PGE-release, blood flow and transmucosal water movement after mechanical stimulation of the rat jejunal mucosa. 1. The influence of weak mechanical stimulation of the jejunal mucosa in vivo on PGE-release, on intestinal blood flow and transmucosal water movement was studied in rats. 2. Mechanical stimulation of the mucosa increased PGE-release into the venous outflow and into the gut lumen. This increase is followed by an increase in intestinal blood flow and transmucosal movement of tritiated water in both directions. 3. Pretreatment of the rat with indomethacin reduced the effect of mechanical stimulation on PGE-release. Indomethacin further reduced the increase in blood flow and in secretion of tritiated water. Absorption of tritiated water was not changed in these experiments. 4. Pretreatment of the rat with atropine (1 mg/kg, i.p.) or perfusion of the gut with methysergide (10 microgram/ml) did not influence the increase in intestinal blood flow after mechanical stimulation. 5. It is suggested that enhanced intestinal blood flow and transmucosal movement of tritiated water after mechanical stimulation are mainly provoked by a preceding release of PGE. 6. It is further supposed that such a mechanism may be physiologically involved in regulation of intestinal blood flow and transmucosal water movement during food intake.


[Dynamics of the spike activity of association cortex neurons in awake cats during elaboration and reinforcement of a defensive conditioned reflex]. Neuronal responses of association field 5 during elaboration of defensive conditioned reflex to sound were studied in chronic experiments on cats. Neuronal activity at the reflex elaboration was usually observed in the first 50 ms after sound stimulation, i.e. it was connected with the action of signal stimulus, but not with the display of the conditioned movement. The most essential changes in neuronal responses of the association cortex were seen at the initial stage of conditioning. In some neurons under conditioning the reaction was stabilized, in others a decrease in both the background impulse activity and intensity of the responses was observed, in some cases the response to either of the applied stimuli disappeared. The latter circumstance allows suggesting the transition from polysensory to monosensory specialized neuronal reaction during conditioned reflex elaboration.


[Mechanisms of interaction between the parietal association and projection areas of the cat neocortex]. The pecularities of evoked potentials changes in the first visual, first somatic and parietal cortical areas locally cooled under nembutal anesthesia, as well as in the association thalamic nuclei (pulvinar and posterolateral) were studied in cats. Two types of interaction between these cortical structures were distinguished. Type I interaction was observed between all the studied cortical areas; type II--took place only between the parietal and each of the projection areas. Type I is suggested to be formed by cortical connections, type II--by direct and indirect subcortical ones. The peculiarities of involving the association parietal area into type I and II interactions according to its activation by different modality signals are discussed.


[Neuronal activity in an epileptic focus formed as a result of the effect of tetanus toxin on the motor area of the cat cerebral cortex]. Activity of single neurons was recorded intracellularly in the cortical epileptic focus produced by tetanus toxin. The activity of all studied neurons correlated positively with ECoG during the interictal period. A group of neurons was found with continuous background activity. The membrane potential of these neurons gradually decreased and the frequency of discharges increased during the interictal intervals. The neurons with continuous background activity during the interictal intervals revealed paroxismal depolarization without the following hyperpolarization. In some neurons with random background spikes hyperpolarizing shifts after paroxismal depolarization were observed. The mechanisms of the organization of the neuronal "epileptic aggregates" as well as of inhibition of these functional structures are considered.


[Participation of interoceptive afferent signals in the polymodal reactions of superior colliculus neurons in cats]. Stimulation of the vagal nerve in unanesthetized immobilized cats evoked marked responses in 43% of neurons of the superior colliculus. In 60% of the responses the changes in the spike activity were of tonic character. After stimulation with single stimuli inhibitory effects prevailed; in half of cases distinct initial inhibition of discharges lasting for 180-1700 ms was observed. Phasic responses with an initial period of activity occurred only in 9-11% of neurons. On the contrary somatic stimuli provoked mainly phasic reactions of activation type. Most of the investigated neurons were bimodal and often the time pattern of the responses depended on the modality of stimulation.


[Change in the concentration of RNA in the cytoplasm of cells of the inferior colliculus in cats during monaural and binaural stimulation]. The method of cytospectrophotometry of the gallocyanin-chromatium stained sections was used to show that the 2-hour monaural and 1.5-hour binaural stimulation with rhythmical noise signals result in a pronounced increase in cytoplasmatic RNA content per cell in the principal and large multipolar neurons. The increase in cytoplasmatic RNA amount in the principal cells both from ipsi- and contralateral central nuclei of the inferior colliculus with monaural and binaural stimulations allows to suggest a uniform distribution of the binaurally converging connection from the lower auditory nuclei to the principal cells. The increase in cytoplasmatic RNA in the large multipolar cells of the contralateral central nucleus following monaural stimulation shows predominant contralateral projections to these cells. A conclusion is made on patterns of binaurally converging connections on the principal and large multipolar cells of the central nucleus of the inferior colliculus.


[Correlation between conduction velocities in fibers of the optic nerve and optic radiation in cats]. The responses of dorsal lateral geniculate body units to striate cortex and optic chiasm stimulation were examined in cats immobilized with d-tubocurarine. A high correlation between antidromic responses to striate cortex and orthodromic responses to optic chiasm stimulation was found (r=0.895; P=0.01). 9% of neurons responded antidromically to optic chiasm stimulation indicating the existence of centrifugal fibres in the optic nerve. The functional significance of time dispersion of the afferent volley in visual system is discussed.


[Comparative characteristics of neuronal response in the vagus and facial nerve lobes of carp medulla oblongata to chemoreceptor stimulation]. The unit activity in the vagal lobe of medulla oblongata in response to stimulation of the mouth cavity and gills chemoreceptors with solutions of hydrochloric acid and sodium chloride was studied in immobilized carps and compared with those in the facial lobe in response to skin chemoreceptors stimulation. The firing rate in the vagal lobe is lower and the latent period is longer than in the facial lobe. The level of the chemical stimuli gradations analysis is different in two parts of the chemoreception primary centre. In the vagal lobe units responding to the impulses from both receptive fields as well as those responding selectively to stimulation either of the mouth cavity or the gills were found. Activity of a firing pattern was predominant in the vagal lobe units in response to stimulation with sodium chloride solutions.


[Ionic mechanisms of the excitatory action of transmitter, exogenous acetylcholine and serotonin on neurons of the superior cervical ganglion in rabbits]. Ionic mechanisms of EPSP and depolarization evoked by iontophoretically applied acetylcholine (Ach) and serotonin (5-hydroxytryptamine, 5-HT) in the neurons of the rabbit isolated superior cervical ganglion (ACh-potential and 5-HT-potential, respectively) were studied using intracellular electrodes. Reversal potentials of EPSP (EEPSP) and Ach-potential (EACh) were -14.4 +/- 1.6 mV and -16.5 +/- 1.2 mV, for 5-HT-potential they were close to these values. More negative values of EEPSP and EACh were obtained in a group of neurons (about 1/3) using the extrapolation method, probably due to an increase in their membrane resistance during hyperpolarization. A decrease in external sodium or potassium concentration made EEPSP and EACh more negative, and an increase in external potassium concentration made them more positive than in normal solution. Changes in external chloride concentration do not influence EEPSP and EACh. It is concluded that excitatory transmitter and exogenous ACh (as well as probably 5-HT) increase membrane permeabilities to sodium and potassium ions.


The small frontolateral approach for the microsurgical treatment of intracranial aneurysms. The authors describe a new approach (the Small Frontolateral Approach) for the elective microsurgical treatment of aneurysms of the rostral part of the circle of Willis, including those arising from the carotid siphon. This approach provides the advantage of permitting an easy, direct and "protective" attack to such aneurysms through a small and merely osteoplastic craniotomy.


[Electric response audiometry (brain stem potentials and late potential N1) in patients with acoustic neurinoma or space-occupying lesion in the region of the brain stem]. In patients with acoustic neuronoma or space-occupying lesion in the region of the brainstem we recorded preoperatively the brainstem potentials as well as the late potential N1. With one exception all patients investigated showed changes in the brainstem potential pattern. When stimulating monaurally there exists a clear side difference, that means the changes in the potential pattern are more distinct on the side of the tumour than on the opposite side and then only if an obstructive hydrocephalus exists. Moreover we could demonstrate in patients with tumours in the region of the brainstem that the brainstem potential IV is no longer suitable for measuring the hearing threshold. On the other hand in these patients an exact determination of the hearing threshold is possible with the late potential N1. Altogether the findings show, that the recording of the brainstem potentials when stimulating monaurally is an important additional diagnostic tool to recognize impairment of the acoustic pathways within the brainstem and probably affords the possibility of perceiving pathological pressure within the brain.


Cerebellar gangliocytoma dysplasticum in an infant. A boy, 25 months old, presented a cerebellar syndrome with increased intracranial pressure. Despite a ventriculo-peritoneal bypass, death occurred at the age of 4 1/2 years. Autopsy revealed a very large cerebellum, presenting a "glossy" appearance, with swelling of the brain stem. Histologically, there was a very unusual lesion with a diffuse disorganization of the cortex, a neuronoglial mixed proliferation, a large number of calcospherites, small tumour-like nodules and many leptomeningeal glial bridges. The authors consider that their case is not related to L'Hermitte-Duclo's disease, nor to gangliogliomas, and they discuss the hypothesis of hamartoma.


Brain abscess (analysis of ten consecutive cases). From our small series of ten consecutive cases five points should be emphasized. 1. In chronic cases radical excision is the treatment of choice. 2. In acute cases radical excision is the treatment of choice, if the lesion is in such a site that can be removed easily without worsening the patient's neurological condition. 3. In acute or chronic deep seated abscess, as the abscess in the parietal lobe, the best way to treat it is by drainage as a first stage. 4. Our mortality is one of the lowest reported, and 5. Patients in relatively good neurological condition and conscious level give the best results but a radical excision is recommended even in comatose patients, if the lesion is in such a site that it can be radically removed.


[Circulatory disorders in the area of supply of the vertebrobasilar arteries in clinical and morphological picture]. The material comprised 40 autopsied cases in which vasogenic lesions in the brain stem were the only area of central nervous system damage or preceded the involvement of the cerebral hemispheres. Only 3 of them had been diagnosed correctly during the life of the patients. The material was divided into three groups: I. 22 cases with very dramatic onset suggesting in neurological appearance injury to the hemispheres, leading in most cases (15 out of 22) to death within 1 week. II. 18 cases in which the survival was from 2 months to 6 years. The vasogenic damage to the brain stem preceded considerably the development of brain softening or supratentorial haemorrhage 12 cases, in 7 cases the brain stem lesion was clinically silent in neurological examination. Fresh infarctions (group I) in the brain stem were located usually in the region of vascularization of the short circumferential and paramedian arteries, mainly in the basal part of the pons and midbrain. In group II single or multiple cavities were situated unilaterally or bilaterally mainly in the pons, at the watershed of the vascularization areas of paramedial and short or long circumflex arteries. The foci in the brain stem were associated in most cases (32 out of 40) with vascular lesions in the remaining areas of the same vascularization region. In the discussion on the pathogenesis the significance of degenerative changes in the walls of the vessels in this region and presence of thrombi in them for the development of necrotic changes has been stressed.


[Risk factors in stroke].

[Risk factors in stroke]. Risk factors were compared in 300 patients with brain stroke and 120 patients with neurosis or sciatic pains. It was found that arterial hypertension (p = 0.001) and diabetes (p = 0.01) were significantly more frequent in cases of brain stroke. Disturbances of lipid metabolism, tobacco smoking and obesity showed no significant difference. Extracerebral atherosclerosis (p = 0.001) increased the risk of stroke. Coronary arterial disease was most frequent (48.8%), myocardial infarction (8.3%) and calcifications in the aorta (32%) were second and third in frequency. Presence of at least two risk factors may be an indication to prophylactic treatment.


[Phosphocreatine kinase activity in the cerebrospinal fluid in different types of stroke]. In 45 patients with brain strokes (thrombosis, embolus, intracerebral haemorrhages) and subarachnoid haemorrhages the CPK activity was determined in the cerebrospinal fluid. In most cases a significant rise was observed in CPK activity in the cerebrospinal fluid as compared to the control group. In two cases the dynamics of CPK activity changes were studied in the cerebrospinal fluid during the stroke. It seems that a significant rise in CPK activity develops in the initial phase of the stroke when the area of nervous tissue softening develops and spreads.


[Importance of EEG studies in the assessment of hearing and equilibrium disorders of central origin]. In a group of 52 patients with hearing and equilibrium disturbances of central origin EEG was done. The obtained EEG findings were correlated with: a) main clinical manifestations of the type of function loss or stimulation, and b) disturbances of behavioural perception, that is specific signs of disturbed perception and non-specific extraperceptive signs. Disturbed hearing, independently of the side of lesion, was accompanied by focal disturbances of electrogenesis in left temporal leads. Vertigo was associated as a rule with focal pathological changes in parieto-occipital leads bilaterally, prevailing in the right-side leads. The pattern of labyrinthine (static) behavioural disturbances was, as a rule, more rich than that of hearing behaviour disturbances. The differences observed in clinical pattern were explained as due to differences in the neurophysiological properties of the temporal and parieto-occipital cortex. Conclusions were based on the hypothesis of minimal brain damage and dipolar organization of the pathological bioelectric function of the brain. Electroencephalography provides objective data which can be used in the diagnosis of diseases affecting the organs of hearing and equilibrium.


[EEG changes dependent on the position of the head in patients with vertebrobasilar circulatory failure]. In a material of 39 cases EEG investigations were carried out in patients with vertebrobasilar failure at rest and in different positions of the head. It was observed that EEG curves in cases of vertebrobasilar failure can be normal or may show different changes. Head movements caused changes in EEG curves in one-fourth of these cases but no correlation was demonstrated between the intensity of these changes and the intensity of clinical changes.


[Blood levels of phenytoin and phenobarbital in epileptics treated with phenydantin and phenytoinum]. In 80 epileptics receiving Phenydantin or Phenytoinum the blood levels of phenytoin and phenobarbital were determined. In all, 160 determinations of phenytoin (PHT) and 120 determinations of phenobarbital (PB) were done. Drug levels were determined spectrophotometrically. In 7% of patients toxic concentrations of PHT and in 3% toxic concentrations of PB were found. The PHT level below the therapeutic one was found in 16% of cases, and PB in 23%. The results of this study point to the necessity of routine control of the levels of anticonvulsants in the blood.


[Exercise therapy in the rehabilitation of epilepsy in children]. Motor exercise was appliced in rehabilitation of 34 epileptic children with mild degree of mental retardation. In 28 children motor performance improved considerably. The increase in frequency of epileptic fits was not observed in any of the cases.


[Haptoglobin levels in the serum and the cerebrospinal fluid patients with multiple sclerosis]. In 47 patients with multiple sclerosis and 10 with other diseases of the nervous system determinations of haptoglobin were performed in the serum and cerebrospinal fluid by the method of Owen et al. The Hp level in the serum of multiple sclerosis patients was normal. Its level in the cerebrospinal fluid was higher in multiple sclerosis patients than in cases of other nervous system diseases (statistically significant difference, p less than 0.001). Raised value of the Hp/IgG index in the cerebrospinal fluid of multiple sclerosis patients points to increased permeability of the blood-brain barrier. The so called normal Hp/IgG index was found in multiple sclerosis patients with high Hp and IgG level. Low Hp/IgG index suggested the possibility of IgG synthesis in the brain of patients with this disease. The comparison of the protein level and protein indexes showed that raised IgG level in the cerebrospinal fluid was present in 80% of multiple sclerosis cases, raised Kabat index in 50%, and low Hp/IgG index in 48%.


[Attempt at treating multiple sclerosis by means of ultrasound stimulation of the lymphatic system]. The authors tried to apply ultrasound stimulation of the lymphatic system in patients with multiple sclerosis. This trial was undertaken in view of reports of German authors on favourable results of this therapeutic method. The treated group included 24 patients aged 20--54 years with steady or slowly progressive course of this disease in whom spastic paraparesis predominated in the clinical picture. Before starting and after the completion of this treatment each patient was examined and graded according to a 65-point scoring system taking into account the most important clinical parameters. After 4--6 months in 15 patients the course of treatment was repeated. One course of treatment included 24 procedures performed once daily. The procedure and technical data are described. The results obtained were as follows: 80% of patients reported subjective improvement, the objective status was improved by a mean value of 19% after the first course of treatment and 5% after the second treatment in relation to the initial state. Apart from some somnolence in the initial period of the course, no other side effects were observed. This report is regarded by the authors as a preliminary communication since for a better evaluation of this method the courses of treatment should be repeated several times and in a greater number of patients.


[Method of objective recording of motor disorders and assessment of improvement in the treatment of dyskinesias]. A method of objective evaluation of dyskinesias before surgical treatment and improvement obtained after stereotaxic surgery, is described. The method is based on the principle of recording photographically the movements of an extremity with a light source attached to it. Four sets for recording motor activity disturbances and improvement achieved after operation are presented. The method can be applied for evaluating the effects of conservative pharmacological treatment as well as for assessing the effects of exercises during rehabilitation treatment. The method which allows objective recording of motoro disturbances to be recorded can be used generally in view of its simplicity.


[Case of extraocular muscle paralysis with changes of the ragged-red fiber type]. The authors describe a case of progressive paresis of the extraocular muscles in a 57-year-old woman followed up since 1974. There were no abnormalities in the biochemical investigations, EEG, EMG, ECG, pneumoencephalography and tests for myasthenia. Only in fragments of the biceps brachii muscle histological and histochemical investigations showed mitochondrial changes of the type of "ragged-red fibres". The authors review the literature pertinent to different syndromes of paralysis of the external eye muscles. This is the first case published in the Polish literature.


[Thrombo-obliterative changes in blood vessels of oculo-cerebral location]. The authors report a 46-year-old woman with discrete signs of central nervous system lesions and thrombo-obliterative changes in retinal vessels. There were no circulatory changes in the extremities. The type of vascular retinal changes, maintained patency of ocular and cerebral arteries and slow course suggested the diagnosis of oculo-cerebral form of thrombo-obliterative changes in blood vessels with involvement of the end portions of these arteries.


[Case of Collet-Sicard-Villaret syndrome caused by metastasis of renal carcinoma]. The authors report a case in which the last cranial nerves were damaged with development of the Collet-Sicard-Villaret syndrome. The cause was metastasis of clear cell renal carcinoma. The syndrome is extremely rare. The fairly long, intermittent course in this case deserves attention.


[Change of diphenylhydantoin tolerance at the time of reaching puberty in a 16-year-old girl suffering from epilepsy]. During a 3-year period of treatment with DPH three episodes of drug intolerance developed in a 16-year-old epileptic girl. The dose tolerated previously was 200 mg daily. The authors stress the effect of hormonal disturbances on the change in DPH tolerance.


[Case of orthostatic arterial hypotension with neurologic manifestations (Shy-Drager syndrome)]. The authors report a case of idiopathic orthostatic arterial hypotension with neurological manifestations, rarely diagnosed in this country. The clinical manifestations corresponded to those of Shy-Drager syndrome, with an akinetic-hypertonic syndrome, pyramidal signs, sphincter disturbances, sexual potency loss and neurogenic muscle atrophy. Attention is called to the recent results of biochemical investigations of the blood in this syndrome, and among them to the blood level of noradrenaline which may be useful in the diagnosis.


[Effect of right-sided hippocampotomy on memory and learning ability]. The authors report the results of memory and learning ability investigations in a patient treated with hippocampotomy (uncotomy) for severe epileptic seizures. In the seeg investigations the changes were most pronounced in the hippocampus. In psychological investigations before the operation deep disturbances of verbal memory with unchanged (normal) level of mental efficiency were found. After stereotaxic treatment epileptic seizures disappeared completely, the patient completed a vocational school and started working. Follow up examinations during 6 years after the operation failed to demonstrate any decrease in mental efficiency. The impairment of verbal memory and learning ability was decreased significantly.


[Dandy-Walker syndrome in a 6-year-old child]. The authors describe a case of Dandy-Walker syndrome. In the light of morphological examination it seems that the membrane obturating the IV ventricle is derived from the posterior medullary velum. Of essential significancy for the development of Dandy-Walker syndrome may be increased pressure in the ventricular system which appears probably at the time of cerebellum development as suggested by data from the literature and the observations of the authors. The importance of cranial trauma for the manifestation of clinical features of increased intracranial pressure in the child developing normally up to the age of 6 years.


[Gasometric studies and lactic acid determinations in arterial blood and cerebrospinal fluid in brain infarction]. In 54 cases of brain infarction and 17 control cases the gasometric parameters and lactic acid level were determined in arterial blood and cerebrospinal fluid. Metabolic acidosis was demonstrated in the arterial blood and cerebrospinal fluid. Respiratory acidosis compensated partly metabolic acidosis. Changes in the cerebrospinal fluid were more frequent and more pronounced, especially in cases with fatal outcome. Deep disturbances of acid-base balance complicated with hypoxia may have prosnostic significance while moderate rise in lactic acid level is without this significance.


[Differential diagnosis in inflammatory and vascular brain diseases]. The course of the disease was analysed from the standpoint of the diagnostic value of various clinical manifestations in a group of 200 patients with preliminary diagnosis of encephalitis or meningoencephalitis and in a group of 200 cases with finally established diagnosis of these diseases. In the group of patients referred as encephalitis cases the diagnosis was erroneous in 31% of cases, while in the group with finally established diagnosis of encephalitis the proportion of patients with erroneous initial diagnosis was 42%. In two-thirds of cases with erroneous diagnosis in the first group cerebral circulatory failure was the cause. On the other hand, however, these circulatory disturbances were a frequent cause of diagnostic errors in cases of encephalitis. After establishing the frequency of different pathological manifestations in the group of encephalitis and in the group with cerebrovascular disturbances the most characteristic symptoms and signs in each of these groups were listed.


[Activity of lactic dehydrogenase and its isoenzymes in cerebrospinal fluid in infantile cerebral palsy]. The observed group included 91 children aged from 2 to 15 years divided into two groups: I control--25 children, and II--66 children with severe infantile cerebral palsy. The following biochemical investigations were done in the cerebrospinal fluid: total LDH activity and total protein level before and after fluid condensation, and determination of LDH isoenzymes after condensation of fluid. In the group of children with absence of organic lesions of the central nervous system the mean total LDH activity was 17.6 mU/ml, this value was similar to that found by most authors. The isoenzyme pattern in the control group contained 3--4 fractions, the LDH4 fraction was, however, found in 2 cases only. In the group with infantile cerebral palsy the total LDH activity in the cerebrospinal fluid showed a considerable range of variations, its mean value was 32.7 mU/ml and was highly significantly above the mean value in controls. The LDH isoenzyme pattern in this group consisted of 4--5 LDH fractions with a fairly high proportion of cases with LDH4 and LDH5 fractions and with a high absolute activity of these fractions.


[Rheoencephalographic evaluation of cerebrovascular circulation in cases of ruptured intracranial aneurysms and after carotid artery ligation]. Rheoencephalographic (REG) investigations were performed in patients with ruptured intracranial aneurysms before and after common carotid artery ligation and in a group of healthy subjects. REG curves after ligation of the common carotid artery showed lowering of the amplitude of waves on the side of ligation and generalized vasospasm of varying intensity and different degree of penetration into the cerebral structures. These changes were more intensive on the side of ligation and persisted for over 2 weeks. REG is a valuable method for early diagnosis of vascular disturbances in acute postoperative period in these operations.


[Early manifestations of vascular anomalies of the central nervous system and indications for angiographic studies prior to hemorrhage]. In a group of 556 patients with ruptured intracranial aneurysms in 80 (14%) prodromal manifestations were present before haemorrhage. They included most frequently headaches vomiting, disturbances of eye movements and transient disturbances of consciousness. Prodromal symptoms were most frequent in cases of vertebral-basilar aneurysms.


[Atypical Opalski's syndrome].

[Atypical Opalski's syndrome]. The authors report a woman aged 53 years with the main components of the syndrome of Opalski coexisting with signs characteristic of Wallenberg's syndrome. The lacking components of the former syndrome included Horner's syndrome, while nystagmus, diplopia without evident oculomotor nerves, paresis, disturbances of speech and deglutition belonged to the latter syndrome. The clinical pattern and the course of the disease suggested a vasogenic focus in the right submedullary region and inferolateral part of the medulla.


[Diagnostic value of the CSF uric acid level (author's transl)]. Uric acid is the end-product of purine metabolism, and purines are the nitrogenous bases derived from the breakdown of nucleic acids. The CSF uric acid level is thought to be the index of the turnover of the nucleic acid and the degree of the cellular destruction in the brain. CSF uric acid levels were investigated in normal controls (30 cases) and in patients with brain tumor (20 cases), microcephalus (8 cases) and craniostenosis (4 cases). The mean values and standard deviations of CSF uric acid levels in normal controls were as follows; Newborn--9 yrs  0.34 +/- 0.09 mg/dl; 10 yrs--19 yrs  0.50 +/- 0.18 mg/dl; 20 yrs--29 yrs  0.46 +/- 0.05 mg/dl; 30 yrs--39 yrs  0.35 +/- 0.10 mg/dl; 40 yrs--49 yrs  0.35 +/- 0.23 mg/dl. Thereafter 0.72 +/- 0.21 mg/dl. The increased CSF uric acid levels after the age of 50 is thought to be due to the cellular destruction in the brain. CSF uric acid levels increased in patients with highly malignant brain tumor such as grade 3 or 4 astrocytoma and sarcomatous meningioma, but were normal in patients with grade 2 astrocytoma and meningiomas of meingothelial or fibroblastic type. CSF uric acid levels decreased in patients with microcephalus, but were almost normal in patients with craniostenosis. There is a significant correlation between CSF uric acid levels and the degree of brain atrophy in infants.


[Case of pineal body tumor].

[Case of pineal body tumor]. A case of epiphyseal tumour diagnosed by means of positive-contrast ventriculography in a male patient is reported. Treatment included ventriculoatriostomy and radiotherapy. In the clinical picture of the disease signs of intracranial hypertension prevailed together with hypothalamic endocrine disturbances, and in view of absent pathognomonic signs of lamina quadrigemina lesion considerable difficulties were encountered and craniopharyngioma was suspected. In the light of the pertinent literature and the present observations the possibility of early diagnosis of epiphyseal tumours based on disturbances of vertical optokinetic nystagmus and changes in auditory tests deserves attention.


[Various features of personality and intellect in patients with multiple sclerosis]. The author analysed comparatively the results obtained in a 16-factor personality inventory of Cattell, in the WISKAD test, and Wechsler-Bellevue intelligence scale in a group of multiple sclerosis patients and a group of patients with radicular pains. Differences were found in factors A, N, O in the test of Cattell, in the Hy, Mk scales of the Wiskad test. In the group of multiple sclerosis the intelligence quotient was decreased in the performance scale and the vocabulary subtest in the Wechsler-Bellevue intelligence test. The obtained results were interpreted and hypotheses were put forward explaining the observed differences.


[Craniolacunia in newborns with myelomeningocele and encephalocele (author's transl)]. Craniolacunia is characterized by clusters of deep pits with steep edges in the cranial vault of newborn infants. And also craniolacunia is anomaly of the skull of the newborn infants usually associated with spinal meningocele, myelomeningocele and occasionally with encephalocele. The purpose of this paper is to report the results of the skull roentgenologic study of 34 newborn infants with myelomeningocele and 11 newborns with encephalocele who were treated within 7 days after birth, and, to discuss the correlations with the head circumference, level of myelomeningocele, location of encephalocele, Arnold-Chiari malformation and hydrocephalus. Roentgenograms of the skull were obtained at the time of admission and were examined regarding the presence and the degree of craniolacunia. The radiographic changes were classified according to the extension of the craniolacunia, from grade 0 to grade 3. Among 34 cases of myelomeningocele, 28 cases (82%) were observed to have craniolacunia and among 11 cases of encephalocele, 4 cases (36%) had findings of craniolacunia. In our cases, the coincidence of craniolacunia with myelomeningocele was 82% and this is higher than in previous reports. But the coincidence of craniolacunia with encephalocele was same as in previous reports. There has been no report about the incidence of craniolacunia within 7 days of life.


[Clinical and experimental study on false lateralizing sign (author's transl)]. Clinical study is based upon the results of 68 cases of infratentorial tumor which have been examined in the Dept. of Neurosurgery, Tokyo Jikeikae University Hospital during the year 1967--1977. False lateralizing signs (F.L.S.) were studied of 57 cases except 11 pontine tumors. The incidence of this peculiar signs was 19.2% in 57 cases of infratentorial tumors, including 31.5% in 19 cases of cerebellopontine angle tumors, and 23.8% in 21 cases of cerebellar hemisphere tumor. A number of hypotheses have been proposed in the literature with regard to false lateralizing sign. The author presented the idea that elevated counter pressure elicited at a distance from the tumor may play significant role in producing this peculiar signs. Then the author undertook three-dimensional experiment on counter pressure mechanism, in order to elucidate the idea in cooperation with Material section, Trial production No. 1, Nissan Motor Car. Co. Ltd. The result showed that high counter pressure was observed at the contralateral cerebellopontine angle than the ipsilateral one to the compression. This means that when a mass grows at the posterior fossa on one side, lower cranial nerves of the contralateral side are easily compressed by the counter pressure mechanism from purely physical point of view. Therefore, there is a fair chance for the manifestation of false lateralizing signs.


[Terminal ventriculostomy in the treatment of syringomyelia]. Terminal ventriculostomy is one of the methods used in surgical treatment of syringomyelia. The procedure is well tolerated and may be used in cases in which atlanto-occipital decompression is too serious an operation. The author used the method in treatment of 10 patients with different stages of syringomyelia. In 5 cases the time of follow-up was 12--20 months, in 2 of them the result was very good with very great improvement, in 3 improvement was slight but the progression of the disease was halted. In 5 cases with shorter follow-up improvement was observed in 3 and no improvement immediately after the operation in 2 cases. Further follow-up of these patients will show whether the results of the operation will be permanent.


[Cerebro-vascular accident during pregnancy (author's transl)]. Cerebro-vascular accident is an uncommon but formidable complication of pregnancy. Faced with these cases, the neurosurgeon and obstetrician might differ in the planning of the treatment, when the interests of mother and child appear to conflict between them. From our clinical data of 5 cases and review of the literatures, the following points should be considered for the management of a cerebro-vascular accident during pregnancy. (1) The possibility of cerebro-vascular accident should be considered in any pregnant patients with neurological symptoms, and full investigation should be done if clini-indicated. (2) Aneurysm and angioma are most often encountered in pregnant patients with a cerebro-vascular accident. (3) Unless labour begins during investigation, a cerebral lesion should be treated before delivery, irrespective of the stage of pregnancy and the method of treatment should be decided primarily on neurosurgical grounds. (4) The time of onset of cerebro-vascular accident may be related to the hemodynamic and hormonal change. It occurs more frequently after the second trimester, when the blood volume and cardiac output reach their peak. (5) Pregnancy per se does not influence the mortality from a cerebro-vascular accident in pregnant patients.


[Case of a particularly severe migraine in a boy]. An unusually severe and uncommon clinical syndrome of migraine with complications in a boy treated during 9 years is described. Severe attacks of migraine were associated with changing cerebral function defects, prolonged disturbances of consciousness, and significant symptoms of intracranial hypertension. Vertebral angiography demonstrated disturbances in cerebral circulation.


[Hemodynamics in the anterior part of the circle of Willis in patients with the anterior communicating artery aneurysm--a study by cerebral angiography (author's transl)]. In order to study the cerebral angiographic findings of the hypoplasia of the A1 of the anterior cerebral artery, and the abnormal blood circulation in the anterior part of the circle of Willis, 485 patients who had had at least bilateral carotid angiography and complete data were selected, out of 1,000 patients with cerebral aneurysms to whom intracranial direct surgery had been done from June 1961 to September 1975. Patients with multiple cerebral aneurysms were excluded in this study. Seventy six patients were selected as controls. 1. Cerebral angiography revealed that hypoplasia of the A1 of the anterior cerebral artery is much more frequent in patients with aneurysms of the anterior communicating artery than in those with aneurysms of other intracranial arteries. It was observed in 145 of the 213 patients with aneurysms of the anterior communicating artery (68.1%). As for the hypoplasia of the A1, the angiographic findings corresponded to the surgical findings in 86.9% of all the patients. The incidence of hypoplasia of the left and right A1 portions was higher in patients with aneurysms of the anterior communicating artery than in those with aneurysms of other intracranial arteries. The incidence was about 3 times higher on the right side than on the left side. 2. It was considered that the abnormal blood circulation was observed in the anterior part of the circle of Willis in 155 patients, including 145 with angiographic findings of hypoplasia of a unilateral A1 and 10 with anomalies of the anterior communicating artery or A1 of anterior cerebral artery other than hypoplasia, out of 213 patients with aneurysms of the anterior communicating artery (72.8%). 3. The above findings are considered important for a diagnosis of an aneurysm of the anterior communicating artery and for a surgical approach.


[Acute traumatic epidural hematoma in a 5-month-old infant]. The authors describe a case of acute traumatic epidural haematoma in an infant aged 5 months after slight head injury Acute anaemia coexisted. In view of the rarity of this complication after craniocerebral trauma in this age group and clinical distinctness of epidural haematomas in children this possibility should be considered in the differential diagnosis of sequelae of head trauma in infants.


[Third ventriculostomy for the hydrocephalus after subarachnoid hemorrhage (author's transl)]. Twenty-eight cases after subarachnoid hemorrhage due to ruptured intracranial aneurysms was undergone third ventriculostomies as the reason that the development of postoperative CSF disturbances was determined to be highly probable. The indication and value of third ventriculostomy was discussed considering various clinical and operative findings. Postoperatively, six of the 28 cases required ventriculoperitoneal shunt operation. Although temporary disturbances of serum electrolytes was noted in three cases, no other side effects was attributed to third ventriculostomy. During hospitalization, no fatalities occured following third ventriculostomy. The addition of third ventriculostomy to surgery for ruptured intracranial aneurysms in highly recommended, especially in cases strongly indicating the possible occurrance of postoperative CSF flow disturbances.


[Diagnosis of abnormal spine motion with cineradiography (author's transl)]. For the past one year, 13 patients were studied 20 times with cineradiography to diagnose abnormal spine motion, which was quite informative compared to usual plain spine X-ray pictures. The direct radiation dosis was only 2.35 rem/min on taking cineradiography at the speed of 60 frames/sec. The camera used was Cardoskop-U and the X-ray generator was Pandoros Optimatic, both of which were of Siemens make. It was keenly recognized that cineradiography was useful to diagnose 1) solidity of spine fusion, 2) effect of spinal traction, 3) efficacy of immobilizing apparatus for spine and 4) abnormal spine motion on dynamic way.


[Falx images on CT scan (author's transl)]. It has been reported that falx images usually are not visualized on CT scan except in the case with brain atrophy of falx calcification. But we have often experienced the falx images on CT scan in the case of normal child, and we have an idea that falx images do not always mean a calcification of the falx. Evaluation of falx images on CT scan was done in 964 normal or abnormal cases in relation to different CT slice level, age, sex, pineal body and habenula and choroid plexus. Results are as follows; 1) Slice of higher level revealed higher incidence of falx image. 2) Incidence of falx images was lowest in the second decade, and showed gradual increase in relation to aging process. 3) Incidence of falx images revealed no sex difference. 4) Incidence of falx images showed a following tendency: a) Under 10 years; falx greater than pineal body and habenula greater than choroid plexus. b) Between 11 years to 20: pineal body and habenula greater than choroid plexus greater than or equal to falx. c) Over 21 years: pineal body and habenula greater than choroid plesus greater than falx. 5) The case with brain edema showed a higher incidence of falx images than the normal case, but the case with brain atrophy did not show a higher incidence. 6) Difference of CT number of falx region between the case of positive falx image and negative could not be recognized.


[A case of spontaneous pontine hematoma in patient suspected of pontine glioma and multiple sclerosis (author's transl)]. A case of spontaneous pontine hematoma in young boy, with remitting and relapsing clinical course of up to 11 years, suspected of having pontine glioma or multiple sclerosis is reported. Differential diagnosis of these are mentioned with reference to our cases of pontine glioma. This patient was a man aged 16. At 5 years of age he had his first episode of double vision. 20 days after first episode, gait disturbance, left facial palsy and consciousness disturbance developed. Neurological and neuroradiological examination revealed a pontine glioma and radiotherapy was administered. All signs and symptoms resolved except for bilateral abducens palsy. Four months later, he again complained of gait disturbance and facial palsy. Examination revealed bilateral conjugate ocular palsy, left facial palsy and cerebellar ataxia. These symptoms again resolved spontaneously, except for bilateral abducens palsy. At age 16 years, having been asymptomatic for 10 years, he suddenly noticed loss of taste. At that time sensory disturbance of the left side of himself, right hearing disturbance, dysarthria and retardation urinae. Neurological examination revealed bilateral optic atropy, bilateral abducens palsy, left facial palsy, right hyperacuisis, dysarthria, left hemiparesis, hypesthesia of the left side of the body and left cerebellar ataxia. The vertebral angiography was no evidences of mass lesion and vascular anomalies. The computed tomography demonstrated a pontine hematoma. Conservative therapy was performed and these symptoms cleared off except for bilateral abducens palsy.


[A surgical case with traumatic false aneurysm, arteriovenous fistula of the middle meningeal artery, ipsilateral chronic subdural hematoma and contralateral subdural hydroma and nontraumatic vertebrooccipital anastomosis (author's transl)]. A 48-year-old man with traumatic false aneurysm, arteriovenous fistula of the middle meningeal artery, ipsilateral chronic subdural hematoma, contralateral subdural hydroma, and nontraumatic vertebrooccipital anastomosis was reported with a review of the literature. Traumatic false aneurysm of the middle meningeal artery of 32 cases was already reported in the world, and traumatic arteriovenous fistula of the middle meningeal artery was found in 47 cases, but combination of the both is very rare and only 6 including ours have been found in the literature. In a case that a fracture line crosses over the middle meningeal artery, meningeal false aneurysm or arteriovenous fistula as well as epidural or subdural hematoma is supposed. Therefore common carotid angiography or selective carotid external angiography should be examined thinking of these above mentioned lesions. Comment was made from the anatomic, angiographic, and therapeutic point of view. In our case, the false aneurysms were removed while necessary ipsilateral craniotomy was performed for the chronic subdural hematoma. And operative and histological findings suggest the false aneurysms were on the way to spontaneous disappearance.


[The angiographical study on cerebral vasospasm following the rupture of intracranial aneurysm (1st report).--Time relationship between vasospasm on angiography and the onset of subarachnoid hemorrhage (aurhor's transl)]. Time relationship between the presence of vasospasm on angiography and the onset of subarachnoid hemorrhage (SAH) was investigated with 797 direct surgical cases with intracranial saccular aneurysm. It has been said that vasospasm would occur in early days after the onset of SAH. But in this paper, in the cases with only one history of SAH, vasospasm occurred within 3 days after SAH was seen in only 4.2% of the 120 cases. The peak of vasospasm on angiography was seen in the period between 10 and 17 days after SAH. During this period vasospasm was seen in 49.1% of the 116 cases. Meanwhile, in the cases with preceding SAH occurred between 1 and 17 days before the onset of the last SAH, vasopasm occurred within 3 days after the last SAH was seen in 38.7% of the 62 cases. On the contrary, during the period between 10 and 17 days after the last SAH, vasospasm was seen in only 20% of the 25 cases. Preceding SAH occurred between 1 and 17 days before the last SAH seemed to be responsible for the high rate of vasospasm within 3 days after the last SAH and the low rate of vasospasm in the period between 10 and 17 days after the last SAH.


[Lateral ventricle tumors (Part 1)--clinical manifestations on 30 cases (author's transl)]. The clinical investigations especially on symptomatology of 30 cases of the tumors of the lateral ventricle are carried out. For the clinical analysis, in agreement with Koos and Laubichler, the tumors of the lateral ventricle are classified into 2 groups, as follows: 1. Intraventricular tumors group (11 cases). 2. Paraventricular tumors group (18 cases). The following points are emphasized in the clinical features excluding radiological findings. 1. Because of symptomatologically no difference between the intraventricular tumors group and paraventricular tumors group, paraventricular tumors are included into the tumors of the lateral ventricle. 2. On neurological signs and symptoms, we contrast "false" localising signs which are common in patients with objective evidence of raised intracranial pressure and intermittent symptoms which occur more frequently with tumors in the ventricular system. 3. The results of surgical removal of the tumors are not always good. The diversity of results probably reflects the grade of malignancy and growth of the tumors, and skillfulness of operative technique is required, not to do damage to essential neurological elements and vital structures neighbouring the lateral ventricle.


[Diabetes insipidus after surgery of intracranial arterial aneurysms--with special reference to the human ADH and aldosterone secretion (author's transl)]. The cases of diabetes insipidus (DI) after surgery of intracranial aneurysms were reported and discussed. 1. Of 112 patients operated on for intracranial arterial aneurysm (microsurgical approach), four patients (3.6%) showed DI in the postoperative period. In 3 cases of these 4, the aneurysms located on the anterior communicating artery and the remaining one was the posterior inferior cerebellar artery. 2. The exact mechanism of occurrence of DI is obscure. We suppose that not only vascular spasm of branches of the anterior cerebral and anterior communicating arteries supplying to the paraventricular and preoptic nucleus, but also surgical trauma with direct tissue injury might explain the symptoms. 3. All patients showed a monophasic type of DI which started 1 to 4 days after surgery and lasted from 6 up to 9 days. 4. Two patients with DI showed decreased plasma ADH values below 0.6 microunits/ml in the few days prior to the appearance of abnormally large amount of urinary output. Therefore, once the diagnosis of postoperative DI is made, the patients should be managed promptly with the replacement therapy of Aqueous pitressin. 5. A slow continuous infusion of Aqueous pitressin in the range of 1 to 1.5 IU/hr effectively reduce the polyuria which were not controlled by intermittent intramuscular injections.


[Brain abscess discovered 38 years after head injury (author's transl)]. We reported a case of delayed brain abscess following a penetrating gun-shot injury. The brain abscess surrounding retained intracranial fragments of bone and shell was found 38 years after head injury. The patient's only symptom had been minimal weakness of the right arm. This case was treated surgically with good results. The long period of silent infection was discussed.


A developmental study of epiplexus cells and supraependymal cells and their possible relationship to microglia. Intraventricular macrophages are first seen attached to the presumptive choroid plexus in the 11 days postconception mouse. By 12 day postconception supraependymal macrophages are present as well as a few macrophages lying apparently free within the ventricles. The number of epiplexus, supraependymal and free macrophages increases rapidly and reaches a peak at 17 days postconception, then fall rapidly until 4 days post natum. A second increase in epiplexus and supraependymal cells occurs at 8 days post natum followed by another decrease up to 15 days post natum. Microglia were first observed in the brain at 13 days postconception and at 17 days postconception a microglial cell was observed apparently entering the ependyma from the ventricle. It is suggested that the large decrease in intraventricular macrophages after 17 days postconception is due to many of these cells migrating into the brain to give rise to microglia. The intraventricular macrophages themselves probably arise from within the choroid plexus, either from stromal cells or from blood-borne macrophages.


Fine structural changes in nerve cell bodies of the adult rabbit dorsal motor vagal nucleus during axon reaction. Counts of neuronal nucleoli were made in the dorsal motor vagal nucleus (DMV) of the adult rabbit 10, 18, 70 and 90 days following unilateral cervical vagotomy. The structural characteristics of nerve cell bodies in the DMV were studied electron microscopically 2--90 days after cervical vagotomy. The nucleolar counts indicated that 20% of the large DMV neurones had disappeared ipsilateral to the operation 10 days postoperatively (p.o.), 65% 18 days p.o. and 70%  70 and 90 days p.o. No loss of small neurones was found. Large neurones ipsilateral to the operation showed nuclear displacement, infoldings of the nuclear membrane and disappearance of granular endoplasmic reticulum beginning 4 days p.o. and being prominent 6--18 days p.o. At the peak of the response, 10--18 days p.o., reacting neurones showed nucleolar condensation and vacuolation, the appearance of intranuclear electron-dense particles, extensive accumulation of intracytoplasmic lipid droplets, increased numbers of microtubules and neurofilaments, focal mitochondrial aggregates, and widespread mitochondrial degeneration. Ten to 21 days p.o. degenerating neurones were observed. After 30 days p.o. survival a partial recovery of surviving large DMV neurones seemed to have taken place. The findings are interpreted as indications of distubed protein metabolism, oxidative metabolism and intraneuronal transport in the axotomized DMV  neurones. The unique response of these neurones compared to previously studied peripherally projecting neurones is emphasized.


Partial demyelination of cat spinal cord after X-irradiation and surgical interference. Following 4000 rad of X-irradiation and transplantation of sciatic nerve over the dorsal columns, extensive partial demyelination occurred in some animals. This dose of radiation inhibits remyelination so this phenomenon could be studied knowing that remylination was absent. Partial demyelination was characterized by translocation of myelin to form large myelin ovoids which remained associated with the remaining thinned myelin sheath: nodal widening, involvement of one paranode only, transition from thin to thick myelin along an internode, enlargement and disorientated oligodendrocyte tongues were also features of this change. It is concluded that partial demyelination results when oligodendrocytes have to function in a sub-optimal environment.


Ultrastructure of the muscle spindle in dystrophia myotonica. I. The intrafusal muscle fibres. The abnormal intrafusal muscle fibres of four spindles located in extensor indicis biopsies from two patients with dystrophia myotonica have been examined by electron microscopy. In all cases, the fibres had undergone severe longitudinal fragmentation in their equatorial, proximal-polar and mid-polar zones. It was not possible to differentiate the fibres into nuclear bag and nuclear chain types. Many of the fragments were arranged in clusters, each cluster being bounded by a single basement membrane. Numerous partially divided fibres were seen in mid-polar sections, and a morphological picture of the fragmentation process has been presented. The ultrastructural appearance of individual fibre fragments ranged from normality through to severe atrophy. Intrafusal satellite cells showed an increase in numbers, presumably in response to the pathological processes affecting the muscle fibres. The nature of this response is discussed.


Ultrastructure of the muscle spindle in dystrophia myotonica. II. The sensory and motor nerve terminals. The normal pattern of innervation was lost in the four dystrophia myotonica muscle spindles examined. There had been a proliferation of both sensory and motor nerve terminals, and many endings showed varying degrees of structural abnormality. The changes seen in the sensory nerve endings were an incomplete contact relationship between the terminal and the muscle fibre, the association of Schwann cell processes with the nerve ending, abnormal shape of the terminal, multiple sensory endings, and changes in the ultrastructural organization of the terminal axoplasm. Remnants of degenerated sensory terminals, and isolated sensory endings were also seen. Motor nerve terminals varied in size and shape. In general, they contained a normal complement of vesicles and mitochondria. Junctional folding was often absent or simplified, and sarcoplasmic specialization was, at the most, rudimentary. The relationship between these changes and intrafusal muscle fibre fragmentation is discussed.


The fine structure of the CNS in multiple sclerosis. I. Interpretation of cytoplasmic papovavirus-like and paramyxovirus-like inclusions. During an electron microscopic study of the white matter in multiple sclerosis (MS), spheroidal reticular particles were found both in MS and in control brains. These particles have previously been described in the brain in MS and in brain-derived cell cultures in subacute sclerosing panencephalitis. In both cases they were interpreted as papovaviruses, but in size, morphology and distribution they are identical to the reticulosomes and related particles which occur as proteinaceous artefacts in a variety of tissues and in subcellular fractions. Inclusions in endothelial cell cytoplasm, previously reported from the CNS in MS as paramyxovirus similar to measles, have also been found in the present study. The were present both in MS and in control brains and are identified as "rod-shaped tubular bodies", normally occurring organelles of endothelial cells. The necessity for a cautious interpretation of virus like inclusions in emphasized.


Primary demyelination in cat optic nerves associated with surgically induced axonal degeneration. Localized Wallerian degeneration was induced in cat optic nerves by the gentle scratching of the exposed retinas. At intervals ranging up to 103 days after operation, the cats were killed and microscopic examination of the optic nerves showed, in addition to axonal degeneration, the presence of both demyelinating and demyelinated normal axons. The tongues of oligodendroglial cytoplasm were still associated with these demyelinated axons. This phenomenon is considered to reflect a change in the homeostasis of the oligodendroglial cell imposed by degeneration of a few axons from a state of maintaining the myelin sheath to one of resorption from adjacent normal axons. No evidence for the involvement of microglia in this process was found. It is concluded also that oligodendrocytes alone can be responsible for the removal of myelin debris during Wallerian degeneragion. This observation may be important to the understanding of certain demyelinating diseases of the central nervous system.


The morphology of spastic intracerebral arterioles. Pial and parenchymatous vessels of cat cerebral cortex were subjected to electrical stimulation by direct current by the application of a silver gel electrode to the vessel wall. A current of small intensity (5V, 10mA, 2s) was sufficient to produce spastic constriction of the pial arteries. Arterial spasm was always segmental and lasted up to 20 min. Intracerebral vessels were stimulated by applying a DC of 20 to 100 V, 20 to 150 mA for 30 s to the brain. Intracerebral muscular vessels showed varying diameters and spastic segments in frozen sections and by electron microscopy. The lumen of spastic vessels was collapsed. The vessel wall convoluted, indicating that the factors causing spastic constriction are different from those responsible for physiological vessel wall constriction. In many cases the perivascular tissue of moderately constricted or spastic arterial vessels was destroyed while the tissue around capillaries always remained intact. It is suggested that periarterial tissue destruction is the result of the sudden and powerful constriction in muscular arteries.


Infundibula may be clinically significant. An infundibulum at the origin of the posterior communicating artery is observed to such an extent that it provokes little interest or comment. Although considered preaneurysmal by some, no serious consideration is given to its surgical removal. We present a patient with a subarachnoid hemorrhage, a middle cerebral artery aneurysm, and bilateral posterior communicating artery infundibula to draw attention to the importance of the infundibulum in certain circumstances.


Computed frontal tomography (CFT) of the orbit using the EMI CT 1010 head scanner. Frontal tomograms of the orbits can be obtained with the EMI CT 1010 head scanner, retaining the fine matrix (320 X 320) and thin slice options. Only minor modifications are required.


Techniques in transfemoral lumbar epidural phlebography. For lumbar epidural phlebography an even distribution of the injected contrast medium over the epidural and intervertebral venous system is of the greatest importance in order to prevent the false positive diagnosis of a lumbar disk lesion due to an artificial filling defect. Various catheter placement techniques and other procedures designed to enhance epidural opacification are compared in this respect. In the author's opinion, selective injection of the contrast medium into an intervertebral vein, when possible, leads to the most reliable epidural filling.


Cerebral mucormycosis--a case report.

Cerebral mucormycosis--a case report. A case of cerebral fungal granuloma with histological evidence of vasculitis is reported and the literature briefly reviewed. The value of surgery and chemotherapy for this entity which cured the patient without any sequelae of the disease process or chemotherapeutic agent is emphasized.


[Wounds of the heart. Diagnostic study and clinical case reports]. Two cases of cardiac wounds in association with acute anaemia and acute cardiac tamponade respectively are presented. The statistical and, more particularly, the diagnostic factors involved are discussed. Stress is laid on the measurement of CVP along with pericardiocentesis. Correct interpretation of the data furnished by these two methods will lead to exact and immediate diagnosis in all cases, and so enable the correct therapeutic strategy to be chosen.


[Treatment of hepatic metastases in tumors of the gastrointestinal tract. Considerations on 25 cases]. Results with liver resection over a period of 3 yr in the treatment of metastases derived from tumours of the gastroenteric tube are reported. An account is given of the data and the techniques used by Italian and foreign workers for this purpose. A personal series of 25 cases is presented and its 2-yr survival figure is stated.


[Peritonitis encapsulans. Anatomo-clinical aspects. Case report]. Peritonitis encapsulans is a clinical interest on account of its rarity and the diagnostic difficulties caused by its aspecific symptomatology. A personal case is presented and its ambiguous clinical and instrumental picture is discussed. Diagnosis was finally obtained intraoperatively, after repeated episodes of mechanical ileus had made surgery mandatory.


[Use of hyaluronic acid in the therapy of varicose ulcers of the lower limbs]. Hyaluronic acid used in the management of ulcers due to chronic venous insufficiency and post-phlebitis syndromes (27 cases) proved to possess an anti-inflammatory and anti-exudative action. It also stimulated regeneration and hence epithelialisation. Comparison of healing times in this series and 35 patients who did not receive hyaluronic acid showed that this drug, in association with other remedies, serves to bring about much quicker healing.


[Epidermoid cyst of the spleen with a picture of acute abdomen]. A case of epidermoid cyst of the spleen in an 8-yr-old boy presented as acute abdomen secondary to rupture of the cyst. The lesion is classified and the relevant literature surveyed. Particular reference is made to the pathogenetic mechanism responsible for the picture of acute abdomen.


[Unusual case of urogenital anomaly].

[Unusual case of urogenital anomaly]. A case of associated malformation of the urogenital apparatus, right renal aplasia associated with uterus unicornis with the second uterine duct being independent of the first and located in the corner of the right iliac vessels, in reported in a woman of 41. Three pregnancies had all terminated regularly with live foetus born from eutocic delivery. The unusual nature of the case is insisted on and it would not seem possible to include it in any of the five classes established by Musset et al.


Effect of cerebral cortex gangliosides on the clinical and electromyographic evolution of "a frigore" facial paralysis. Apropos of 24 cases. Results obtained with gangliosides in cases of frigor facial paralysis were assessed in the light of the clinical and EMG pictures. It was found that early and continuous administration reduced the risk of failure (16% in treated and 66% in untreated subjects).


[Programmed rehabilitation of infarct patients. Methods and results]. Rehabilitation is now regarded as an integral part of the treatment of myocardial infarctees. The programme followed by the cardiological institutions of the Udine regional hospital and physical medicine and rehabilitation is described. Divided into four stages, it is put into effect after careful assessment of the patient's physical capability and psychological profile. The results of three years' work are presented.


[Acute renal insufficiency caused by rifampicin]. A case of acute renal insufficiency associated with acute hepatitis that arose in the course of intermittent rifampicine management is reported. Specific reagin-type antibodies were noted in the circulating blood. The clinical, morphological and pathogenetic aspects of the case are compared with those of kidney disease caused by penicillin. While certain clinical features appear in both situations, the histological and immunofluorescence data suggest that two separate pathological entities are involved.


[Functional diagnosis of bronchospasm].

[Functional diagnosis of bronchospasm]. The main theories concerning the pathogenesis of bronchospasm are cited and reference on is made to the part played by the respiratory physiopathology laboratory with respect to past or present patients with this symptom. Attention is then directed to the action of bronchodilatatory substances in the resolution of a proven state of bronchospasm. Administration modalities, techniques, parameters, and percent improvements considered as significant in the light of the literature data and personal experience are illustrated. Bronchoprovocation tests are briefly reviewed. These are divided into aspecific and specific, according to the mediator employed. The first group involve the action of distilled water, physical effort, F2alpha prostaglandins, acetylcholine, and propranolol. The second, which are much more delicate, less certain in their meaning, and not entirely risk-free, offer information of a general nature and impose the need for due care in their practical application.


[Genetic markers in insulin-dependent juvenile diabetes]. A significant association has been established between insulin-dependent diabetes and HL-A. This was appraised in a selected series of 16 patients and 64 of their first-degree relatives by HL-A typing. The relatives also underwent a glucose tolerance test. The results showed a high incidence of B8 in the patients (31%, VS 15% in controls: p less than 0.01). A previously observed prevalence of Bw 15, however, was not noted. In addition, an increased incidence of Bw 35 was detected (38%, VS 23% in the controls: p less than 0.02). In the case of the relatives, no significant differences in HL-A frequency were apparent, nor could a relationship between HL-A phenotype and altered glucose tolerance be established. The true aetiopathogenetic significance of this association is discussed in the light of recent views concerning HL-A and diseases.


[Gastric juice proteins in neoplastic diseases with and without involvement of the digestive system]. Gastric juice proteins were studied in normal subjects and persons with gastro-intestinal, lung and pancreatic neoplasia and chronic systemic lymphopathy and haemoblastosis, using cellulose acetate and acrylamide gel electrophoresis of the freeze-dried dialyaste and chromatography of the amino acids obtained from the hydrolysate. Definite evidence was gathered of both qualitative and quantitative changes in protein fractions. Patterns varied from one group of subjects to another, though the basic picture was the same in both intestinal and extra-intestinal conditions. An effective relationship between the diseases considered is postulated and the data are interpreted with a view to evolving other points for further investigation.


[Mastalgia].

[Mastalgia]. A series of 624 cases of breast pain examined over a period of 5 years is reviewed in the light of age, fecundity, side affected, and occupation. The gynaecological evidence made it clear that most cases where attributable to hormone disorders. In particular, there were no instances in which initial cancer was detected as a result of the pain symptom. The findings are discussed in the light of the literature.


[Familial hypercholesteremia. Clinico-diagnostic and therapeutic aspects]. A case of familial hypercholesterolaemia detected in a homozygous subject following the investigation of two large families with a high incidence of the disease, is presented. The genetic background of this form is discussed. Reference is made to the difficulty of identifying heterozygotes and homozygotes and the mode of transmission followed in the two families. The results of 45 months' treatment with cholestiramine and clofibrate and a dietary regimen are described.


[Transendoscopic retrograde cholangiography in the diagnosis of primary sclerosing cholangitis. Study of 6 cases]. Primary sclerosing cholangitis (PSC) is a rare disease of unknown etiology characterized by severe chronic inflammation, fibrosis and stenosis of variable length of the extra and/or intrahepatic biliary ducts in the absence of recent operative trauma, biliary stones, cancer or infection. Diagnosis has been made only at operation. The introduction of endoscopic retrograde cholangiography (ERC) offers the possibility of preoperative diagnosis. Six cases of PSC diagnosed by ERC are presented. Characteristic roentgenologic findings include strictures of variable length of extra and intrahepatic biliary ducts, beaded appearance and decreased arborization of intrahepatic biliary tree. The roentgenological anatomy of biliary tree at ERC influence the subsequent therapy, i.e. surgical therapy is indicated if a drainage can be performed above the site of the stenosis, while medical therapy (steroids and/or immunosuppressive drugs) is the choice when intrahepatic biliary tree is involved.


[Skeletal manifestations of primary and secondary hyperparathyroiditis. Differential radiological diagnostic problems]. Primary and secondary hyperparathyroidism are both marked by widespread skeletal demineralisation, subperiosteal erosion of the cortex, brown tumours, osteosclerosis, and extraosseous calcification. Differential diagnosis is guided by the different association of these findings. Brown tumours and more extensive erosion are marks of the primary form, whereas osteosclerosis and extra-osseous calcification are a prominent feature of secondary hyperparathyroidism. Radiologists, therefore, should direct their attention to features suggesting the presence of secondary forms in addition to looking for bone alterations associated with hyperparathyroidism.


[Clinical and hematological manifestations of infectious mononucleosis. Personal cases]. An account of the incidence and features of fever, angina, adenopathy and splenomegaly in infectious mononucleosis is followed by an explanation of the importance of palpebral oedema, nasal obstruction, and exanthema and enanthema, the characteristics of which may prove of diagnostic assistance. Attention is drawn to the presence of maculopapular and itching exanthema, particularly after semi-synthetic penicillins. An assessment is also made of liver, myocardial and renal changes, since it is felt that involvement of these organs is an integral part of the clinical picture.


Sequential determination of serum human placental lactogen, estriol, and estetrol for assessment of fetal morbidity. Serial measurements were made of the concentrations of maternal serum human placental lactogen (hPL) (300 determinations), estriol (E3) (460 determinations), and estetrol (E4) (275 determinations) in normal human pregnancy during the third trimester period. Simultaneous determinations of serum hPL, E3, and E4 were also made sequentially on blood samples from 6 diabetic and 5 toxemic pregnant women to ascertain the relative usefulness of these parameters as indicators of fetal welfare. In uncomplicated diabetic patients controlled with insulin, all parameters increased with gestational age. In three pregnancies complicated by severe toxemia in which fetal distress progressed to intrauterine fetal death, both serum E3 and E4 levels decreased progressively, but E4 concentration started to decrease at least 1 day earlier than E3 prior to fetal death. In other women, the E4 levels appeared to drop or decrease significantly whereas the E3 levels remained almost unchanged. Daily hPL levels remained low in chronic fetal distress and, therefore, appeared to be of minimal value for predicting either intrauterine death or acute fetal distress. Therefore, serum E4 measurement seems to provide a more sensitive and reliable indicator of fetal morbidity than the measurement of serum E3 during toxemic pregnancies.


Placenta previa. Predisposing factors and effects on the fetus and surviving infants. The pathogenesis of placenta previa was analyzed in a large prospective study that included more than 1000 medical, demographic, hereditary, and postmortem variables. It caused 73 perinatal deaths per 100,000 births. The frequency of the deaths increased with short maternal stature, increasing parity, prior preterm deliveries, and prior perinatal deaths. More male infants died than females. Placentas showed diffuse hyperplastic enlargement of terminal villi, marginal decidual necrosis, and marginal thrombi. These abnormalities were likely related to blood loss and abruption. Both the infants who died and those who survived had a pattern of fetal growth retardation characteristic of undernutrition. Long-term physical growth and psychomotor development were normal in the surviving infants except for a small excess of neurologic abnormalities.


Shoulder dystocia. A complication of fetal macrosomia and prolonged second stage of labor with midpelvic delivery. Shoulder dystocia is an infrequently encountered obstetric emergency varying in incidence from 0.15 to 0.60% of all deliveries. Previously identified risk factors include maternal obesity, previous infants weighing greater than 4 kg, maternal diabetes, and fetal macrosomia (greater than 4 kg). To evaluate the role of prolonged second stage of labor (PSS) as a warning sign for shoulder dystocia, 9864 deliveries at LAC-USC Women's Hospital were retrospectively reviewed. Ninety percent delivered vaginally and 4.89% had PSS with midpelvic delivery. Shoulder dystocia occurred in 0.37% of all vertex vaginal deliveries. In the absence of PSS and midpelvic delivery, the incidence of shoulder dystocia was 0.16%. However, with PSS and midpelvic delivery, the incidence of shoulder dystocia was 4.57% (P less than 0.01). Infants weighing in excess of 4 kg were at increased risk of shoulder dystocia compared with infants weighing less than 4 kg. When PSS occurred and midpelvic delivery was attempted, the incidence of shoulder dystocia was 21% in infants weighing in excess of 4 kg; 8% had had failed vaginal delivery. All shoulder dystocias and failed vaginal deliveries occurred after use of the vacuum extractor. Immediate neonatal injury was apparent in 47% of infants with shoulder dystocia after PSS with midpelvic delivery. There were no maternal or fetal deaths related to shoulder dystocia during the study period.


The effect of postural changes on plasma renin activity during normal and pathologic pregnancies. A study of the effect of posture on plasma renin activity (PRA) in the third trimester in 27 gravidas revealed a significantly greater increase in PRA in the supine position, compared to the left lateral. The women were classified into 3 groups: normal pregnancy, preeclampsia, intrauterine fetal death. There was no statistical difference in PRA among the 3 groups. It is assumed that the increase of PRA in the supine position was due mainly to mechanical pressure by the gravid uterus on the great vessels (regardless of whether the fetus was dead or alive) and that effective circulatory volume was thus reduced. However, low PRA in the left lateral position in women with preeclampsia seemed to correlate with more severe disease in these women.


Fetal immunoglobulin production following prenatal glucocorticoid treatment. In order to accelerate fetal lung maturation 46 pregnant women were given either dexamethasone or betamethasone intramuscularly during 3 consecutive days during 29--36 weeks of gestation. At birth, the infants appeared to have intact humoral immune function in that they could produce normal amounts of immunoglobulins in utero, and 2 fetuses responded with increased synthesis of IgA or IgM following premature rupture of the membranes. The clinical course did not show any increased incidence of puerperal or neonatal illness attributable to intrauterine infection.


The site of amniocentesis and the lecithin-sphingomyelin ratio. Simultaneous sampling of amniotic fluid from two sites within the amniotic cavity proximal and distal to the fetal mouth was performed. The lecithin-sphingomyelin (L/S) ratio of amniotic fluid obtained close to the fetal mouth was usually higher than that of amniotic fluid obtained from a site distal to the fetal mouth (20 of 26 cases). Differences of up to 0.7 in the two L/S ratios were measured. This suggested that pooling of amniotic fluid phospholipids occurred and in cases of borderline pulmonary maturity the site of amniocentesis may have influenced the predictive value of the L/S ratio.


Ultrasound placental site in relation to bloody taps in midtrimester amniocentesis. In an unselected, consecutive series of 137 midtrimester amniocenteses for prenatal genetic diagnosis, it was found that the incidence of blood contamination of amniotic fluid samples was similar regardless of placental site as determined by ultrasound localization. Three (5.8%) patients with anterior placental location versus 5 (9.1%) patients with posterior placentas had gross blood in the amniotic fluid by visual inspection. These results support the view that placental penetration during amniocentesis is not the major cause of bloody taps. Ultrasound studies done prior to midtrimester amniocentesis should, perhaps, be more specifically evaluated in relation to pregnancy information obtained rather than solely as an aid to improve technical performance of amniocentesis.


Effect of fenoterol and isoxsuprine on myometrial and intervillous blood flow during late pregnancy. The use of beta-adrenergic agonists in high-risk pregnancies has shown evidence of favorable effects on the fetus. Intravenous injections of 133Xe were given to evaluate the effects of short-term administration of fenoterol (3 microgram/min) and isoxsuprine (150 migrogram/min) on the intervillous and myometrial blood flow in a series of 48 women during the last trimester of pregnancy. Both fenoterol and isoxsuprine treatment increased the maternal heart rate significantly. There was a significant rise in myometrial blood flow when fenoterol was given, but the intervillous blood flow did not change significantly during the administration of either isoxsuprine or fenoterol. Previous oral isoxsuprine treatment did not diminish the cardiac effect of intravenous fenoterol, but the improvement in myometrial blood flow was eliminated. This result indicates that beta-adrenergic agonists may have a specific dilatational effect on the myometrial blood vessels. From the hemodynamic point of view, the beta-adrenergic agonists have a limited value in the treatment of chronic fetal asphyxia or intrauterine fetal growth retardation.


Distribution of relaxin in women during pregnancy. The purpose of this study was to determine by RIA the concentrations of relaxin in various compartments and tissues in pregnant women. Ten pairs of maternal venous and cord blood were studied. The mean relaxin concentrations, in immunoreactive equivalents of porcine relaxin, were 0.683 ng/ml in maternal serum and 0.009 ng/ml in cord serum. Relaxin was undetectable in 8 of 9 samples of amniotic fluid. Mean concentrations of relaxin in pg immunoreactive equivalents of porcine hormone per mg protein, from maternal tissues at term pregnancy were as follows: fat 96 (N = 5), myometrium 47 (N = 4), skin 62 (N = 5), placenta 51 (N = 9), and corpus luteum 13,000 (N = 8). These data suggest that little relaxin crosses the placenta and little is produced in the fetus. Contrary to prior suggestions that relaxin may also be a placental product, relaxin appears to be solely produced in the corpus luteum, making it the only peripherally measured hormone that can be used as an index of luteal activity in pregnancy.


Natural family planning. I. The peak symptom and estimated time of ovulation. The observation of the "Peak" mucus symptom in women using the ovulation method of natural family planning has been correlated with the estimated time of ovulation, as evaluated by indirect hormonal parameters. In 65 cycles of the 73 studied in 24 patients, there was hormonal confirmation of ovulation; in eight cycles, anovulation or luteal dysfunction was suspected. In the 65 normal cycles, 64 exhibited a Peak symptom. In those cycles, ovulation was estimated to occur from 3 days before to 3 days after the Peak symptom with a mean of 0.31 days before the Peak symptom. In 95.4% of these cycles, ovulation was estimated to occur from 2 days before to 2 days after the Peak symptom. The variation between cycles of the same patient ranged from 0 to 4 days with a mean of 1.8 days. The beginning of the mucus symptom preceded the estimated time of ovulation by an average of 5.9 days.


Irrigation technique for detection of Mycoplasma intrauterine infection in infertile patients. To improve the method for identification of Mycoplasma as a cause of unexplained infertility and to test whether mycoplasmal endometritis could be responsible for reproductive failure, successful endometrial jet washing technique was performed on 59 infertile patients. Sixteen patients (27%) showed positive Mycoplasma growth. Five patients (31%) from this group became pregnant within a few months following an antibiotic treatment. These results were compared with 50 control patients and only 3 (6%) showed positive Mycoplasma growth from endometrial washings. The data reported in this paper support the concept that endometritis due to Mycoplasma of T-strain or hominis can be a cause of infertility.


Factors influencing the success of salpingostomy techniques for distal fimbrial obstruction. The present study reviews the pregnancy outcome of 99 patients treated with salpingostomy techniques for distal fimbrial obstruction. Eighty-seven patients were treated with terminal salpingostomy, 10 with medioampullary salpingostomy, and 2 with isthmic salpingostomy. The pregnancy rates were 28%, 20%, and 0%, respectively. Within the terminal salpingostomy group, 5 of 18 patients treated with a prosthesis conceived, for a pregnancy rate of 28%. Nineteen of the 69 patients treated with an eversion technique conceived, for a pregnancy rate of 28%. No advantage with the use of a terminal prosthesis could be demonstrated. Tubal disease treated with techniques of salpingostomy was categorized according to a classification incorporating the several prognostic factors thought to influence subsequent conception. The pregnancy rate was found to be in direct relationship to the extent of tubal disease and pelvic adhesion formation. The tubal patency rate decreased in direct relationship to the extent of disease. The use of postoperative hydrotubation did not appear to improve the conception rate after salpingostomy for distal fimbrial obstruction.


Ovarian pregnancy associated with copper-7 intrauterine device. This report documents the second case of an ovarian pregnancy with a Cu-7 intrauterine contraceptive device. All of Spiegelberg's criteria were satisfied. A summary of the literature is presented, revealing 33 ovarian pregnancies in users of an IUD. The overall frequency of primary ovarian pregnancy is 1:40,000 deliveries. There is a ratio of one ovarian pregnancy to nine ectopic pregnancies among IUD users, compared to 1:150 to 1:200 in the general population.


Fibrin degradation products and the diagnosis of ovarian carcinoma. This project was designed to determine if the presence of fibrin degradation products (FDP) in the blood are of value in the preoperative evaluation of patients with pelvic masses. This study comprised 120 consecutive patients who were evaluated for a diagnosis of pelvic mass, ovarian cyst, or ovarian carcinoma. A blood sample was drawn from each patient and fibrin degradation products were determined utilizing the Thrombo-Wellcotest. Platelet counts and partial thromboplastin time (PTT) were also determined on each patient. Ovarian carcinoma was present in 17 (14.2%) of the patients. The FDP was found in the serum of 16 (94.1%) of the patients with ovarian carcinoma. One (5.9%) of 17 patients with ovarian carcinoma had a negative FDP (less than 10 mg/ml). Eleven of the 120 patients (9.2%) had a positive FDP with no demonstrable etiology. A sample of fluid was obtained from two cystic ovarian carcinomas and when analyzed for FDP both samples were strongly positive.


Appearance of maternal anti-JK a antibody following intrauterine transfusions and amniocentesis. A case is presented that suggests that intrauterine transfusion carries the risk of sensitization to red cell antigens other than Rho. In this case intrauterine transfusions of JK a-positive red cells were followed by the appearance in the mother's serum of anti-JK a, an antibody known to cause hemolytic disease of the newborn. The use of the mother as a donor of red cells for her fetus will circumvent the problem of further maternal sensitization.


Pregnancy and the Turner syndrome.

Pregnancy and the Turner syndrome. A 21-year-old white female with short stature, cubitus valgus, multiple cutaneous nevi, and no other major features of the Turner syndrome is described. She had normal secondary sex development and menses. She recently completed a normal pregnancy with delivery of a normal male infant. Postpartum endocrine studies were normal. All cells examined from blood, skin, uterus, and both ovaries had a 45,X karyotype. She is the sixth reported monosomy X patient to achieve pregnancy. A literature review indicates increased fetal wastage (22 of 46 pregnancies) and increased chromosomal errors in the offspring (8 of 26 liveborn infants) of patients with a 45,X cell line. Three cases of trisomy 21 occurred in these infants. Amniocentesis and prenatal diagnostic studies are indicated for women with a 45,X chromosome constitution. The pathogenesis of the Turner syndrome is considered in relation to these findings.


Abruptio placentae. An assessment of the time and method of delivery. Abruptio placentae occurs once per 120 deliveries, but accounts for 15--25% of all perinatal mortality. Several series in the literature suggest that an abnormal fetal-maternal relationship exists in patients with abruptio placentae weeks prior to the actual placental separation and that the separation is only the terminal event. A review of the literature and an analysis of 388 cases of abruptio placentae from the US Navy Coding System were undertaken. It was found that approximately 75% of fetal deaths occurred more than 90 minutes after admission to the hospital and almost 70% of all perinatal mortality occurred in infants who were delivered more than 2 hours from the time of diagnosis. Delivery by cesarean section improved survival in those infants weighing 1500 g or greater and reduced perinatal mortality as much as fourfold in some reports. A prospective study is proposed which would compare two methods of management of this condition.


Use of professional patients in teaching pelvic examinations. Learning proper techniques in physical examinations is mandatory for a physician. Although students may examine each other in early training, examination of the female pelvis does not readily conform to this reciprocity. A randomized study was conducted, comparing teaching methods utilizing professional patients or plastic models. Training on a professional patient significantly increased a student's chance of palpating one or both ovaries, reduced the student's anxiety about performing a pelvic examination, and may have improved the student's gentleness. Costs of the professional patient method were minimal. It is recommended that teaching pelvic examinations with the professional patient replace teaching on the plastic model.


Isoenzymes of human prostate acid phosphatase. The isoenzymes of human prostatic acid phosphatase have been studied by an isoelectric focusing technique. Purified acid phosphatase from malignant prostates contained eight isoenzymes with pI 4.4--5.3. The sera from patients with prostate cancer were shown to have similar acid phosphatase isoenzyme patterns at pI 4.0--5.5; as the serum enzyme activities increased, the pI of isoenzymes shifted to more acidic pH. These isoenzyme patterns of sera from patients with prostate cancer were different from those of patients with Gaucher's disease or from acid phosphatase of human erythrocytes, both of which exhibited only one enzyme band around pI 5.0 and 6.0, respectively. Treatment of serum sample of prostate cancer with neuraminidase did not result in a single enzyme band but alter the pI of isoenzymes, which shifted to a higher pH region. The significance of acid phosphatase activities and its isoenzyme patterns in prostate cancer merits further investigation.


Investigations on general immune reactivity in untreated cervical cancer patients. 74 patients with untreated cervical cancer (FIGO II and III) were skintested with a battery of recall antigens, and also sensitised and challenged with DNCB. A significant reduction of reaction to Tuberkulin, Varidase and also to DNCB was found in patients with stage III in comparison to healthy females of the same age group. Significant changes in immunoglobulin levels, increase of IgA and decrease of IgG were observed in the cancer patients. Serum lysozyme values were the same as in the control group.


[Dynamics of the sex hormone and progesterone level in the peripheral blood and their production by the gonads and adrenals in postnatal ontogeny in silver foxes]. The newborn males of silver-black foxes are characterized by the high specific production of testosterone by the testes and its relatively high level in the blood. These indices sharply decreased by the end of the first month of life and then increased, this increase being most expressed during the prepuberate period. The suprarenals do not play any important role in the production of sex hormones in males. The newborn females are characterized by the high provision of the organism with oestradiol and progesterone produced by the gonads and suprarenals. The production of hormones decreased by the end of the first month of life and then increased in the prepubertate period.


[Thyroid hormone metabolism and the functional activity of the thyroid gland in mother and fetus]. The functional activity of the thyroid glands of the pregnant rats and their foetuses prior to the birth and the deiodizing ability of the liver of the mother and the foetus on the 18-th day of pregnancy were studied. The reliable differences were shown between the levels of protein bound iodine in the blood serum of the pregnant rats as compared with the control ones, as well as the high content of thyroid hormones in the blood serum of the foetuses. The process of thyroxin and diiodothyrosine deiodizing in the foetal liver was more active than in the mother. The results obtained suggest the increase of functional activity of the thyroid gland in the mother by the end of pregnancy and the presence of such an activity in the foetus, as well as the high activity of the deiodizing system in the foetal liver during the last days of prenatal development.


[Mechanism of genome inactivation in avian erythrocytes. IV. New data on the mechanisms of cytodifferentiation in erythropoiesis]. In was shown earlier (Gazaryan & Kulminskaya, 1975; Kulminskaya & Gazaryan, 1976) that under the conditions of anemia a new (reserve) mechanism of the terminal differentiation of erythroid cells was induced. It was now found that in the course of cell development along this path the basophylic erythroblasts doubled the amount of DNA passed in the peripheral blood where they transformed into basophylic, polychromatophylic and orthochromic reticulocytes. Thereafter they entered the mitosis and transformed into the mature erythrocytes with diploid nuclei. It was shown for the first time that the cell delayed in the G2 phase could actively accumulate the specific product (hemoglobin) and keep its ability to enter the mitotic division.


[Lenticular and adenohypophyseal differentiation in the oral region ectoderm of chick embryos in tissue culture]. The ectoderm of oral regions from the chick embryos at the stage of 10 to 19 somites was cultivated in vitro and on chorioallantois in the complex with underlying tissues. In all the explants which, besides ectoderm, contained head gut and mesenchyme, lentoids and lenses formed within 6 days of in vitro cultivation. All specific antigens of chicken lens (alpha, beta- and delta-crystallins) were found in them by means of immunofluorescence. In the explants which contained diencephalon, besides single lentoids or lenses, adenohypophyses were found. The possibility of direct lens-inducing effect of the head gut endoderm on the ectoderm of oral region and the participation of diencephalon in this process are discussed.


[Late labelling of pigment epithelial and iridic cells in smooth newts]. The late labelling of the actively proliferating cells of iris and pigment epithelium in the regenerating eye was found in the adult smooth newts within 2 to 12 days following the intraperitoneal injection of 3H-thymidine. This late labelling is due to the long-term presence of the labelled precursors of DNA synthesis in the organism and to their reutilization. The index of labelled nuclei upon reutilization in the pigment epithelium is twice and in the iris 3 to 4 times higher than in the experiments with pulse labelling what cannot be accounted for by the label dilution only in the process of proliferation. The intensity of labelling upon reutilization is 10 to 20 times weaker than upon the pulse 3H-thymidine incorporation. This phenomenon is of general biological value and it is to be taken into consideration when determining the parameters of cell cycles and studying the cell migration. It can also be utilized as a technique for determination of the maximum number of labelled cells and the rate of their entrance into S phase of the cell cycle. Mitoses in the iris cells of the regenerating eye appeared on the 4--6th day following the removal of retina and lens, i.e. long before the formation of retinal rudiment. These data do not confirm the hypothesis by Reyer (1971) and Yamada (1977) on the role of retinal factor in the transition of the iris cells from G2-block to mitosis.


[Testosterone-1 alpha, 2 alpha-3H(n) absorption by target organ tissues in rabbit embryos in vitro]. The dynamics of uptake of testosterone-1alpha,2alpha-3H(n) by different tissues of the reproductive system in the rabbit embryos from the 18th till 25th days of development was studied in vitro experiments. The specific uptake of the hormone was recorded at all stages under study and in all organ rudiments. The selective uptake was observed in males in the genital tubercle from the 20th till the 25th day, in the ducts on the 19--21st and 25th days, in the urogenital sinus (the cyclic one) on the 19th, 21st, 23rd and 25th days. The character of the hormone selective uptake in the organs-targets is similar in the embryos of both sexes and corresponds to the male morphogenesis. The females were, however, characterized by the higher uptake of the hormone in the ducts on the 19--21st days and in the urogenital sinus on the 19--23rd days. The hormone uptake in the gonads is similar in embryos of both the sexes. The problem of reception of the organs-targets rudiments during the period of growth and differentiation of the embryonic genital system is discussed.


[Teratoid formation after implanting early embryos]. The ability of embryos of different age to form teratoids upon their transplantation under the renal capsule was studied in the CBA mice. The teratoids were shown to form most actively upon transplantation of 10 days old embryos; 7 days old embryos, besides teratoids, may give origin to rapidly growing teratomas. The number of differentiated tissues in teratoids increases with the age of transplanted embryo.