[Dynamics of the dilatation of as uteri during birth]. 219 partogramms of primipares and 219 partogramms of multipares were analysed retrospectively. Only normal deliveries after normal pregnancies were taken into consideration. Graphs were plotted of time intervalls against the width of the cervix. The mean duration of dilation were 6 hours for multipares and 9 hours for primipares. All phases of first stage of labour were reduced in multipares. The results were compared with observations of other authors.


[Possibilities to influence the duration of labor through decompression treatment during the third trimester]. Comparative examinations of labour duration in primipara and multipara of the age groups: before 20, between 20 and 25, 25 and 30, and over 30 (so called "old primipara") were performed. Equal numbers of women with and without abdominal decompression treatment during the III. trimenon were analysed, altogether 1312 patients. In the groups before 20 and between 20 and 25 years of age only an insignificant decrease in duration in treated cases against the control group was found objectively, despite the almost subjectively reported easing and shortening of labour.--On the other hand in 30 year old patients a clear and in over 30 year old women (so called "old primipara") a highly significant decrease was recognizable, which demonstrates the value of prenatal preparations by abdominal decompression treatment in these age group.


[Effect of anesthesia on the condition of newborn infants following cesarean section]. A comparative study of the anesthesia at cesarean section with application of d-tubocurarine in 602 cases and application of only succinylcholine in 69 cases before delivery showed no differences in the Apgars-scores of the newborn. Only severe obstetric complications and long duration of the anesthesia influenced the clinical condition of the infants. There was no correlation between the doses of barbiturates or tubocurarine given to the mother and the Apgars-scores.


[Cardiovascular changes during ethanol-tocolysis]. The cardiovascular effects of an intravenous infusion of a 5% ethanol-10% fructose-solution was examined in 10 healthy late pregnant women with the method of quantitative sphygmometry. There are insignificant changes of the arterial pressure, but increase of stroke volume, cardiac output, work and power and a decrease of total peripheral resistance. In spite of these favourable hemodynamic alterations, particularly the constant heart rate, ethanol should be used only for a short-time-tocolysis.


[Relationships between the HPL determination in maternal serum and the condition of the associated placental villous trophoblast]. Relationships between the determination of human placental lactogen in materna serum and the condition of associated placental villous trophoblasts.--Taking as a starting point both qualitative and quantitative differences in the composition of placental villous trophoblasts subsequent to risk pregnancies, the proportions of different qualities of syncytium and average numbers of Langhans' cells per field of view in 24 placentas of neonates of the 37th to 41st weeks of pregnancy are compared with the corresponding maternal serum HPL (human placental lactogen) values. The significantly lower proportion of mature syncytium determined in the case of a low HPL value as well as the result of linear regression analysis are indicative of a dependence of maternal serum values for HPL upon the proportion of mature syncytium. This particular result is also interpreted by the authors as confirming the view that "mature" syncytium can be considered to be "functional" syncytium. Like other investigators, the present authors should also point out the importance of the total mass of placenta which can compensate for lower proportions of functional syncytium in individual resorption villi. Whereas there are clearly evident relationships between the maternal estriol values and the condition of placental villous trophoblasts, such relationships could not be observed in our material for oxytocinase and HSAP.


[Effect of abortion on subsequent fertility with special reference to the abortion process]. The influence of a first gravida's legal abortion to the later reproduction was researched on 406 patients in the age between 13 up to 18 years-- The rate of abortion and premature birth is significantly increased at subsequent pregnancies when there took place an interruption of the first gravidity.--About 70% of the coming gravidities following an interruption of the first gravidity deliver in the time between 37. up to 39. week of pregnancy.--Premature births having a birth weight below 2500 g are found in 10,17% of the cases compared with a control group showing 5,45%.


[Abortion complications and their effect on subsequent pregnancies]. About complications in 2147 interruptions of pregnancy, carried out between February 15, 1974 and December 31, 1976 was reported.--48,4 per cent was nullipare or primipare. The rate of early complications was 5,28 per cent. During the period of report 7,03 per cent of patients became pregnant again. The fates from these pregnancy were following: 37,6 per cent interruptions of pregnancy once more. 15,2 per cent abortion and 18,4 per cent premature birth. Prenatal mortality was 3,1 per cent.


[Abortion induction in early pregnancy using prostin F2 alpha and 15(S)-15-methyl PGF 2 alpha]. In early pregnancy up the 8th week of pregnancy Prostin F2 alpha was infused and 15(S)-15-Methyl PGF 2 alpha was used i.m. to induce menstruation in 20 or 19 cases, respectively. In the tested form application 15(S)-15-Methyl PFG 2 alpha is effective in 89 per cent of the cases and in 74 per cent complete abortion was achieved, Prostin F 2 alpha produced bleeding in 80 per cent only and complete abortion in 55 per cent. The differences in these two groups were not statistically significant.


[Induced abortion using intrauterine, extra-amniotic administration of prostaglandin F2 alpha in primigravidae]. With 115 nulliparae abortion was induced through intermittend extraamniotic application of PG F2alpha. The intermittend PG-application was successful in 99.13% (81.73% incomplete abortions; 17.40% "missed abortions" with opening of the cervix uteri). In the opposite to others authors "missed abortion" looks as a good result. The mean PG-Dosis was 14,33 mg and the abortion time 15,40 hours.--The rate of morbidity was 6,1 per cent.


[Safety and health aspects in urbanised areas of different density (author's transl)]. Germans like to live in one-family houses. This way of living prevails more and more during recent years. However, the increase of one-family housing implies a high state of car dependence. Especially for children, youths, aged and disadvantaged people living in a car oriented city becomes difficult. Also a higher use of cars implies more air pollution and waste of energy. And additionaly, the increasing travel distances cause higher rates of traffic accidents. To avoid these disadvantages the alternative must be the high density development comprising both, high density-low-rise buildings and especially high rise buildings. By abandoning all one-family homes and using only tall buildings for dwelling and other purposes (stores, offices, schools etc.) the area of a city could be reduced to about one tenth of that what is urbanized today. Because of the short distances in such a city most of the trips could be made by walking or by using lifts. Accordingly traffic accidents could be reduced to one tenth of today's figures too. Despite of the many advantages the high density city has with respect to safety and health of its population such a city will be rarely realized because it does not meet the ideas and imaginations of many people. Nevertheless it seems to be advisable to promote high density residential areas for all those people who are willing to accept it or who prefer this way of living. This minority, however, should not be irritated by unqualified generalizing negative reports in the media.


[Hygienic and bacteriological comparative studies in 50 hospitals. V. Bacterial contamination of hospital surfaces (author's transl)]. Environmental examination were carried out in 50 hospitals using "rodac-plates" (size: 21 cm2) for 7971 samples, to acquire a semiquantitative assessment of microbial contamination of surfaces. Up to 20 percent of the impression cultures showed uncountable numbers of colonies (more than 300/21 cm2). Therefore statements on the microbial content were not to be based on mean values alone. The actual state of surface contamination was assessed by the mean value of all plates with colony counts below 300 and by the median value. Additionally numbers of samples with colony counts below 10 and more than 300 were recorded. The mean value of all samples with less than 300 colonies/21 cm2 was 58. 21% had less than 10, 23% more than 300 colonies. In operating suites, delivery rooms, and premature wards the mean value was 30 colonies/21 cm2. Surfaces with less than 10 colonies amounted to 30 percent, with more than 300 to 5 percent. Samples from intensive-care units, from new-born-, and childrens wards had mean values of 50 colonies/21 cm2. Percentages of plates below 10 and above 300 colonies differed too much to be grouped. Surgical, internal, and gynaecological wards showed mean values of more than 60 colonies/21 cm2. 15 percent of plates had less than 10 colonies, 10 percent more than 300. Differentiations as to specifications of rooms and surfaces in regard to bacterial contamination have been made.


[Experience in the isolation of salmonellae in foods of different risk categories (author's transl)]. 146 samples of pancreatic powder, 208 samples of pasteurized egg albumen, both deep-frozen and spray-dried, and 355 samples of frozen poultry were investigated for the presence of salmonellae. Four pre-enrichment media (lactose broth, nutrient broth, buffered peptone water and tryptone soya broth) and two direct selective enrichment media (dulcitol selenite and tetrathionate) were used. For the pre-enrichment of frozen poultry, buffered peptone water and tryptone soya broth proved to be more satisfactory than lactose broth and nutrient broth. Pre-enrichment of freeze-dried material in a non-selective medium yielded more Salmonella than were obtained by a direct selective enrichment. 16 of 146 samples of freeze-dried pancreatic powder contained salmonellae. Accordingly, tissue and organs of slaughter animals designed for the production of pharmaceutical preparations require regular bacteriological control.


Characterization of the Brucella strains from milch animals. A survey of incidences of brucellosis was carried out in 1378 lactating animals (590 buffaloes; 290 cows; 471 goats; and 108 sheep). Individual reactors to MRT were further identified with blood serum tube and quick agglutination tests.--Recorded incidences of brucellosis in the present investigation were found to be low, 1.4% in cows, 1.3% in goats, 1.2% in buffaloes and 0.9% in sheeps. The present investigation supports the wide use of MRT for screening antibodies for brucellosis in lactating animals which can be followed by SAT.--All those animals which responded to tube agglutination test were also positive for blood serum quick agglutination test.


[Investigation of the hygienic standard in two hospitals including the control of disinfection (author's transl)]. In two operative departments with different architectural presuppositions, the hygienic standard was checked up. Under favourable conditions in clinic B (Hosch-filter, sluice-systems) the relative frequency of demonstrable bacteria amounted to 55%. In clinic A, where these conditions failed, it amounted to 80%. Among the non pathogenic bacteria DNase-negative staphylococci were demonstrated more frequently than others. 13.4% and 18.9% resp. of the bacteria were DNase-positive staphylococci. We used Clostridium perfringens for detecting invasion-paths of germs. The most important ones are leaky windows, air conditioning and insufficient sluice-systems. The success of desinfection was examined. It fluctuates from 67% to 100%. One control amounted to 42%. The results show, that it is impossible to establish sterile rooms for common operative departments. But they show as well that a satisfying hygienic standard cannot be arrived without sluice-systems and appropriate air conditioning.


[Wound contamination in conventionally air-conditioned operating rooms as compared to laminar-flow-operating-rooms (author's transl)]. Two operating rooms (OP K I, OP K II) with conventional air-conditioning and one operating room with horizontal laminar-flow-ventilation (TAVS) were compared by measurements of airborne microorganisms, settling microorganisms and wound contamination. In OP K I and OP K II the number of airborne colonie forming units (cfu) was about 8/m3 when the rooms were empty and between 70/m3 (OP K I) and 140/m3 (OP K II) during operations. The first air in the TAVS-OP contained less than 1 cfu/m3, downstream of the operating team up to 80 cfu/m3. The number of settling microorganisms at the wound site was about 13 cfu/100 cm2 h in OP K I and OP K II, and about 2 cfu/100 cm2 h in the TAVS OP. Wound swabs showed a contamination rate of 45% (OP K I) and 54% (OP K II) versus 31% under TAVS-conditions. The difference is statistically significant with p less than 0.05. Various other factors as e.g. the duration of exposition, traffic of persons into and out of the rooms and the fate of microorganisms after sedimentation into the wound are discussed. While the number of settling germs is growing in linear proportion to the duration of exposition, the number of wounds found contaminated does probably approach a steady state in dependence of sedimentation rate and die-off rate in the wound.


[Behaviour of gram-positive and gram-negative bacteria in dry and moist atmosphere (author's transl)]. The results of bacteriologic environmental studies show the frequently appearance of Staphylococci in dry and of Pseudomonas in moist atmosphere. There is a small frequency of Enterobacteriaceae in both cases. Therefore experiments are done about the behaviour in dry atmosphere of 5 different strains of Staph. aureus, Strept. faecalis, E. coli, Kl. pneumoniae, S. marcescens and P. aeruginosa. The bacterial suspensions are scored on aluminium foil and exposed at room temperature and constant air-moisture. The results show Enterobacteriaceae more sensitive for drying as Staph. aureus and Strept. faecalis. In dry atmosphere Pseudomonas is nearly not able to survive. In contrary to the other examined bacteria only Staphylococcus can be transfered by air or dust. The behaviour in moist environment is examined at room temperature in aqua bidest. and sterile tap-water. In both liquids only S. marcescens is able to grow. It is conspicous that P. aeruginosa dies off in aqua bidest, within 4 d while it is able to grow in tap-water. In tap-water the initial colony count of E. coli keeps constant, but in aqua bidest. E. coli is no more present after 24 d. In both liquids, Staph. aureus and Strept. faecalis have limited surviving rates: Staph. aureus can't be cultured in aqua bidest, after 5 d, in tap-water after 7 d, Strept. faecalis survive 11 and 10 d respectively. Additional the behaviour in tap-water is examined at 30 degrees C and 40 degrees C. These temperatures are characteristic for ultrasonic nebulizers and humidifiers respectively. At both temperatures only P. aeruginosa is able to grow. The other bacteria--including S. marcesens--die off at 30 degrees C and even faster at 40 degrees C. Furthermore mixed cultures are made with 5 strains each of Staph. aureus (= St), Strept. faecalis (= Sf), E. coli (= Ec), S. marcescens (= Se) and P. aeruginosa (= Pa) which formed the following groups: St/Sf, St/Ec, St/Se, St/Pa, Sf/Ec, Sf/Se, Sf/Pa, Ec/Se, Ec/Pa, Se/Pa. The examinations are done in aqua bidest. and tap-water at room temperature. Additional the behaviour in tap-water at 30 degrees C and 40 degrees C was tested. A mutual influence cannot be found. It is the conclusion to use the humidifiers and nebulizers with sterile aqua bidest. only and to prefer the humidifiers to the nebulizers.


Investigations on the carcinogenic burden by air pollution in man. XVIII. The morphology of neoplasms induced in NMRI Mice after subcutaneous administration of PAH (individual or combination treatment). A single s.c. dose of polycyclic aromatic hydrocarbons (PAH) administered individually or in combinations in the neck area to NMRI mice produced mainly malignant mesenchymal neoplasms at the injection site. Parts of these tumours frequently showed a high degree of polymorphism and, as a detailed examination of their morphology demonstrated were similar to sarcomas of the subcutaneous tissue observed in other animal models.


[Comparative analysis of the glycoproteins of the mineralized tissues of several species of animals]. Studies have been made on carbohydrate components of glycoproteids from normally mineralized tissues of different animals. Experiments were made on the scales of the fish Leuciscus idus, on shells of hen eggs, on shells of the molluscs Modiolus modiolus, Anodonta cygnea, Rapana thomasiana, Bithynia tentaculata, on bone tissue, the enamel and dentine from cows, pigs, dogs and albino rats. In the glycoproteids studied, hexoses, fucoses, ketone sugars, hexosamines, uronic and sialic acids were found and quantitatively determined. Using ion-exchange chromatography on DEAE-Sephadex, acid glycosamineglycanes were divided into two fractions--gialuronic acid and chondroitynsulphates. Marked quantitative, for some of the species qualitative differences as well, were found in carbohydrate composition of glycoproteids from mineralized tissues.


[Insulin concentration in the blood of normal chick embryos and after glucose administration]. Studies have been made on the content of immunoreactive insulin (IRI) in the blood serum of 10--16-day chick embryos. A totally homologous radioimmune assay system consisting of a standard and labelled chick insulin together with antiinsulin guinea pig serum to chick insulin, was used. The results obtained show that IRI content increases with the age of embryos. Intravascular injection of glucose increases IRI content in embryos of all the ages investigated.


[Relationship between the ionic composition and functional activity of rat skeletal muscles]. Studies have been made on the relationship between the pattern of distribution of sodium and potassium ions in skeletal muscles of rats (tissue concentrations of ions, ionic selectivity of the tissue) and the level of functional activity of these muscles under experimental influences upon the motor system of the animals. It was shown that prolonged (20 days) effect of weightlessness during a cosmic flight (functional unloading of the motor apparatus) induces changes in tissue concentrations of Na+ and K+ (the increase of the former and the decrease of the latter) only in postural-tonic m. soleus, which accounts for antigravitational function in the organism. In m. phrenicus and m. plantaris no significant shifts in tissue concentrations of ions were detected. severe hypokinesia (30 days) in the laboratory, as well as denervation (30 days) considerably decrease tissue concentrations of K+ and increase that of Na+ in fast skeletal muscles; under the same conditions, slow m. soleus exhibits simultaneous changes in tissue concentrations of Na+ and K+, although these are less significant.


[Ionic conductivity of muscle fiber membranes of Locusta migratoria]. On muscle fibers from m. flexor tibiae of the locust studies have been made of the effect of rapid changes in potassium and chloride concentrations on the membrane potential (MP). The MP constituted 56.0 +/- 1.0 mV. The relationship between the MP and the external potassium at [K]o.[Cl]o equals const may be described by Nernst equation for two different intracellular concentrations of these ions, at [K]o less than or equal to 40 mM and at [K]o greater than or equal to 80 mM. From the relationship between the MP and rapid changes in [K]o or [Cl]o at constant concentration of correspondingly [Cl]o and K]o relative membrane conductivity for these ions were found (TK=0.55 and TC1=0.41). Using impulse analysis, electrical constants of muscle membrane were determined (lambda = 1.9 +/- 0.1 mm; Ri equals 103 +/- 7 ohm.cm; Rm = 1.430 +/- 76 ohm.cm2; Cm = 16 +/- 1 muF.cm-2). High values for Cm correlate with numerous invaginations in muscle membrane which were revealed in electron microscopis investigations. Active responses of the membrane are gradual. In the presence of ions of Sr they are transformed into regenerative action potentials.


[Minimal brain dysfunction in children (neurologic aspect)]. The paper contains some data of a dynamical study of 108 children with early organic brain lesions. Starting from the neonate period, in 29 cases (26,8%) there was a stable focal neurological symptomatology, in 42 (38,9%)--symptoms of neuropsychic abnormalities were not found. In 37 cases (34,3%) there was a neurological and psychopathological symptomatology, typical for minimal brain dysfunction. The studies indicate a certain role of the organic factor in the etiology and clinical signs of minimal brain dysfunction in infants. The conclusion is made that there is a necessity for a thorough neurological examination of infants with pathology in the perinatal period with slight neurological changes or considered to be practically normal. Early treatment and prevention of clinical signs in minimal brain dysfunction is stressed.


[Enzymes of the pentosephosphate pathway in the tissues of cyclostomes at different stages of ontogenesis]. Studies have been made on the activity of the enzymes of pentose phosphate shunt in the heart, liver and somatic muscles of two lamprey species, Lampetra fluviatilis and L. planeri, at various stages of ontogenesis. It was shown that the activity of these enzymes in larval tissues is significantly higher than in adult lampreys. In adult animals, the enzymes investigated exhibit low tissue specificity.


[Nemaline myopathy (clinico-morphologic study)]. For the first time in Soviet literature a description of 2 cases is given; both sibs demonstrate a muscular weakness, hypotension, moderately expressed hypotrophy of the body muscles, extremities and face. There were also specific bone anomalies. An electron-microscopic study detected typical "nemaline structures" in the muscular fibres. The disease in both sibs was identical even in details. The authors discuss the possible mechanisms of motor disorders. Besides personal material the paper contains the main facts of modern literature in relation to the clinical picture and pathogenesis of nemaline myopathy.


[Value and feasibility of electromyographic studies in the diagnosis of birth injuries to the cervical portion of the spinal cord]. A total of 160 patients with natal lesions of the spinal cord were examined by EMG. Of them 34 subjects showed lesions in the cervical part. The clinical data were compared with EMG findings. EMG changes, typical for anterior horn localization (II type of EMG) were found in the position of rest in 41.1% of the cases, while in synergy and voluntary movements in 70.6%. The author considers EMG an important and perspective method of examining children with natal spinal lesions.


[Characteristics of the neuronal composition of the central nervous system of nudibranch mollusks]. Studies have been made on the neuronal composition of the central nervous system of the Nudibranch molluscs from the White Sea -- Coryphella rufibranchialis, Dendronotus arborescens and Cadlina laevis -- at various stages of their postlarval development, Localization maps for the largest neurons were composed. For C. rufibranchialis and D. arborescens, about 65--78 neurons were mapped; some of the characteristics of these neurons were investigated, such as age changes in the body size, the shape, pigmentation and neurosecretory activity. Using impregnation of silver nitrate into slices, two types of branching of neuronal processes were revealed (nervous cells with "branching" and "bifurcational" axons).


[Focal EEG pathology in young children with infantile cerebral paralysis and an epileptiform syndrome]. A polygraphic study of 63 children of the 1st and 2nd year of age with child cerebral paralysis and a convulsive syndrome in 17 detected focal changes of the EEG, mainly in the central and parietal areas. The detection of the focus in many cases depended upon the phase and stage of sleep and could correspond to certain states (mainly--slow sleep, sometimes to rapid sleep, sometimes--intermediary stage). The mechanisms of these phenomena are discussed.


[Changes in the bioelectrical activity of the brain in children with spastic cerebral paralysis following correctional straightening of their gait]. In normal children and patients with cerebral spastic paralysis from 7--12 years there were similar changes of the bioelectric brain activity under conditions of directed correction of gait. There were 3 stages of EEG changes: desynchronozation, synchronization of the dominating rhythm, local synchronization in the form of flashes of the dominating rhythm biopotentials. It was established that a correlational interconnection of the level of integrated EMG and changes in the level of bioelectric brain activity is detected in normals and in ill children on a certain phase of elaborated motor habits. The authors demonstrated an increase of intrahemispheric correlational connections of the bioelectric activity in the motor zones in the process of directed correctional gait. The achieved data concerning the changed EEG in the process of a directed regulation of bioelectrical muscular activity during walking is one of the criteria of a formation of motor functions.


[Functional connections between the suprapharyngeal ganglion and segmental motor centers of the cockroach Periplaneta americana]. Studies have been made of non-specific influences of supraesophageal ganglion on the excitability of the segmental centers in the cockroach P. americana. It was shown that electrical stimulation of the mushroom bodies decreases the frequency of the background discharges which are observed in the neuropile of the central body, decreasing simultaneously the activity of motor fibers of the Vth nerve. On the contrary, stimulation of the central body increases the frequency of the spontaneous activity in motor output. It is suggested that the inhibitory influences from the mushroom bodies upon the segmental motor apparatus may spread both directly and in a stepwise fashion, i. e. via the intermediate structure of the central body. The latter is involved into the control of muscle tonus in the cockroach.


[Round nucleus of Emys orbicularis tortoises during ontogenesis (light and electron microscopy findings)]. It has been demonstrated that in the tortoise after hatching the round nucleus and its neurons are rather small, neuronal density is high. Neurons contain a large amount of free ribosomes, Nissl bodies are absent. Single axodendritic synapses are predominant, polysynaptic complexes of the glomerula type are absent. These data indicate that in newborn tortoises the round nucleus does not attain definitive form, differentiation of its main elements proceeding after hatching.


[Electroneuromyographic studies intaxia-telangiectasia]. An electroneuromyographical study of 29 patients with ataxia-teleangiectasia was performed. It was established that the structural and functional disturbances of the central and peripheral nervous system increase as the disease progresses. The changes found in the spinal motor cells, in the afferent and efferent links of the peripheral neuromotors apparatus permit to recommend drugs directed towards normalization of the processes of nerve conductivity in the peripheral part of the nervous system to be included in the comprehensive therapeutical and rehabilitative measures in this form of pathology.


[Changes in the retinotectal system of the tortoise Testudo graeca following enucleation]. Electrophysiological and electron microscopic studies have been made on degeneration in the optic nerve and midbrain tectum after enucleation of the tortoise T. graeca. It was found that intensive degeneration of terminals which follows "dark" type (1/2--1 month after enucleation) corresponds to degeneration of myelinated fibers. Mass degeneration of the "light" type is associated with degeneration of unmyelinated fibers, being observed 1 1/2--2 months after the enucleation. The main bulk of fibers and terminals degenerates at the period of 4--4 1/2 months. Changes in functional characteristics of the evoked potentials (EP) follow morphological ones and consist in an increase of the interval between the stimulus and the peak of EP components, as well as of the decrease of the amplitude of the EP. Within 4--4 1/2 months, both EP components disappear almost simultaneously.


[Central muscular hypotonia of early childhood (hypotonic form of infantile cerebral paralysis)]. A total of 64 children from 6 months to 2,5 years with a hypotonic syndrome were observed. Follow-up studies were performed twice: after 1--1,5 years and after 2--3 years. In most of the cases (52 patients) the hypotonic syndrome towards the age of 6 slowly regressed, up to its complete disappearance. In these cases other neurological syndromes could appear (dyskinetic, spastic, minimal brain dysfunction), in the structure of which cerebellar symptoms occupied an important place. The intellectual development of these children was subnormal. In a lesser part of the cases (12 patients) the indicated dynamics of hypotonia was not seen, or it increased, while the intellectual devleopment of the children was characterized by mental retardation. These cases were evaluated as desintegration of development. The practical significance of the study of hypotonia for the prognosis is discussed.


[Hemiatrophy in children].

[Hemiatrophy in children]. A clinico-electrophysiological characteristic of 56 children with the hemiatrophy syndrome is presented. The main clinical variants of hemiatrophy in children were distinguished. Some materials on the etiology and pathogenesis of this disorder are considered. The authors used electrophysiological methods in the study of this disorder: EEG, Echo EG, REG. The nozological entity of hemiatrophy the secondary symptomatical variants and features of the clinical development are discussed.


[Experience with using amedin in children with movement disorders of extrapyramidal and labyrinth origin]. Using previously obtained data concerning the effectivity of amedin in motor and speech disorders due to muscular dystonia the drug was used for the treatment of 50 children from 3.5 months to 18 years, with motor disorders of an extrapyramidal and labyrinth nature. A high therapeutical effectivity of amedin in an increased pathological activity of tonic cervical and labyrinth reflexes in infants and in torsion spasm of school age children is demonstrated.


[Schwartz-Jampel syndrome. Positive therapeutic effect of diacarb]. For the first time in Soviet literature a case of Schwartz--Jampel syndrome is described. In a 4 year old girl, besides skeletal abnormalities there were also muscular disturbances typical for this disease: myotonia, a syndrome of constant muscular contraction (rigidity) and expressed cramps. The paper contains a concise literary review concerning the Schwartz--Jampel syndrome and indicates absence of effective treatment. The author succeeded in attainment of a distinct improvement by administering diacarb, a drug previously not used in this disease.


[Differential diagnosis of slowly progressive schizophrenia in children]. Slowly progressive schizophrenia in children is marked in 45.5% of all the cases. This form of development usually cannotes a favourably developing variant of continuous and attack-like schizophrenia, characterized by a gradual increase of psychopath-like (schizoid) personality changes. For this reason it is necessary to differentiate the diagnosis of schizophrenia with the dynamics of psychopathy in children. The paper contains data of some criteria of a differential diagnosis of slowly progressive schizophrenia in relation to early childhood autism, psychic infantilism, obsessional neurosis, pathologically developing age crises and cyclothymia in children.


[Depersonalization disorders in schizophrenic children]. The paper is concerned with a study of age variants of depersonalizational disturbances in schizophrenia children of early preschool age and preschool age. Depersonalizational disorders proper were found in 25 cases, disturbance of the self-conscious and its deterioration in 59, retardation in the development of the self-conscious formation--in 32 cases. Depersonalizational disturbances appear in children over 3 years, i.e. following the first physiological age crises. The following types of depersonalizational disturbances were distinquished: 1) moderately expressed loss of the self-conscious with disorders in the differentiation of the "I" from the associates; 2) a deeper disorder of the "I" with a substitution of the personal "I", by another "I"; 3) phenomena of estrangement of the self-conscious with a state similar to the splitting of the self-conscious, up to the appearance of the phenomena of a twin; 4) a change of the self-conscious expressed in a pathological play transformation and a substitution of the "I" by another "I", or a splitting of the self-conscious into the syndrome of play transformation near to a delusional; 5) derealization; 6) loss of the conscious of personal sex; 7) estrangement of the conscious of personal actions; 8) disturbance of self-conscious of a physical whole; 9) disturbance of the self-conscious in a deep depression with a loss of "I-vitality" appearance near to "anaesthesia psychica dolorosa" and "nihilistic delusions"; 10) loss of "I" conscious and regress of speech, motor activity, behaviour; 11) retardation in the formation of "I" conscious.


[Effect of the acceleration factor on formation of the clinical picture of schizophrenia in adolescents]. A comparitive clinico-psychopathological study in 275 cases of schizophrenia in adolescent boys with different variants of sex maturation (accelerated, retarded and normal) demonstrated significant differences in the clinical picture and development of schizophrenia depending upon the physical and in particularly the sex maturation. The authors come to the conclusion of a modifying influence of maturation on the formation of the clinical picture and development of schizophrenia in this age period. At the same time acceleration of maturation is not considered as an unconditioned unfavourable prognostical sign.


[Relationship between sex and the clinical picture of schizophrenia in adolescents]. In 100 boys and 100 girls with an onset of schizophrenia in adolescency, the hereditary loading, traits of premorbid personality, the clinical picture and development of the disease depending upon the sex were studied. Some sex differences in the clinical picture of adolescent schizophrenia were demonstrated, for instance, an earlier onset in girls, a prevalence in the clinical picture of affective disorders. The clinical picture of boys was mainly characterized by psychopath-like behaviour and its specificity in adolescents of both sexes. There were also other sex differences in the clinical picture, development and prognosis of the disease.


[Clinical picture of "difficult" adolescents]. Some data of a comprehensive clinico-psychological, anthropological, neurological and neurophysiological study of 150 adolescents--75 "difficult ones" and 75 in the control group are presented. There were 3 main clinico-psychopathological variants of disturbed behaviour; with a prevalence of instability, affective explosiveness and desinhibition of drives. It was possible to demonstrate their pathogenetical connections with some biological traits (abnormal sexual maturation, insufficiency of the nervous system, mainly of an organic character) and environmental factors, which to a certain extent were specific for each of these variants.


[State of short-term memory in dyslexic children]. Thirty children from 7--8 years who were not able to master the technique of reading and 18 normal children from 5--6 year were studied. As a method special tasks were used, characterizing a short-time acoustico-speech and visual-space memory. In 86% of the children with dyslexia there was a drop in the range of acoustico-speech memory, in 63%--of the visual spacial, and in 57%--a combination of both. The author discusses the role of disturbed short-time memory in the pathogenesis of dyslexia.


[Role of biogenic amines in the pathogenesis of intellectual disorders in children with minimal psychoorganic syndromes]. Memory, attention and emotional reactivity in comparison to indices of catecholamine and serotonin metabolism were studied in 25 children from 7 to 10 years with the minimal psychoorganic syndrome during aminalon treatment. According to the excretion indices the activity equilibrium of catecholamines and serotonin were changed and were accompanied by disturbances of memory, attention and emotional reactivity. An improvement of these indices during treatment corresponded to a normalization of the activity in these systems. Questions concerning the signficance of disturbed metabolism of biogenic amines in the pathogenesis of the psychoorganic syndrome are discussed.


[Hyperactive states in children (clinical picture, therapy and rehabilitation)]. On the basis of a study of 1000 hyperactive children the authors clarify the limits in the understanding of hyperactivity and distinguish the following variants: emotional, behavioral and intellectual irregularity. The secondary neurotic symptoms are considered as a structural component of hyperactivity. As one of the mechanisms the correlation of excitability and inhibition is discussed. Data on complex pathogenetical treatment and rehabilitation are given.


[Clinico-physiologic study of several aspects of the pathogenesis of stuttering]. Data on a comparative clinico-physiological study of children with neurotical and pseudoneurotic stuttring are presented. Clinically 60 patients from 2.5 to 6 years were studied, among them the articulatory and respiratory component of expressive speech formation was studied in 30 cases. The data indicate the complication and deepening of the neurotical and pseudoneurotic symptomatology in the age group from 5 to 6 years. A correlation of clinical and physiological parameters showed that neurotical stuttering appears against the background of a normally formed speech stereotype. In treating neurotical stuttering more attention should be paid to medicamental tranquilizing therapy and a correct psychotherapeutical approach, along with logopedical lessons. In pseudo-neurotical stuttering there is a pathological onthogenesis of the speech functioning--an abnormal formation of the speech stereotype. In both cases durative logopedical correlational work and an active goal-directed medicamental treatment are required.


[Personality formation in younger school age children afflicted with cerebral paralysis]. Attempts were made to study the pathogenetical significance of the feeling of inferiority and the psychogenic syndrome, appearing in early school children (60 cases) with cerebral paralysis. Psychogenic reactions, appearing on an organically changed ground are formed in 2 directions: some children are characterized by neurotic reactions in combination with passive-defensive (astheno-phobic, astheno-depressive, etc.); other children react by agressive-defensive forms of behaviour (pathopersonality reactions--opposition, etc.).


[Reactive suicide attempts in children, adolescents and young adults]. The paper is concerned with the study of 86 patients from 9--18 years who suffered from hysterical, affective-shock reactions and reactive depressions, accompanied by suicidal acts. Suicidal tendencies in these conditions appeared following acute psychic traumas. Their formation was facilitated by different unfavourable factors. As the children become older there is a complication not only of the clinical picture of the psychogenic disorder, but of the suicidal syndrome. The suicidal act in children proceeds impulsively, while in adolescency there is a presuicidal period. The stability of suicidal tendencies depends upon the depth of depressions; repeated suicides from the expressiveness of psychopathical personality traits and the existence of unsolved psychotraumatizing situations.


[Development of suicidal tendencies in schizophrenic adolescents and children]. The report is concerned with a clinical study of 197 schizophrenic patients (children and adolescents) who attempted suicide. The study demonstrated that this form of behaviour may be observed even in a relatively favorable variant of the disease. Of certain importance in the development of a suicidal attempt may be psychotraumatizing factors. This may be reflected in the subjective motivation and a certain shade of the main processual symptoms. In relation to the syndrome level, suicidally important may be not only a depressive condition but other affective disorders, such as anxiety, perplexity, fears and a malicious-agressive affect.


[Initial manifestations of alcoholism in adolescents (social-psychological and clinical aspects)]. The authors studied the traits of initial symptoms of early alcoholism in 100 boys-pupils of a special boarding-school. It was established that in the appearance of early alcoholism a certain role is being played by unhappy families. A significant importance in the formation of an inclination for alcohol is the character of the first pharmacological influence: euphoric reaction of the first intoxication increases the risk of becoming an alcoholic. The most expressed initial signs are the following: a stable pathological craving for alcohol, use of substitutes, transformation of intoxication.


[Effect of protective helmets and head guards on localization of injuries to the skull and brain in cranio-cerebral injuries]. The results of post-mortem examination of 140 cadavers of persons who had died of craniocerebral injuries are appraised. It was established that in injury inflicted through a protective head-piece, the proportion of damage to the bones of the base of the skull, basally located structures of the large hemispheres and stem of the brain in the total number of injuries increases. The study is supplemented with mathematical calculations which explain the dependence observed.


[Orbital arteriovenous anastomoses].

[Orbital arteriovenous anastomoses]. Separate angiography of the channels of a. carotis externa and a. carotis interna revealed two cases with orbital arteriovenous anastomoses between the branches of a. maxillaris interna and v. ophthalmica inferior. In one of these cases the fistule was additionally supplied with blood by branches of a. ophthalmica. The clinical picture of arteriovenous anastomoses of the orbit resembles that of carotid-cavernous fistules. Surgical management consisted in embolization of the channel of a. maxillaris interna on the side of the anastomosis with muscular emboli. The vascular murmur and exophthalmos disappeared after the operation.


[Dynamics of cerebral blood filling in epileptic patients during seizure activation]. The interrelationship of cerebral hemodynamics and cerebral vascular tonus was studied in 36 patients with epilepsy during activation of discharges and provocation of epileptic seizures by hyperventilation and intravenous corazol infusion by simultaneous EEG and REG recording. It was found that regional functional hyperemia in the brain corresponding to the side of the epileptogenic focus increases during activation of the discharges despite a certain increase in the tonus of the cerebral vessels. During and immediately after an epileptic seizure angiospasm is replaced by vasodilation with further growth in blood filling of the brain. The possible mechanisms of the vascular reaction are discussed.


Codon-specific serine transfer ribonucleic acid synthesis in avian liver during vitellogenin induction. The relative rates of synthesis of two major tRNASer species in rooster liver were simultaneously assessed during induction by estradiol-17beta of the synthesis of a serine-rich phosphoprotein, vitellogenin. The relative rates of tRNA synthesis were determined by a double-label method in which nonspecific effects of the hormone were avoided. Isotope ratios of highly purified tRNASer species were measured following an in vivo labeling procedure which included a 7-day labeling period with [5-3H]orotic acid prior to, and a 6 h labeling with [6-14C]orotic acid from 42 h after the hormone injection. tRNASer (AGU,C) and tRNASer (UCU,C,A) were extensively purified by chromatography on benzoylated DEAE-cellulose in the presence and absence of Mg2+. In three separate labeling experiments the rate of tRNASer (UCU,C,A) synthesis was slightly but not significantly increased relative to the rate of tRNASer (AGU,C) synthesis during the period when vitellogenin was synthesized at a constant rate and the level of tRNASer continued to rise. The results suggest that mechanisms other than a differential rate of transcription are involved in the regulation of tRNASer levels in avian liver during vitellogenin induction.


[Muscle tonus in rigidity and spasticity]. The results of the examination of the muscle tone by passive movement of the extremity at a low and high rate in patients with spasticity are discussed. In parkinsonism high resistance was noted to passive movements of the extremity at a low rate (with a period of oscillatory movement of 100 s and more) as well as in the first cycles of rapid sinusoidal movement (with a period of 1 s) if the extremity had been at rest for a lengthy period of time. In spasticity of other etiology, there was a gradual increase of the amplitude on the mechanomyogram in high rates of passive movements, which was evidently due to growth of stimulation in the stretch-reflex arc from cycle to cycle as the result of sumation with trace stimulation from the preceding cycles. The shape of the spectromechanomyogram, which is marked by a rise in the region of the high rates, is considered to be a sign of spasticity, whereas the size of this rise is accepted as a quantitative index of the spastic component of the muscle tone.


[Surgical treatment of ischemic strokes]. The following operations were performed for ischemic strokes in 116 patients: resection of a loop of the internal carotid artery on the neck, resection of the sympathetic ganglion, and the creation of anastomosis between the branch of the superficial temporal artery and the cortical branch of the middle cerebral artery. The method of the microsurgical intervention is described in detail and the indications and contraindications for various operations in ischemic strokes are discussed. Elaboration and improvement of the methods of microsurgery will make it possible to map out the prospects in the treatment of cerebral circulatory disorders.


[Solitary abscess in the region of the pons varolii]. An abscess in the region of pons varolii in a male 69 years of age with the erythrodermic form of mycosis fungoides is described. It is presumed that the source of the purulent infection were small skin excoriations from scratches due to excruciating skin itch. Long-term cytostatic and immunodepressant therapy promoted generalization of the infection and formation of the cerebral abscess.


[Occipital foramen in pathology of the osteoarticular apparatus of the craniovertebral region and in normal subjects]. Clinical and X-ray examination of the occipital foramen in healthy individuals and in persons with various congenital and acquired lesions in this region showed, on the one hand, a wide variety of shapes of the foramen in normal conditions and, on the other, the direct dependence of neurologic disorders on the degree of changes in the position of the occipital foramen, its constriction and deformity of its edges. Marked bone changes call for emergency decompression of the compressed or dislocated bulbospinal parts of the central nervous system, the nerves and vessels.


Insulin and metabolism of glycosaminoglycans in rabbits. The effect of insulin on the concentration of different glycosaminoglycan (CG) fractions was different in different segments of aorta. Chondroitin sulphate A and heparin were increased in the aortic arch, thoracic and abdominal aorta, while chondroitin sulphate B and C were increased only in the aortic arch and abdominal aorta. Heparin sulphate and hyalutonic acid were increased only in the abdominal aorta. In the liver, significant increases occurred in all GG fractions. All enzymes studied which are involved in the biosynthesis of GG precursors, i.e. glucosaminphosphate isomerase, UDP glucose dehydrogenase and glucose-1-phosphate uridylyltransferase, were increased in the animals of the insulin group, while all enzymes involved in the degradation of GG, i.e. hyalurono glucosidase, beta-glucosaminidase, arylsulphatase, and cathepsin D, were decreased. Concentration of hepatic PAPS, activity of the sulphate-activiting system and sulphotransferase increased on administration of insulin.


The Snell-dwarfmouse. I. General growth pattern, before and during growth hormone and thyroxine therapy. In order to obtain more insight in the general growth pattern of the Snell-mouse growth in length and weight of normal and dwarf Snell-mice before and during treatment with human growth hormone (hGH), porcine growth hormone (pGH) and L-thyroxine (T4) were studied. In normal mice the length velocity has a peak at 1 1/2 week of age and diminishes gradually therafter. In contrast the weight velocity peaks at 4 1/2 week. These differences result in a biphasic pattern of the length/weight relationship. Dwarfmice exhibit marked growth retardation at 2 weeks of age and growth arrest at 4 weeks. From birth on a marked difference in length velocity is observed, compared to the normals. This contrasts with the weight velocity, which discriminates at a later age (2-3 weeks). In the dwarfmice dose and age dependent growth occurred with all tested hormones. A combination of pGH and T4 shows a growth response which is equal to the sum of the effects of the hormones given separately. Doubling the dose of pGH after 12 weeks of treatment did not much influence the growth curve. However, addition of T4 induced a small but definite further height increment.


Prognostic value of fluorescein angiography of the funds in diabetic children. A positive fluorescein angiographic (FLAG) finding is a frequent occurrence in ophthalmoscopically negative cases. By repeated FLAG examinations good follow-up of the variability of the finding is possible. After 4--8 years of diabetes, ophthalmoscopically diagnosable retinopathy is to be expected in the patients in whom the initial FLAG examination showed signs of angiopathy.


The Snell-dwarfmouse. II. Sulphate and thymidine incorporation in costal cartilage and somatomedin levels before and during growth hormone and thyroxine therapy. Costal cartilage activity ([35S]sulphate and [3H]thymidine incorporation) and somatomedin (SM) activity in normal Snell-mice and dwarfmice before and during treatment with human growth hormone (hGH), porcine growth hormone (pGH) and L-thyroxine (T4) were studied, in order to obtain more insight in the interrelationship of these parameters with growth velocity. In normal mice endogenous (21 h incubation in medium with label) and plasma stimulated cartilage activity (21 h pre-incubation in medium, 48 h incubation with 20% human plasma, supplemented for the last 24 h with label) slows down immediately after birth, whereas the length velocity has a peak at 1 1/2 week of age and diminishes gradually thereafter. The endogenous activity of dwarfmice between the ages of 7 and 17 weeks is comparable with 3 weeks old normals, however plasma stimulated activity is much higher indicating a discrepancy between growth capacity of the cartilage and chronological age. Cartilage of dwarfmice recognizes growth hormone dependent differences in human plasma. The SM content of mouse serum using homologous cartilage turned out to be low for dwarfs, reaching subnormal values during hGH treatment. Three days after initiation of treatment with hGH endogenous sulphate and thymidine incorporation in costal cartilage is increased compared to saline treated dwarfmice. The effect is age-dependent and a combination of GH and T4 shows an effect equal to the sum of the effects of hormones given separately. After treatment for 5 weeks with hGH no differences between treated and untreated animals could be observed anymore, although the length velocity did not change throughout the 10 weeks of treatment. A difference of the cartilage sensitivity to human plasma between hGH treated and untreated mice is noted one week after treatment and a small difference remains after 5 weeks of treatment.


Circadian and 30 minutes variations in serum TSH and thyroid hormones in normal subjects. Ten normal young males were investigated in order to examine diurnal and short-term variations in serum TSH and serum thyroid hormones. In five subjects blood samples were obtained every 30 min during a 24 h period of daily life. A synchronous diurnal rhythm was found for free T3 and serum TSH with low levels in the day-time and higher levels at night. The mean increase from day to night was 15 and 140 per cent, respectively. There was a tendency to a similar rhythm in free T4, but the increase of 7 per cent fell short of statistical significance. In the other five men blood samples were obtained every 5 min in a 6 to 7 h period starting within the interval from 19.15 to 22.00 h. A significant regular variation with a cycle-length of half an hour was found in TSH, free T3 and free T4. This rhythm accounted for a significant part of the total variation in the levels of TSH, free T3 and free T4. The mean amplitude of the short-term variation is 13, 15 and 11 per cent of the mean level of the respective hormones. The data suggest a pulsatile release of hormones from the thyroid gland governed by a pulsatile TSH secretion.


Influence of thiazides on thyroid parameters in man. Iodine metabolism and thyroid hormones in blood were studied in 19 men and 11 women who had been treated with thiazides for arterial hypertension from 1 month to 15 years. The results were compared with the findings from age-matched normal controls. No differences were found regarding 24-h 131I-thyroid uptake, thyroid iodide clearance, renal iodide clearance, plasma inorganic iodide, absolute iodine uptake (AIU), serum thyroxine (T4 (D)), resin T3 test (T3U) and TSH after TRH. Twenty-four-hour urinary iodine was higher in the patients treated with diuretics which could be explained by increased iodine intake. The findings of increased serum triiodothyronine (T3 (RIA)) and reverse T3 (rT3) might be due to changes in distribution volume in the thiazide-treated patients. Long-term treatment with thiazides in man do not lead to iodine depletion.


The fatty acid pattern of triglycerides in liver, adipose tissue and serum of diabetics with hyperlipoproteinemia before and during clofibrate treatment. In 20 diabetic inpatients with type IIb, III, IV and V hyperlipoproteinemia (HPL) the triglyceride fatty acid pattern (TFAP) of serum, adipose tissue and liver biopsy specimens before and after one year of clofibrate treatment has been determined by gas-liquid chromatography. Compared to previous results which revealed a correlation between fat droplet size and the TFAP in liver parenchyma cells, remarkable changes were observed after long-term therapy. In adipose tissue, only linoleic acid increased significantly from 8.6 to 11.3%. In serum, myristic and palmitic acid decreased, whereas linoleic, eicosatetraenoic (arachidonic) and eicosapentaenoic acid rose significantly. In liver fat, palmitic acid decreased, whereas linoleic, eicosatrienoic, arachidonic and eicosapentaenoic acid significantly increased. After clofibrate therapy, the TFAP in diabetic subjects with HLP became similar to that of diabetics without HLP. The most pronounced changes were found in the liver, serum having an intermediate position between liver and adipose tissue. The pathophysiological relevance in view of possible relations to prostaglandins has been discussed.


Usefulness of serum lipid determination in diabetic practice. In order to evaluate the importance of measuring serum lipids in the current care of diabetics, blood triglycerides were measured in 155 diabetics and 59 controls. Comparison with a chemical method confirmed the usefulness of the nephelometric method for the diagnosis and control of hyperlipemia in current practice. The importance of measuring serum lipids was confirmed by a close correlation between lipemia and cardiovascular complications such as coronary insufficiency, high blood pressure, and peripheral arterial insufficiency. It appeared also that glycemia and cholesterol are not sufficient to assess the biological pattern and prognosis of diabetes. Thus, lipemia is an essential parameter in the evaluation of any diabetic because of its value regarding prognosis and control therapy.


Long-term application of intermittent urethral catheterization to the neurogenic bladder of diabetes mellitus. Two case reports are presented of patients who utilized long-term intermittent urethral catheterization as a primary management of diabetic neurogenic bladder. The results indicate fewer complications than with a continuous indwelling Foley catheter. Further, only two urinary tract infections occurred during 39 months of patients utilization. No renal or vesical lithiasis occurred. One patient had a remission and went on drug therapy alone. The other patient may use this technique indefinitely.


Correlation of reverse-T3 and 3,3'-T2 (T2') plasma concentrations under physiological and experimental conditions in man. T2' plasma levels are measured under different conditions and correlated to the repective rT3 concentrations. Specific RIAs for T2' and rT3 are used. Pharmacological doses of T3 cause an increase of plasma T2'; if T3 or T4 doses are administered to an athyroid patient which cause a similar level of plasma T3 the increase of T2' is much larger during T4 treatment. Cord blood levels of T2' are 2--3-fold higher than in normal adults whereas rT3 concentrations are about 10 times higher than normal. After birth rT3 and T2' levels decrease in about a parallel manner. After a bolus iv injection of 500 microgram rT3, T2' starts to increase as early as 2 min after injection. PTU in therapeutic doses causes a rapid increase of plasma rT3 with a maximum 4 h after ingestion. A dose of 150 mg PTU causes a maximum of about 100% above baseline. T2' also increases but to a lesser degree (about 50% above baseline). We conclude that rT3 is a most important precursor of T2' whereas T3 contributes only to a minor degree to the total T2' production under physiological conditions.


Lack of influence of arginine preloading on the insulin response to I.V. glucagon in children and adolescents. Nine normal children (6 males and 3 females) aged from 7 1/2 to 14 1/2 years underwent a 30-min arginine infusion (0.5 g/kg) followed at 90 min by one bolus i.v. glucagon injection (0.03 mg/kg). On a separate occasion the same children underwent an i.v. glucagon only test. No significant difference was found when the glucose and insulin responses in the two glucagon tests were compared, in contrast to previous findings that preloading with glucose resulted in a significantly increased response of insulin to glucagon.


Exploration of the early insulin response by two small successive loads of I.V. glucose in normal and obese subjects. Two 5 g glucose loads at 1-h interval were given to healthy controls and obese subjects with slightly altered or normal OGTT in order to explore the capacity of restoration of the "rapid insulin response" to i.v. glucose. In the normal subjects, the two successive loads gave rise to identical responses as far as maximum increase (delta max), average increase at 2-5 min (delta 2-5 min), area of increase 0-15 min (delta 0-15 min) for both glucose and IRI, were concerned. Obese subjects could be divided on the basis of their insulin response to the first load into normal responders (group I) and high-responders (group II). In group I obese subjects, the responses to the second load were identical to those to the first. In group II obese subjects delta max, delta 2-5 min and delta 0-15 min of the insulin response to the second load were reduced as compared to the first.


The effect of lithium on the peripheral turnover of thyroxine and triiodothyronine. The effect of litium on the peripheral turnover of T4 and T3 was investigated in 14 euthyroid subjects using lymphocytes as target cells. Lithium caused a dose-dependent rise in T4 turnover, which did not lead to increased T3 production, but no rise in T3 turnover. A further 3 patients with lithium induced hypothyroidism were studied. Patients with high T4 turnover had high TSH values and in these patients lithium induced a decrease in T4 turnover. This may lead to the conclusion that the demonstrated effect of lithium in the control group did not cause the low T4 in these patients. In 2 patients defective T4 degradation was demonstrated.


Cholinergic influences on hypothalamic-pituitary-adrenocortical activity of stressed rats: an approach utilizing agonists and antagonists. Cholinergic involvement in the regulation of the hypothalamic-pituitary-adrenocortical (HPA) system of male rats was evaluated using muscarinic (atropine and methacholine) and nicotine (mecamylamine and nicotine) agents, which were selected for their specificity on cholinergic receptors (ChR). They were administered either intracerebroventricularly (icv) to produce central effects, or ip to produce both central and peripheral effects, prior to subjecting the animals to either auditory or hypercapnic stress for 1 h. Plasma corticosterone was used as an index of HPA activity. The results suggest that central muscarinic ChR are involved in inhibiting HPA activity in both non-stressed and stressed animals, whereas central nicotinic ChR are excitatory during stress but inactive in the non-stressed state. Stimulation of peripheral nicotinic ChR appeared to potentiate the HPA response to hypercapnia, and to inhibit the central excitatory nicotinic ChR when the latter were activated in non-stressed and auditory stress rats. These data suggest that during auditory stress the HPA system is more dependent upon the cholinergic system for its activation than during non-stressed and hypercapnic states.


Hormonal and ultrastructural observations in a case of resistant ovary syndrome. This report describes in detail the hormonal and ultrastructural findings in a 21 year old woman with secondary amenorrhoea, who fulfilled all the criteria necessary to establish the diagnosis of resistant ovary syndrome. Ovarian biopsies revealed numerous primordial and primary follicles, which both by light and electron microscopy showed a normal morphology. Nevertheless, the follicles could not be stimulated neither by large doses of human gonadotrophins alone nor by simultaneous administration of cortisone acetate and large doses of human gonadotrophins. The association of a decreased target cell response with increased levels of serum FSH and LH might be explained in different ways. The presence of an inhibitor preventing the normal action of gonadotrophins could not be substantiated, because we did not detect any circulating gonadotrophin antibodies. Furthermore the serum prolactin level was normal.


Secretion of the androgens in the male guinea-pig during the perinatal period. Plasma and testicular testosterone, androstenedione and dihydrotestosterone concentrations have been estimated by radioimmunoassay in the male foetus and newborn guinea-pigs between day 62 of pregnancy to day 12 of post-natal life. The prenatal period is characterized by low plasma androgen levels and high testosterone and androstenedione testicular content. After birth there is a peak of plasma testosterone concentration on day 3 concomitant with a release of testicular androgens; no similar increase of androstenedione or DHT is observed in plasmaa. This peak in plasma testosterone is testis dependent because it disappears after castration; it is also light dependent at birth. The investigations on testosterone and androstenedione peripheral metabolism have shown that day 3 after parturition is a "critical period" in the evolution of the metabolic clearance rate, the production rate and the conversion rate of these two androgens. The neonatal increase in plasm testosterone may be accounted for by the variations in these metabolic parameters and may have an influence upon certain sexual target organs, especially upon the vas deferens, the androgens content of which increases during the same "critical period".


Developmental patterns of plasma and testicular testosterone in mice from birth to adulthood. Male mice were raised in cohabitation with females from birth to 90 days. Testosterone was measured every 10 days in plasma and testes. Sex difference in body weight was related to the pre-pubertal increase of testosterone levels in males. The weight of the seminal vesicle was positively correlated with circulating testosterone levels between 1 and 40 days but not between 50 and 90 days. Testosterone concentrations in the plasma and testes were high at birth: 630 pg/ml and 58.0 +/- 17.7 ng/100 mg; they subsequently decreased during the first days of life and remained low until day 20:240 +/- 110 pg/ml and 0.1 +/- 0.03 ng/100 mg. The testosterone levels then increased rapidly between days 20 and 30 and especially between 30 and 40 reaching their maxima: 5770 +/- 1720 pg/ml and 123.7 +/- 18.3 ng/100 mg testis. This increase was transitory and testosterone levels fell after day 40. By 90 days, the testosterone levels, 440 +/- 65 pg/ml and 43.2 +/- 5.5 ng/100 mg testis, were comparable to those measured at birth. Plasma testosterone and age were positively correlated between 1 and 40 days, and negatively between 50 and 90 days. The first fertile matings occurred at age 40 days.


A quantitative study on feedback control of LH by testosterone in young adult and old male rats. The hypothalamic pituitary gonadal axis was studied in young adult (3 month old) and old (24 to 27 month old) male Wistar rats. Plasma testosterone decreased significantly in old animals (x: 262 hg/100 ml (n = 35); versus x: 110 ng/100 ml (n =30). The fall in LH was less pronounced but still significant (54.5 ng LH-RP-1/ml in young versus 39.5 ng/ml in old rats). Groups of 6 to 8 animals of both ages were castrated and implanted with silastic capsules continuously releasing testosterone. The length of the capsules was directly proportional to the plasma testosterone levels achieved (range between 63 and 350 ng/100 ml). After one week young castrated rats not substituted with testosterone showed LH values three times higher (x: 351 ng/ml) than old rats treated in the same way (x = 126 ng/ml). LH values in the animals substituted with testosterone indicate that the sensitivity of the negative testosterone-LH feedback is greatly increased in old rats. Testosterone can be depressed to 60 ng/100 ml before an increase in LH occurs. In young rats no increase in LH was observed when testosterone values were higher than 170 ng/100 ml. In the range between 170 and 100 ng/100 ml about half of the young animals reacted with increased LH secretion, while an increase was observed in all young animals when testosterone dropped below 100 ng/100 ml.


[Mononuclear peripheral blood cells in patients with non-Hodgkin's lymphoma synthesizing DNA in vitro]. In 82 patients with non-Hodgkin lymphoma (NHC) the DNA synthesis by mononuclear cells from the peripheral blood was assessed by means of the index of mitoses (IM) or by pulse labelling of cells with 3H-TdR. In chronic lymphatic leukaemia (47 cases), hairy-cell leukemia (1 case), plasma-cell leukaemia (1 case) no synthesis of DNA was found in mononuclear cells. On the other hand, it was raised in most cases of lymphoplasmocytoma, centrocytoma, centroblasto-centrocytoma, centroblastoma and in lymphoblastic leukaemia or lymphoma.


[Rare erythrocyte phenotypes imitating weak variant of antigen A]. Two phenotypes with defect of sialic acid in the cell membrane of erythrocytes due to some unknown factor, imitating the weak variant of antigen A are reported. One of them found in a healthy candidate for blood donation was called Tn. The second one associated with thrombocytopenia and anaemia differed from all as yet classified ones in that it had simultaneously increased expression of antigen H and lack of reaction with Dolichos biflorus lectin. For demonstrating the diagnostic difficulties differentiation against the weak variant of antigen A approaching A3 is described.


Anesthesia and the porphyrias.

Anesthesia and the porphyrias. The porphyrias are a result of disordered heme metabolism. The sequelae are related to the accumulation of precursors and/or their metabolism. Induced drug metabolism can lead to acute attacks and may result in fatalities. Careful selection of intravenous agents, absolute avoidance of barbiturates, and use of inhalation agents can enable the anesthetist to administer safe anesthesia to these endangered patients.


Sphenoidal electrodes: their use and value in the electroencephalographic investigation of complex partial epilepsy. The diagnostic value of sphenoidal electrode EEG recordings in patients with seizures characteristic for epilepsy with complex partial symptomatology was assessed in a study comprising 404 patients; 71.3% of the patients had seizures with automatisms and amnesia, and 28.7% had psychic seizures with subjective phenomena such as hallucinations and illusions. A total of 59.6% of the patients had diagnostic EEG changes in routine waking or sleep EEG. In sphenoidal EEG recording including thiopenthone activation, diagnostic changes were found in 40.5% of the patients without specific changes in waking or sleep EEG, the chance of a positive finding being more than five times higher in patients with automatisms than patients with psychic seizures. Apart from cases where surgical treatment of temporal lobe epilepsy is considered, sphenoidal electrode EEG recording, including intravenous thiopenthone activation, should be performed in patients with seizure phenomena raising suspicion of epilepsy with complex partial symptomatology but where waking and sleep EEGs fail to demonstrate specific abnormalities.


Correction of the biochemical effects of neonatal hypothyroidism by daily low doses of thyroxine. Comparative effects of hyperthyroidism and these corrections. The purpose of the present communication was to study the corrective effects of low daily thyroxine doses, on the cerebellum biochemical maturation in propylthiouracile (PTU)-treated rats during the early postnatal life. The corrected hypothyroid animals were compared to the normal, hypo- and hyperthyroid ones. The protein, RNA and DNA cerebellar contents were evaluated at 6, 10, 14, 18 and 35 days old animals. At all ages hypothyroidism and hyperthyroidism decreased cerebellar protein, RNA and DNA contents, except in 35-day-old hyperthyroid animals, where DNA content returned to normal level. In these two experimental groups, protein/DNA and RNA/DNA ratios were higher than those of controls at 10 days and lower at 35 days. In hypothyroid animals treated by corrective doses of T4, cerebellar protein, RNA and DNA contents and DNA concentration were not different from hyperthyroid animal values at all stages, while protein/DNA and RNA/DNA ratios were higher than those of hyperthyroid animals. Administration of physiological doses of T4 to hypothyroid animals led to the same effects as higher doses in normal animals. Thus, neonatal hypothyroidism seems to lower the sensitivity threshold of the cerebellum to thyroid hormone effects.


Clinical picture of multiple sclerosis with late onset. A group of 47 patients (multiple sclerosis (M.S.) diagnosed according to Schumacher's criteria) with age at onset over 40 years, was studied by statistical analysis and compared with a control group (100 M.S. patients with onset between ages 18 and 38). The following features appear peculiar in this group: --the most frequent initial symptoms are motor disturbances --the onset is generally monosymptomatic --the course is generally progressive and more severe than that of controls, as seen by Kurtzke's Disability Scale, relapse rate, interval between first and second attack --the course is more severe when the onset is progressive and characterized by motor disturbances.


[Ventriculo-cardiac derivation in late complications of hemispherectomy (author's transl)]. After briefly stating the circumstances in which hemispherectomy is indicated the authors review the possible complications of the operation on the basis of available literature. Two cases are described, one with autopsy findings and the other with CAT scan data which revealed extreme dilatation of the remaining ventricle and led to the installation of a ventriculo-cardiac derivation; this case progressed favourably. The author concludes that this type of complication could be detected rapidly by CAT scanning, with no risk to the patient. Ventriculo-cardiac derivation could prevent further complications. Hemispherectomized patients must undoubtedly be monitored closely by regular clinical examinations, EEGs and CAT scanning.


Spinal components of the cerebral somatosensory evoked response in normal man: the "S wave". Responses evoked over the scalp and the neck by median nerve (or finger I) stimulation were concurrently recorded in 10 subjects. It was found that the first component of the cortical SEP consists of a small amplitude polyphasic wave (S wave) which could be recorded bilaterally upon unilateral stimulation. The polarity of the S wave varied according to the reference electrode position, at variance with the P15 component which remained constantly positive. It is therefore correct to assume that different generators are responsible for these two potentials. The synchrony between the S wave and the cervical response, which is largely spinal in origin, as well as some pertinent experimental data, suggest that the S wave is a far field reflection of activity generated mainly in the cervical dorsal columns. These findings might be relevant to the diagnosis of neurological disorders.


[Peripheral facial paralysis and post-antirabies-vaccination polyneuroradiculitis (author's transl)]. A case of facial diplegia with albuminocytologic dissociation of cerebrospinal fluid after antirabies vaccination prompts the author to attempt a retrospective study of post-antirabies-vaccination neuropathies, with facial or extensive involvement. Fifty-seven cases are considered. Irrespective of vaccine type, certain clinical similarities emerge, notably the age of occurrence (adult), the early onset of the paralysis (during vaccine therapy or in the following week), and the prognosis (good survival rate, severity of functional impairment varying with extent of involvement). The author attributes the main pathogenic role to the peripheral myelinic basic protein contained in varying proportions in conventional vaccines, the corollary being that such accidents should disappear completely with the new vaccination based on tissue culture material. A therapy programme comprising the discontinuation of vaccine therapy and administration of corticoids is proposed.


Bismuth encephalopathy. A clinical and anatomo-pathological report of one case. A fatal case of toxic encephalopathy due to ingestion of bismuth salts is reported in a twenty year old female patient. The clinical features were characterized by a confusional state, ataxia, myoclonic jerks, and epileptic seizures. Despite supportive therapy and administration of chelating agents, there was an irreversible evolution towards coma. The immediate cause of death was an intercurrent septicaemia. The anatomo-pathological study showed non specific anoxic lesions including a widespread loss of Purkinje cells in the cerebellum. Despite a drastic decrease of bismuth levels in blood, the concentration of bismuth in visceral organs and different parts of the central nervous system remained very high.


Scanning electron microscopy (s.e.m.) of biopsy specimens of ruptured intracranial saccular aneurysms. Surgical specimens of 4 intracranial saccular aneurysms were studied by scanning electron microscopy. The internal surface of the aneurysms showed crater-like defects and cytoplasmic bridges. In some areas the endothelium was preserved, but its longitudinal convolutions were higher and thicker than those found in unchanged areas. On the damaged endothelial surface there was an increased number of blood cells. The adventitia resembled that of a normal cerebral artery. In conclusion the alterations observed are similar to those found in atherosclerosis and are most likely due to the high wear and tear provoked by the blood streaming into the aneurysm. The results of this study are in agreement with the findings of a companion transmission electron microscopy study and emphasize the importance of degenerative changes on the development and rupture of intracranial saccular aneurysms.


Electron microprobe study of calcifications in human brain tumors. Preliminary electron microprobe studies of a small number of meningiomas, oligodendrogliomas, glioblastoma multiformae, craniopharyngiomas, and metastatic epithelioma of the breast suggest that the elemental composition of the deposits associated with these tumors is characteristic for each type of tumor.


Frequency of surface microprojections and coated vesicles with increased malignancy in human astrocytic neoplasms. Surface membrane microprojections and coated vesicles of a well differentiated (Kernohan-Sayre grade I) cerebral fibrillary astrocytoma were compared with those of anaplastic astrocytic (grade IV, glioblastoma) cerebral tumors. Both phenomena increase with increased malignancy. This provides further evidence for membrane alterations with malignant change in human astrocytic cells. It is the first comparison of fibrillary astrocytoma surface phenomena with those of more malignant astrocytic tumors of the cerebrum.


Cadmium induced endothelial cell alterations in the fetal brain from prenatal exposure. Pregnant rats received a single administration of 0.5, 1.0, or 2.0 mg/kg of cadmium on day 18 or 20 or gestation. Maternal animals were killed on day 21 and samples of the caudate nucleus from fetal brains were examined using the transmission electron microscope. A 2.0 mg/kg dose of cadmium administered to maternal rats on day 20 of gestation caused the formation of vacuoles in the endothelial cells of capillaries in the fetal brain. Significant endothelial cell vacuolization was not observed in the brain of fetuses from other treatment groups. The vacuoles occurred singly, were spherical in shape, were located adjacent to the intercellular junctions and caused focal distortion of the endothelial cell. Vacuoles were the only ultrastructural alteration observed in the caudate nucleus of fetal brains.


Lymphocytes within glial cells ("emperipolesis") in a case of a granular cell tumor. A case of a combined neurofibroma - granular cell tumor of the left middle cranial fossa with infiltration of the temporal lobe and expansion into the orbit is presented. The granular cell tumor shows big fibrillary astrocytes in its peripheral zone. Even in the tumor-free brain tissue adjacent to the tumor plenty of these obviously reactively proliferated astrocytes are found. Furthermore, lymphocytes within the cytoplasm of such astrocytes ("emperipolesis") strike the eye. Neither the lymphocytes nor the astrocytes show signs of damage. A review of the literature and the theories concerning the phenomenon of emperipolesis are given. The problem of its biological significance and the question whether emperipolesis is the result of invasion of engulfment must remain unsolved.


Spontaneous lower motor neuron disease in rabbits (oryctolagus cuniculus). Spontaneous neurologic disease was observed in 6 to 8-week-old rabbits. Both males and females from several different litters were affected but all were sired by the same male. Clinically, the disease was characterized initially by posterior weakness and incoordination which progressed to tetraplegia within 3--4 weeks. With light microscopy there was neuronal degeneration and loss within the ventral horns of the spinal cord and brain stem and type-II fiber atrophy of skeletal muscles. Ultrastructurally the neuronal degeneration was characterized by accumulations of 100 A neurofilaments within the perikaryon. These findings are compared to diseases with neurofibrillary accumulation in animals and man.


The efferent innervation in the region of inner hair cells in the organ of Corti. The efferent innervation of the inner hair cells in Corti's organ of the laboratory rat and of a bat was investigated with help of histochemical staining of the inner spiral bundle. The area of acetylcholinesterase-positive fibres in the inner spiral bundle regions was measured. The bulk of the efferent fibres lie in the middle part of the cochlea. Towards the apical and lower basal turns a distinct decrease in the number of fibres was observed.


Mechanical properties of basilar membrane. A fresh basilar membrane has different mechanical properties in the radial and in the longitudinal directions. When pressure with a needle is exerted on the basilar membrane, a narrow radially oriented strip is deflected. The form of the deflection can be deduced from the pathological consequences of the acoustic trauma as well. The observed anisotrophy is a property of the vital membrane and is disturbed by chemical and physical influences and is lost post mortem. The post-mortem changes can explain the results obtained by von Békésy which differ from ours. The physiological meaning of the mechanical properties of the basilar membrane is discussed here.


Reduction of the endocochlear potential by the new "loop" diuretic, bumetanide. The effect of bumetanide upon the endocochlear potential (EP) was examined in 46 guinea pigs. The EP was reduced with dosages of 5 mg/kg or more. The maximum depression of the EP (reduction to -30 to -40 mV) was obtained at a dosage of 30 mg/kg. The recovery of the potential was incomplete at any dosage within three hours and the response pattern of the EP to bumetanide was similar to that to ethacrynic acid. The present experiments revealed that bumetanide, by weight, has a stronger ototoxic potency than the other "loop" diuretics--furosemide and ethacrynic acid. However, the diuretic effect of 1 mg bumetanide is equivalent to 40 to 60 mg furosemide or ethacrynic acid. Therefore, the relative ototoxic potency of bumetanide is much smaller suggesting that from a clinical standpoint bumetanide is much safer than the other "loop" diuretics.


The development of hair cells in the embryonic chick's basilar papilla. During the 7th to 21st (hatching) days, hair cells of the embeyonic chick transform from an undifferentiated epithelium into cylindrically-shaped tall hair cells (THCs), pitcher-shaped short hair cells (SHCs), or intermediate hair cells that share structural characteristics of the first two. By the 11th day hair cell types are unambiguous. "Hairs" (stereocilia and a kinocilium) were first identified on the 7th day and resembled the adult pattern the 13th. The nucleus occupies relatively less volume as hair cells increase in size, becoming positioned centrally in THCs and basally in SHCs. Nucleoli, which are prominent throughout development, remain conspicuous even in newly hatched chicks. The cuticular cone begins to form the 11th day. By the 10th day, sensory nerve endings synapse on the bases of the HCs, which by the 11th day develop synaptic bars. Although efferent neurites were in evidence as early as the 11th day, synaptic contacts and their cisterns were identified by the 19th day but may form earlier. Supporting cells transform from cylindrically to flask-shaped cells with constricted necks and may secrete at least a portion of the tectorial membrane.


Evoked potential correlates of genetic progressive hearing loss. Age-related changes from the ear to the inferior colliculus of C57BL/6 and CBA/J mice. Volume-conducted auditory evoked potentials were simultaneously measured from the level of the ear to the inferior colliculus of mice. The C57BL/6 mouse, which displays genetic sensorineural progressive hearing loss, was compared with the CBA/J mouse. At 50 days post partum, amplitudes of the summating potential (SP) and cochlear microphonic (CM) were lower in the C57BL/6 genotype, and they decreased progressively with age. Fifty days later, changes were seen in responses from the auditory nerve and cochlear nucleus of this mouse. By 200 days of age, the C57BL/6 had a "recruitment" pattern at CNS regions, but not at the auditory nerve.


Single-cell layer membrane covering the degenerated cochlear duct after perilymphatic perfusion of streptomycin. Ultrastructural changes of the extrasensory epithelium in the scala media of guinea pig cochleae were observed from 3 to 137 days after perilymphatic perfusion with 20% streptomycin. The degeneration started in the organ of Corti, progressed to the interdental cells and roots of the outer sulcus cells and finally involved other epithelial cells such as Claudius and the inner and outer sulcus cells. In the final stage, except for the stria vascularis and Reissner's membrane, all epithelial cells which lined the cochlear duct were replaced by a single-cell layer membrane which originated medianly from the epithelial cells of Reissner's membrane and laterally from the superficial outer sulcus cells.


A test battery approach to the investigation of susceptibility to temporary threshold shift. This study examined individual differences among various psychophysical measures that have been suggested previously as predictors of susceptibility to noise-induced temporary threshold shift (TTS). The test battery was administered to a group of five normal-hearing young adults and consisted of the following procedures: (1) critical intensity (CI) at 2 kHz; (2) loudness discomfort level (LDL) at 0.5, 1, 2 and 4 kHz; (3) aural overload thresholds at 0.5, 1 and 2 kHz. Three measures of TTS, one employing a broad-band noise as the exposure stimulus and two others using tonal fatiguers, were utilized to assess susceptibility to TTS. Results revealed that the test battery delineated tough from tender ears. Furthermore, the aural overload test was found to be a highly accurate predictor of TTS.


CSF total protein: normal values. A re-appraisal and discussion of its value in diagnosis of acoustic neuromas. A reference material of total cerebrospinal fluid protein (CSF protein) from 53 men and 45 women is presented. Lowry's Folin-phenol method for determining CSF protein has been used unchanged in this laboratory since 1964, with normal values ranging from 0.2 to 0.4 g/l. In this new reference material higher values were found with the 0.05--0.95 fractile interval for normal CSF protein determined to 0.29--0.88 g/l. This implies that the value of determining CSF protein in diagnosis of acoustic neuromas is most questionable. Among the medium sized tumours there were statistically significant increased values, but no clinical significance. The large tumours showed both statistically as well as clinically significant increased protein, but these tumours can be easily diagnosed by other means. A more detailed determination of CSF protein is discussed.


Transcutaneous Po2 monitoring in neonatal intensive care. The transcutaneous Po2 monitoring technique was applied in 20 newborns. The method proved reliable during hypoxemia, normoxemia and hyperoxemia, with a high correlation between Ptco2 and Pao2 in simultaneously obtained arterial samples. Although Ptco2 reliably reflects changes in Pao2, occasional arterial samples are still required for establishing the relationship between Ptco2 and Pao2, especially in patients with impaired circulation. When this relationship has been determined, the therapist may rely on the recorded Ptco2 level for hours, given that the energy supply required to maintain the electrode at a preset temperature level remains constant. A considerable difference between Ptco2 and Pao2 or a change in the energy supply level to the electrode may alert the therapist to check the patient's circulatory status. The Ptco2 technique is now fully developed and can be recommended for use in neonatal intensive care.


Possible effects of kanamycin and incubation in newborn children with low birth weight. In an acoustico-vestibular follow-up investigation of 91 four- to six-year-old children with birth weight below 2000 g, the same incidence of sensorineural hearing loss (19%) was found in 54 children treated with kanamycin in the neonatal period as in a group of 37 infants not treated with kanamycin. When comparing a group of children treated with both kanamycin and incubator (54 children) with a group treated with incubator only (16 children), no definite signs of synergism between incubator noise and kanamycin were found. However, the 5 cases of moderate or severe hearing loss all belonged to the group treated with both incubator and kanamycin. These 5 children had more severe neonatal complications, especially apnea, cyanotic spells and hyperbilirubinemia, which may increase the severity of the hearing loss. Among 56 incubator treated children with normal hearing (ISO standards) 52% had an audiogram pattern suggesting minor noise-provoked cochlear lesions. Among 18 non-incubator treated children with normal hearing only one child (6%) had a similar pattern. It should be stressed, however, that these children had no clinical symptoms of hearing loss.


The effects of experimentally-produced middle ear lesions on tympanometry in cats. Tympanometry was performed before and after producing specific lesions in the middle ears of cats. The lesions selected for study included stapes fixation, ossicular discontinuity, and scarred tympanic membranes. Stapes fixation resulted in marked increases in middle ear impedance, easily detected with tympanometry. Ossicular discontinuity resulted in complex tympanometric shapes which were easily accounted for by simple interactions between acoustic resistance and reactance. The complex shapes that occurred in normal and abnormal ears with pressure changing from negative to positive resulted from more complicated interactions. Large surgical incisions in the posterior-superior quadrant of the eardrum were quite visible at otoscopy but could not be detected tympanometrically one month after surgery.


Allergy, otitis media and serum immunoglobulins after adenoidectomy. The incidence of atopic disease and of episodes of otitis media, respiratory tract infections as well as levels of serum immunoglobulins were followed during 16 months after adenoidectomy in a consecutive group of 274 children. The total incidence of atopic disease was high (23.6%) at the start of the study and increased further to 39.0% during the study. Increased serum IgE levels, positive RAST tests and/or positive provocation tests were found before the onset of atopic symptoms in 13 out of the 19 children developing such symptoms during the observation period. Otitis media continued to occur in 42.9% of the children. The incidence of episodes of otitis media after the adenoidectomy was higher with lower age, a high number of episodes of otitis media before the operation and/or a history of atropic disease. None of the laboratory tests could predict subsequent episodes of otitis media. Protracted respiratory tract infections developed only in children with laboratory findings indicative of atopy. Serum IgE and IgM levels decreased significantly. No serious infections and no dysgammaglobulinaemias developed. Adenoidectomy seems to be a rather minor trauma from an immunological point of view, but further and controlled studies are needed concerning the possible clinical benefit of adenoidectomy in children with recurrent otitis media.


The central rhythm of the nasal cycle.

The central rhythm of the nasal cycle. The resistance to air flow of each nasal passage was recorded in 2 subjects over a period of 7 days. The cyclical changes in nasal resistance observed were very regular, with a consistent pattern apparent over the period of study. The regular changes in nasal resistance recorded under laboratory conditions may be directly related to changes in activity of an autonomic centre in the brain.


Bacterial meningitis in childhood in an African city. Factors influencing aetiology and outcome. In a retrospective study of 120 children aged 1 month and above with bacterial meningitis confirmed by positive CSF culture, 88.4% were found to be due to three common organisms: H. influenzae, Str. pneumoniae and N. meinigitidis. Gram-negative enteric organisms accounted for 10% of the infections. Despite intensive antibiotic and ancillary therapy, there has been no significant change in case fatality and sequelae over the past decade in this institution. The present study confirms that factors related to the organism and the host are important in determining the outcome of therapy. H. influenzae and Str. pneumoniae infections are associated with statistically significant rise in case fatality rate and neurologic sequelae at the end of therapy. The presence of neurological abnormality at the time of diagnosis significantly increases case fatality rate while delay in diagnosis appears to primarily influence the frequency of neurological sequelae. Protein-energy malnutrition increases the frequency of neurological sequelae and death from bacterial meningitis without significantly influencing the pattern of bacterial aetiology. The finding of enteric Gram-negative meningitis in association with diarrhoeal disease in the present study adds a new dimension to one of the most prevalent health problems in developing countries and needs to be confirmed.


Combined effects of noise and neomycin. Cochlear changes in the guinea pig. Cochlear damage resulting from the combination of neomycin with acoustic overstimulation was investigated in guinea pigs. Four groups of animals received subcutaneous injections and exposure to broad band noise daily for 7 days, as follows: I. Neomycin (200 mg/kg) followed by 10 hours of noise at 115 dB SPL; II. Saline followed by 115 dB noise: III. Neomycin followed by low intensity noise (45 dB as an acoustic control); or IV. Saline followed by 45 dB noise. After a 30 day stabilization period, each ear was examined electrophysiologically and histologically. Measures of cochlear integrity included AC cochlear potentials from 100 Hz through 20 kHz as well as outer hair cell (OHC) counts. A marked interaction leading to augmentation of damage was found when neomycin was combined with 115 dB noise (Group I). Losses in cochlear sensitivity, averaged across all frequencies, amounted to 62 dB in Group I, whereas the averaged losses for Groups II and III were only 16 dB and 17 dB respectively. Loss of OHC's was close to 100% in Group I, while OHC losses were only 17% in Group II and 26% in Group III.


Patulous Eustachian tube. Diagnostic evaluation by sonotubometry. Twenty-five patients (31 ears) with pathologically patent Eustachian tubes are presented and the symptoms are analysed. All the ears were examined by sonotubometry and two different opening patterns could be separated for the patulous tube. The variations in impedance of the ear during respiration were recorded from nearly all ears and three ears with eardrum perforation were also investigated by means of the airpressure equalization method. Only sonotubometry brought out clearly the patulous Eustachian tube in all the ears examined. It is thus a useful addition for diagnosing the abnormal patency of the Eustachian tube and for following up the results of its treatment, then the explanation of the cure does not remain open to conjecture.


Empyema in children in tropics.

Empyema in children in tropics. Thirty-six cases of empyema were diagnosed in children over a two year period, giving an overall incidence of 0.11% of the total hospital admissions. Many of them had measles bronchopneumonia and most were malnourished. 16 children had penicillin resistant staphylococcal infection. 29 of them were treated with closed tube drainage. Thirteen died during the course of treatment, the majority within three days of admission. The rest were followed up over a period of up to six months and showed good recovery. Six of these patients developed pneumothorax during the course of treatment. Various combinations of Ampicillin, Cloxacillin, Gentamycin and Cotrimoxazole parenterally were used. Supportive treatment with blood transfusion was found to be beneficial.


Evaluation of three spirometers on healthy children. Two electronic spirometers (Dräger Spirotron and Monaghan M403) and one wedge bellows spirometer (Vitalograph) were compared with a Bernstein spirometer. Healthy children, 30 girls and 31 boys, were investigated. The regression lines of VC and FEV1.0 in relation to the body height to the third power are very close and the S.D. values around the lines are very similar. The correlation coefficients of the regression lines are high for all the spirometers. An analysis of the paired differences showed slight differences of the mean values. The S.D. of paired differences was for VC 4.6--6.6% and for FEV1.0 4.8--6.2%. The PEFR values obtained by the two electronic spirometers deviated substantially and highly significantly from the values obtained by the Wright peak flow meter.