[Erythropoietin in serum and urine in healthy persons and patients with chronic renal disease upon hypoxic stimulation and hypoxic stimulation after pretreatment with fluoxymesterone (author's transl)]. The question of a latent erythropoietin (ESF)-deficiency was studied in incipient renal anemia using a double stimulation technique for ESF. After a 4-week stimulation of ESF production with oral administration of fluoxymesterone (flu) intermittent hypoxic ESF stimulation was performed corresponding to a maximum altitude of 4000 m in 7 patients with chronic renal disease without or with incipient renal anemia (mean hematocrit 40%) and in 11 normal subjects (mean hematocrit 46%). Double stimulation in patients was compared with hypoxic stimulation alone and both were compared with controls. After flu alone only ESF excretion was increased in patients and in normal subjects. After flu plus 10 h of hypoxia serum ESF--titers were higher in healthy subjects than in the patients. The mean ESF titer after double stimulation was 81 mU/ml in patients and 115 mU/ml in normal persons. Forty-eight hour ESF excretion was 11 U and 43 U respectively. Compared to hypoxic stimulation alone double stimulation increased serum ESF titers in patients by 5% versus 80% in controls. Correspondingly, ESF excretion was enhanced by 19% and 49%, respectively. Finally, renal ESF clearance was increased by 42% versus 200%. After hypoxia alone non-anemic patients had higher serum ESF titers than healthy controls excluding a latent ESF deficiency in incipient renal anemia. It is concluded that decreased ESF production after double stimulation in patients was due to a nephrotoxic effect of flu followed by a decreased excretory and ESF-producing function of the damaged kidneys.


Circulating endothelial cells in acute myocardial infarction and angina pectoris. The authors have counted circulating anuclear carcasses of endothelial cells by a new method in 105 patients with acute myocardial infarction and angina pectoris. In infarction cases as well as in severe angina a significant increase of endothelaemia was observed in duration of several days. No increase was observed in milder angina cases (type I--II).


A new form of automatic watering system for laboratory animals. During a 2 1/2 year trial of this new system no algal or bacterial build-up occurred, and filters were changed only at infrequent intervals. Among the labour-saving advantages of it is that cleaning of the system can be done when cage racks are changed, normally monthly.


The microbiology of a new recirculatory automatic watering system compared with a conventional automatic system. Continual recirculation and filtration of drinking water prevents the contamination that often mars automatic watering systems by removing algae and fluorescent pseudomonads. Without filtration and recirculation, the algae were clearly visible after 40 days use, and the fluorescent pseudomonad count rose from 10(1) to 10(5) per ml after 72 h use.


Tubular device for intraoral examination of rodents. The device consists of a tube with a conical end, a base, and a movable stem. The rodent is anaesthetized lightly with ether and inserted quickly into the tube so that the head extends beyond the opening at the conical end, where cheeks, upper and lower incisors are secured to permit illumination and direct visual or microscopic examination of the palate, molars or gingiva.


Water-borne Bacillus licheniformis infection in mice. A  water-borne Bacillus licheniformis infection was associated with depressed haemoglobin content, white cell and platelet count. The epidemic was resolved by changing from tanked to mains water supply.


A new guinea-pig watering system.

A new guinea-pig watering system. Automatic drinking valves were mounted outside solid-flour cages, the guinea-pigs gaining access to them through holes in the cage walls. The animals were thus provided with a constant supply of clean water without the danger of their cages being flooded.


Segmental aplasia of the vagina in the beagle bitch. Segmental aplasia of the vaginal mucosa was discovered in 3 beagle bitches at the end of a routine toxicological experiment. Anomalies of Müllerian duct development in the bitch are discussed.


Automation in the animal house.

Automation in the animal house. Whilst appearing attractive, automation must be appraoched with caution. Much time, effort and money is put into curing 'symptoms' without really defining the problem. Too often organizations launch a programme of automation when what they really need is rationalization. Unless you know precisely how much time and effort is currently involved in an operation, you are in grave danger of making costly mistakes in considering automation. A prerequisite is to make sure that your present operation is as productive as it is capable of being.


Postnatal changes in body composition of laboratory maintained brown lemmings, Lemmus sibiricus. Postnatal changes in the body composition components, namely, body water, fat-free dry solids, and fat, were determined for laboratory-maintained brown lemmings, Lemmus sibiricus. The proportion of body water decreased while the proportion of fat-free dry solids and fat increased from birth to approximately 15 weeks of age. From 20 through 80 weeks of age, the proportions of all body composition components as well as total body weight remained relatively constant. Body composition components were more closely correlated with body weight than with chronologic age. As a function of body weight, body water decreased while fat-free dry solids and fat increased. Body fat was the most variable body composition component as related both to body weight and chronologic age. The von Bertalanffy growth equation and the differential growth equation were used to describe the body composition component data as related to chronologic age and body weight, respectively.


Incidence of struvite urinary calculi in two ancestral lines of beagles. In the last 17 years, 55 of 2,125 (2.6%) purebred beagles maintained in a closed colony had urolithiasis. Males comprised 72.7% of the affected animals. All the uroliths except one set in the kidneys were in the urinary bladder, the urethra, or both. All uroliths were nearly pure magnesium ammonium phosphate hexahydrate. Partially inbred beagles had a 10.7% incidence of urolithiasis, compared to a 2.0% incidence in an outbred line.


Effects of diet on feline urine.

Effects of diet on feline urine. Urine specific gravity, osmolality, and the incidence of proteinuria were assessed in 18 caged cats. The values for these parameters were increased when dry, as compared to moist, cat food was fed. Failure to recognize these characteristics of feline urine could lead to erroneous interpretations of laboratory data since elevation of these values, particularly protein, has been associated with renal disease.


Spontaneous extragonadal teratocarcinoma in a mouse. A spontaneous extragonadal teratocarcinoma was detected in a 7.5-month-old multiparous mouse. The tumor was composed of a disorganized mixture of tissues in various stages of maturation. Neural tissue and cartilage were abundant. The tumor also contained embryoid bodies and numerous foci of embryonal carcinoma cells.


Effect of a conditioning method on general safety test in guinea pigs. Prior to utilization for safety tests, one group of guinea pigs was selected after a 1-week conditioning period, on the basis of physical appearance and a 5% body weight gain. Those in a second group were selected shortly after being received, on the basis of their physical appearance. All guinea pigs were maintained under identical management conditions during the safety tests. The number of guinea pigs that gained weight from both groups were compared. The conditioning method used resulted in significant (p less than 0.001) increase in the number of guinea pigs that maintained or increased body weight during general safety tests.


Low-temperature urine collection apparatus for laboratory rodents. An apparatus for the collection of urine at -19 degrees C from unrestrained small laboratory animals was developed. The cooling unit accommodated five rodent metabolism cages for the collection of urine volumes up to 50 ml per collection period. The unit operated continuously for 5--6 weeks with no maintenance other than removal of the urine specimens, cleaning of the cages and collection dishes, and provision of feed and water.


Continuous long-term intra-arterial infusion in the unrestrained rabbit. A technique for the catheterization and intra-arterial infusion of the common carotid artery of the rabbit utilized a simple swivel apparatus, an acrylic head mount, and a silicone rubber sleeve. This method was used for continuous intra-arterial infusion in 29 unrestrained rabbits for periods up to 61 days.


Pulmonary cryptococcosis in an Atlantic bottlenosed dolphin (Tursiops truncatus). Pulmonary cryptococcosis was diagnosed in a 7-year-old dolphin which had been in captivity for about 4 years. Cryptococcosis has been reported in a variety of animals, but this is the first report in a cetacean.


Hematologic parameters for wild and captive nine-banded armadillos (Dasypus novemcinctus). Hematologic parameters were determined at capture and during captivity for nine-banded armadillos. Compared to the time of capture, the mean erythrocyte counts were significantly lower after 6 months in captivity. After 1 year in captivity, the mean hematocrit was significantly higher and the mean neutrophil count in males was significantly lower. Although the number of armadillos sampled was greater than in previous research, the variation within groups was large.


Controlled breeding of sheep for studies in fetal physiology. A supply of fetal sheep of known gestational age was ensured after synchronizing estrus in the ewes, by means of an intravaginal pessary impregnated with a progestagen. Estrus occurred approximately 2 days after the pessary was removed. Conception rates at different times of the year and for a period of 4 years were described.


Simple technique for chronic venous catheterization of swine. Catheters were placed into the vena cava of swine via the external jugular vein. The catheters were then passed subcutaneously through a cannula to the back and exteriorized. These catheters were impregnated with heparin and were functional for more than 46 days. Length of estrous cycle and hematology traits were not affected adversely by this technique.


Retention of insulin-stimulated D-glucose transport activity by adipocyte plasma membranes following extraction of extrinsic proteins. Plasma membrane vesicles prepared from adipocytes incubated with insulin exhibited accelerated D-glucose transport activity characteristic to insulin action on intact fat cells. Both control and insulin-stimulated D-glucose transport activities were inhibited by cytochalasin B and thiol reagents. Extraction of plasma membranes with dimethylmaleic anhydride eluted 80% of the protein from plasma membrane vesicles. The two major glycoprotein bands (94,000 and 78,000 daltons) and small amounts of a 56,000-dalton band were retained in dodecyl sulfate gels of the extracted membranes. Both control and insulin-activated D-glucose transport activities were retained by plasma membrane vesicles extracted with dimethylmaleic anhydride. Cytochalasin B binding activity was also retained by extracted membrane vesicles and D-glucose uptake into extracted vesicles derived from untreated or insulin-treated fat cells was inhibited by cytochalasin B. These results suggest that the modification of the adipocyte hexose transport system elicited by insulin action is not altered by a major purification step which involves quantitative extraction of extrinsic membrane proteins.


Characterization of the ribosomal binding site in rat liver rough microsomes: ribophorins I and II, two integral membrane proteins related to ribosome binding. Rat liver rough endoplasmic reticulum membranes (ER) contain two characteristic transmembrane glycoproteins which have been designated ribophorins I and II and are absent from smooth ER membranes. These proteins (MW 65,000 and 63,000 respectively) are related to the binding sites for ribosomes, as suggested by the following findings: i) The ribophorin content of the rough ER membranes corresponds stoichiometrically to the number of bound ribosomes; ii) ribophorins are quantitatively recovered with the bound polysomes after most other ER membrane proteins are dissolved with the nonionic detergent Kyro EOB; iii) in intact rough microsomes ribophorins can be cross-linked chemically to the ribosomes and therefore are in close proximity to them. Treatment of rough microsomes with a low Triton-X-100 concentration leads to the lateral displacement of ribosomes on the microsomal surface and to the formation of aggregates of bound ribosomes in areas of membranes which frequently invaginate into the microsomal lumen. Subfractionation of Triton-treated microsomes containing invaginations led to the recovery of smooth and "rough-inverted" vesicles. Ribophorins were present only in the latter fraction, indicating that both proteins are displaced together with the ribosomes when these aggregate without detaching. Measurements of the ribosome-binding capacity of rough and smooth microsomal membranes reconstituted after solubilization with detergents suggest that ribophorins are necessary for in vitro ribosome binding. Ribophorin-like proteins were found in rough microsomes obtained from secretory tissues of several animal species. The two proteins present in rat lacrimal gland microsomes have the same mobility as hepatocyte ribophorins and cross-react with antisera against them.


Membrane permeability of bifunctional, amino site-specific, cross-linking reagents. The membrane permeability of a series of reversible cross-linking reagents which are diazide tartarate derivatives has been compared with that of dimethyl-3,3'-dithiobispropionimidate (DTBP). The diazide tartarate derivatives tested include tartryl-diazide (TDA), tartryl-di(glycylazide) (TDGA), tartryl-di(beta-alanylazide) (TDAA), tartryl-di-(gamma-aminobutyrylazide) (TDBA), tartryl-di(epsilon-aminocaproylazide) (TDCA). TDA, which has the shortest chain length of the diazide tartarate derivatives tested, proved to be readily permeable through the erythrocyte membrane. When added at equal concentration to unsealed ghosts, TDGA was at least as reactive as DTBP in its ability to cross link the internally displayed proteins 1, 2, 4.1, 4.2, and 6. Treatment of resealed ghosts by DTBP produced oligomeric complexes of these proteins plus apparent homooligomeric complexes of hemoglobin. TDGA at the same concentrations did not cross-link any of these components, indicating its membrane-impermeable nature. As the chain length of the homologous series increased from TDGA to TDCA, the cross-linkers became increasingly permeable through the erythrocyte membrane.


Fine structure of the band 3 protein in human red cell membranes: freeze-fracture studies. The major red cell membrane protein, band 3, is a glycoprotein which extends across the membrane from the extracellular space into the cytoplasmic compartment. It is widely held that band 3 is a component of the intramembrane particles (IMP) which can be demonstrated by freeze-fracture electron microscopy. In this study, we find that the outer surface poles of the IMP can be seen by freeze-etching after they are unmasked by proteolysis under conditions which excise the surrounding sialopeptides from the membrane. The poles appear as distinctive projections, 30--50 A in diameter, the "ES particles." The ES particles remain associated with the outer surface of the membrane following cleavage of the band 3 polypeptide by chymotrypsin or pronase. This is consistent with previous biochemical studies which have shown that the 38,000-dalton outer surface segment of band 3 is intercalated in the lipid bilayer. A granulofibrillar component at the inner surface of the membrane is provisionally identified as the 40,000-dalton inner-surface domain of band 3.


Distribution of glycophorin on the surface of human erythrocyte membranes and its association with intramembrane particles: an immunochemical and freeze-fracture study of normal and En(a-) erythrocytes. Human erythrocyte membranes of the En(a-) blood group lack the major sialoglycoprotein (glycophorin). By absorption of a crude antiglycophorin antiserum with En(a-) membranes a specific antiglycophorin antiserum was obtained. By immune electron microscopy we showed that glycophorin is randomly distributed on the surface of normal erythrocytes. When polycationized ferritin, which mainly binds to glycophorin, was used as a marker a similar even labeling of normal erythrocyte membranes was seen. En(a-) membranes bound much less of this marker. In freeze-fracturing the intramembrane particles of both membrane types had a similar distribution and appeared in equal amounts. However, partial removal of spectrin from these membranes, followed by incubation at pH 6 resulted in more extensive aggregation of the particles in En(a-) membranes than in normal membranes. The results may be interpreted as glycophorin contributing by electrostatic repulsion to the random distribution of the intramembrane particles in normal cells. This repulsion is weakened in in En(a-) cells by the lack of glycophorin.


Molecular characteristics of the transferrin-receptor complex of the rabbit reticulocyte. A macromolecular complex of transferrin and a membrane component was isolated by gel filtration chromatography from Triton X-100-solubilized ghosts of reticulocytes previously incubated with 125I-labeled transferrin. This complex is believed to be transferrin specifically associated with its primary receptors. Following the procedures of Clark [14], the complex in Triton X-100 was found to behave as an asymmetric molecule with a molecular weight of approximately 250,000 and an axial ratio of 9:1. On SDS-poly-acrylamide gel electrophoresis the complex displays, in addition to transferrin, components of molecular weights 176,000 and 95,000, respectively. The larger component may be a dimer of the smaller. Each appears to crosslink, with dimethyl suberimidate, to transferrin. These results are compatible with the hypothesis that the transferrin receptor itself has a molecular weight near 175,000 and may be a dimer of two smaller components each of molecular weight near 95,000.


Physical-chemical studies of spectrin.

Physical-chemical studies of spectrin. In recent years considerable progress has been made in the understanding of the structure and function of the red blood cell membrane. The protein spectrin, of high molecular weight and propensity for self-association, appears to play a major role, in concert with actin, in maintaining the shape and integrity of the membrane. A study of the physical-chemical properties of spectrin, and its size, shape, self-association pattern, and its interaction with other components, leads to a plausible model for the way this protein performs its biological role. The evidence from the structure and interactions of spectrin suggests a structure which is relatively symmetrical yet highly expanded, and which allows extensive, two-dimensional network formation with actin. In these respects,  the structure of spectrin is quite different from that of myosin, to which it has often been likened.


Vesicles isolated from ATP-depleted erythrocytes and out of thrombocyte-rich plasma. When human erythrocytes are depleted of endogenous ATP they release spectrin-free vesicles as a light vesicle fraction [Lutz et al: J Cell Biol 73: 548, 1977] and chains of rounded vesicles as well as flattened myelin forms in a heavy vesicle fraction. The heavy fraction retains some spectrin, and glycophorin is partially degraded. The release of both types of fragments is not dependent upon added Ca+2, and 50 micrometer EGTA does not prevent the vesicle release. Concomitant with vesicle release, a large fraction of the major protein components of the cell is found in disulfide-bonded aggregates. A protocol is outlined to recover erythrocyte-specific fragments from thrombocyte-rich plasma. It allows detection of spectrin-free vesicles in whole blood stored under blood bank conditions for 12 days. In freshly drawn blood no such vesicles are observed, but particles are obtained that are different from thrombocyte fragments and that show a prominent glycoprotein running slightly faster than glycophorin.


The exchangeability of human erythrocyte membrane cholesterol. A new method has been used to determine what fraction of human erythrocyte cholesterol is available for exchange with plasma unesterified cholesterol. Erythrocytes labeled with 3H-cholesterol by this exchange process were incubated with sonicated phosphatidylcholine vesicles, giving rise to a net movement of cholesterol out of the cells. The specific activity of cholesterol taken up by the vesicles depended on the length of time of incubation. Initially the specific activity in the vesicles was greater than that in the cells, but after approximately 10% of cell cholesterol had been removed, the specific activity of subsequently removed cholesterol was equal to that of the remaining erythrocyte cholesterol. We conclude from these data that a) all of the cholesterol in the erythrocyte is exchangeable with plasma, and b) approximately 10% of erythrocyte cholesterol is in a more rapidly exchangeable pool than the remainder.


Triton shells of intact erythrocytes.

Triton shells of intact erythrocytes. About 40% of human erythrocyte membrane protein is resistant to solubilization in 0.5% Triton X-114. These components comprise a structure called a Triton shell roughly similar in size and shape to the original erythrocyte and thus constitute a cytoskeleton. With increasing concentrations of Triton the lipid content of the Triton shell decreases dramatically, whereas the majority of the protein components remain constant. Exceptions to this rule include proteins contained in band 3, the presumed anion channel, and in band 4 which decrease with increasing Triton concentration. The Triton-insoluble complex includes spectrin (bands 1 and 2), actin (band 5), and bands 3' and 7. Component 3' has an apparent molecular weight of 88,000 daltons as does 3; but unlike 3, it is insensitive to protease treatment of the intact cell, has a low extinction coefficient at 280 nm, and is solubilized from the shells in alkaline water solutions. Component 7 also has a low extinction coefficient at 280 nm. Spectrin alone is solubilized from the Triton shells in isotonic media. The solubilized spectrin contains no bound Triton and coelectrophoreses with spectrin eluted in hypotonic solutions from ghosts. Electron micrographs of fixed Triton shells stained with uranyl acetate show the presence of numerous filaments which appear beaded and are 80--120 A in diameter. The filaments cannot be composed mainly af actin, but enough spectrin is present to form the filaments. Triton shells may provide an excellent source of material useful in the investigation of the erythrocyte cytoskeleton.


Influence of increased membrane cholesterol on membrane fluidity and cell function in human red blood cells. Cholesterol and phospholipid are the two major lipids of the red cell membrane. Cholesterol is insoluble in water but is solubilized by phospholipids both in membranes and in plasma lipoproteins. Morever, cholesterol exchanges between membranes and lipoproteins. An equilibrium partition is established based on the amount of cholesterol relative to phospholipid (C/PL) in these two compartments. Increases in the C/PL of red cell membranes have been studied under three conditions: First, spontaneous increases in vivo have been observed in the spur red cells of patients with severe liver disease; second, similar red cell changes in vivo have been induced by the administration of cholesterol-enriched diets to rodents and dogs; third, increases in membrane cholesterol have been induced in vitro by enriching the C/PL of the lipoprotein environment with cholesterol-phospholipid dispersions (liposomes) having a C/PL of greater than 1.0. In each case, there is a close relationship between the C/PL of the plasma environment and the C/PL of the red cell membrane. In vivo, the C/PL mole ratio of red cell membranes ranges from a normal value of 0.09--1.0 to values which approach but do not reach 2.0. In vitro, this ratio approaches 3.0. Cholesterol enrichment of red cell membranes directly influences membrane lipid fluidity, as assessed by the rotational diffusion of hydrophobic fluorescent probes such as diphenyl hexatriene (DPH). A close correlation exists between increases in red cell membrane C/PL and decreases in membrane fluidity over the range of membrane C/PL from 1.0 to 2.0; however, little further change in fluidity occurs when membrane C/PL is increased to 2.0--3.0. Cholesterol enrichment of red cell membranes is associated with the transformation of cell contour to one which is redundant and folded, and this is associated with a decrease in red cell filterability in vitro. Circulation in vivo in the presence of the spleen further modifies cell shape to a spiny, irregular (spur) form, and the survival of cholesterol-rich red cells is decreased in the presence of the spleen. Although active Na-K transport is not influenced by cholesterol enrichment of human red cells, several carrier-mediated transport pathways are inhibited. We have demonstrated this effect for the cotransport of Na + K and similar results have been obtained by others in studies of organic acid transport and the transport of small neutral molecules such as erythritol and glycerol. Thus, red cell membrane C/PL is sensitive to the C/PL of the plasma environment. Increasing membrane C/PL causes a decrease in membrane fluidity, and these changes are associated with a reduction in membrane permeability, a distortion of cell contour and filterability and a shortening of the survival of red cells in vivo.


Characterization of the glucose transporter from human erythrocytes. The D-glucose transporter from human erythrocytes has been purified and reconstituted by Kasahara and Hinkle (J Biol Chem 252:7394--7390). Using a similar purification scheme, we have isolated the protein with 65% of the extracted phospholipid at a lipid-protein ratio of 14:1 by weight. The KD (0.14 micrometer) and extent (11 nmoles/mg protein) for binding of 3H-cytochalasin B was determined by equilibrium dialysis. Glucose was a linear competitive inhibitor of binding of cytochalasin B, with an inhibition constant of 30 mM. To further characterize the protein, samples were filtered in the presence of sodium dodecyl sulfate (SDS) through Sepharose 6B to remove 95% of the lipid followed by filtration of Sephadex G150 to remove the remaining lipid and a contaminating amount of a minor, lower-molecular-weight protein. This preparation contains only 24% acidic and basic amino acids. The protein also contains 5% neutral sugars (of which 3% is galactose), 7% glucosamine, and 5% sialic acid.


Spectrin binding and the control of membrane protein mobility. Transmembrane proteins of the human erythrocyte show restricted in-plane mobility. Many of the restrictions on mobility are attributable to the molecules of spectrin which are located on the protoplasmic surface of the erythrocyte membrane. These molecules are elongate, form end-to-end heterodimer associations, and bind selectively to protein (or proteins) accessible on inside-out, but not right-side out, membrane vesicles.


Analysis of the major polypeptides of spectrin by tryptic digestion. The two major polypeptides of erythrocyte membrane spectrin have been isolated by preparative polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate. The tryptic peptide maps of the two polypeptides have been prepared by thin-layer chromatography and electrophoresis. Radioactive peptides have been prepared by 14C-carboxymethylation and chloramine T-catalysed 125I iodination. Maps of both sets of peptides demonstrate a marked similarity between the two parent polypeptides.


Effects of abnormal cation transport on deformability of desiccytes. We have studied the deformability of subpopulations of red cells from a patient with "desiccytosis," a disorder characterized by increased membrane permeability to potassium and associated with a probable increase in sodium-sodium exchange. Cells become increasingly dehydrated after maturation because of continued potassium loss without compensatory sodium gain, and they exhibit a progressive increase in mean cell hemoglobin concentration (MCHC). This increase in MCHC causes the cells to become underformable at shear stress values which result in extensive deformation of normal cells. Reduction of MCHC to approximately normal levels by suspending the cells in hypotonic medium restores normal deformability to all but 0.1--0.2% of the cells. These results suggest that the major factor leading to premature destruction in this disorder is whole cell rigidity conferred by increased intracellular hemoglobin concentrations, rather than any associated membrane rigidity.


[The candida-endocrinopathy syndrome].

[The candida-endocrinopathy syndrome]. The boy who was eleven and half years old with candida-endocrinopathia syndrome has been presented. He had infection with candida, hypoparathyreoidism and hypoadrenocorticism. By immunologic tests it has been proven also the damage of cellular immunity. The patient's sister suffers from chronic mucocutaneous candidiaza. After the therapy the complete clinic remission has taken place. For this disease is characteristic that the disease course is gradual but progressive, and this remission does not mean that the destruction of endocrine glands is stopped.


[Diagnosis and therapy of primary hyperparathyroidism (author's transl)]. Of 51 patients with primary hyperparathyroidism (2 patients with MEN, Type 1 clinical symptomatology, diagnostic procedures, differential diagnosis, operative strategy and long-term results are being reported. Aside from clinical findings and radiologic signs in our hands determination of the ionized serum calcium fraction, results of chrest bone biopsies and parathormone determinations are best parameters to substantiate the diagnosis of PHPT. Parathormone radioimmunassay determination is very helpful in localizing the adenoma, especially in cases of reoperations. Five patients were seen in acute hypercalcemic crises, in which emergency operations are absolutely indicated. Postoperative hypercalcemia and recurrencies were observed in 3.9%. Successful extirpation of parathyroid adenomas (15% multiple adenomas were found) is the therapy of choice in PHPT, only in cases with hyperplasia subtotal parathyroidectomy is indicated.


[Conservative treatment of intestinal obstruction: prospects and limits. Experiences with 27 cases treated by Miller-Abbott-tubes inserted endoscopically (author's transl)]. 27 cases of intestinal obstruction primarily treated conservatively by means of Miller-Abbott-tubes are presented, technical details, clinical results, indications and risks of the procedure discussed. The controlled placement of the tube using a gastroscope rules out technical failures. Fifteen patients were cured, 2 patients removed the tube; in 8 cases the procedure turned out to be ineffective; they were cured by laparotomy. The separate monitoring of gastric and intestinal secretion permits early prognosis in respect to efficacy. Two patients died. Strict limitation of indication is of decisive importance. The method is highly effective in early postoperative intestinal obstruction--apparently of mechanical as well as of paralytic origin. In our experience, the possible mistaking of anastomotic leakage for postoperative ileus is practically negligible. For acute admissions with intestinal obstruction of unclear origin, however, the procedure should only be aimed at the resotration of general condition before surgery. In spite of the fact, that some cases of late postoperative intestinal obstruction could be cured conservatively, the risk of delaying operations of utmost necessity in cases of strangulation, incarceration and perforation is too high.


[Transvenous perfusion, a new simple and effective technique of regional renal hypothermia. An experimental study (author's transl)]. In an experimental study, involving ten dogs, the feasibility of transvenous perfusion cooling of the kidney is proven. The theoretical basis of this new method of regional renal hypothermia is presented. The technique is easy to perform and requires cannulation of the renal vein. The perfusate leaves the kidney either via the capsular veins which were divided during renal exposure or through the proposed nephrotomy. Renal vein thrombosis or venous disruption have not been observed. The only complication encountered in one instance was hemorrhage from the puncture site of the renal vein.


[Myositis ossificans following head injury (author's transl)]. This is a report on 14 patients with myositis ossificans with simultaneous head injury. Predilected sites are the hip and elbow joints as well as thigh musculature, where particularly in the youthful and younger adults ossifications occur 5--8 weeks after the accident. Premature operative treatment is useless because of the danger of recurrence. The process of ossification usually comes to a standstill 8--12 weeks following the trauma. The diagnosis is made on the basis of clinical examination (hardening of muscles, immobility of joints) and X-ray pictures. The pathogenesis and modes of therapy are discussed in detail. Furthermore, the incidence of this complication of head injury in various age groups is evaluated statistically.


[Sciatic nerve: special topography and possibility of injuries in surgery of the hip joint (author's transl)]. The minimal distance between the dorsal acetabulum and the sciatic nerve can be 1.5 cm. This topographic situation is extremely important for surgery of the hip and dorsal pelvis (for e.g.: total hip prothesis, osteosynthesis of dorsal acetabulum-fractures). Various operative approaches to the hip joint lead to different intraoperative aspects including the danger of iatrogen sciatic nerve-lesions. In most cases the nerve cannot be seen but only be palpated during operation. If the stem of the sciatic nerve is injured intraoperatively, lesions can be found in the whole field of its innervation. For this reason specimen operations were performed in human cadavers using various approaches to the hip joint. We systematically investigated the topography of this region--layer by layer--cutting sections in horizontal and sagittal plains. Based on our findings the course of the sciatic nerve is described with special emphasis on the danger of lesions during surgery of the hip joint and dorsal pelvis.


[Residual-and recurrent cholesteatoma at preservation of the external auditory bony canal (author's transl)]. During the last four years we controlled 351 operations in order to check the indication of preservation of the posterior canal wall on patients with cholesteatoma. The aim of this study was to make a comparison between operative technique and the frequency of residual and recurrent diseases. It has shown that the consistent reconstruction of the lateral attic wall by endogenous conchal cartilage reduces the number of recurrence on a level of 3%. Since we haven't got yet a follow-up period of five years for all patients, the percentage of recurrent cholesteatomas was forecasted with 16% from the sample of patients with a follow-up period of two years, mixed with and without reconstruction of the lateral attic wall. The percentage of residual cholesteatoma was calculated with 25% from 104 revision operations. In future, a planned revision operation seems to be necessary for each patient with a posterior canal wall being preserved in cholesteatoma surgery. Osteoplastic management of the bony canal wall should lower the rate of residual cholesteatoma.


[A pilot study of sulfur hexa fluoride (sf6) injection into middle ears. An alternative to prevent atelectatic ears (author's transl)]. A new method to prevent middle ear atelectasis is presented. Sulfur Hexa Fluoride (SF6), a synthetic inert gas with a very low water solubility, has been injected into the middle ears of two patients with a long-standing conductive hearing loss due to nasopharyngeal carcinoma. The hearing gain expressed as lowered air-bone gaps lasted 6--10 weeks. No side effects were noted. In a later serie children with serous otitis media will be treated in the same way and followed with tympanograms and gas analyses of the gas mixture within their middle ears.


[A "mother-and baby scope-optic" for middle ear endoscopy (author's transl)]. A new optic system for middle ear endoscopy is presented. It was developed in collaboration with Ltd. Wolf during the past 2 years. Via a bigger optic a smaller optic can be introduced under control. Through the new optic system it is possible to get a good survey about all "hidden places" in the middle ear. The optic can be used for pre- and intraoperative diagnostic.


[Reaction pattern of the cochlea in cases of experimentally induced sudden hearing loss (author's transl)]. Acute auditory damage is produced in 127 guinea pigs. In one group (n = 68), sound damage is effected (140 dB SPL white noise for 5 min.). In a second group (n = 59), the cochlea is damaged with a cryoprobe (-196 degrees C, 1 min.). Both methods produce a middle-grade hearing impairment. With the aid of indwelling cathodes, the input-output curves are determined before and after the damage as well as up to the 16th postoperative day. Statistical comparison of the results shows that the reaction of the cochlea to the same irritation can be very different. This must be taken into consideration especially in evaluating the effect of pharmaca.


[The acoustic trauma in animal experiment. II. Morphological reaction in the guinea pig cochlea after traumatisation by pure tones and octave band noise (a SEM- and TEM-study) (author's transl)]. Guinea pigs were exposed in groups to pure tones of varying frequences (1000, 3000, 5000 cps) and intensities in the range of 85--130 dB SPL. Other guinea pigs were exposed to octave band noise (180--5600 cps). By means of morphology we examined the immediate and late degenerative changes of the cochleae. The changes in sensory and supporting cells were simular after a short time overstimulation (130 db SPL--15 min) compared to a 5-days-stimulation at the 85 dB SPL level. After an OBN-Stimulation with 105 dB SPL--61 hours, lesions of sensory cells were found spread over several coils of the cochleae, with a predominance of the basal and 2nd coil. After pure tone stimulation the destruction of the organ of Corti was not tonotopically related according to the frequencies which were used in the experiments. The circumscribed destroyed areas in the organ of Corti were found mainly in the tonotopical range of the receptors of 2000--5000 cps--this means the end of the basal coil and the 2nd coil. The probable mere influence of direct mechanical stress is discussed.


[Cogan's syndrome--report of a case (author's transl)]. A case of Cogan's syndrom--the combination of nonsyphilitic interstitial keratitis and vestibuloauditory symptoms--is presented. The differential diagnosis of the disease that corresponds little to any treatment, is discussed.


[Tonsillar cavernosusthrombosis and sepsis after brain-commotion. A question of consequence (author's transl)]. A 12-year-old boy acquired two days after an accident with a light brain-commotion an acute tonsillitis, followed by a leftside peritonsillitis, infection of the spatium parapharyngeum, ascending to the endocranium with a thrombosis of the sinus cavernosus and septicopyaemia. Complete healing by Antibiotics, Heparin and blood-transfusions. In an judgment for an insurrance company the author states that the accident and commotion partly (30%) was the cause for the tonsillar complications.


[How great is the risk of injury to vessels during mediastinoscopy? (author's transl)]. In performing mediastinoscopy the scope will pass the innominate artery, the innominate vein, the aortic arch, and the right pulmonary artery. The pretracheal fascia will protect these vessels if the tube is inserted exactly between the trachea and the fascia. However, bleeding could be caused by injuring a lymph node vessel or a bronchial artery. If this happens the bleeding can be stopped by packing the wound canal with a gauze wick soaked in adrenaline, by electrocoagulation, or by using an Ethislipknot. When mediastinoscopy is performed as micromediastinoscopy by means of using the Zeiss operation microscope and special instruments in most cases bleeding will be avoided.


[Experiences in the treatment of children with pseudocroup (author's transl)]. In most of the own 93 cases the paediatrician could manage the syndrome conservatively. In 14 children of them the question of an active procedure was discussed in cooperation of paediatricians, laryngologists and anaesthesiologists. In most of the cases this was necessary in the first 2 to 3 hours after admission. Recommendations for the active procedure are given in detail, generally spoken a balanced manner with confined prolonged orotracheal intubation.


[Long-term results of submucous septal resection (author's transl)]. 250 adults were checked-up 1 to 19 years following submucous septal resection, most of them after 4 to 6 years. In two thirds of these cases the nasal obstruction was abolished, and in 60 to 80 per cent sequelae of nasal blockage (otitis, non-specific rhinitis, sinusitis, pharyngitis, tonsillitis) were reduced or healed. The positive influence of the resection on allergic rhinitis and headache was less (20 to 40%). 33 per cent of the patients complained of permanent nasal obstruction instead of surgery. In 45 per cent of these cases the obstruction appeared with a postoperative delay of 6 months and more! Deviation of the anterior septal remnant is the most frequent reason for obstruction. Other negative sequelae following submucous resection are atrophy of the mucosa (45%), hyperplasia of the inferior tubinates (38%), excessive mobility of the septum (13%), perforations (9%), and saddling of the cartilaginous nasal roof (7%). A comparison of the long-term results following submucous resection and following septoplasty show the better results by septoplasty.


[On secondary operations following submucous septum resection (author's transl)]. The submucous resection of septum by Killian is not appropriate as a primary correcting treatment, especially in case of traumatical septum deformities. Due do the loss of cartilage often form and function of the nose deteriorates in a typical way. These complaints demand an operative correction under complicated circumstances. Based on the patient clietele of the Univ.-HNO-Klinik Erlangen it is demonstrated how secondary operations with the special technique of displacement of the remaining cartilage a satisfying result finally can be achieved.


[Diagnostic possibilities in salivary gland diseases (author's transl)]. A survey about different diagnostic parameters in salivary gland diseases is given. History, inspection, palpation, radiologic examinations by sialography and szintigraphy as well as sialometric and sialochemic findings are compared for their diagnostic value. Thereby by sialochemie and sialometrie a differentiation between sialadenitis and sialadenoses is possible in nearly all cases. Also in the differential diagnosis between benign and malignant tumors sialochemic findings are helpful.


[The role of the glycerol test for diagnosis and treatment of Menière disease (author's transl)]. 60 patients--25 with different hearing losses and 35 with Menière disease--underwent the glycerol test. It was demonstrated that only the group with endolymphatic hydrops showed in about 60% a positive test result. The meaning of the glycerol test for differential diagnosis of Menière disease from other diseases with attack vertigo is discussed and the role to select the patients for endolymphatic sac surgery is emphasized.


[Ionized calcium and total calcium of parotid saliva in normotension and in arterial hypertension (author's transl)]. By the development of a disc-electrode and of an electrically neutral calcium carrier a precise determination of calcium ions in the parotid saliva has become available. With this new and simple method an exponential flow rate dependance of the concentration of calcium ions was found in normal persons. A steady state was observed in higher flow rates than 0.5 ml/min. The ionized/total calcium ratio was 54% in the average and was not influenced significantly by the flow rate. The values of both the ionized and total calcium concentrations were slightly lower in females than in men. The salivary ionized calcium concentration was significantly reduced in patients with arterial hypertension, and was not influenced by the flow rate. Its percentage against total calcium was 42% and was reduced to 39% by increased flow rates.


[Immunological investigations on human parotid saliva in comparison with submandibular fluid (author's transl)]. By immunoelectrophoresis with homologous antisera 5--7 saliva specific antigens were proved in parotid- and submandibular saliva respectively. Both secretions contain 14 respectively 15 serum proteins identified by double radical immunodiffusion.


[Repeated recurrences after operations of non-malignant parotid tumours (author's transl)]. Recurrences of 222 operated on parotid tumours (1961--1975) are analysed. Recurrences and repeated recurrences of benigh parotid tumours are based on not corresponded praeoperations (without nerve preparation). The half of cases of first-recurrences (mixed tumours) will become further recurrences. In repeated parotid-recurrences should be done total parotidectomy with careful treatment of facial nerve.


[Auditory prosthesis (author's transl)]. 1. Replacement of a non-functioning cochlea by a prosthetic device appears to be quite feasible. 2. In their current form, such prostheses provide only a rudimentary auditory perception, permitting discrimination of some simple noises, but providing substantial aid in lip reading. Speech perception is limited to a few words. 3. Further improvements of the prosthesis must take the patho-physiological situation into account: (a) It will be necessary to establish connections between individual electrodes and limited groups of cochlear nerve fibers so as to achieve a correct space/time/amplitude distribution of the applied signals; (b) signal components which are to be transmitted to selected nerve-fiber groups have to be encoded in such a way that they can be correctly processed by those fibers. 4. Only the future will show if the current prosthesis can still be improved. Even if one assumes that substantial improvements can be made, it is doubtful that "normal" speech perception can be restored.


[New possibilities of hyposensitization with pollen-l-tyrosine complexes (author's transl)]. The so far most comprehensive individual study into the clinical findings in the hyposensitization therapy with pollen-L-tyrosine complexes in 253 pollinosis patients, who were first subjected to a hyposensitization therapy, permitted a comprehensive evaluation of the indication possibilities of these preparations (Pollagen, Tyrosin-Allergoid; in other countries available as Pollinex, Polvac, Bencard-Polen). The success of this hyposensitization, which may be reduced to three injections, can be immunologically established and is only slightly smaller than in the case of a specific desensitization over a period of 5--6 months preseasonally. The therapy is indicated first and foremost in patients who either have a moderate or medium-degree sensitization to grass pollens or who come to a medical examination only briefly before the pollen season. The addition of rye pollens obviously gives the preparation Tyrosin-Allergoid an advantage over the mixture of pure grass pollens as used in Pollagen. Rye pollens are responsible for the highest pollen concentrations and thus for the most severe complaints of pollinosis patients. A considerable increase in the therapeutic success, approximately 20%, can be achieved on the basis of a therapy modification, presented here for the first time: The patient is treated preseasonally with a specific desensitization vaccine and immediately before the pollen season he is additionally vaccinated with tyrosine-adsorbed pollen allergens as a kind of booster vaccination.


[Surgical restitution of function after laryngectomy (author's transl)]. A surgical technique aiming to the reconstruction of the phonatory and respiratory function after laryngectomy is presented. This technique, which is performed in three stages, utilizes a deltopectoral flap, containing autogenic or allogenic cartilage, as a laryngeal substitute. To date, 13 patients have been submitted to this operation. Although both laryngeal functions, respiration and voice, were restored only in one patient, further refinements of the utilized surgical procedure may contribute to solve the problem of a complete functional rehabilitation after total laryngectomy.


[Valve-neoglottis by placing ear cartilage and mucosa on inverted lateral tracheal wall after liquid insufficiency of a Staffieri fistula (author's transl)]. Six month after laryngectomy with a neoglottis phonatoria (Staffieri) one patient developed increasing trouble when swallowing liquids. When the patient was operated on again, the upper end of the trachea was closed up to a small anterior opening, by turning the lateral parts of the trachea into the lumen with dexon sutures. On this material cartilage from the ear was transplanted (because of the missing epiglottis) and covered with a free transplant of mucosa from the pharynx underneath the Staffieri fistula. After this second stage operation the patient had no more trouble when swallowing liquids and he developed again a good voice.


[On morphological changes in the hypopharynx-esophageal region following laryngectomia (author's transl)]. This report deals with the morphological changes in the hypopharynx-esophageal region of two patients following laryngectomia. In these patients we found two sagittal infoldings of the lateral walls of the hypopharynx-esophageal region. Histological examination revealed a nodular circumscribed hypertrophy of the innermost fascicle of the continuous helical system which, by time, becomes replaced by a fibrous tissue. Later on, the middle and outer fascicles of the continuous helical system undergo the same changes. Both these processes result in the formation of a hypertrophic scar which finally turns out in an atrophic scar. The volume of the esophageal wall at the same time as maintained by an increase of adipose tissue in the outer third. This adipose tissue spreads towards the lumen and finally replaces all the scar tissue. In clinical experience such infoldings are not a rare finding, however it seems doubtful if they can get any meaning in the phonation. Nevertheless the formation of such infoldings seems to be intimately related to the altered function of the hypopharyngeal region following laryngectomia.


[Evaluation of the fistula test and the positional test in the diagnosis of a fistula of the labyrinth (author's transl)]. In 111 patients with a chronic otitis media and symptoms of dizziness the positional reactions were examined. Among 75 patients, who underwent operations later on, a fistula of the labyrinth was preoperatively expected in 25 patients according to a positive fistula pressure sign or a pathological fistula positional reaction. A positive fistula positional sign shows a contralateral beating transitory nystagmus in the head hanging position, while after rapid sit up the nystagmus is starting to beat into the ipsilateral direction. A labyrinthine fistula was operatively confirmed in 15 patients out of 25 suspicious cases. In these 15 cases both the fistula and the positional test were positive in 9 cases. 3 had a positive fistula pressure test and 3 a positive fistula positional sign. In 50 patients with negative fistula reactions only one fistula was observed during operation. These data underline the importance of both pressure and positional reactions in the prediction of labyrinthine fistulas.


[Betahistine treatment of Menière's disease (author's transl)]. An evaluation of Betahistine hydrochloride treatment of 92 patients suffering from Menière disease and Menière-like syndrom is presented. Observed for more than one year 54 (89%) patients showed complete relief of vertigo-attack symptoms. 7 (12%) patients showed a distinct improvement in their hearing as reflected in their audiograms, only 7 (12%) patients showed a further loss of hearing. There appeared to be a trend toward further improvement when therapy was maintained over at least a period of 3--4 month. Vertigo seemed to be the symptom most responsive to treatment and tinnitus the most resistant. Minimal side effects were observed in 17 (18%) patients.


The effect of arylsulfonate esters on cholesterol--aggravated atherosclerosis in White Carneau Pigeons. The arylsulfonate esters of linoleyl, stearyl, and decyl alcohols were found to reduce significantly the accumulation of cholesterol in the plasma and livers of White Carneau pigeons subjected to a diet of Purina pigeon pellets coated with 0.25% cholesterol and 10% lard when fed for periods ranging from 9--12 months; no effects were observed in normocholesterolemic pigeons. These compounds produced no toxic side effects and were found to significantly attenuate the development of aortic atherosclerosis. The effect on aortic atherosclerosis was most likely the result of the lowering of plasma cholesterol concentrations. Linoleyl p-toluenesulfonate appeared to be the most effective of the three arylsulfonates tested, both with respect to the reduction of plasma and liver cholesterol accumulation and attenuation of the atherosclerotic process.


Fatty acid metabolism in L1210 murine leukemia cells: differences in modification of fatty acids incorporated into various lipids. L1210 leukemia cells can utilize all of the main fatty acids that normally are present in the ascites fluid in which they grow. This finding is consistent with the view that L1210 cells derive most of their fatty acids from the ascites fluid. From 80--90% of each fatty acid was incorporated into cell lipids without structural modification, suggesting that the lipid composition of these cells can be altered by changing the type of fatty acids to which they are exposed. Most importantly, the palmitate that was subsequently incorporated into total cell phospholipids was elongated and desaturated somewhat more than that incorporated into triglycerides. This difference was due primarily to more extensive modification of the palmitate incorporated into the ethanolamine phosphoglycerides fraction. Although there was no difference between total phospholipids and triglycerides with linoleate, more of the linoleate incorporated into ethanolamine phosphoglycerides was elongated and further desaturated than that incorporated into choline phosphoglycerides and triglycerides. These findings indicate fatty acids incorporated into various cell lipid fractions are not structurally modified to the same extent. There appears to be greater modification of fatty acid used for ethanolamine phosphoglyceride synthesis as compared with triglyceride and choline phosphoglyceride synthesis.


Composition of lipids of bovine optic nerve. Lipids from bovine optic nerve were analyzed. The total content of 16.5% by weight included 27.2% nonpolar lipids, 26.1% glycolipids, and 46.7% phospholipids by weight. Free cholesterol was the major component of the nonpolar lipid fraction. The cerebrosides, 73.5% of total glycolipids, were separated by thin layer chromatography (TLC) into two bands (upper and lower) that were present in equal proportion. Cerebroside sulfates comprised about 27.5% of total glycolipids. Gangliosides were also detected in the glycolipid fraction. In order of predominance, choline glycerophospholipids, ethanolamine glycerophospholipids, ethanolamine plasmalogens, serine glycerophospholipids, sphingomyelins, and inositol glycerophospholipids were the major phospholipids. Palmitoyl (16:0), stearoyl (18:0), and oleoyl (18:1) groups were the major acyl groups in all neutral and phospholipid classes. However, ethanolamine glycerophospholipids, serine glycerophospholipids, and inositol glycerophospholipids contained a large percentage of 22:6 (docosahexaenoyl) group. The major alk-1-enyl groups of the plasmalogens were 16:0, 18:0, and 18:1. Steroyl (18:0), lignoceroyl (24:0), and nervonoyl (24:1) were the major acyl groups in all sphingolipids. Lower cerebroside band and cerebroside sulfates contained large amount of hydroxylignoceroyl (cerebronoyl) and hydroxynervonoyl groups.


Sterol-polyene antibiotic complexation: probe of membrane structure. Polyene antibiotics are useful tools for studying the role of sterols in biological membranes. The interaction of polyene antibiotics with membrane-bound sterols in artificial membrane systems, prokaryotic and eukaryotic cells, and lipid-containing viruses is reviewed. The pentaene macrolide, filipin, is shown to serve as a probe of phosphatidylcholine-sterol interaction and of the localization of cholesterol in the membrane of mycoplasmas.


Inhibition of cholesterol synthesis by oxygenated sterols. Sterols derived from cholesterol by introducing a ketone or hydroxyl function in the 6, 7, 15, 20, 22, 24, or 25 positions are known to be potent inhibitors of sterol synthesis in cell cultures. To gain more information regarding structural requirements for inhibitory activity, inhibitory potencies were determined for a series of 18 C27-steroids with various combinations of ketone and hydroxyl functions substituted in positions 3, 4, 5, 6, and 7, or with a single ketone or hydroxyl function in one of these positions. The effects of nuclear double bonds upon inhibitory activity were also examined. A ketone or hydroxyl function in position 3 and a second ketone or hydroxyl function in position 6 or 7 was required for inhibitory activity with two kinds of cell culture. A 3beta5alpha6beta-triol was not more inhibitory than a comparable 3beta,6beta-diol. Cholestane-3beta 5alpha-diol inhibited sterol synthesis in L cells but not in liver cell cultures. The inhibitory activities of 7-oxygenated sterols were not markedly affected by the presence of a double bond in position 4 or 5. Current knowledge of the mechanism through which the oxygenated sterols suppress cholesterol synthesis is reviewed.


Cyclopamine and related steroidal alkaloid teratogens: their occurrence, structural relationship, and biologic effects. A spontaneous congenital deformity is produced in lambs whose dams consume Veratrum californicum on the 14th day of gestation. The deformity is generally expressed as cyclopia, cebocephaly, anophthalmia, or microphthalmia. This teratogenic effect is produced by certain steroidal alkaloid teratogens from the plant - most notably the compound cyclopamine. Cyclopamine is a C-nor-D-homo steroid with fused furanopiperidine rings E and F at right angles to the plane of the steroid because of spiro attachment at C-17 of the steroid. Among veratrum alkaloids, only those with an intact furan ring E were teratogenic in sheep, whereas those in which the peperidine ring is not rigidly positioned at right angles to the steroid were not. Many ruminants and laboratory animals are susceptible to the teratogen. It has wide species and tissue specificity and appears to have a direct effect on the embryo, not as a consequence of metabolic alteration of its structure nor as an indirect effect through a maternal influence. Other plant sources, notably potatoes, tomatoes, and eggplant contain related spirosolane steroidal alkaloids. Among naturally occurring spirosolanes, solasodine is teratogenic in hamsters, but neither tomatidine not diosgenin, the non-nitrogen containing analog of solasodine, is teratogenic. Results of these and other studies suggest that a basic nitrogen positioned alpha with respect to the steroidal plane and at appropriate distance beyond the D ring confers the teratogenicity on the molecule. Potato sprouts with high alkaloid content are teratogenic in hamsters, but tubers and peels are not.


The interaction of 1,25-dihydroxyvitamin D3 with its intestinal mucosa receptor: kinetic parameters and structural requirements. Vitamin D3 and its metabolites comprise an endocrine system which plays a critical role in calcium homeostasis. The active form of vitamin D3 is 1,25-dihydroxyvitamin D3 [1,25(OH)2D3]. Chromatin localization of 1,25(OH)2D3 and sucrose density gradient centrifutation have demonstrated the presence of an intestinal mucosa cytosol receptor which specifically binds 1,25(OH)2D3. The kinetic parameters of 1,25(OH)2D3 binding to its receptor have been determined by hydroxylapatite and reconstituted chromatin cytosol assays. Utilization of these assays has also permitted a determination of the precise structural requirements of the vitamin D ligand for the intestinal receptor. Furthermore, it has been possible to propose two receptor-ligand models which are capable of accommodating the conformationaly modile A ring of the vitamin D seco-steroids.


Maximal oxygen uptake and muscle fiber types in trained and untrained humans. Maximal oxygen uptake (Vo2 max) was determined in 138 male and 41 female human subjects and muscle fiber composition (gastrocnemius and vastus lateralis) in 53 of the males. Highest values for Vo2 max were 7.38 1 x min-1 and 4.341 x min-1 in males and females, respectively. In relation to body weight the highest values were 94 and 77 ml x (kg x min)-1. Athletes participating in endurance events had very high Vo2 max and predominantly slow twitch (ST) fiber populations whereas weight lifters attained rather low values for Vo2 max and had a higher percentage of fast twitch (FT) fibers. Among subjects with the same fiber composition, Vo2 max was higher in the athletes than in the moderately trained. All groups taken together demonstrated a positive relationship between Vo2 max and the relative number of ST fibers (r = 0.67). For endurance and strength athletes r = 0.72 and for the moderately trained r = 0.34, both correlation coefficients being significant.


Effects of caffeine ingestion on metabolism and exercise performance. In an effort to assess the effects of caffeine ingestion on metabolism and performance during prolonged exercise, nine competitive cyclists (two females and seven males) exercised until exhaustion on a bicycle ergometer at 80% of Vo2 max. One trial was performed an hour after ingesting decaffeinated coffee (Trial D), while a second trial (C) required that each subject consume coffee containing 330 mg of caffeine 60 min before the exercise. Following the ingestion of caffeine (Trial C), the subjects were able to perform an average of 90.2 (SE +/- 7.2) min of cycling as compared to an average of 75.5 (SE +/- 5.1) min in the D Trial. Measurements of plasma free fatty acids, glycerol and respiratory exchange ratios evidenced a greater rate of lipid metabolism during the caffeine trial as compared to the decaffeinated exercise treatment. Calculations of carbohydrate (CHO) metabolism from respiratory exchange data revealed that the subjects oxidized roughly 240 g of CHO in both trials. Fat oxidation, however, was significantly higher (P less than 0.05) during the C Trial (118 g or 1.31 g/min) than in the D Trial (57 g or 0.75 g/min). On the average the participants rated (Perceived Exertion Scale) their effort during the C Trial to be significantly (P less than 0.05) easier than the demands of the D treatment. Thus, the enhanced endurance performance observed in the C Trial was likely the combined effects of caffeine on lipolysis and its positive influence on nerve impulse transmission.


Muscle force-velocity and power-velocity relationships under isokinetic loading. Various studies have indicated that human muscles in-vivo manifest a substantially similar, if not the identical force-velocity relationship established for isolated, maximally stimulated animal muscles. In the present study, fifteen healthy males and females, 18 to 38 years old and representing varied activity patterns from sedentary to athletic, performed maximal dynamic knee extensions on an isokinetic loading dynamometer. Maximal torque forces attained at a specific point in the range (30 degrees before full extension) and at seven loading velocities from 0 (isometric) to 288 degrees/sec were recorded. The maximum 30 degrees torques exhibited by the various subjects ranged from 29 to 245 Newton-meters. However, over the four lower test velocities (0, 48, 96 & 144 degrees/sec), all subjects exhibited less than a 15% deviation from their respective maximum 30 degrees torque values, which occurred most often at the 96 degree/sec test velocity. Maximal instantaneous power output at the 30 degree position ranged from 98 to 680 Watts. In all 15 subjects this was attained at and remained generally constant over the three highest test velocities (192 to 288 degrees/sec). A neural mechanism that restricts a muscle's maximal tension in-vivo is postulated as being responsible for the marked difference between the force-velocity relationship found for human muscles in-vivo and that exhibited by isolated animal muscles.


Effects of O2 breathing on RQ, blood flow, and developed tension in in situ dog muscle. The Vo2, VCO2, RQ, blood flow and developed tension of in situ dog gastrocnemius muscle were studied during contractions at 2.5 tw/sec for both normoxic and hyperoxic breathing conditions. Vo2 and developed tension were not significantly altered by the breathing gas changes. CaO2 rose by 11% during O2-breathing, however, a significant decrease of 15% in muscle blood flow resulted in no significant change in O2-transport (CaO2 X Q) to muscle comparing hyperoxia to normoxia. Hyperoxia resulted in a significant decrease in muscle VCO2 and RQ. The cause of the RQ change with breathing gas O2 content is not certain, however, evidence is presented indicating that infused epinephrine and propranolol can effect the response.


The effect of circuit weight training on strength, cardiorespiratory function, and body composition of adult men. The purpose of this study was to determine the changes elicited by circuit weight training (CWT) and running (RN) programs conducted 3 days/week for 20 weeks. Subjects were randomly assigned to one of three groups: CWT (n = 11); RN (n = 16); and control (n = 14). CWT consisted of 10 exercises performed in 2 sets of 15 reps with 20 to 25 sec rest between exercises. CWT workout time decreased from 30 min to 23 min; exercise heart rate (HR) increased from 79% to 84% max; average weight increased from 42% to 56% of max 1 RM strength and total weight increased 81% (1506 to 2720 lbs/workout). The RN group exercised at 85% max HR for 23 to 27 min/workout. Multivariate and step-down analyses showed the CWT group to be significantly different from the control group at the end of 20 weeks in leg press strength, fat weight, and Vo2 max (1/min). The RN group was significantly different from the CWT group in Vo2 max and treadmill time. Univariate analyses revealed no differences between the CWT and control groups in Vo2 max expressed as ml/kg LBW.min but did show a significant superiority of the RN group over the other two groups in this variable. It was concluded that the CWT program was most specific in improving strength and changing body composition and produced only a small aerobic effect as measured on the treadmill running test.


Effect of antecedent muscle tension levels on motor behavior. In Experiment 1 there was an appreciable elevation in the levels of electromyographic activity recorded from the right forearm flexor of intercollegiate wrestlers prior to an important competition. With the aid of biofeedback, subjects in the second experiment maintained these same elevated levels of electromyographic activity before performing a battery of simple motor tasks. These elevated levels of antecedent muscle tension were found to disrupt hand steadiness and grip strength. Thus, the high levels of pre-competition muscle tension occurring in athletes are capable of disrupting performance. The use of biofeedback relaxation techniques in the pre-competition period may significantly improve the performance of competitive athletes hampered by particularly high levels of pre-competition muscle tension.


Glycogen depletion patterns during continuous and intermittent ice skating. The glycogen depletion patterns in the vastus lateralis muscle were studied during ice skating using eight hockey players. For each subject, exercise consisted of either repeated bouts (10) of high intensity work (120% Vo2 max) or continuous work (60 min) of low intensity (55% Vo2 max). During continuous skating, glycogen showed a 29% decline (p less than 0.05) over the 60 min. In the intermittent condition, there was a two fold greater depletion (p less than 0.05) with the most rapid loss occurring during the first five, one min work bouts. Histochemical analysis by fiber type indicated that the most pronounced glycogen loss was from the Type I fibers during continuous skating whereas during the intermittent condition, a preferential loss occurred in the Type II fibers, most notably the Type IIB fibers. Measurements of muscle metabolites during continuous skating indicated no change for ATP from the rest condition at 30 or 60 min, a reduction (p less than 0.05) in CP (4.1 mmoles.kg-1) at 60 min and an elevation (p less than 0.05) in lactate (0.85 mmoles.kg-1) at 60 min. In the intermittent condition, reductions (p less than 0.05) in ATP (0.47 mmoles.kg-1) and CP (8.7 mmoles.kg-1) and elevations (p less than 0.05) in lactate (21.7 mmoles.kg-1) were found following 5 work bouts. Thereafter, no significant changes were observed. It is concluded that the glycogen depletion patterns and alteration in muscle metabolites are similar to those seen during cycling at similar percentages of Vo2 max.


Urinary catecholamine excretion during competition in 11 to 23 year old hockey players. Stress experienced by young athletes (ages 11 to 23 years) during competition was studied by comparing urinary epinephrine (E) and norepinephrine (NE) excretion at rest, during bicycle exercise (55% max) and during a hockey game. Athletes were divided into four groups: 11, 12, 16, and 23 years olds with four subjects in each group. Urinary production rates were similar between experimental conditions and age groups. Both resting E and NE levels were constant across all ages. Game E levels were significantly higher (P less than 0.05) than resting and bicycle levels in both the 16 and 23 year old groups. Epinephrine excretion during hockey was also significantly higher (P less than 0.05) in the 23 year old athletes than in the 11 and 12 year olds and in the 16 year olds compared to the 11 year olds. Game NE was significantly elevated (P less than 0.05) above resting levels in the 16 and 23 year olds. Submaximal NE excretion was not significantly different from resting levels in any of the age groups (P greater than 0.05). Physical stress as reflected by NE excretion was constant across all ages within each experimental condition. Generally, sympathetic stimulation and NE excretion appeared to be related to intensity of physical activity, being greater during hockey than during submaximal exercise. Significant adrenal medullary activation and E excretion was evident only during hockey and then, only in the older athletes.


Effect of experimental alterations in excess weight on aerobic capacity and distance running performance. To experimentally investigate the effect of excess body weight or fat on maximal oxygen uptake (Vo2 max) and distance running performance, the metabolic response to maximal and submaximal treadmill running and the 12-min run performance were measured in six subjects under each of four added-weight (AW) conditions: normal body weight and 5, 10, and 15% additional external weight, added to the trunk. AW was found to systematically and significantly decrease Vo2 max expressed relative to the total weight carried (ml/min.dg TW), maximal treadmill (TM) run time and 12-min run distance, but not to systematically affect Vo2 max (1/min) or Vo2 max (ml/min.kg FFW). An increase of 5% AW was found, on the average, to decrease Vo2 max (ml/min.kg TW) 2.4 ml, the TM run time 35 sec and the 12-min run distance 89 m. These decreases were a direct consequence of the increased energy cost of running at submaximal speeds. It was concluded that changes in excess body weight can influence Vo2 max expressed relative to body weight and distance run performance independent of any change in cardiovascular capacity. Failure to distinguish the metabolic effects of body fatness from the influence of cardiorespiratory capacity may result in misleading interpretation of distance run test scores.


Differences and changes in VO2 among young runners 10 to 18 years of age. Twenty young males, all active in middle-distance running, were studied between January 1968 and May 1974 for the purpose of gathering longitudinal data regarding Vo2 during treadmil running. Vo2 submax (measured during the last 2 min of a 6-min run at 202 m/min) and Vo2 max values (measured during a 5-8 min increasing-speed run to exhaustion) were collected approximately every 6 months for 6 years. Different groups, starting at ages of 10, 12 and 13 years were followed for periods of 2 to 5 years continuously. In all longitudinal comparisons. Vo2 max (ml/min) changes peralleled changes in body weight; consequently, Vo2 max (ml/kg.min-1) did not show a significant change. In every group Vo2 submax (ml/kg.min-1) dropped significantly over time. All data were pooled by 1 yr age groups, providing cross-sectional data for active boys 10-18 yrs of age. Vo2 max ranged from 1933 ml/min for 10-yr olds to 4082 for 18-year olds. Concurrent changes in weight resulted in no significant differences in Vo2 max (ml/kg.min-1) from the overall mean of 61.5 Vo2 submax (ml/kg.min-1) was highest among 10-year olds (53.3) and lowest among 18-yr olds (42.5). Based on these longitudinal and cross sectional findings and significant improvements in times for 1- and 2-mile races, it was concluded that Vo2 max (ml/min) increases no faster than does body weight among moderately active growing boys and that both age and training contribute to a change in Vo2 submax; a factor which accounts greatly for improvements in middle-distance race performance.


Cardiorespiratory alterations in 9 to 11 years old children following a season of competitive swimming. The purpose of this study was to describe cardiorespiratory alterations in a group of perviously untrained 9-to-11 year old children resulting from seven months of swimming training. Fifteen members of a competitive swim team served as subjects. A non-training group of fifteen children of similar age, height and weight were studied at the same times. All measurements were made on three separate days both before and after the training period. On Measurement Day One the subjects were measured for VC, FEV1.0, and MVV. On MEasurement Day Two they were measured for PWC170 and on MEasurement Day Three height (cm), weight (kg), VE max (1/min), Vo2 max (ml/kg.min) and HR max were determined. Results of the analyses indicated that: (1) the mean PWC170 change in the trained children (+80.00 kgm/min) was significantly greater than that in the reference group (+30.00 kgm/min) (P less than .05); (2) the mean Vo2 max change in the experimental group (+8.411 ml/kg.min) was significantly greater than in the reference group (2.21 ml/kg.min) (P less than .01); and the mean changes in VC, FEV1.0, MVV, VE max, and HR max were not greater than one would expect to see in normal children of similar age and body dimensions (P greater than .05).


Field testing of cardiorespiratory fitness in primary school children. The purpose of the investigation was to explore the validity of using timed distance runs as predictors of cardiorespiratory fitness in first, second and third grade children. Maximal oxygen uptake (Vo2 max), determined via the open-circut method during treadmill running, and performance on runs of 800, 1200 and 1600 meters were compared for 83 children. Males were found to exceed females on Vo2 max and possessed significantly faster times on all the distances run. The 1600-meter run proved to be the best predictor of Vo2 max (ml/kg) in both sexes. Test-retest reliability of the 1600-meter run was checked with 120 students and found to range from +.824 for first grade females to + .918 for third grade males. Normative values for first, second, and third grade students were calculated from data collected on 1440 elementary students. All subjects studied had previously received instruction and practice on the phenomenon of paced distance running.


Maximal and submaximal exercise in different positions. Maximal aerobic power tests on a treadmill and on a bicycle ergometer while sitting upright and in a low-sitting position were performed by seven males and five females. Treadmill max Vo2 for men and women combined was 4.0 and 11.2% higher compared to upright and low-sitting cycling, respectively. Maximal pulmonary ventilation, related respiratory measures, and heart rate were similar in all three tests. Submaximal work performed in the two cycling positions resulted in similar levels of oxygen uptake, ventilation, and heart rate. Work loads of 360 and 720 Kpm/min were performed by males with oxygen uptakes of 14.7 and 25.2 ml/kg . min, which corresponded to 30 and 52% of their upright-sitting maximal oxygen uptakes and to 33 and 55% of their low-sitting aerobic capacities respectively. Oxygen uptakes for work loads of 360 and 540 Kpm/min by females were 15.6 and 21.6 ml/kg . min, being equivalent to 42 and 58% of the maximal oxygen uptake in the upright-sitting, and to 43 and 60% in the low-sitting ergometer position, respectively.


Age at menarche and selected menstrual characteristics in athletes at different competitive levels and in different sports. Ages at menarche in 110 non-athletes, 59 high school atjletes, 53 college athletes, and 18 olympic volleyball candidates were determined through interview. The athletes attained menarche significantly later than the non-athletes (p less than .001), and the olympic athletes attained menarche significantly later than the high school and college athletes (p less than .001). The high school and college athletes did not differ significantly in the mean age at menarche. When menarche in college athletes was analyzed by specific sports, the small samples of participants in golf (n = 4), volleyball (n = 7), swimming (n = 7), basketball (n = 16), and gymnastics and track (n = 6) did not differ significantly from each other in the mean age at menarche. The olympic volleyball aspirants attained menarche significantly later than all sport-specific groups (p less than .05 to p less than .001) except the gymnastics-track and tennis (n = 13) athletes. Smaller samples of non-athletes (n = 27) and college athletes (n = 21 from volleyball and basketball), plus the olympic athletes were also interviewed regarding selected menstrual characteristics. Although the athletes reported a greater incidence of dysmenorrhea and menstrual irregularity, none of the chi square values comparing the three groups was significant.


The effect of physical training on the serum iron levels of college-age women. Physical training in women has been found to be associated with a significant decrease in serum iron levels suggesting a state of deteriorating iron stores. To further study this phenomenon, seventeen women, aged 19 to 23 years, volunteered to participate in a 10-week physical training program to study the effect of training on serum iron levels. The training consisted of three 20-25 minute exercise bouts per week on a bicycle ergometer with individual workloads equivalent to approximately 70% of each subject's maximum aerobic capacity. Additionally, eight women, aged 19 to 28, volunteered to act as a control group. Assessments of hemoglobin (Hb), hematocrit (Hct), serum iron (SeFe), and maximum oxygen uptake (Vo2 max) were made on both groups prior to and at the conclusion of the training period. Upon completion of training, Vo2 max (ml/kg/min) increased by eleven percent (p less than .05) whereas Gb and Hct showed no significant changes for the trainign group with respect to the control group. Se Fe levels (microgram/100ml) in the training group did not differ significantly from those of the control group in both pre-training (128.8 +/- 7.6 vs 103.7 +/- 13.7, X +/- SE) and post-training (126.6 +/- 7.9 vs. 120.9 +/- 16.3, X +/- SE) conditions. Neither day of menstrual cycle nor use of oral contraceptives nor use of iron supplements was found to have any systematic effect on SeFe levels. The results suggest that short term physical training in college-age women does not significantly lower SeFe levels.


[Theoretical aspects of the formation of a roentgenokymographic image]. A procedure for estimating optimal values of parameters for the roentgenokymographic devices, including the basic parameter--the slit width, has been devised. An interrelation between the slit width in ordinary and perspective protective roentenokymographic devices was determined. The optimal slit width in the ordinary roentgenokymographic device was found to equal 0.5+0.03 mm, and in the protected roentgenokymographic device the investigation of adults and children indicated 0.15+0.02 and 0.22+0.02 mm, respectively. The resulting theoretical values are supported by experimental findings.


[Method of assessing the information content of gamma chambers in studying mobile organs]. In investigating mobile organs, such as the liver, lungs, spleen and heart their image on the scintigram is blurred which deteriorates the function of the modulation transmission (FMT). An analytical expression for calculating the FMT in investigating the mobile organs was deduced. Examples of the FMT impairement in investigating the liver and heart are cited. Concrete recommendations for increasing the informativeness of investigation with a gamma-chamber are given.


[Optimal operating mode for x-ray diagnostic apparatus]. By analyzing quite a number of studies a correlation between some parameters in making X-ray diagnoses, X-ray emitters and converters is determined. From this, a new optimum duty cycle for the X-ray diagnostic generator, securing a maximum diagnostic value and examination effectiveness of a high degree automation and reliability of the system may be suggested.


[Operating mock-up of a scintillation gamma chamber]. An operating model constructed by using devices, components and materials batch manufactured by the Soviet industry has been designed. The basic parameters of the model lie within the bounds corresponding to the most widely used types of the foreign-made gamma-chambers. The phanthom tests set up on the model and clinical investigations of the thyroid, as well as trial tests with point and linear technetium-99m sources showed the device to perform satisfactorily.


[Use of corrosion inhibitors during the presterilization preparation of medical instruments]. Corrosion inhibitors that may be used for pre-sterilization treatment of medical instruments are described and investigated. The investigation included potentiostatic and gravimetric measurements along with the visual control. It was found that in order to reduce the corrosion activity of detergent solutions the use of bi-substituted sodium phosphate is advisable.


[Current methods and means of reconstructive tomography (x-ray scanning)]. As the number of detectors per a layer grows, that of the matrix elements increases and the size of the transmitted elements diminishes the devices for reconstructive transmission (x-ray) tomography approach by their informativeness that of the ordinary tomographs, but being appreciably superior to the latter by the number of transmitted contrast gradations. In both cases the X-ray load on the patients is practically the same.


[Unit for the registration of cinekymograms]. The principle underlying the action of basic subassemblies of the appliance for registration of kymographic curves from roentgenocinemafilms is described. A comparison of the cinemakymographic method with that of electrokymography is given and advantages of the proposed method are indicated.


[Improving the quality of roentgenograms on the RUM-20 apparatus]. In the apparatus of the PYM-20, output 1973--1976 the factual errors in the anode voltage reach 30%, which impedes standardization of the roentgenography conditions. In order to take account of the factual error a reduced setting of voltage by one-two positions is recommended.


[Operation of the optical centering guides of x-ray diagnostic apparatus]. Because of a long-term operation of roentgenodiagnostic apparatus the light field illumination intensity of optical centering devices falls. An analysis of possible causes accounting for this phenomenon justified recommending to rate the intensity of the centering device field illumination and also to search for new materials for manufacturing a base for the centering devices mirrors.


[Stomatological amalgam mixer].

[Stomatological amalgam mixer]. For preparing silver amalgam an amalgam mixer AC-01 has been constructed with a time relay. This is a table apparatus in whose body and oscillating movement mechanism with an electric drive and a time relay are arranged. Mixing the amalgam is done in capsules. The set is made up together with proportioners for mercury, powder and capsules for the preparation of the amalgam.


[Staphylococcal septicemias in Algiers (report of 14 cases) (author's transl)]. Staphyococcal septicemia is rare (0.19 p. 100 of admittances). The origin of this kind of infection could be located in all cases out of the sanitary units, and in 12 out of the 14 cases, patients under 30 years old were concerned. The main disorders were in pulmonary tract, kidneys and heart. A fatal issue occured 6 times due in most cases to a delayed admittance. A good study of sensitivity to antibiotics and a treatment associating several antibiotics are necessary.


[Heart and schistosomiasis (author's transl)]. The review is based on three studies previously reported and involving the clinical, epidemiological and hemodynamic aspects of this problem. Schistosomasis may give frequently (21.6 p. 100) an arterial pulmonary hyperpressure related to the development of granulomas and arteriolitis. A myocarditis may be suspected but is rarely proved. Anemia and specific treatment are also responsible for myocardial deficiency. The parasitic changes of the urinary tract may give a systemic hypertension. Some very rare cases of acute pulmonary heart insufficiency have been reported and the responsibility of schistosomiasis in constrictive fibrous endomyocarditis is still questionned.


[Comparative statistics of cancers in Sahara (author's transl)]. Statistics of 204 cases of cancer observed in Saharian populations from 1969 to 1976 and a comparison with studies previously made in this area and statistics from other countries. Skin cancer have a special frequence which may be related to climatic and atmospheric environment.


[An attempt to normalize the methodology of clinico parasitologic surveys of onchocerciasis in West-Africa (author's transl)]. In order to be able to compare in time and space the results of onchocerciasis surveys in West Africa, the authors suggest to standardize the methodology of these surveys. The following points are defined : criteria to choose the villages, selection of population specimen, registration of socio-demographic data, clinical examination, assessment of visual acuity, parasitological examination founded on two quantitative bloodless cutaneous biopsies, definition of epidemiologic indices, adjustement of these indices to a standard population, synthesis of results by age-group and sex on the one hand by the presentation of frequency distribution of cutaneous microfilarial densities, on the other hand by calculation of geometric means of these densities.


[Idiopathic mega-oesophagus with an "historic" evolution (author's transl)]. Report of an african case of idiopathic mega-oesophagus observed after 6 years of evolution without any treatment. Surgery (Heller technic) gave a good result and brought evidence of a non-expected peritoneal tuberculosis related to cachexy. The patient having discarded all medical follow-up, death occured 2 years later.


[Acute evolution as a rare complication of a chronic calcified pancreatitis. Report of a Malagasy case (author's transl)]. Report of an acute inflammatory syndrome of the right side of the belly with fever, polyleucocytosis and diabetes in a 35 years old patient with chronic calcified pancreatitis. The right colon was moved forward by an important retroperitoneal infiltration and the pathology demonstrated a cytosteatonecrosis. The post-operative period was disturbed by hyperamylasemia, hyperamylasuria and an external pancreatic fistule.


[The new features of meningococcal meningitis (author's transl)]. According to a previous pattern epidemics of meningococcal meningitis (MM) were localized in North tropical Africa, caused by A serotype, easily treated with sulfanilamides and prevented by a polyosidic vaccine, A type. Changes have occured : epidemics in Finland and Brazil, with an African A type germ, in place of the American, sulfa-resistant, C type; outburst of epidemics in South tropical Africa; presence of C type in Tchad, Niger and Nigeria. In the same time dramatic evolutions due to endotoxinic processes and drug-resistances are more frequently observed.


[For detection of parasite eggs in human stools. A comparison between 3 technics (author's transl)]. The use of the device called Fecalyzer is the best technic for detection in human stools of eggs of ascaris, Hymenolepis and other taenias. It is worth also for trichocephalus and Trichostrongylus eggs.


[Hematological features of sickle-cell disease (author's transl)]. The diagnosis of S hemoglobin is easy and always given by the laboratory. It must be performed in every black individual. Three tests are commonly used: Emmel test, in vitro solubility test and electrophoresis which, is necessary to differenciate homozygotic and heterozygotic individuals. The others blood data are liable to vary according to the homo or heterozygotic condition and to the evolutive periods of the disease. One must always consider the eventuality of an association of S hemoglobin with an another abnormal hemoglobin or with various hematological conditions.


[Pathogenesis of chronic hemolysis in drepanocytemia (author's transl)]. Frequently chronic hemolysis is not obvious in drepanocytemia and must be looked for with proper technics. Its origin lies chiefly in the corpuscular process of sickling but extra-corpuscular factors must be considered, and among them the role of spleen seems prevailing.


[Pathophysiology of drepanocytemia (author's transl)]. The mutational molecular processes are reminded with recent advances in the understanding of the sickling phenomenon and the pathogenesy of the thrombotic complications. New therapeutic prospects are considered.


[Homozygotic drépanocytemia (author's transl)]. A clinical description according to four age groups: before 5 with hand and foot syndrome, hemolytic chronic and sometimes acute anemia; after 5 with frequent surgical-like abdominal syndromes and development troubles; after puberty with patent dystrophia and anemia; adult age group of rare surviving patients. The drepanocytic condition is aggravated by various infections and reversly facilitate lung infections and osteitis caused by staphylococci or salmonellae. Malaria trophozoïte is suspected of inducing sickling which gives way to a rapid phagocytosis of both sickle cell and Plasmodium.


[Is drepanocitic trait asymptomatic? (author's transl)]. With regard to its distribution the drepanocytic trait has a slight pathological incidence and does not appreciably alter the vital prospect. It is not, still, completely asymptomatic and may be, in special pathophysiological conditions, a morbidity and even lethality risk factor. Its connexions with various other diseases should be considered.


[Geographical survey of drepanocytemia: causes of its distribution in Africa south of Sahara (author's transl)]. In Africa South of Sahara, HbS is distributed in east-west oriented belts, its frequency decreasing from equator to tropics. This singular feature results from interaction of various and complex phenomenons: apparition and diffusion of the mutation, role of malaria, climatic conditions.


[Epidemiological aspects of poliomyelitis in Mali (author's transl)]. 1800 cases of poliomyelitis has been observed in Mali during 8 years from 1968 to 1975. Children, and specially infants from 6 months to 2 years are specially concerned with a sex-ratio giving a higher frequency in boys though this difference goes decreasing with age. The dry season and the hotter one are the two periods of great morbidity. The three types (I, II, III) have the same importance. Oral immunization at the age of 3 or 4 months must be extended.


[Pulmonary complications of drepanocytemia: recent advances (author's transl)]. Pulmonary complications are non very frequent in drepanocytemia (3 to 7 p. 100) but they are often severe and sometimes dramatic. They happen in the homozygotic forms or in the double heterozygotic ones (SC and Sbeta Tahal). Infections, most often due to pneumococcus, are specially frequent in children, though infractions are generally observed in youth and grown-ups. All these patients suffer of an impairement of their respiratory function and of their immunological capacity.


[Renal complications of drepanocytemia (author's transl)]. Changes in glomerular capillaries, mensangial structures and tubules are caused by the sickling process. In young patients tubules are caused by the sickling process. In young patients there is an increase of the renal blood-flow but the flow passing in the vasa recta is reduced. A by-pass gives a congestion of the vessels situated at the cortico-medullary junction and around the renal pelvis. All this gives 3 main clinical syndromes: hematuria, nephrotic syndrome and renal insufficiency.


[Heart in sickle-cell anemia (author's transl)]. Sickle-cell anemia may give heart troubles: heart insufficiency by chronic anemia, pseudo-rhumatic heart, chronic pulmonary heart, coronarian ischemia and cardiomyopathic syndrome. The homo or heterozygotic status and the age are important factors. A rather clear pathogenesis has been built up for these various troubles but therapy has only a limited efficiency.


[Neurological disorders in sickle-cell disease (author's transl)]. Neurological disorders may be, specially in children, the first and dramatic troubles giving notice of the hematological disease. These disorders, listed according to their frequency are: cerebral vascular thrombosis, epilepsy, bacterial meningitis, meningism, cerebral thrombo-phlebitis, disorders of cranial nerves, hydrocephalus related to a pachy meningitis. One must be cautious with transfusions. Paraclinical neurological tests have no specificity.


[Drepanocytic retinopathy (author's transl)]. Hemoglobinopathies and specially drepanocytosis SS and its heterozygotic form SC are responsible of important pathological changes of retina. These changes caused by ischaemia due to vascular thrombosis are generally silent at their beginning, because of their first development in a peripheral area. They have a tendency to progress towards the posterior pole and to get complicated by hemorrhages and detachment of retina. Their study is still to be completed but these disorders already appear as being an important cause of blindness in the populations concerned by this hemoglobinopathy. Treatment is unsatisfactory.


[Drepanocytic osseous complications: dystrophia and osteonecrosis (author's transl)]. Osseous troubles are the most frequent and earliest signs of drepanocytemia. They are due to the bone dystrophia observed in any chronic hemolytic anemia, to aseptic infarcts and to bacterial infections. These syndromes are described according to age and localizations, and proper surgical tactics are proposed.


[Drepanocytic osseous infections (osteitis and osteomyelitis) (author's transl)]. Osseous infections have a special importance among the various polymorphic osteoarticular troubles of drepanocytemia. From 92 cases, the authors emphasize 4 points: --Osteitis and osteomyelitis are frequent, specially in the homozygotic form. --Salmonellae are the prevailing pathogenic bacterias. --Osteomyelitis caused by staphylococcus have, in drepanocytic patients, a more serious and more expanding evolution than in other patients. --Anatomic and radiologic features as well as evolution are different in the staphylococcal forms and in the salmonellal ones in which, most often, surgery may be discarded.


[Osteonecrosis in drepanocytemia (author's transl)]. Aseptic osteonecrosis is due to local hypoxemia related to the sickling process. Its frequency in the U.S.A. is 8,5 p. 100 for heterozygotic patients and 0,2 p. 100 for homozygotic ones. It is rare in AS status but frequent in the double heterozygotism SC. Alcoholism, hyperlipidemia, hyperuricemia, cortisonic treatments and pregnancy are facilitating factors. For vascular causes the femoral epiphysises are most often affected. Radiological features are described.


[Questions about the medical treatment of homozygotic drepanocytemia (author's transl)]. The medical treatment of drepanocytemia requires a three-ways action: --Symptomatic treatment of the various and more or less acute clinical troubles. --Preventive treatment of these troubles. --Chemical inhibition of the sickling process.


[Emergencies related to visceral and genital drepanocytic thrombotic complications (author's transl)]. Thrombotic complications in drepanocytemia may induce 3 main syndromes: splenic infarctions and abscesses; severe and uncontrollable hematurias; priapism. Clinical features and surgical treatments are described with detailed procedures for priapism surgery.