep after pulmonary microembolism. Since the role of prostaglandins (PGs) in the response of the lung to pulmonary microembolism is unclear, this study examined the effects of indomethacin (INDO), an inhibitor of PG synthesis, on pulmonary hemodynamics and lung fluid balance in normal sheep and in sheep subjected to pulmonary microembolism. Anesthetized, ventilated ewes were given either INDO (5 mg/kg in saline) or emboli (Sephadex G-25, 0.1 ml/kg in saline) via a cannulated jugular vein. Pulmonary arterial (Ppa) and left atrial (Pla) pressures were measured. The ratio of extravascular lung water content to dry weight of the blood-free lung (Qwl/dQl) was measured. Animals were given either INDO 1 hr prior to embolism (Group IV), emboli only (Group III), INDO only (Group II), or were saline controls (Group I). While INDO had little effect in normal animals, Ppa was significantly attenuated in those pretreated with INDO prior to embolism (Group IV) as compared to those embolized only (Group III), and while Qwl/dQl for Group III was significantly elevated compared to Group I, it was not in Group IV. Results suggest that INDO attenuates the pulmonary hypertension caused by microembolism via inhibition of a vasoconstrictor PG, which may in part mediate embolism-induced edemogenesis.


Protective effects of a novel thromboxane analog in lethal traumatic shock. Pinane thromboxane A2 (PTA2) an analog of thromboxane A2 that inhibits the formation of thromboxanes as well as antagonizes their biological actions, at an infusion rate of 1.0 mumole . kg-1 . h-1, prolonged survival in traumatic shock in rats. PTA2 also prevented the accumulation of thromboxane B2, the lysosomal protease, cathepsin D, and the cardiotoxic peptide MDF in the circulating blood.


The influence of diazepam administration in rats bearing the R3230AC mammary carcinoma. The growth of the R3230AC mammary carcinoma was studied in female Fisher 344 rats that were treated with diazepam. Diazepam at 250 micrograms/animal/day (2.5 mg/kg body weight) and 500 micrograms/day was administered for 4 weeks, starting 2 days before subcutaneous transplantation of uniform pieces of the tumour. Tumour size was significantly increased in the group receiving 250 micrograms but was below the levels observed in the saline treated controls in those given 500 micrograms diazepam. Plasma PGE2 and PGF2 alpha concentrations were comparable in control and diazepam treated animals.


[Chronic idiopathic fibrous mediastinitis]. We present two cases of idiopathic mediastinal fibrosis. Morphological study disclosed the presence of fibrosis, granulomas and an inespecific inflamatory infiltration. Because this morfological pattern, the entity has been confused with Hodgkin's disease, tuberculosis, hystoplasmosis and silicosis. Idiopathic mediastinal fibrosis is probably a fibromatosis and the amount of inflammatory infiltration dependes of the clinical stage.


[Communication between the right coronary artery and the right atrium. Apropos of 2 surgical cases]. Two cases of anomalous communication of the right coronary artery with the right atrium (the so-called coronary artery fistula) are presented. Both were young females in which a continuous murmur was heard during routine examination. The x-ray image was typical, with a huge bulge in the right border similar to that seen in cases of right atrium enlargement. The ECG was normal in both patients. The diagnosis was made during cardiac catheterization and angiocardiography. A slight left-to-right shunt was present and the aneurismatic dilatation of right coronary artery and communication with the right atrium could be documented. In both cases a surgical closure of the defect was performed, both being well after two years and eight months respectively.


[Incidence of diabetic retinopathy].

[Incidence of diabetic retinopathy]. The epidemiology of retinal microangiopathy in 410 diabetic patients is discussed. The correlations between age, duration of diabetes, treatment, artheriosclerotic disease, arterial hypertension and obesity was determined.


[Hepatosplenic sarcoidosis. Apropos of a case]. We present a case of hepatosplenic sarcoidosis without associated pulmonary affection. We have also revised the literature in this respect with special emphasis on the etiopathogenic aspects. The evolution and treatment followed during the period two liver biopsies were performed. The good response to treatment with steroids, clinically and histopathologically, are commented on.


[Clinical course characteristics of polymyalgia arteritica. Study of 16 cases]. Clinical and biological characteristics are studied in 16 patients with polymyalgia arteritica. 12 of them were diagnosed by biopsy of the temporal artery and the other 4 because they presented clinical, biological data and a high response to corticosteroids. There were no differences according to sex. Most patients (75%) had symptoms since 1-6 months, headache being the most common (75%). Fever (56%), polymyalgia (50%), weight loss (37%), intermittent claudication, loss of vision and arthritis (12%) were the symptoms seen in these patients. ERS was high in all cases, hemoglobin was less than 8 g/100 ml in 8 cases and an increase of alfa-2-globuline was found in 8 patients. Temporal artery palpation was abnormal in 11 patients. Two of 5 patients who presented a normal arterial palpation had a positive biopsy. All patients received 6-metil-prednisolone. 3 are well after 3, 4 and 6 months therapy. 8 are also well but receiving small doses of steroids as treatment.


[Neonatal convulsions of a familial character and with a benign prognosis. Nosological classification. Apropos of a new case]. A new familial observation (3 members affected) of neonatal seizures without C. N. S. nor methabolic disturbance and subsequent normal development is reported. Seven other observations have been published before. The characteristics of this syndrome are discussed.


[Antitussive effect of amphetamine].

[Antitussive effect of amphetamine]. The effect of the amphetamine in coughing by trachial excitation and the delay of respiration by laryngial excitation is studied in experimental investigations in dogs, a very significant decrease of the two responses is produced in the dosis of 1 mg/kg.


[A new technical variation of the latex agglutination test for the diagnosis of human hydatidosis]. A new variant of the latex agglutination test using latex particles of 0,81 mu diameter is described. Hidatid cyst fluid antigen standardized by immunoelectrophoretic analysis was used. Fifty-one human sera from surgically confirmed hydatidosis and ninety control sera from non-hydatid diseases and healthy donors were studied. The method showed a sensibility of 86,2% and a global inespecificity of 1,1%. A human case of teniasis by Taenia saginata was positive. General considerations about the interpretation of results in human hydatid disease serology are made.


[A clinical report. Atypical subacute thyroiditis]. We present a patient 52 years old with a symtomatology of three month's evolution with: rapid weight loss, weakness in legs fasciculated tremor increased by any physical effort, nervousness and anxiety. The isotopic exploration of thyroid in basal conditions and after estimulation with TSH shows a very small captation of iodide. The determination of T 4 shows a notable increase (24 U. U. Normal range is 7,5 to 10,5 U. U.). The clinical symtomatology biochemical and gammagraphic datum support the diagnostic of subacute thyroiditis and also the posterior evolution of symtomatology in spite of the absence of odynophagia and the increase of syze of the thyroid. We comment on the particularity of this clinical entity that could be confused with thireotoxicosis because of its atypical character of presentation.


[Role of humoral and cellular immunity in the evolution of hepatitis B]. An immunocellular and immunohumoral assay was made among a total of 75 individuals HBsAg positive, with different evolutive forms (acute hepatitis, active chronic hepatitis, persistent chronic hepatitis and asymptomatic carriers), comparing the results among the different groups and those obtained in 20 healthy persons used as control. First of all, the immunohumoral response was studied by determining the three main immunoglobulins in each group. Afterwards, the quantitative immunocellular response was analyzed by the porcentual recount of spontaneous E-rosettes with mutton's red cells. The qualitative immunocellular response against the proper HBsAg was determined by previous concentration and purification of HBsAg and by the test of inhibition factor of migration of periferic human leukocytes. Finally, results are statistically related in both immune activities in each group, as well as other non immunologic factors, trying to classify the pathogenetic mechanisms responsible of different evolutive forms in hepatitis B.


[Comparative studies on pirbuterol, salbutamol and a placebo administered as an aerosol in asthmatic patients]. In a single blind cross-over study 12 patients with asthma received in randomised order aerosols of pirbuterol 400 micrograms, salbutamol 200 micrograms or placebo. Only 9 patients met the criteria and were taken into account for the statistical analysis, namely a stable reversible broncho-obstruction. Pirbuterol and salbutamol did induce a considerable bronchodilation. Both drugs had a similar activity and few side effects.


Metabolic and pharmacokinetic studies on Bamifylline. A review. The metabolic fate and pharmacokinetics of Bamifylline have been investigated by high performance liquid- and gas-chromatography techniques and radio-isotopic methods in several experiments following oral and intravenous administration of single and repeated doses of 300 mg, 600 mg and 900 mg of this drug. The 300 mg single- and multiple-dose experiments were performed by comparing Bamifylline with 200 mg of Theophylline within the confines of controlled double-blind randomized cross-over studies. Bamifylline is catabolized into several closely related compounds and into sulpho- and glucurono-conjugates of an hydroxylated derivative. Its metabolites are rapidly and extensively excreted via the kidneys and the liver. Only the unchanged Bamifylline has been recorded in the blood following administration of the radio-labelled parent compound. Bamifylline achieves peak plasma levels more rapidly than Theophylline. The half-time of Bamifylline plasma concentrations ranges from 1.5 hours to 2.0 hours, which is appreciably shorter than that of Theophylline which exceeds four hours. By further contrast the distribution volumes of Bamifylline are three to ten times larger than those of Theophylline. No evidence of cumulation has been found in blood following the repeated administration off doses as high as 900 mg administered at intervals of eight hours.


[Ventilatory effect and side effects of oral bamifylline]. The results are in agreement with the hypothesis that 900 mg oral bamifylline, as a unique dose, should produce slight and temporarily bronchodilating effects. This phenomen may be discussed from the 30th minute after intake. It was significant after 2 hours and remained significant till the 4th hour. It is interesting to stress that this conclusion is in agreement with some isolated observations we could make before in our laboratory by means of injections or suppositories with the same product [9]. We did not observe facts suggesting a possible cumulative effect of the drug, when taken at a dosage of 3 times 900 mg regularly spread over the day. The drug seems to be perfectly tolerated. A 10 days' treatment with the above mentioned posology did not produce neither haematological, haepatic, renal, nor vascular side-effects which could be identified by the techniques classically used in these respective fields.


Contribution to the standardization of pharmacodynamic tests in lung function. By bringing the aerosols in a spirometrical bell from which a constant volume aerosol was thereafter inhaled by each subject through a bi-directional valve, we observed more consistent and reproducible ventilatory results than by giving the aerosols by means of a classical device via a face mask. Moreover the results were significantly higher with the first technique; this fact suggests that the quantity of inhaled broncho-active drug with suitable granulometry would have been on the average greater per minute with the first method.


[Computer-controlled ventilation at Waterschei in the Kempen coal mines]. The paper describes the research activities that have been accomplished in recent years in order to realise a computer controlled ventilation-system at Watershei Colliery (Kempense Steenkolenmijnen) in Belgium. Chapter I sums up the original objectives and describes some changes in the philosophy of this project, the objectives already reached, those nearly accomplished and some others that were abandoned. Chapter II contains relatively precise data concerning Waterschei Colliery; this is justified by the fact that local conditions obviously play an important role in the development of any such project. Chapter III and IV give extensive information about those parts of the research-project that have known a major development: i.e. the design, the installation and the remote control of the regulators, especially regulating doors, as well as the development of dialogue procedures between the regulators and the computer.


[Dust control in Belgian coal mines. Conditions at the beginning of 1979]. The present communication gives a general view of the methods of dust control in the Belgian coal mines at the beginning of 1979. The statistical data received from the mines are presented in tabular form. The length and the output of coal faces treated by the classical methods of pre-spraying of the wall, wet cutting and water infusion are given separately; in some cases two or more of these technics are used together on the same coal face. The number of stone drivages in which different methods of dust control are used, is also given.


Dust and non-specific respiratory disorders in foundry workers and coal miners in the Rhine-Ruhr area. A review is given about various epidemiologic and pathologic studies in coal workers and foundry workers, regarding the prevalence of respiratory symptoms, chronic bronchitis and pulmonary emphysema in those workers in the Rhine-Ruhr-area. It is evident that these diseases are much more frequent in dust-exposed workers than in the other population.


Airborne coalmine dust and chronic bronchitis. The prevalence of chronic bronchitis was compared in a group of 970 coalminers and in 538 controls by means of a standardized questionnaire and of VC and FEV1 measurements. The coaldust present in the galleries had a low content of free silica and the dust levels were lower than the maximal permissible concentrations with reference to the US standards. The socio-economic characteristics, and mean height values were identical in both groups. The controls were somewhat older than concerning bronchitis symptoms were found in the non-smokers. The non-smokers exposed to coaldust showed higher prevalences of cough and FEV1 abnormalities than their matched controls. The unfavourable effect of exposure to coaldust on the bronchi was masked by cigarette smoking.


Contribution to the natural history of chronic bronchitis in coal-miners. Two epidemiological surveys were made by the same research team on the prevalence and the aetiological factors of chronic bronchitis symptoms in coalminers. The first study was made in a coalminers' community of Belgian Limburg, the other one in a representative sample of coalminers regularly at work. In both surveys an excess of dyspnea complaints was observed in comparison to the prevalence of this symptom in controls. These dyspnea complaints often presented themselves as isolated symptoms, without chronic cough or phlegm production. Dyspnea in excess could not be explained by massive fibrosis. The prevalence of the symptom was not linked, neither to the spirometric values, nor to the results of respiratory challenge tests with acetylcholine, tobacco use, or the length of exposure at the coalface. When dyspnea was associated with cough and phlegm production there was on the contrary a statistically significant relation with the spirometric values and the effect of acetylcholine. It seems therefore reasonable to explain at least partially the isolated dyspnea complaints in coalminers by specific mechanisms not related to bronchitis but resulting from the pathological lesions characteristic of simple pneumoconiosis. Complaints of cough and phlegm production appear as a rule later in the coalminer's life. In the groups taken into consideration in the study they were linked with cigarette smoking which appeared as the predominant aetiological factor for these complaints; in a subgroup a synergic action of coaldust, tobacco use and air pollution could be discussed in this respect. Notwithstanding the pathogenic independence of some dyspnea complaints versus cough and expectoration, it is quite clear that when productive bronchitis develops and causes broncho-obstruction, it may aggravate pre-existing dyspneic patterns.


[Current aspects of clinical bronchopulmonary and cardiovascular clinical pharmacology. Talampicillin in acute bronchopulmonary diseases in mine workers]. The results observed with talampicilline in our clinical study confirmed the observations made by others regarding the activity and the improved tolerance for this drug versus ampicilline. The use of a high daily dosage of 3 g per day was neither a cause of more frequent nor more severe side-effects than the usually smaller posology used in other studies published in the literature.


[Study in vitro of effects of nitric oxide and carbon monoxide on human and rabbit blood (author's transl)]. Fixation of CO on human blood or rabbit blood in presence of NO in similar concentrations is diminished by the formation of methemoglobin and nitrite methemoglobin. NO is oxidised in nitrate. Furthermore, it appears that oxidation of nitrite in nitrate is realised by red-blood cells. Spectrography study of blood trated by NO indicates presence of methemoglobin, nitrite methemoglobin.


[Arginine aspartate effects on acute human alcoholizing test (author's transl)]. One oral arginine aspartate administration (10g), 30 minutes after the beginning of acute human alcoholizing test (150 ml whisky 45 degrees, 67,5 g pure alcohol, mean load about 1 g/kg), provokes the following effects. Clinically, intensity and lasting alcohol manifestations are reduced. Alcoholemic absolute curve (g/l) does not vary: 1 h peak equal in the two treated and non treated groups, similar 6 h levels but a little lesser in the treated subjects, without significative difference. Alcohol space does not vary. Arginine aspartate provokes a significant increase between 1 h and 4 h of alcoholemic disparition slope, when rapported to body weight: mg/kg/h (p < 0,02), and ethyloxydation coefficient: mg/kg/h (p < 0,05).


Thallium intoxication caused by a homoeopathic preparation. A case of human thallotoxicosis caused by the taking of a homoeopathic preparation is reported. This preparation was taken accidentally by a patient who rapidly developed symptoms of thallotoxicosis. Treatment with Prussian blue resulted in rapid and total recorvery.