Aneurysm of sinus of Valsalva: cause of dynamic coronary constriction after aortic valvular replacement and bacterial endocarditis. A patient who had endocarditis on a prosthetic aortic valve and who had undergone two aortic valvular replacements developed classic angina pectoris. Cardiac catheterization revealed an aneurysm of the left sinus of Valsalva, which constricted a proximal segment of the left circumflex coronary artery during systole. This type of dynamic coronary arterial narrowing has not been previously described secondary to an aneurysm of a sinus of Valsalva and may be responsible for this patient's manifestations of ischemia.


An electrophysiologic study of swallowing-induced tachycardia. Electrophysiologic studies were performed on a 73-year-old man with swallowing-induced supraventricular tachycardia, in order to define the characteristics of this unique dysrhythmia in this patient. Swallowing reliably provoked an automatic atrial focus type of atrial tachycardia, which usually changed into an atrioventricular nodal reentrant tachycardia when a critical delay in atrioventricular nodal conduction (atrio-His interval greater than or equal to 340 msec) was achieved. The atrioventricular nodal reentrant form of tachycardia did not occur spontaneously. The ease of induction and the duration of the episodes of supraventricular tachycardia were facilitated with the intravenous administration of atropine and ouabain and were decreased with administration of procainamide hydrochloride.


Cleft tongue and ulceration of hard palate: complications of oral intubation. In a prospective study of the complications of endotracheal intubation and tracheotomy, we encountered an unusual complication of oral intubation. This report describes a 32-year-old man who sustained laceration and cleft of the tongue and ulceration of the hard palate as a result of the use of an oral airway in conjunction with oral intubation.


Administrative issues in child and adult psychiatry training programs. Child psychiatry training programs have encountered a number of administrative problems resulting from efforts to recognize, without isolating or submerging, the unique aspects of child psychiatry within existing departments of psychiatry. This paper questions the validity of the concept of general psychiatry, which may be responsible for many of these administrative dilemmas. The thesis is advanced that adult and child psychiatry actually represent distinct fields of practice, however, training programs for each should be integrated within departments of psychiatry through both adult and child divisional administrative lines.


Help-seeking mothers and their children. Forty-three mothers sought help with management of childhood behaviors. Presenting complaints in half or more of the families included stubbornness, talking back to parents, disobedience and other traits indicative of parent-child interaction difficulties. Pretreatment behavioral observations revealed that mothers shared common characteristics of being low in positive warmth and high in negative and oppositional responses. The children were observed to share common traits of little independent play, frequent frustration, and either ignored their mothers or were verbally and physically oppositional. Behavioral counselling and monitored rehearsal served to reverse many of the behaviors. Almost all mothers reported reduction in problem behaviors. Mothers varied widely in attributing usefulness to different program components.


Shapes and sounds as self-objects in learning geography. The pleasure which some children find in maps and map reading is manifold in origin. Children cathect patterns of configuration and color and derive joy from the visual mastery of these. This gratification is enhanced by the child's knowledge that the map represents something bigger than and external to itself. Likewise, some children take pleasure in the pronunciation of names themselves. The phonetic transcription of multisyllabic names is often a plearurable challenge. The vocalized name has its origin in the self, becomes barely external to self, and is self-monitored. Thus, in children both the configurations and the vocalizations associated with map reading have the properties of "self=objects" (Kohut, 1971). From the author's observation the delight which some children take in sounding out geographic names on a map may, in some instances, indicate pre-existing gratifying sound associations. Childish amusement in punning on cognomens may be an even greater stimulant for learning than visual configurations or artificial cognitive devices.


A new approach to teaching normal human growth and development. The role of clinical simulations as a teaching and evaluation device for preclinical medical students. A new approach to teaching Normal Growth and Development to preclinical medical students is described. By using specially constructed multidisciplinary clinical simulations as training and evaluation devices, students were gradually and simultaneously exposed to: (1) subject matter; (2) the concept of multidisciplinary health care delivery; and (3) the objectives, strategies, and techniques of problem solving and diagnostic reasoning that characterize experienced physicians. The course, designed by a child psychiatrist and medical educators, was taught by a multidisciplinary teaching team drawn from faculty and health care representatives. Student evaluations of the course were favorable.


Consistent caretakers in the premature nursery. Consistent caretakers for premature neonates in the nursery become involved emotionally with them during their lengthy stay. This is apparent in the mourning reaction they have when the infants are discharged. This should augur well for the infants since the caretakers offer many modes of stimulation necessary to the infants' optimal development. If there is deficient caretakers' involvement, it may contribute to a lag in development or emotional difficulties in the infants. These data suggest that a positive involvement by consistent caretakers may be a decisive contribution to developmental progress in premature infants.


What next in child abuse policy? Improving the knowledge base. A serious lack of reliable data and adequate theory hampers effective service and decision making in the area of child abuse.


The uses and misuses of central registries in child protective services. A national survey questions the effectiveness of computerized central registry systems, as now operated, in acheiving goals. The potential for abuse of individual civil rights indicates the need for further study.


Some guidelines for the use of behavioral change techniques. In using behavior modification methods, an approach employing gradual stages is suggested, beginning with the enhancement of positive behavior.


[Computerized tomography and its significance in preoperative abdominal diagnosis]. Computerized tomography (CT) has considerably improved preoperative radiological diagnosis. Localization and extension of pathological findings are determined reliably with CT. Measurements of density in regions of interest enable a differential diagnosis. Moreover the questions about the advisability of surgery and the likehood of cure or palliation can be better answered by CT than by any other noninvasive procedure. With the use of CT in the abdominal region increasing indications for conventional radiological methods have decreased considerably. In this paper, some examples are given of CT diagnoses of the liver, the pancreas, the kidneys, and the retroperitoneal space. As the techniques involved are improved, computerized tomography is certain to replace conventional diagnosis methods.


[Results of enteral antibiotic preparation prior to colon surgery]. Of the 108 patients explored, all received four days preoperatively dietary and mechanical preparation and were given one of the two antibiotic combinations according to their date of birth (58 patients, group I--Neomycin-Bacitracin; 50 patients, group II--Cephaloridin-Colistinsulfate). Bacteriologic studies of stools from the day before beginning of preparation, preoperatively and from the day of operation (intestinal mucous membrane of 70 patients) revealed that the fecal flora of the majority of the patients was abnormal. After antibiotic treatment the bacteriologic studies of stools showed a significant reduction of bacteria. In group II, full asepsis was reached in 42.4% of patients, in group I, in only 13.5%. The price of antibiotics and the preoperative intestinal bacteria should be used as criteria in choosing the preparation for colon operations.


[Height of rectum amputation. Management, complications, disease significance]. Management of the pelvic space after rectal excision is still problematic. Two methods have to be preferred: (1) closed suction lavage drainage and (2) open wound plugging; then the pelvic floor best remains unsutured. Plugging is always indicated in difficult pelveoperitoneal suture, unsatisfactory hemostasis and fecal contamination of the pelvic space. Retardation of wound healing is compensated for by more comfort for the patient and elimination of late complications, compared with those with partially closed or secondary opened wounds. The sacroperineal scar is the origin of a lot of complaints and morbidity. The most important are: infectious complications and persistent fistula (17.3%), pseudosinus perinealis (10%), perineal hernia and genital prolapses (16%), urologic complications (recidivating infections [26.9%], changes of the position of the urinary bladder [56%], secondary retroperitoneal fibrosis with urinary restriction [19.2%] or hydronephrosis [3.8%], disturbances of bladder emptying [36.5%], frequently combined with neurogenic lesions because of intraoperatively dissected autonomous pelvic nerves), local recurrence of carcinoma (17.3% in reexamination, but still much more important), and pain, often of unknown origin (34%).


[Parathyroid neoplasm associated with hyperparathyroidism]. Over a 25-year period, two carcinomas of the parathyroid were observed in 67 cases of primary hyperparathyroidism. The most important signs and symptoms were bone disease, palpable neck metastases, renal stones, and hypercalceamia with high blood levels of parathyroid hormone. Histology revealed that in principle parathyroid carcinoma can be distinguished from adenoma by a trabecular pattern and thick fibrous bands. The presence of cellular atypia and variation or mitotic figures (regressive polymorphia) was not a useful criteria for carcinoma. Local recurrence occurred in both cases.


[Transposition of the jejunum and selective proximal vagotomy following duodenopancreatectomy]. We report the use of a new surgical procedure following pancreaticoduodenectomy in nine patients with chronic relapsing pancreatitis and its complications. The modification of the Whipple reconstruction following resection of the head of the pancreas consists in selective proximal vagotomy, transposition of a jejunal loop for bile duct, and pancreatic anastomosis. The longest follow up period has been 18 months. In agreement with reports on other procedures for resection of the head of pancreas, the patients who had been operated on suffered few symptoms. With one exception they had no pain at all; they all gained weight. The results of early follow-up examinations of the patients treated by to these procedures encourage continued use of duodenopancreatectomy.


[Reflux-preventing gastric resection. An animal experiment study]. In 30 pigs the prevention of duodenogastric reflux following distal gastrectomy through different types of jejunal transposition or Roux-en-Y-gastroenterostomy was studied. The reflux was measured by determination of the intragastric amounts of bile acids and lysolecithin, and by the total number of glycerophosphatids. After distal gastrectomy and proximal selective vagotomy, isoperistaltic jejunal segments of different lengths were transposed between gastric remnant and duodenum. The reflux was normalized by 25-cm segments. Shorter segments led to no significant decrease of the reflux. The jejunal invagination of additional isoperistaltic valve did not have a significant effect. The same protection as from 25-cm segments was obtained by Roux-en-Y-gastrojejunostomy. The role of the duodenogastric reflux following gastrectomy for the gastric mucosa is disucssed. The necessity of the reparation of the pyloric function is shown.


[Experimental studies on the effect of pyloroplasty on gastric emptying, serum gastrin and duodenogastric reflux in selective proximal vagotomy (SPV)]. The influence of selective proximal vagotomy (SPV) and of an additional pyloroplasty (Heineke-Mikulicz) on gastric emptying, acid and gastrin secretion, and duodenogastric reflux was examined experimentally. After SPV, gastric emptying of fluids and a solid meal was significantly faster than before surgery. An additional pyloroplasty did not influence gastric emptying time significantly. Gastrin secretion after stimulation with a protein-rich meal increased significantly after SPV and did not change much after pyloroplasty was added. It can be concluded that increased gastrin secretion after SPV is not a result of delayed emptying. Pentagastrin-stimulated acid secretion was reduced by 70% after SPV and after additional pyloroplasty as well. The results show that reduced acid secretion after SPV causes the rise in serum gastrin levels. After SPV no duodenogastric reflux occurred. An additional pyloroplasty led to a significant rise of bromsulphaleine used as a marker for bile in gastric aspirate. Obviously destruction of the pylorus leads to a loss of its antireflux function. This leads to an antral gastritis which after 3 months is of chronic-atrophic type. A stimulation of gastrin output by bile could not be demonstrated. It can be concluded that after SPV gastric emptying is not delayed. A pyloroplasty does not affect gastrin release and acid secretion. Drainage procedures together with SPV should be avoided to prevent duodenogastric reflux and antral gastritis.


[Dysphonia following strumectomy. Laryngeal and vocal cord changes as sequelae of thyroid surgery]. In 142 patients function and morphology of the larynx were clinically assessed before and after strumectomy. The postoperative incidence of irreversible recurrent nerve pareses amounted to 2.1% whereas incidence of pareses of the n. laryngeus superior was 1.4%. The rather high number of laryngeal asymmetries (49.3%) is, in most cases, reversible after strumectomy. The number of intubation injuries does not significantly differ from the figures obtained after intubation anesthetics based on other indications. Hyperkinetic dysphonia is partly reversible after strumectomy, an unspecific recuperation effect probably playing the most important role. In 3% of the cases the enlarged thyroid gland caused a venous congestion in the endolarynx. Dysphonia following strumectomy is, in most cases, not to be attributed to a lesion of the laryngeal nerves, although the diagnosis dysphonia should under no circumstances lead to an expectant, conservative "wait and see" attitude whenever such a dysphonia (paraphonia) occurs. On the contrary, an otorhinolaryngologic diagnosis and, if need be, therapy are mandatory in all such cases.


[Arterial involvement in elbow-proximal injuries]. Nine cases of distal brachial artery injury were discussed. We refer to case No. 7 in which a complete dorsal displacement of the artery occurred through the fracture-line of the epicondyle. Trauma caused dislocation, laceration, or spasm of the artery, with or without intravascular thrombosis. Vascular spasm should not be diagnosed unless an arteriogram is available. If not done preoperatively, it can be done during operation. In this case inspection of the vessel during operation seems essential. Venous interposition is satisfactory for bridging defects of the distal brachial artery even in the elbow region.


Differences in the number of nucleolus organizers in Chironomus tepperi shown by in situ hybridization. Two stocks of Chironomus tepperi could be isolated. One stock, N(IV)+, contains nucleolus organizers in chromosome I and IV, whereas the other one, N(IV)-, shows only one nucleolus in chromosome I. It is demonstrated by in situ hybridization with radioactive rRNA that the absence of the nucleolus in chromosome IV of stock N(IV)- is not related to an inactivation of the nucleolar DNA, as might have been suggested, but is due to the lack of ribosomal cistrons.


Patterns of RNA synthesis in early meiotic prophase oocytes from fetal mouse ovaries. In a study of the early meiotic prophase stages of mouse oogenesis from d12 of gestation to 10d post-partum the patterns of RNA synthesis during these stages of oogenesis using H3-uridine incorporation as visualized by light microscope autoradiography are reported. We find that chromosomal RNA synthesis occurs in all stages except early to mid-pachytene, the time of maximum chromosome condensation. Diplotene and dictyate nuclei are the most heavily labelled stages. Nucleolar labelling ceases before leptotene and reappears in late pachytene or early diplotene, even though nucleoli can be identified in all stages except early to mid-pachytene.


Higher corticosterone values at a fixed single timepoint in serum from mice "trained" by prior handling. Results of "training" rodents for bioassay of synthetic corticosteroids are not consistent with expectations presumably based upon earlier implied claims stemming, perhaps, from over behavioral patterns displayed by handled as compared to nonhandled rodents (or the observer's wishful thinking?). At the timepoints investigated, "habituation" of mature mice and rats by exposure to handling, injection and killing procedures results in statistically significantly increased corticosterone concentrations. For younger animals the elevation in corticosterone concentration may also be applicable; although, it is not known to what extent we are dealing with an effect of "habituation" and/or age. Lowest hormone concentration occurred in the groups of mice housed undisturbed in an animal chamber separate from the room housing mice subjected to habituation. The results of this study suggest that for certain rodents kept in L from 0600 to 1800 "habituation" for 1 week, at least at the circadian stage corresponding to 0800, is not only ineffectual (in eliminating the rise in serum corticosterone associated with handling) but detrimental to the evaluation of synthetic corticosteroid potency by bioassay (to the extent that such a rise in exaggerated rather than reduced). In these acute experiments, methylprednisolone was more suppressive than dexamethasone and the water soluble ester-salts less suppressive than the 21-hydroxy bases. These results suggest the possibility of important differences in the distributive stage and/or the metabolism of these compounds--factors affecting the speed of onset of the desired as well as undesired effects.


Circadian rhythms of self-selected lighting in golden hamsters: relation to gonadal condition. Golden hamster (20 males, 8 females) were maintained in isolation boxes for 4-7 weeks. The animals had access to wheels and selected their own lighting by pressing one bar to turn light-on and another bar to turn the light-off. All hamsters maintained circadian rhythms of wheel-running activity. Seventeen of 28 hamsters selected lighting with a circadian periodicty. For 9 hamsters, there was a significant positive correlation between wheel-running activity and self-selected darkness, while this correlation was significantly negative for 10 hamsters. Four hamsters had regressed testes at the end of the experiment. These 4 had significant positive correlations between activity and self-selected darkness, while none of the  hamsters with significant negative correlations between activity and self-selected darkness had regressed testes. Light in phase with activity seems to be more important to the prevention of testicular regression than is the total daily amount of light.


The effect of sleep upon human circadian rhythms. Subjects who slept for 4 h from 0000, and for a second 4 h variously distributed over the day, have provided values for rectal temperature and for urinary excretion of water, potassium, sodium, chloride, phosphate, creatinine, calcium and urate in the sleeping subject at all hours of the 24. These are compared with similar values in the wakeful subject. Temperature was lower during sleep at all hours except 1000 and 1200, and the difference was maximal shortly before 0000. At all hours potassium excretion was lower and phosphate excretion higher during sleep. Cosinor analysis of the different variables in the sleeping subject is compared with that in subjects following nycthemeral habits, and the interaction between endogenous rhythms and external influences such as sleep is discussed. The phasing of the temperature and urinary rhythms was essentially normal by the end of the observations. By contrast in a subject who slept at irregular hours mimicking the habits of an air pilot a free-running rhythm unrelated to the habits of sleep emerged. When he was finally living again on normal time his temperature and urinary acrophases had moved to the middle of the night. Phosphate excretion was largely exogenous, falling consistently when subjects rose after 8 h, but not after 4 h of sleep.


Circadian susceptibility rhythms to some organophosphate compounds in the rat. LD50 values after i.p. doses of phenitrotion (PH), dichlorvos (D) and methyl parathion (MP) were established at 0600, 1200, 1800 and 0000 and plasma corticosterone was determined in male rats. The PH toxicity was significantly higher at 0600 than at 1800. Moreover, there was a significant difference between the PH toxicity at 1200 (lower) and 0000 (higher). The D toxicity differed significantly only between 1200 (higher). There was however a lack of circadian susceptibility, rhythm to MP. The results differ according to the metabolic fate and the solubility of the tested compounds.


The development of the angle of the anterior chamber in vertebrate eyes. The development of the angle of the anterior chamber of the eye in chick embryos (avian eye), in new born rats (rodents), in calf fetuses (ungulates) and in humans (primates) has been studied. The main determinant in the configuration of the angle is the two-layered structure of the mesoderm of the ciliary body: the external muscular layer inserted into the spur and growing with same growth rate as that of the corneoscleral mesoderm and internal fibrovascular layer giving rise to the ciliary processes and growing with same growth rate as that of the neural ciliary and iris epithelium. First the neural epithelium grows faster than the corneoscleral mesoderm and the ciliary processes appear anteriorly positioned and later the corneoscleral mesoderm grows faster than the neuroepithelium and the ciliary processes appear posteriorly positioned. The eyes of premature and low birth weight babies present the different stages of normal embryological development of the angel. The angle in eyes of various embryopathies and developmental diseases presents aspects similar to those of the premature and low birth weight babies. The etiopathogenic mechanism in cause is the same in both groups: arrest of development. During the first post-natal years, the corneoscleral mesoderm grows at a greater rate than the inner neuro-epithelium and the region of the most active growth is located at the ora serrata. That is why, during this period, the ora serrata recedes, giving rise to the formation of retinal teeth, the angle despens and makes a recess and the Lange fold disappears.


The oscillatory network of glycolysis: a model for multiple phase output derived from a single master oscillator. In oscillatory glycolysing yeast cells the reaction rates of 11 enzymic steps are almost completely in phase whereas the concentrations of intermediates fluctuate with highly different phases. Metabolite concentrations depend on the amplitudes of reaction rates even more than on their phases. In this way almost, synchronized enzymes can given rise to a variety of phases, resembling a "master oscillatory" which controls a series of peripheric event with different phases.


Mathematical optimization of glaucoma visual field screening protocols. There is potential for significantly shortening the time required for visual field screening protocols by a precise specification of the number, exact location, and sequence of points to be tested. Through statistical and mathematical methods, protocols have been developed for maximizing the probability of detecting at least one visual field defect in a subject who is a risk for early glaucomatous field loss. The mathematical formulation was derived in a generalized manner so that it could be applied to most kinetically or statically determined visual field screening methods.


A simulation study of oscillating glycolysis: a comparison between a model and experiments. Glycolysis is the best known biochemical oscillator and suitable for the exploration of the basic features of biological rhythms on a biochemical and mathematical level. Because of our detailed knowledge of its component structure (enzyme kinetics, metabolite pattern) glycolysis can be described by a set of coupled nonlinear differential equations of first order with respect to time, whose individual terms consist of enzyme velocities assuming a steady state hypothesis for the enzymatic forms. Due to the feedback control of PFK by the adenylates the system is able to oscillate. The outcomes of a simplified model, containing only the basic elements of glycolysis, show good agreements with experimental results.


Retinal receptive field-like properties and Stiles-Crawford effect in a patient with a traumatic choroidal rupture. Simple psychophysical techniques were used in order to assess layer-by-layer retinal functions in a patient with sub-retinal fluid due to a choroidal rupture following ocular trauma. A substained-like and a transient-like function believed to reflect retinal receptive-field-like properties, and an indicator of retinal receptor orientation (the Stiles-Crawford effect) have been followed in time. Central visual acuity was also measured. Initially all measured functions provided anomalous responses in affected retinal areas. Of interest here is the nature and order of recovery of the measured response functions. Most notable was the rapid rate of recovery of receptor orientation and the slower rate of recovery of the transient-like function.


Food, water and ethanol consumption by rats under a fixed-interval schedule of food presentation. Rats could lever press 24 hours a day for 97 mg food pellets under a fixed-interval (FI) 90 second schedule. During the first 4 days, an ethanol solution was the only available fluid, after which both water and ethanol solutions were available. At ethanol concentrations (w/v) of 5%, 7.5% and l0%, total caloric intake and total fluid intake remained constant, while ethanol consumption was inversely proportional to the concentration of the solution. When the FI 90s schedule was changed to FI 45 s, or to FI 180 s, there were only small changes in total caloric intake, total fluid intake and in percentages of total fluid consumption and total caloric intake as ethanol. The data suggest that the intake of ethanol under this fixed-interval schedule depends more on the ethanol concentration than on the calories obtained from ethanol drinking.


Psychosocial correlates of chronic cannabis use. The psychosocial effects of chronic heavy use of cannabis were studied in a rural population of males in north India. The user group comprised thirty persons who had been taking only cannabis at least 11 times a month over a period of five years or more. The controls were fifty subjects selected from among the general population to which the users belonged. The controls had not been using any drugs. The subjects had similar age distribution, occupation, socioeconomic status, and educational background. Psychosocial adaptation was assessed by enquiries into such areas as self-aspiration, present occupation, occupational satisfaction, marital status, marital relationships, sexual behaviour, self-reported deviant behaviour, and future planning for children. On no variable were the present users found to be different from the non-user control group.


Test-retest reliability and validity information for a high school drug use questionnaire. This study reports test--retest reliability and validity information for an anonymous high school drug use questionnaire. All drug use items were highly reliable in testings on the same students eight weeks apart. Composite drug scores were also highly reliable. A nine-item lie scale gave virtually identical results on the two testings. The majority of students regardless of the frequency of their drug use stated that they would honestly report their cannabis and opium/heroin use. There was little evidence of defensiveness judging by the lie scores.


Factors contributing to self-reported drug use among London undergraduates 1971-72. A questionnaire study of drug taking by 1113 London University undergraduates has been undertaken. This paper sets out to relate drug taking to student life. The variables which discriminate those who have tried illicit drugs from those who have not are conceptualised as representing alienation from study, distance from authority, and separation from parents. These variables are consistent with a general factor best labelled "non-conformity". The variables which seem to discriminate between degrees of involvement in psychoactive substances are ease of obtaining cannabis, estimated percentage of friends who use drugs, use of tobacco, seeing someone inject themselves, operational use of substances (i.e. use for purposes other than recreation or pleasure), and choice of future career. These variables represent four overlapping factors which affect involvement with psychoactive substances: contact with drugs, contact with drug users, identification with the user class, and within-class deviance. While non-conformity appears to be the factor in student life predisposing students to try illicit drugs, the factors which affect the degree of involvement with such substances seem relatively independent of student status.


[Risk to patients with latent or manifest hyperthyroidism through iodine-containing contrast media and drugs (author's transl)]. Severe iodine-induced hyperthyroidism occurred in 25 patients with, at the time not yet fully diagnosed thyroid function after administration of iodine-containing contrast media, disinfectants or drugs, in four of them precipitating a thyrotoxic crisis. As iodine-induced hyperthyroidism is often resistant to the usual antithyroid treatment, thyroid function should be checked whenever the use of iodine-containing contrast media is indicated.


[Reye's syndrome in adults (author's transl)]. The clinical picture of Reye's syndrome, characterized by an acute severe disease of brain and liver, initially has nonspecific generalized symptoms with cough, myalgia, and fever. The prognosis is poor. The disease starts with an infection, quickly followed by vomiting and loss of consciousness. In this phase the serum bilirubin is moderately raised, the transaminases markedly so. In addition to gastro-intestinal bleeding there may be hypoventilation, hypoglycaemia and seizures. Morbid anatomically there is a small-drop fatty infiltration of the liver and other organs with cerebral oedema. Aetiology and pathogenesis remain uncertain. Numerous therapeutic measures have been proposed.


[The Bayesian theorem in clinical differential diagnosis (author's transl)]. New (a posteriori) probablities of medical diagnosis can be calculated by the Bayesian formula from a priori probabilities of the diagnosis or diagnoses under consideration and from the probabilities of a given test result occurring with each disease. Using sequential iteration, the Bayesian formula is applicable to the calculation of a posteriori probabilities after multiple tests have been performed. When this iterative process has been programmed for a pocket calculator it can easily be used in clinical practice. As a consequence, medical knowledge can be applied more rationally. Many inconsistent data can be more easily interpreted as a result. Furthermore, results of diagnostic tests can be used more extensively and normal test results given their full weight.


[Ergometry in the assessment of antihypertensive treatment (author's transl)]. A standardized ergometric test, suitable for recognizing abnormally high exercise blood pressures as well as the influence of hypotensive drugs on blood pressure, was employed in 13 of 28 hypertensives being treated with a combination of beta-receptor blockers (oxprenolol, 80 mg), a diuretic (chlortalidone, 10 mg), and a vasodilator (hydralazine, 25 mg). This combination was an effective antihypertensive measure with few side effects, particularly so in reducing elevated exercise blood pressures.


[Age-dependent mechanical properties of the lung (author's transl)]. Capacity resistance breaking and volume resistance breaking were determined in normal subjects divided into three groups according to their age. There was a statistically significant age dependence with regard to both values. At a higher age, capacity resistance breaking increases in the respiratory tract already above the end-expiratory intrathoracic gas volume. There is a clear-cut age-dependent narrowing of the ventilatory reserve. This points to a relationship to "senile emphysema". It is probable that the premature loss of individual bronchi is a factor in the abnormal clearing mechanism of the elderly lung.


[The Rubinstein-Taybi syndrome (author's transl)]. The clinical picture of the Rubinstein-Taybi syndrome is characterized by mental retardation, broad thumb and large toe, beaky nose, antimongloid lid axis and numerous morphological signs. The patients resemble one another so that in many instances the diagnosis can be made on sight. Three cases are described. The exact differentiation from other abnormalities with mental retardation is important, especially  in genetic counselling of the affected families.


[Cardiac side-effects of oesophago-gastro-duodenoscopy in relation to premedication (author's transl)]. The electrocardiogram was monitored in 100 patients undergoing oesphago-gastro-duodenoscopy. Premedication differed: 25 patients each were given either (Group I) atropine 0.5 mg, hyoscine-N-butylbromide 20 mg, and diazepam 5 mg, or (Group II) hyoscine-N-butyl-bromide 20 mg and diazepam 5 mg, or (Group II) diazepam 5 mg and glucagon 0.2 mg, or (Group IV) only diazepam 5 mg intravenously. After injection of the parasympatholytic drugs (Groups I and II) there was a significantly higher heart rate duringthe entire length of the examination than in groups III and IV. Nine of the ten cases of ascending S-T depression were found in Groups I and II, while descending (ischaemic) S-T changes occurred equally frequently in patients of all four groups. Two of the three more serious arrhythmias were registered after atropine. Since parasympatholytic drugs fail to inhibit arrhythmias and ST-T changes, while accentuating the rise in heart rate, it is recommended that premedication for oesophago-gastro-duodenoscopy should not include such drugs.


[Importance of bromocriptine in dysthymic schizophrenia]. The authors report two observations of excited schizophrenics treated by Bromocriptin. To this point, they debate on the biochemical mechanisms of this dopaminergic agonist.


[Use of evaluation scales in psychopharmacology]. Rating scales are used to assess the intensity of psychiatric attributes such as anxiety and depression: they are generally composed of several items to be rated. They postulate: the continuity of the "measured" attribute; a monotonic attribute-item scores relationship; and the cancellation, within the final score of "parasitic" factors due to other features than the one which it is desired to measure. The main metrologic qualities are: sensitivity to states of different intensities, reliability in respect to time and rater, validity: relative to an external clinical classification, to another rating scale, or to known efficacy of a treament on the studied attribute. Self-rating scales avoid an intermediate rater and are easy to use. But they allow for no interpretation from external information, and cannot be used in patients with linguistic difficulties, or severely impaired. Scales rated by a rater consist of codification of a well-conducted interview. They allow for correction of erroneous answers from the patients. They may be affected by certain systematic rater errors (attenuation, central or extreme tendency, halo effect, etc...) which are decreased by training. The global score can be obtained by summing item scores, or from a factor analysis. Construction of a rating scale is a difficult task which implies a series of approximations to obtain, from an initial collection of items, satisfactory metrologic qualities. Translation and adaptation of a rating scale are difficult manoeuvres, which may jeopardize its validity.


[Objective evaluation of the effectiveness of amineptine in the treatment of severe depressive states using the Hamilton depression scale]. The Amineptine antidepressive action is proved in cases of neurotic, psychotic or reactive depression. The Hamilton Depressive Rating Scale is used. The target symptoms statistically improved by Amineptine are: depressed mood, guilt, suicide, work, and interests, and retardation. Amineptine has no anticholinergic or cardio-vascular effects.


[Schizophrenia and histocompatibility antigens]. Schizophrenias have a genetical support as it is now proved by the study of twins born from schizophrenic parents and of the adopted children of schizophrenics. The HLA typing brings an additional argument in favour of this hypothesis. After a recall of data concerning the system of tissular histocompatibility, the results are given of the HLA typing of a population of 65 schizophrenics (59 men, 6 women) including 27 hebephrenics and 38 paranoïds. The paranoïd group is clearly individualized from a genetic point of view. If 40% of the schizophrenics carry the A9 antigen versus 21,2% found in the normal population, 47,4 % of the paranoïd schizophrenics present this antigen (X2) = 12,16 p less than 0,001). The association of the two antigens A9 and CW4 is even more significant: 14,3 % of the total schizophrenic population, as opposed to 2,7 % in the normal population (X2) = 13,3 p less than 0,0005). The paranoid group reached a rate of 24,3% (x(2) = 27,3 p less than 0,0005). A subject carrier of both antigens A9 + CW4 has 11,5 times more the risk of being a paranoïd schizophrenic than a subject not possessing these two antigens.


A case of pituitary apoplexy with spontaneous recovery. A patient, 38-year-old man, with hemorrhage into a prolactin-secreting pituitary adenoma, or pituitary apoplexy, is reported. On his admission, clinical examinations revealed typical stigmata indicating that he suffered from an acute attack of pituitary apoplexy probably induced by acute meningitis. He survived the acute attack and recovered spontaneously without an urgent operation. Although there was no suspicious sign and symptom of hypopituitarism, the first study performed immediately after the attack suggested strongly that hypopituitarism might acutely developed during the hemorrhage into the tumor. Moreover, the follow-up studies indicated that TSH, LH and ADH recovered spontaneously from the initial damage following the resorption of hemorrhage for the next 3 months.


Accumulation and binding of 3H-estradiol-17beta by lymphoid tissues of castrated mice. The in vivo uptake of 3H-estradiol-17beta by the various lymphoid tissues, fat tissue, skeletal muscle and circulating blood of castrated male and female mice of C57BL strain was studied after an intravenous injection of the hormone. In both sexes the highest uptake was by the bone marrow and fat tissue, followed by the spleen, thymus and mesenteric lymph node. The lowest was by the muscle and the blood serum. The lymphoid tissues in the female took up a slightly more amount of radioactivity than those in the male until 1 hr after the injection, but thereafter the uptake was at almost the same level between both sexes. The lymphoid tissues showed a relative and long-term retention of the radioactivity, as compared with that in the muscle and blood serum. The binding of 3H-estradiol-17beta by the lymphoid tissue cytosol and their binding specificity for the hormone were examined in vitro by  Sephadex G-100 column analysis. All the tissue cytosols tested contained estradiol-binding component(-s). Among those the thymic cytosol showed to contain the component(-s) which is fairly specific to this hormone. These results suggest that there is a relatively high uptake and retention of estrogen in the lymphoid tissues in which it is bound to cytoplasmic binding component(-s).


Changes in serum 17alpha-hydroxyprogesterone levels during periovulatory phase in women. In order to investigate a physiological role of 17alpha-hydroxyprogestone (17-OHP) during the periovulatory phase, serum levels of LH, FSH, estradiol (E2), progesterone (P) and 17-OHP were determined by the radioimmunoassay daily throught the menstrual cycle and during the treatment for induction of ovulation. In 5 ovulatory women serum, values of these hormones were also examined every 8 hr during the periovulatory phase. By average data on five cases whose blood samples were taken every eight hr, the first significant rise in 17-OHP began 8 hr after the time of the E2 peak and the initial rise of LH levels, and the 17-OHP levels increased steeply as E2 falled down from the peak. But in 2 cases among 4, 17-OHP values increased 8 hr prior to or simultaneously with the initial rise of LH and the remaining 2 cases, 17-OHP values started to increase on 16 hr after the initial rose of LH. These results suggest that the mid cycle 17-OHP peak is not a reflection of increased E2 synthesis but that 17-OHP may have a physiological role in inducing and/or facilitating LH release. But this role of 17-OHP in LH release should be further investigated.


Influence of 3-methylether of ethinylestradiol (Mestranol) on oviductal egg transport in rats. The development of fertilized eggs and their transport through the oviduct were studied in rats treated orally with 3-methylether of ethinylestradiol (mestranol) at a single administration in different doses. The ED50 values were in the same range (0.11--0.34 mg mestranol/kg b.w.) as well in postcoital pregnancy inhibition test as in the experiments on tubal egg contents on day 3 as in implantation sites in niagara blue test on day 6. This suggests that the uniform cause of pregnancy inhibition of postcoital mestranol treatment on day 1 in rats is the acceleration of tubal egg transport. The ED50 of mestranol given on day 1 shortened the stay of eggs in tubes to 24 hours. Mestranol dosage above the ED50 reduced the tubal stay towards two days in comparison to five days in control animals. The number of eggs prematurely expelled from the tubes into the uterus was relatively high on day 2 and 3 in animals treated with mestranol in high dosage and with ligated cervix, compared with animals without ligation. But on day 4 on blastocysts were found. This result shows that the prevention of pregnancy is caused by the expulsion of blastocysts from uterus and/or the degeneration of zygotes in utero. Blastocysts or morulae recovered from treated rats in high dosage were transferred to the uteri of pseudopregnant recipients: 29% developed into normal term foetuses compared to 29 or 30% for both untreated control groups.


The response to insulin by adipose tissue of insulin-dependent diabetics in vitro. Subcutaneous adipose tissue was removed by surgical biopsy from 10 normal subjects and 4 insulin-dependent diabetics under exact intracutaneous anaesthesia. The adipose tissue fragments or isolated fat cells were incubated with a tracer amount of labeled glucose. In the presence of insulin (62.5 muU/ml) the production of carbon dioxide from glucose by adipose tissue fragments of nonobese controls as well as diabetics increased up to 286 +/- 62% and 198 +/- 14.7%, respectively. Furthermore, triglyceride synthesis was raised to 257 +/- 30% and 267 +/- 34%, respectively. There were no differences in the sensitivity of adipose tissue to insulin of healthy volunteers and juvenile diabetics.


Influence of diet composition on insulin output, carbohydrate tolerance and lipid values in primary hypertriglyceridemia (HT). Hypertriglyceridemic patients generally show a post-challenge hyperinsulinemia. In patients where carbohydrate intolerance coexists, increasing of reactive insulin is relatively diminished and delayed. In a group of 31 hypertriglyceridemic patients these characteristics of insulin increments in peripheral blood during a 50 g OGTT were constant: neither a low-fat (carbohydrate-rich) nor a high-fat (low carbohydrate) isocaloric, weight-maintaining diet had a significant influence on this parameter when compared with a standard diet (protein content unaltered throughout all diet periods). Glucose tolerance was significantly improved after the low-fat, high-carbohydrate diet. The results were neither correlated with the type of dietary inducibility of fasting triglyceride levels in individual cases nor with the sequence of diet periods prescribed. Hyperinsulinemia in hypertriglyceridemic patients is not believed to be the direct consequence of abnormal composition of the antecedent diet.


Morphological differentation of limbic nuclei during sexual maturation of female rats. Cell nuclear volumes were measured in the central parts of the medial amygdaloid nucleus (MAN), cortical amygdaloid nucleus (CAN) and basolateral amygdaloid nucleus (BLAN), the anterior part of the ventral hippocampus (VHPC) and, for control, in the parietal cortex of immature female rats at 21, 26, 32, or 36 days of age, or at the onset of puberty. The cortical cell nuclei did not show any variation of their volumes during the period of development under investigation. In all limbic regions studied, a significant increase of cell nuclear size was found from day 21 to day 26 indicating that a general maturation process runs off in the limbic system during the fourth week of life. Cell nuclei were significantly smaller in 32-day-old rats as compared to 26-day-old females in the MAN, CAN and VHPC, but not in the BLAN. From day 32 to day 36, nuclear volumes had distinctively increased in the MAN and BLAN, not changed in the CAN, and further decreased in the VHPC. The first ovulatory oestrus was associated with diminution of nuclear sizes in the MAN and BLAN, and with enlargement of cell nuclei in the CAN and VHPC. The results which suggest a specific development of different limbic nuclei are discussed with regard to recent findings on the gonadotrophin-controlling function of the limbic system in immature and cyclic female rats.


Effect of follicle stimulating hormone on the testes of Puntius ticto (Ham.). Histomorphological study of the testes reveals that 0.2 mg and 0.4 mg of follicle stimulating hormone (FSH) do not show any marked effect on the spermatogenesis of Puntius ticto except that the production of primary germ cells and primary spermatogonia is slightly stimulated. A dose of 0.6 mg of FSH initiates the formation of primary spermatocytes, and with 0.8 mg the secondary spermatocytes and spermatids appear. With 1.0 mg of FSH the testes attain full maturation. By an administration of a further dose of 0.2 mg of FSH the commencement of oozing is initiated. Each addition of 0.2 mg of FSH from now onwards up to 2.0 mg gradually increases the number of primary germ cells and primary spermatogonia and decreases the number of spermatozoa which reveals uninterrupted oozing of the latter.


Sex differences in adrenocortical structure and function. IV. Effects of postpubertal gonadectomy and sex hormones on adrenal steroid 5alpha-reductase activity in the rat. Studies on the effects of gonadectomy and gonadal hormones on adrenal 5alpha-reductase activity in the rat were performed. In rats of both sexes postpubertal gonadectomy is followed by an increase in adrenal 5alpha-reductase activity. The enzyme activity gradually increases during 6 postoperative weeks. Replacement of testosterone or estradiol to gonadectomized rats within 5 days lowers the enzyme activity to the level observed in intact control rats. Likewise, testosterone injected to ovariectomized rats and estradiol administered to orchiectomized animals within 5 days reversed the effect of gonadectomy on 5alpha-reductase. In all experiments the temporal changes in 5alpha-reductase activity were similar. By contrast, the weight of seminal vesicles of gonadectomized rats was normalized after 7 days of testosterone action whereas the highest uterine weight was found 3 days post depot-estradiol injection. Regarding temporal changes in 5alpha-reductase activity the experiments revealed similar inhibitory action of testosterone and estradiol. This action probably depends on the inhibition of enzyme synthesis by gonadal hormones. Moreover, greater sensitivity of adrenals of gonadectomized rats to testosterone, if compared with seminal vesicles, was observed.


Regulation of plasma aldosterone by glucose-induced paradoxical hyperkalemia in the presence of suppressed renin-angiotensin system. In a hyperkalemic patient with stable chronic renal failure and suppression of the renin-angiotensin-aldosterone system intravenous infusion of hypertonic glucose induced a paradoxical transitory rise in serum potassium accompanied by a similar change in plasma aldosterone. The close significant correlation indicated a prominent role for serum potassium in the acute regulation of plasma aldosterone when the renin-angiotensin-aldosterone system was suppressed. However, when the renin-angiotensin-aldosterone system was stimulated by sodium depletion the glucose-induced paradoxical hyperkalemia was abolished and the governing role of potassium became less evident. The results support the concept of an equal and supplementary role of renin-angiotensin-aldosterone system and potassium in the acute regulation of aldosterone production.


Histochemical investigation of aldosterone-secreting cells adenoma of the adrenal cortex. Two cases of adenomas of adrenal cortex were examined. Both cases presented clinical symptoms of autonomic hyperaldosteronism. Histologically one adenoma had a benign structure, the other a malignant one. An ultrastructural and cytochemical assay of the benign form suggests that it is composed of so called "hybrid cells". Histochemically the cells of both adenomas were characterized by a 3-beta hydroxysteroid and succinic dehydrogenase reaction, the presence of MAO and nonspecific esterases and in some single cells 17-beta hydroxysteroid dehydrogenase.


[Effect of diet and thyroxine on body composition in rats]. In young male Wistar rats the influence of different fat content of the diet (7 or 25 or 50 weight percent of fat) and of thyroxine (5 or 50 microgram/100 g body mass, 2 times/week, sc.) on body composition was investigated by carcass analysis. After high doses of thyroxine the percentage body fat decreases and protein and water content increases within the same diet group (7 or 25 or 50% fat diet). Smaller doses of thyroxine have only the same effect as high thyroxine doses in the 7% fat diet group; the body composition is unchanged in the 25% fat diet group, and in rats after 50% fat diet thyroxine even brings about an increase in body fat. It is concluded that the fat content of the diet makes thyroxine partly ineffective. A comparison of the different diet groups, also with or without thyroxine treatment, brings the result of significantly increased percentage body fat after 25 and 50% fat diet; body protein and body water decreases respectively. It appears from the present study that controversial results in literature concerning body composition after thyroxine treatment, may be caused by different diets, especially the fat content of the diets.


Experimental and seasonal changes in the pituitary of the Teleost Heteropneustes fossilis (Bloch). The pituitary of Heteropneustes fossilis is composed of a glandular adenohypophysis and a neurohypophysis (NH). The adenohypophysis is divided into three regions namely: rostral and proximal pars distalis (RPD and PPD) and pars intermedia (PI) consisting of seven different cell types. The RPD is made up of two cell types, the erythrosinophilic acidophils which form the major component of this region and H. Pb positive cells which border the NH. The latter exhibited hypertrophy during spawning and in radiothyroidectomised fishes. The erythrosinophils and H. Pb positive cells can be compared to the lactotrophs and corticotrophs described in the literature. The PPD is composed of three cell types: thyrotrophs, gonadotrophs and acidophils. The gonadotrophs and thyrotrophs readily take up the PAS, aldehyde fuchsin and anilin blue. The gnadotrophs show a marked numerical increase and hypertrophy in the breeding season, whereas they are small and comparatively few in nonbreeding season. In radiothyroidectomised fish the thyrotrophs show hypertrophy and degranulation and tendency to migrate into all the component parts, reaching upto the stalk region. In the control only few cells compared to thyrotrophs are seen in the NH and PI. The PI consists of H. Pb and PAS positive cells. They may be involved in the secretion of melanocyte stimulating hormone (MSH) and osmoregulation as suggested in the literature.


The course of serum antibody development in two ponies experimentally infected with contagious metritis. Serum agglutination tests, anti-globulin tests, and complement fixation tests were carried out on sera taken over a period of 98 days from two fillies experimentally infected with the contagious equine metritis organism. The pattern, and significance in diagnosis, of these results is discussed. All 3 tests showed positive titres in the acute phase of experimental disease; reactions in the complement fixation test persisted longest.


The experimental infection of ponies with contagious equine metritis. Four pony mares were readily infected with the organism of contagious equine metritis by intracervical inoculation and one by coitus with an infected stallion. Infected mares developed an acute endometritis with local destruction of the endometrial epithelium. In 2 experimentally infected mares, infection appeared to have been spontaneously eliminated from the genital tract within 3 to 4 weeks. A third mare however remained persistently infected in the clitoral fossa over a long period and was a symptomless carrier. Four pony stallions were readily infected in the urethral fossa and the organism survived for varying periods without giving rise to any signs of infection. From 2 of these animals it appeared eventually to have been eliminated spontaneously. An experimentally infected stallion transmitted infection to a healthy mare by coitus. Bacteriological examination of infected pony stallions may occassionally give false negative results and fail to reveal the organism in the external genitalia. Repeated bacteriological examinations need to be undertaken before it can be concluded that a stallion is free of infection.


Absorption of sodium benzylpenicillin from the equine uterus after local Lugol's lodine treatment, compared with absorption after intramuscular injection. Plasma concentrations of sodium benzylpenicillin following intrauterine infusion were increased by reducing the volume of solution and expelling air from the vagina after infusion. Instillation of 10 per cent Lugol's iodine solution into the uterus before penicillin infusion further increased the absorption rate, although peak plasma levels of penicillin were less than half those which resulted from intramuscular injection of the same dose.


Respiratory sounds recorded by radio-stethoscope from normal horses at exercise. A graphic representation is presented of respiratory sounds recorded by a radio-stethoscope from normal horses exercised at the walk, trot, canter and gallop. Methods whereby inspiratory and expiratory sounds were distinguished are discussed. The form of amplitude envelopes of the sounds recorded at different gaits are compared. Certain measurements of relative amplitudes and the form of amplitude envelopes of the recorded respiratory sounds can be recognised as typical of normal horses when exercised at the canter and gallop. The influence of some physiological events (e.g. deglutition on the rhythm of normal respiration at the canter and gallop) is indicated.


Limb skin thermometry in racehorses.

Limb skin thermometry in racehorses. Skin temperature measurements were recorded of the legs of 13 racehorses between 2 and 5 years old. The normal limb temperature patterns are described. In over 90 per cent of the normal horses the difference between contralateral limbs was less than 1 degree C, but in the remainder differences of up to 8 degree C were recorded due to the excessive cooling of one limb. One horse had a constant temperature elevation of one foreleg, but it remained in training for 7 weeks without any obvious ill effects. Because of the small numbers of horses in the survey and their freedom from tendon injuries it was not possible to draw any conclusions about the efficacy of thermometric screening in the early diagnosis of tendon injuries.


Tetralogy of Fallot and cranial mesenteric arteritis in a foal. A 5 month old colt foal with recurrent pyrexia and a loud pansystolic murmur later developed signs of cardiac failure. Peritoneal fluid and blood samples both demonstrated an extreme leucocytosis and neutrophilia. At post-mortem both a cranial mesenteric arteritis and the congenital cardiac anomaly, Tetralogy of Fallot were found. The detailed clinical and post-mortem findings contributing to the case are described.


Haemodynamics in the horse: 1. Pressure pulse contours. Using a catheter with 2 transducers, one mounted at the tip and one 9 cm proximal to it, enabled transvalval pressure waveforms to be recorded in 8 horses. A simultaneous electrocardiogram acted as a time base. The changing waveforms produced in the chambers of the heart and great vessels are described and related to the events of the cardiac cycle. The effect of second degree AV block, ectopic beats, a pan diastolic murmur and chronic obstructive pulmonary disease are described.


Calcium uptake in skeletal muscle mitochondria. II. The effects of long-term chronic and acute exercise. In order to ascertain the effects of long-term exercise training and long-term exhaustive exercise on mitochondrial 45Ca2+ uptake and related variables in rat skeletal muscle, female rats were randomly divided into three groups: sedentary-rested (SR), trained-rested (TR), and trained-exhausted (TE). The trained groups were exercised five times per week on a treadmill for 22 weeks. At the conclusion of the training period, the TE group was exercised to exhaustion following their daily 1 h run. The 45Ca2+ uptake and endogenous mitochodrial Ca2+ content of skeletal muscle followed stepwise increases of approximately 25% and 50%, respectively, across the groups, suggesting that long-term exercise induces the mitochondria to play an important role as a Ca2+ uptake buffer. A 75--83% reduction in 45Ca2+ binding  in the TE group suggests a selective loss and partial saturation of membrane phospholipids with exhaustive exercise. The TE group had a two-fold greater content of mitochondrial Mg2+ than did the rested groups. It is speculated that the mitochondria accumulate Mg2+ during acute exercise to maintain the functional integrity of the membrane, thus offsetting the deleterious effects of excessive Ca2+ uptake


Lactate kinetics after short strenuous exercise in man. Arterial blood lactate was measured at 10 s time intervals after a 3 min strenuous exercise for six athletes pedaling a bicycle ergometer in the sitting position. Recovery curves were fitted to the equation: Y(t) = A1(1-e-gamma1t)+A2(1-e-gamma2t)(0). The evolution of arterial lactate concentrations during recovery can accurately be represented by this equation. The values of the coefficients A and gamma found were used for a numerical application to an open two-compartment model: the "working muscle space" (1) and the "lactate space" (2). Intramuscular concentrations, the transfer coefficients from compartment 1 to compartment 2 and from compartment 2 to compartment 1 and the fractional turnover and basal turnover rate were calculated. Computed intramuscular lactate concentrations at the end of exercise compare favorably with those found earlier by muscular biopsic samplings. The turnover data are higher than those previously reported. This discrepancy may possibly be attributed to the method of mathematical analysis.


Skeletal muscle enzyme activity, fiber composition and VO2 max in relation to distance running performance. Muscle biopsy samples were obtained from the gastrocnemius of 26 well-trained runners of widely varying ability. Portions of the sample were analyzed for succinate dehydrogenase (SDH) activity and for muscle fiber composition. VO2 max was determined during uphill treadmill running. Mean values for muscle SDH activity (14.6 U/g), fiber composition (55% slow twitch) and VO2 max (60.9 ml/kg x min(-1)) were lower than reported previously for groups of elite and sub-elite runners. The physiological data were consistent with the performance ability of the sample [5 : 12,11 : 20 and 36 : 40 (min :s) for 1, 2 and 6 miles, respectively]. Within the sample, performance was most strongly related to VO2 max (r=-0.84,-0.87 and -0.88 for 1, 2, and 6 miles). There was little relationship between muscle SDH activity and either performance (r=-0.11, -0.14, -0.20 for 1,2, and 6 miles) or VO2 max (r=0.23). The relationship between muscle fiber composition and performance was only modestly strong (r=-0.52,-0.54, -0.55 for 1,2, and 6 miles). The results indicate that the primary determinant of cross-sectional differences in running performance is VO2 max. Skeletal muscle metabolism apparently contributes little to these cross-sectional differences and may be of much greater importance to variations in performance within an individual.


The microvibrations of the body, an index for examination stress. Changes of whole-body microvibrations (MV) were quantitatively analyzed in 123 voluntary subjects during two examination situations and compared with the results obtained during the ensuing vacation. The force oscillations in the three space directions were measured during quiet bipedal standing and simultaneously recorded as a time function with the rectified and integrated force-time function (= rectified impulse). The rectified impulses related to body weight were used as a measure for the MV. Immediately before the examinations, all the subjects showed high values. These decreased significantly in the control measurement if the subjects passed the exams, but remained relatively high in the subjects who failed. In all three measurements, smokers and candidates who took tranquilizers before the exams show higher MV values than do the other subjects. Females are less tense than males, a difference particularly significant in the vertical (z) direction. The rectified impulse in this direction correlates positively with the estimated cardiac output. Body weight and body length show a positive correlation with the MV values in the horizontal forward-backward (x) and vertical (z) direction. The measurement of the whole-body MV enables quantitative evaluation of the complex load due to an examination situation. The hypothesis that different types of stress or personality affect given directions in space requires further investigation.


Activity pattern, smoking habits, and somatometric variables of the Czechoslovakian population. A total of 3762 subjects of both sexes, natives of Czechoslovakia, ranging in age from 12--55 years, were examined. Both anamnestic data and selected anthropometric variables were evaluated. The proportion of non-smokers for adult males was 47--56%, and for adult females was 54--74% of the population. The proportion of subjects not engaged in any type of physical activity decreases in boys between 12 and 18 years from 28 to 16%, in girls between 12 and 15 years from 25 to 22%; from then on the trend reverses and the percentages rises up to 42% in men and 65% in women. The number of subjects participating in competitive sporting activity reaches its peak at 18 years, when 46% of boys annd 43% of girls compete, but then decreases quickly. 12 year old girls are taller and heavier than boys but at 15 years the relationship is reversed. The LBM at the age of 12 is equal in boys and girls, but from then till 18 years the increase is larger in boys. The LBM weight in adults remains steady, women attaining 77% of the value found in men. The skinfold increases with age similarly in both sexes, except for an interval between 12 and 18 years, when girls show a steeper increase. Adult women attain 121--160% of the values characteristic for men. The grip strength of the right hand equals about 50 kp in adult men and 30 kp in adult women. Within the age range followed, it remains unaffected by age.


Resting values of left ventricular work to coronary blood flow ratio in rats exposed to intermittent high altitude hypoxia and swimming. Total hemodynamic values and left ventricular blood flow were studied using Sapirstein's method of 86Rb uptake in female rats 24 h after a last exposure to high altitude. A stimulated altitude of 1350 m was used, initial exposure being for 30 min, gradually increased by 30 min daily up to 330 min daily for 5 days a week; the total number of exposures was 32. In another animal group the hypobaric exposure was combined with swimming in water at 37 degrees C. In both experimental groups the cardiac output and stroke volume increased, and in rats undergoing swimming the total peripheral resistance decreased as well. In the rats exposed to intermittent hypoxia only, left ventricular blood flow increased by about the same proportion as the cardiac output. The ratio of left ventricular work to coronary blood flow was significantly increased. In rats exposed to the combined influence of hypoxia and swimming, the increase in left ventricular blood flow did not match either the increase in cardiac output, or the weight gain of the left ventricle. The ventricular work to coronary blood flow ratio was the same as in controls.


Comparison of the potential elastic energy stored and used by two antagonistic muscular groups. The potential elastic energy stored and used by the flexors is compared to that of the elbow extensors in man. This comparison is made during a series of isolated and to-and-fro movements. The integrated EMG-work relationships are established for the isolated movements of flexion and extension and for the to-and-fro movements. For a same integrated EMG value: 1. The work done by the flexors or the extensors during to-and-fro movements is superior to that done during isolated movements. 2. In comparison to isolated movements the energy saved in to-and-fro movements is greater in the case of the extensors than in the case of the flexors. It appears that: 1. The extra work supplied during to-and-fro movements comes only from the extra positive work done after stretching. 2. The best performance of the extensors can be explained by the comparative study on the one hand of the potential elastic energy-force relationships and on the other hand the lever arm-elbow angle relationships for the Equivalent Flexor Muscle and the Equivalent Extensor Muscle.


Changes in serum creatine kinase and hexose phosphate isomerase activity with exercise duration. In 18 groups of trained healthy male subjects (n = 166; age 17--42 years) the influence of type and duration of long-lasting exercise on the changes of creatine kinase (CPK) and hexose phosphate isomerase (PHI) activity in serum was studied. Above 65--70% of maximal aerobic capacity, a serum enzyme activity increase proportional to the exercise time was found with a different slope in each of the three exercise types examined [a) bicycle ergometer; b) ski race; c) impact-type exertion]. Work duration of more than 300 min induced in the third type of exertion an accelerated increase in serum CPK. A third degree equation best describes the changes in serum CPK for nine of our groups and five others from the literature. To ascertain the possible influence of intravascular hemolysis, sera were mixed with autologous erythrocyte hemolysates and enzyme activity measured. The findings are discussed with reference to critical aspects of the analytical methods, possible causes of serum enzyme changes, and possible use of enzyme measurements in evaluating adaptation of the organism to prolonged exercise.


A method for the measurement of tremor, and a comparison of the effects of tocolytic beta-mimetics. A method permitting measurement of finger tremor as a displacement-time curve is described, using a test system with simple amplitude calibration. The coordinates of the inversion points of the displacement-time curves were transferred through graphical input equipment to punched tape. By means of a computer program, periods and amplitudes of tremor oscillations were calculated and classified. The event frequency for each class of periods and amplitudes was determined. The actions of fenoterol-hydrobromide, ritodrin-HCl and placebo given to 10 healthy subjects by intravenous infusion in a double-blind crossover study were tested by this method. At therapeutic doses both substances raised the mean tremor amplitude to about three times the control level. At the same time, the mean period within each class of amplitudes shortened by 10--20 ms, whereas the mean periods calculated from all oscillations together did not change significantly. After the end of fenoterol-hydrobromide infusion, tremor amplitudes decreased significantly faster than those following ritodrin-HCl infusion.


The conformation of histone H5. Isolation and characterisation of the globular segment. Treatment of chicken erythrocyte histone H5 with trypsin in a high-ionic-strength medium results in very rapid initial digestion and the formation of a 'limiting' resistant product peptide. Under these solution conditions the H5 molecule is maximally folded by spectroscopic criteria and it is concluded that the resistant peptide, GH5, represents a globular folded region of the molecule whilst the rapidly digested parts are disordered. The peptide GH5 is shown to comprise the sequence 22-100. In support of this conclusion it is shown that whilst intact histone H5 is hydrodynamically far from being a compact globular shape, peptide GH5 is approximately spherical by hydrodynamic and scattering criteria. Further more, peptide GH5 retains all the alpha-helical structure of intact H5 (circular dichroism) and appears to also maintain all the tertiary structure (nuclear magnetic resonance). It follows that in solution at high ionic strength, histone H5 consists of three domains: an N-terminal disordered region 1-21, a compact globular central domain 22-100 and a long disordered C-terminal chain 101-185. Structural parallels are drawn with the three-domain structure of the histone H1 molecule.


Isolation and characterization of the hemoglobin from the lanceolate fluke Dicrocoelium dendriticum. The hemoglobin of the flatworm Dicrocoelium dendriticum, a lanceolate fluke which infests the hepatic ducts of certain mammals, has been isolated by gel filtration and ion-exchange chromatography. The molecular weight of the denatured protein was found to be 15500, a value in the same range as hemoglobin subunits. The fact that the native hemoglobin has an apparent molecular weight of 22000 in 0.01 M phosphate buffer, pH 7.4, suggests limited aggregation. The protein contains, as all other myoglobins and hemoglobins, one molecule of non-covalently associated ferroprotoporphyrin IX per polypeptide chain. It forms the same ligand derivatives with very similar spectral properties as vertebrate hemoglobins. The high oxygen affinity (p50 is 0.07--0.1 mmHg or 9.3--13.3 Pa at 20 degrees C and pH 7.0) and the absence of heme-heme interaction of (Hill coefficient nH=1.0) are properties which this heme protein shares with other monomeric hemoglobins from invertebrate and lower vertebrate organisms. The native hemoglobin exists in two forms, having isoelectric points of 4.51 and 4.53, which do not differ in their amino-acid compositions. Dansylation indicated that the amino-terminal amino-acid residue is alanine. The carboxy-terminal sequence, determined by carboxypeptidase A digestion of the globin, is -His-Ala-Leu.


Stability of polyadenylated RNA in differentiating myogenic cells. Three independent methods of measurement showed that cytoplasmic polyadenylated RNA from the differentiating myogenic cell line L8 consists of two main populations with regard to stability, one with a half-life of less than 4 h and the other with a half-life of 17--54 h. Similar results were obtained in the presence and absence of actinomycin D. During the fusion of mononucleated myoblasts into multinucleated fibers, there was an increase in both the steady-state pool of the more stable polyadenylated RNA and the proportion of stable polyadenylated RNA synthesized in pulse labelling.


The capacity of polyadenylated RNA from myogenic cells treated with actinomycin D to direct protein synthesis in a cell-free system. Cytoplasmic polyadenylated RNA of myogenic cells was shown to decay with biphasic kinetics, suggesting the existence of two main populations of mRNA with respect to stability. In the present study, the stability of mRNA extracted from actinomycin-D-treated cultures of a myogenic cell line was tested by its capacity to direct protein synthesis in the wheat germ cell-free system. The products were analyzed by dodecylsulphate/polyacrylamide gel electrophoresis. All major radioactive bands found in gels used for analyzing the products of the cell-free system directed by polyadenylated RNA extracted from untreated cultures were also found in similar gels containing products of RNA extracted after many hours of application of actinomycin D. The capacity to code for specific protein bands decays with a half-life ranging between 11 and 40 h. No fast-decaying translatable mRNA could be detected by this method. Instead, it was found that during the first 4--6 h following application of actinomycin D, the capacity of RNA to stimulate incorporation of amino acids into total acid-insoluble material increased by 20--30%. The synthesis of specific products increased by up to 100%. The possibility that the fast-decaying polyadenylated RNA or part of it is nontranslatable RNA is discussed.


Study of tropomyosin labelled with a fluorescent probe by pulse fluorimetry in polarized light. Interaction of that protein with troponin and actin. Tropomyosin has been labelled with a fluorescent probe N-iodoacetyl-N'-(5-sulfo-1-naphthyl)-ethylenediamine which is presumed to bind preferentially to the unique reactive cysteine residue of the alpha chain. Anisotropy decay measurements show that tropomyosin monomer and polymer are flexible molecules. This flexibility decreases when troponin interacts with tropomyosin, and is partially restored by a micromolar concentration of Ca2+.


The purification and properties of pig-liver catechol-O-methyl transferase. A procedure utilising affinity chromatography is described for the large-scale purification of pig-liver catechol-O-methyl transferase. The enzyme prepared by this method appears to be homogeneous by polyacrylamide gel electrophoretic criteria and gel chromatography. It is stable for prolonged periods when stored at -5 degrees C in 20% (v/v) glycerol. The enzyme has a molecular weight of about 23000 and does not appear to be a compound of subunits, or to associate to any appreciable degree. The pH optimum of the enzyme's activity is approximately pH 7.1--7.4, it does not catalyse the methylation of benzimidazole and has a Km of 0.64 mM and 0.056 mM towards 3,4-dihydroxyphenylacetic acid and S-adenosyl-L-methionine, respectively. Amino acid analysis showed the presence of five cysteine residues.


Enzymatic attack on immobilized substrates. 2. Diffusional limitations in the alpha-chymotrypsin-catalyzed hydrolysis of polyacrylamide-bound l-phenylalanine 4-nitroanilide. 1. The chymotrypsin-catalyzed hydrolysis of polyacrylamide-bound L-phenylalanine 4-nitroanilide was studied. As a spacer, one or two 6-aminohexanoyl residues were inserted between the matrix and ligand. 2. In the course of the enzymatic hydrolysis of polyacrylamide-bound substrates, enzyme adsorption by the gel substrates was observed. A quasi equilibrium of enzyme partitioning was reached after approximately 20-min incubation time. The enzyme adsorption could be described by the Langmuir adsorption isotherm. 3. The substrates attached via spacers to the matrix were completely hydrolyzed. 4. The initial course of the product vs time curves, as well as the dependence of the initial hydrolysis rates on enzyme concentration or substrate concentration, have been interpreted by the Nernst reaction theory. From the results obtained it has been concluded that the inital rate of the hydrolysis of polyacrylamide-bound L-phenylalanine 4-nitroanilide depends on the velocity of enzyme diffusion into the matrix.


Immobilization of reticulocyte elongation factor EF-2. Conditions are described whereby the ADP-ribosylation (from NAD+) of reticulocyte elongation factor EF-2, catalyzed by diphtheria toxin, is essentially complete and whereby the reverse of this process may be carried out with recovery of 60--70% of the original EF-2 activity. Both reactions proceed well at room temperature. The reverse reaction is much slower than the ADP-ribosylation process and requires high nicotinamide concentrations. For the reverse reaction to occur at a significant rate it is necessary to lower the pH to 6.5 (from the 7.5 used for the forward reaction). NAD+ covalently linked to agarose may replace NAD+ in the diphtheria toxin reaction. The characteristics of this reaction are similar to those of the reaction employing free NAD+ except that the velocity is reduced and the concentration of NAD+ moieties greatly increased. NAD+ immobilized on agarose through the C-8 of the adenine ring is a superior substrate compared with NAD+ linked to agarose via its periodate-oxidized ribose moieties. Preliminary experiments indicate that reversal of this latter reaction with recovery of biological activity may be possible.


Incorporation rates of [1-14C]glycerol into the molecular species of alkyl ether phospholipids of Ehrlich ascites tumor cells in vivo. [1-14C]Glycerol was injected into the peritoneal cavity of mice bearing Ehrlich ascites tumor cells and the lipids were extracted from the cells after selected periods. 1-O-Alkyl-2-acyl-3-acetyl-glycerols and 1,2-diacyl-3-acetylglycerols were prepared from the ethanolamine and choline phosphoglycerides and fractionated by AgNO3-impregnated thin-layer chromatography into seven molecular species. Bands 1--7 obtained in this way can be designed as saturated, monoene, diene (11), diene (02), triene, tetraene and pentaene + hexaene species, respectively. Band 7, composed mainly of hexaene species, was predominant among those derived from ether phospholipids. The predominant species was band 4 (saturated/linoleate) in both diacyl ethanolamine and choline phospholipids. The specific radioactivities of the fractionated species were determined. In diacyl or alkyl ether compounds of ethanolamine and choline phosphoglycerides, disaturated species turned over very rapidly, while in alkyl ether ethanolamine phosphglyceride, hexaene + pentaene molecular species turned over rapidly. In diacyl compounds of the ethanolamine phosphoglyceride, hexaene molecular species also turned over at a high rate. In diacyl ethanolamine or choline phosphoglycerides, dienoic species turned over rather slowly.


Evidence for multiple reactive forms of papain. The pH-dependence of the second-order rate constants of acylation and alkylation reactions of the -SH group of papain were determined by using neutral and charged reactants under identical conditions. From these pH rate profiles, in contrast to previous claims, different pKa values were obtained with different groups of reactants. In the case of charged reactants, like chloroacetate (pKa = 3.6) and arginine derivatives (pKa = 4.3), the pKa differences can be attributed to electrostatic effects. However, the fact that a pKa of 3.25 was found with methyl and ethyl bromoacetate, and a pKa of 4.0 was obtained with bromoacetamide and a number of neutral substrates, is inconsistent with the theories put forth hitherto for the meaning of such pKa values, because they all consider only one reactive enzyme form. The different pKa values obtained here with neutral reactants are explained in terms of various reactive papain forms. The perturbation of pKa by electrostatic effects was examined by reacting simple thiol compounds containing different charges, like 2-mercaptoacetate, 2-mercaptoethylamine, 2-mercaptoethanol and glutathione, with the neutral chloroacetamide and with the negatively charged chloroacetate. Differences in pKa can be interpreted in terms of intramolecular and intermolecular electrostatic interactions.


Lipid-bound oligosaccharides in insects. Membrane preparations from immature stages of the fruit fly Ceratitis capitata catalyze the transfer of mannose from GDP-[14C]mannose into lipid-linked oligosaccharides. These compounds behave as polyprenyl derivatives and their formation is stimulated by the addition of an acidic glycolipid fraction isolated from insects. The mannose-labeled oligosaccharides are attached to the poly-isoprenol by a pyrophosphoryl linkage and can be released by mild acid hydrolysis. The trisaccharide lipid has been partially characterized. The results indicate that the compound is polyprenyl-pyrophosphate-N,N'-diacetylchitobiose-mannose. Incubation of dolichyl phosphate [14C]mannose or lower 14C-labeled oligosaccharide lipids with unlabeled GDP-mannose and the insect enzyme leads to the labeling of a higher lipid-bound oligosaccharide. When UDP-N-acetyl[14C]glucosamine was incubated with insect membranes a 14C-labeled chitobiosyl lipid was synthesized. If unlabeled GDP-mannose was also present, the 14C label appeared in the trisaccharide and higher oligosaccharide lipids. Preliminary evidence indicates that the insect polyprenyl oligosaccharides described here might participate in glycoprotein biosynthesis.


Interaction of human blood platelets with the 2',3'-dialdehyde and 2',3'-dialcohol derivatives of adenosine 5'-diphosphate and adenosine 5'-triphosphate. 1. The 2',3'-dialdehyde derivative of ADP (oADP) at concentrations approaching the millimolar range induces human blood platelets to undergo the transition from discoid to globular morphology (the 'shape change') but is incapable of inducing aggregation. 2. When incubated with platelets for 1 min before addition of the agonist, oADP acts as a competitive inhibitor of shape change and aggregation induced by ADP. Under these conditions secretion and hence aggregation induced by low concentrations of collagen; and secretion and hence secondary aggregation induced by adrenaline, thrombin and vasopressin are also inhibited by this analogue. In addition, oADP stimulates the rate of primary aggregation induced by adrenaline and causes partial inhibition of primary aggregation induced by thrombin or vasopressin. When longer preincubation times are employed the extent of inhibition with respect to all agonists, except for high concentrations of collagen, is increased and the competitive character of the inhibition with respect to ADP is no longer apparent. 3. Incubation of human platelets with the 2',3'-dialdehyde derivative of ATP (oATP) causes effects similar to those described for oADP except that the analogue neither induces platelet shape change, nor stimulates the rate of primary aggregation induced by adrenaline. In addition oATP fails to cause significant inhibition of platelet shape change induced by serotonin. The extent and character of inhibition caused by addition of oATP is not a function of the time of incubation. 4. The 2',3'-dialcohol derivatives of ADP and ATP and orATP) effect the aggregation properties of human blood platelets in a manner generally resembling those observed for the 2',3'-dialdehyde analogues. However, orADP is only weakly effective in causing platelet shape change and stimulating the rate of primary aggregation induced by adrenaline and does not inhibit secretion induced by adrenaline, collagen, thrombin and vasopressin. The extent of inhibition by orADP increases only slightly with increased time of incubation. 5. The data suggest that oADP acts as a partial agonist, and oATP as an antagonist, at the platelet ADP receptor, but that platelet membrane stabilisation also results from interaction with these dialdehyde analogues. Such membrane stabilisation does not complicate the interaction of platelets with orADP, which appears to act as a classical antagonist for the ADP receptor.


Phosphorylase b covalently bound to glycogen: properties of the complex. Rabbit skeletal muscle glycogen phosphorylase b was covalently bound to oyster glycogen by means of cyanogen bromide. Removal of the unbound enzyme was achieved, using DEAE-Sephadex A-50 chromatography. Glycogen-bound phosphorylase b showed a higher affinity toward glucose 1-phosphate but a lower homotropic cooperativity, with respect to AMP activation, than the native enzyme. However, at low AMP concentrations conjugated phosphorylase b was as efficient as the free enzyme. It is of interest that glycogen-bound phosphorylase b exhibited catalytic activity upon its polysaccharide carrier. Kinetics of heat and cold inactivation indicated that the bound enzyme was considerably more resistant toward heat inactivation but less stable upon exposure to cold. It was shown also that both conjugated and native enzymes had identical pH optima, similar activity/temperature dependencies and the same resistance against trypsin inactivation.


Presence of non-histone proteins in nucleosomes. It has been established that nucleosomes are made of histones and DNA fragments. The purpose of this work to establish whether some non-histone proteins are also present in these chromatin subunits. We have found that nucleosome preparations contain phosphorylated non-histone proteins and protein kinases by sucrose gradient analysis. In order to establish whether these proteins are actually bound to nucleosomes or if they represent unbound or aggregated proteins, the following experiments were performed. (a) Free non-histone proteins and proteins released from chromatin by DNase overdigestion were analyzed by sucrose gradient centrifugation. No phosphoproteins but some phosvitin kinase activity was found in the part of the gradient which contained the nucleosomes. It could be assumed that part of the phosphoproteins are bound to nucleosomes. (b) A digestion of nucleosomes with DNase I suppressed the phosvitin kinase activity in the 11-S region of the gradient. (c) High ionic strength, which extracted non-histone proteins, suppressed the phosvitin kinase activity in the nucleosome region. Part of phosvitin kinase and of nuclear phosphoproteins are therefore bound to nucleosomes and are released by nuclease digestion and by high ionic strength.


Ribosomal genes in Physarum polycephalum:  transcribed and non-transcribed sequences have similar base compositions. The transcribed and non-transcribed sequences in Physarum polycephalum ribosomal DNA (rDNA) were separated by restriction nuclease digestion of pure rDNA and the products fractionated by zone sedimentation in sucrose gradients. The base compositions of the fragments were determined by analytical centrifugation in CsCl or in CsCl with netropsin. All the fragments had dA + dT contents in the range 44-48%. From the known sequence arrangement and transcription pattern of Physarum rDNA it was concluded that coding sequences, transcribed but non-coding sequences, and non-transcribed sequences all possess similar base compositions, contrary to the situation in many other systems. The thermal denaturation profile of Physarum rDNA is reported. It suggests the rDNA sequence is complex and supports the above conclusion of limited heterogeneity of base composition.


Role of virus for the induction of myasthenia gravis. Virus has been suggested as an etiological agent in myasthenia gravis. In this investigation 36 patients with the clinical diagnosis of myasthenia gravis were tested for antibodies against ornithosis, mycoplasma pneumoniae and 16 viral antigens. Rabbits with experimentally induced autoimmune myasthenia gravis were similarly tested. There was no overall correlation to any microorganism, which might have suggested the involvement of a viral infection in the pathogenesis of the disease. Neither was there any difference in incidence of antibodies in female patients carrying the HLA B8 antigen, an antigen which is associated with myasthenia gravis, as compared to HLA B8 negative individuals.


Cerebrovascular permeability in acute arterial hypertension. Effect of unilateral ligation of the common carotid artery. Ligation of the right common carotid artery prevented protein extravasation in the homolateral cerebral hemisphere when a blood pressure increase was induced by bicuculline or amphetamine. In addition to a blood pressure increase these two drugs induce a vasodilatation, which makes the resistance vessels particularly vulnerable to the mechanical stress of high intravascular pressure. The ratio between the mean arterial blood pressure in the femoral artery and the carotid artery distal to the ligation was approximately 0.5; slightly higher after than prior to the pressure increase.


Origin and localization of Evans blue extravasations in acutely-induced hypertension in cats. An intravital-microscopic study on cat pial vessels for the localization of Evans blue extravasation during acute hypertension was performed. The onset of extravasation was seen 10 sec to 2 min after the beginning of hypertension. The localization of initial extravasation turned out to be little venules, not arterioles. Venular congestion by an overload of venous outflow seemed to be the origin of extravasation.


Influences of phasic changes in systemic blood pressure on intracranial pressure. In acute experiments on lambs, the effects of short-lasting induced modifications in arterial and venous systemic blood pressure on intracranial pressure have been studied. Haemodynamic changes have been provoked by increasing the cardiac venous return, by increasing or decreasing the arterial resistance and by stimulating the vagus nerve. Intracranial pressure modifications have been demonstrated to depend essentially on arterial influences. A direct venous influence is apparent only when the central venous pressure is increased, as occurs in the case of increased venous cardiac return.


Frontal dynamic thermometry. Improvement in diagnosis of carotid stenosis. This new method of frontal thermometry is based on a recording of the spontaneous reheating curve of the skin after cooling it to 25 degrees C. In cases of carotid stenosis, a thermal asymmetry of one of the three following kinds can be observed: thermal asymmetry from the start; asymmetry only during the reheating, or asymmetry during reheating and remaining afterwards. The reduction of the blood flow and a vaso-motor factor explain this asymmetry. This method allows better detection of clinical latent carotid stenosis.


Atypical juvenile neurolipidosis. Ultrastructural study of a cerebral biopsy. The description is given of a structural and ultrastructural aspect of a cerebral biopsy specimen collected from a 17-year-old patient, with very frequent convulsive seizures, dementia, motor aphasia and spastic tetraparesis. The disease started at the age of 9 years and evolved very slowly. The morphologic diagnosis was neurolopidosis, the ultrastructural one was atypical juvenile lipofuscinosis, the electron microscopic aspect being identical to that of another 3 cases published in the literature: highly polymorphous membranogranulovesicular cytosomes.


Pneumatosis cystoides coli recurs after oxygen treatment. A clue to the pathogenesis? Two patients with pneumatosis cystoides coli associated with chronic pulmonary disease are described. In both patients, cysts and symptoms recurred after successful treatment with O2. Both patients had exceptionally high expiratory H2 fasting values. On the basis of these and other observations a new hypothesis is proposed for the pathogenesis of the cysts and for their frequent association with chronic pulmonary disease. It is suggested that the cysts result from excessive colonic gas production in a patient unable to excrete this excess gas via the lungs.


Cellulr restitution after 3 h of complete tourniquet ischemia. The refinement of techniques for extremity surgery makes it urgent to get more information at cell level of the effects of tourniquet times exceeding the usually accepted 90--120 min. Therefore, in the present experiments, the cellular metabolic and functional restitution of canine skeletal muscle after 3 h of complete tourniquet ischemia was studied. During the ischemia and after recirculation, repeated skeletal muscle samples were taken for ATP, CP and lactate analyses. At the same time periods, blood from a regional vein and vena cava was drawn for pH, pyruvate and lactate analyses. Cellular function was evaluated from repeated measurements of transmembrane potentials. The tourniquet ischemia resulted in a rapid decrease of CP to 40% of the initial level within 1 h and a continuous decrease of ATP. The lactate levels increased continuously. The transmembrane potentials decreased from an initial level of --90 to --54 mV. The release of the tourniquet resulted in a hyperemic reaction and a rapid regain of tissue CP and ATP levels within 5 min of recirculation. There was a continuous washout of lactate up to about 1 h after the release and the transmembrane potentials were normalized after about the same time period. The latter parameters indicate that areas of no-reflow persisted for up to 1 h after restored circulation. The results indicate that after a 3-hour tourniquet ischema, the cellular energy metabolism as well as the membrane function are completely normalized after about 1 h of recirculation.


Distribution of microspheres with different diameters in the small bowel wall of the cat. The purpose of the present study was to investigate the distribution in the small bowel wall of intracardially injected microspheres with different diameters, and to find a sphere size that could be used for determination of blood flow to the different layers of the bowel wall. Microspheres were injected into the left ventricle of the hearts of cats in the following order of succession, 8--10, 15 +/- 5, 25 +/- 5 and 50 +/- 5 micrometer. Samples of the proximal part of the jejunum and the distal part of the ileum were examined microscopically, and the size and the location of the spheres recorded. The following distribution of the microspheres was found: villi 6--16 micrometer, crypt layer 6--20 micrometer, propria below the crypts and the muscularis mucosa 11--24 micrometer, submucosa 9--66 micrometer and muscularis 6--30 micrometer. Spheres between 8 and 13 micrometer appeared to be fairly uniformly distributed in the different layers of the intestinal wall.


Regional and central hemodyanamics during segmental ischemia of the small intestine in the rat. The influence of segmental small intestinal ischemia on the central circulation and on the regional blood flow to consecutive segments of the small intestine in the rat was investigated with the microscphere method. Ischemia was established by ligating 11 arterial mesenteric end arcades, corresponding to one quarter of the total length of the small intestine. The blood supply to different organs and central circulatory variables were determined before, and 10 min, 30 min, 2 h and 14 days after the establishment of the ischemia. After 10 min of ischemia, there was an increase of the blood flow to the segments distal to the ischemic region but after 30 min, this blood flow was the same as the control flow. The central circulatory variables weere not affected. After 2 h of ischemia, the blood supply to both the ischemic and the non-ischemic part of the small intestine had deteriorated considerably. Thus, the vascular resistance in the ischemic segments and the segments surrounding it was increased. Cardiac output was reduced by about 50%. In the experimental group investigated 14 days after establishment of the ischemia, the mortality rate was about 50%. In the survivors, the intestinal blood supply had returned to normal.


Propulsion and mixing of small bowel contents after laparotomy in rat. Radioactive test substances were infused slowly into the duodenum of conscious rats via a permanent catheter starting 2, 12 and 24 h after a standardized laparotomy. Two differently labelled but otherwise identical test substances were used. The first test substance (125I-PVP) was infused for 4 h, the second (131I-PVP) for the remaining 1 h of the 5-hour infusion period. Immediately after the infusion the animals were killed, and the radioactivity emanating from each isotope was recorded from the excised bowel specimen. The bowel length passed by the border zone and the degree of overlap between the labels in this zone were taken as measures of propulsion and mixing, respectively. Propulsion and mixing were uninfluenced by laparotomy as measured 2--17, 12--17 and 24--29 h after laparotomy. The present findings indicate that laparotomy is not followed by a disturbance in the capability of the small bowel to transport and mix chyme, at least when no high demands with respect to chyme volume are required.