["Minimal" focal potentials of the hippocampus and their post-tetanic alteration]. The work was aimed at recording in the hippocampus of unanesthetized rabbits changes in the EEG evoked by a single afferent spike. Extracellular focal activity was summarized by a computer triggered by spontaneous single unit discharges from a contralateral homotopic hippocampal point. No stable signal was revealed consistent with characteristics of EEG evoked by a unit discharge. Discharges of presumed Shafter collaterals were recorded at CA1 in two cases. After summation of focal activity recorded by the same microelectrode negative of 40-60 micronV amplitude were seen when the computer was triggered by these discharges. Such waves are supposed to be evoked by single spikes. Evoked potentials were recorded at the level of Shaffer collaterals (CA1) and mossy fibres (CA3) layers. In most cases the dependence of the evoked potential amplitudes on the current strength was not smooth but stepwise at nearthreshold stimulation. "Minimal" evoked potentials corresponding to the first step (40-80 micronV) are supposed to be produced by impulses in a single afferent fibres. No long-lasting posttetanic potentiation of "minimal" evoked potentials produced by the Shaffer collateral synapses was found. "Minimal" evoked potentials after mossy fibres stimulation underwent prominent potentiation. These data are consistent with the hypothesis of synaptic localization of the mechanisms of the long-lasting hippocampal posttetanic potentiation.


[Different forms of potentials discharged by caudate nucleus neurons]. Background and evoked activities of the caudate neurons were recorded extracellularly in acute experiments on cats. Different forms of potentials were observed in background and evoked activity. They could be divided into three types: (a) simple full size action potentials; (b) prepotentials characterized by smaller amplitudes and slower decrement; (c) complex discharges consisting of simple potentials of smaller amplitude accompanied by slow positive-negative waves. Prepotentials were observed in background activity separately or as components of full size spikes. Frequency range of complex discharges was 0.5-1 per s. Prepotentials and full size potentials were arrested by slow waves of the complex discharges. The observations are discussed with regard to the origin of diverse forms of the potentials in the caudate nucleus neurons and compared to those made on the cerebellar Purkinje cells.


[Functional relationships between the midbrain tegmentum and the supraoptico-hypophyseal neurosecretory system of the white rat hypothalamus]. Bilateral electrolytic destruction of the paramedian midbrain caudal tegmentum caused the appearance in the internal part of the hypothalamic supraoptic nucleus of neurosecretory cells with low functional activity and degenerating forms (dark-stained and pycnomorphic cells); in the posterior hypophysis the destructed gigantic terminal varicosities (Herring bodies) were revealed; the posterior hypophysis contained a subnormal amount of neurosecret; the vasopressin-antidiuretic hormone level in blood plasma was reduced. Painful stimulation of animals with the destructed midbrain tegmentum revealed the functional insufficiency of the supraoptic hypophyseal neurosecretory system (SHNS). The results obtained permit considering that the paramedian midbrain tegmentum exerts a modulating influence upon the SHNS function during stress.


[Cooperative forms of activity of the granular and Purkinje cells in the frog cerebellar cortex]. The method of multimicroelectrode recording of impulse activity from 2 or more neurons with subsequent statistical analysis was used to study spatial and time characteristics of functional relations between granular and Purkinje cells in the frog cerebellar cortex. It was found that under the influence of both mono- and polymodal afferent stimulation the excited granular and Purkinje cells organize themselves into cooperating groups, elementary ensembles 200-300 and 300-400 micronm in size, respectively. Elementary ensembles of these cells are considered as parts of functional blocks which provide information processing in the frog cerebellar cortex. Some of their properties are studied related to the cooperative principle of their organization and activity.


[Synaptic organization of supraspinal control of the propriospinal neurons of the ventral horn of the cat and monkey spinal cord]. In experiments carried out on cats and monkeys synaptic actions evoked in propriospinal interneurons of the upper lumbar segments by reticulo-, vestibulo- and cortico-spinal volleys were investigated by means of intra- and extracellular recording. Propriospinal interneurons identified by antidromic invasion from the fibres of the ventrolateral funiculi were located in different zones of the ventral horn of the upper lumbar segments. In cats a monosynaptic effect could be evoked by a vestibulo- and reticulo-spinal volley. In monkeys monosynaptic brain-stem-propriospinal actions are complemented by cortico-propriospinal monosynaptic connections. The convergence of monosynaptic effects from different supraspinal sources was shown.


G-6-PD activity of the red cells in chronic renal failure. The G-6-PD activity of erythrocytes was studied in 75 patients with chronic renal failure and 74 normal subjects. The mean value of G-6-PD was higher in the chronic renal failure group and the difference was highly significant. During haemodialysis the G-6-PD activity did not return to normal but was further elevated, though the increase was not statistically significant. A highly significant negative correlation was found between red cell G-6-PD and haematocrit. After separation of the red cells according to age by centrifugation, G-6-PD was highest in the top (young cells) and lowest in the bottom (old) cells, both in normals and uraemic patients. The enzyme activity was higher at all levels in the uraemic subjects, significantly in the top and middle layers. Although our findings may be due to an increased proportion of young erythrocytes in uraemia there are objections to this explanation; the alternative possibility of a life-long metabolic abnormality in uraemic red cells deserves careful consideration.


Gentamicin gradient patterns and morphological changes in human kidneys. The gentamicin gradient pattern was studied in ten autopsied patients who expired during gentamicin therapy. Although two of the patients had acute renal failure, none was thought to have gentamicin-related nephrotoxicity. Gentamicin concentrations in cortex significantly exceeded those in medulla or serum (p less than 0.05 and p less than 0.01, respectively). No correlation was found between the cortical concentrations and the total drug dose, the time interval between the last injection and death, or the plasma creatinine concentrations in this heterogeneous group of patients. In addition, two specimens were suitable for electron microscopy which displayed cytosegrosomes and myeloid bodies previously noted in experimental animals. We conclude that gentamicin forms a gradient pattern in human kidney similar to that described in experimental animals. Furthermore, it evokes similar morphological changes.


Diffuse necrosis of the renal medulla in an infant. A case of diffuse and bilateral necrosis of the renal medulla in an infant aged 2-1/2 months is reported. The possible causes of such severe lesion are discussed. Gastroenteritis, hypotensive state and use of a nephrotoxic drug (gentamicin) are considered to be important pathogenetical factors acting simultaneously in this patient.


[Behavior of lactate dehydrogenase in typhoid infection]. The study of LDH in typhoid infection showed that its increases sharply and constantly in the first week of the disease before falling and returning to normal in the fourth week and later. The increase of LDH in the circulation depends above all on cell necrosis in intestinal lymphatic tissue, which is particularly marked at the beginning of the disease. In other salmonellosis conditions, variations are less evident and significant.


[Bronchofibroscopic and bronchographic aspects of the senile bronchus]. A comparison is made between the bronchofibroscopic and bronchographic pictures observed in aged volunteers with healthy lungs and bronchi. The main finding was of simple atrophy of varying type and degree (more or less marked, diffuse or local), mainly affecting the large bronchi. Age and the extent and magnitude of the alterations were not related: marked atrophy was noted in presenile and slight atrophy in greatly aged subjects. Both types of atrophy may be treated as physiological, since they are presumably connected with differences in the incidence of various factors (diasthetic, constitutional, dysmetabolic, hormonal) and variously numerous microtrauma. The same picture was given by both types of examination, despite the wide differences between their methods.


[Clinical behavior and outcome of 213 cases of tubal sterility]. The problem of oviduct sterility is an important section in the enormous field of female sterility. Current diagnostic findings enable us to document oviduct obstructions arising following silent inflammatory processes in the adnexa. Of these, genito-pelvic TB is one of the most important aetiological agents of sterility. Medical therapy with hydrointubation alone and surgical treatment (salpingoplasty) are discussed. All cases of oviduct obstruction, including those subsequent ot episodes of genito-pelvic TB which had stabilized without serious endosalpingeal impairment, were treated surgically. The results obtained with the various salpingoplasty techniques were encouraging although the number of cases considered to be negative was increased by all the patients coming in from other regions that could not be followed up. Special attention was paid to peri- and postoperative treatment to prevent processes of adhesion invalidating recreated oviduct patency. Remembering the high percentage of stabilized genito-pelvic TB among operated patients there was absolutely no resort to the massive cortisone treatment used by other workers in the postoperative period.


[New prospects for hospital health assistance. Departmental structure and the emergency department in a provincial hospital]. The medical and social factors underlying the creation of the departmental structure of a hospital are examined, with particular reference to organisation modernity and, with respect to patient health, the multi-disciplinary set-up of the emergency department, whereby a variety of specialists can be summoned, as required, for the purpose of preliminary diagnosis and treatment immediately on admission. Diagnosis and hospital stay are also benefited by the presence of a continuous polyambulatorial and temporary admission service. Attention is also given to the possibilities and aims of extra-mural extension of departmental activities. Suggestions are made for an efficient, cheap and viable organic structure for emergency departments of the type described.


[Some aspects of otovestibular function in hyperbaric saturation]. Otovestibular performance was investigated in divers undergoing air and helium-oxygen hyperbaric saturation cycles. The subjects were all very experienced deep-sea divers. Before cycles, they presented various signs of altered otovestibular performance. These were not altered when controlled subsequently. No conclusions can be drawn from this small series, though its heterogeneity lends some significance to the results and it has been presented on account of the lack of other studies of this question.


[Possibilities and limitations of air travel]. The medical aspects of journeys by air are often of practical interest. They obviously depend on the constitution of each passenger. Their clinical picture varies considerably and may occassionally be severe. The incidence of such affections in civil aviation has not been determined, though experience shows that they are by no means rare. Evaluation of the harmful effects of flying must clearly take individual habits and histories must be taken into each account, since predisposing factors will lead to unusual features.


[Air transport of pregnant women].

[Air transport of pregnant women]. Note is taken of the fact that air travel is increasingly frequent on the part of persons of nearly all categories. The effect of hypoxia due to altitude on the body, especially during pregnancy, is considered. Particular attention is given to vasomotor activity, uterine contractility and anxiety. Flight in air-conditioned, pressurised cabins with reduced noise and vibration is recommended for pregnant women, following obstetric examination to see whether the history contraindicates travel by air. Elementary recommendations are made with respect to what should be done during the journey.


[Thoracic injuries in the field of aviation medicine]. In civil and war traumatology, 33% of deaths are due to chest traumas although this involves only 25% of cases. Examination of the physiopathy clinical medicine and treatment of the various traumatic lesions of the chest and their complications shows that rapid transfer of such patients to suitable places of treatment following adequate first aid is indispensable. The use of fully equipped aircraft is thus vital. Transport criteria are dictated by the environment, first aid resources, meterorological conditions, cruising altitude, available equipment [an automatic respirator and aspirator are essential], the training of staff, and the conditions of the patient. Above all, however, the situation is a function of the handling of the patient on the ground in relation to the facilities available on board the craft. It can be stated in conclusion that aircraft in traumatology are the best way of saving lives, not only when the patient's chest is damaged.


[The diffusion of salmonellae. Study of a homogeneous sample of 1257 children under 3 years of age in day-nurseries of Rome]. With a view to examining the importance of healthy carriers in the diffusion of salmonellas, 1257 faeces cultures were examined in a homogeneous population sample, well distributed in the area and considered healthy. The research was carried out between 5th March and 16th June 1975. 5 pathogenic germs were isolated: 2 S. London, 1 S. Wien, 1 S. Blokey and 1 Shigella. The S. Wien proved resistant to several antibiotics. Discussing the technical and epidemiological aspects of this investigation, particularly in relation to the recent epidemic of S. Wien and to the increasing isolation of germs which present polychemoantiobioticoresistance, the importance of the health carrier is stressed along with the need to obtain an antibiogram before therapy to help eliminate germs resistance to several antibiodics.


[Use of deoxyribonuclease in the therapy of the neoplastic patient]. The anti-inflammatory actvity of desoxyribonuclease has been demonstrated on a number of occasions. It has been suggested that its particular features may mean that it possesses an antineoplastic action, especially if employed in asociation with radiation or chemotherapy. The drug, which depolymerises DNA, was administered for 15-60 days [ 1 million U. on alternate days] over a period of 1 yr. in a series of 99 patients, with or without radiation or chemotherapy. No evidence of its antineoplastic activity was obtained, though the anti-inflammatory effect was distinctly observed. Quickly reversible signs of intolerance were noted in about 4% of the series.


[Preliminary study on immunoglobulins G in the cerebrospinal fluid of neurological patients]. The preliminary data from a study of the cerebrospinal fluid IgG of 76 neurological patients are reported. The radial immunodiffusion method was employed. The absolute and percentage increase of IgG with respect to total proteins in the various diagnostic classes involved in the series was considered. The most significant increases were encountered in M.S., in neuropathies and radiculopathies and in tumor involving the subarachnoid spaces. The high percentage is, however, characteristic of M.S. The method is thus particularly useful in diagnosing M.S. and in differentiating it from other neurological diseases.


[Attempt to solve technical problems involved in the re-utilization of coil filters for hemodialysis]. The problem of the reutilization of coil filters in haemodialysis is discussed. The methodologies in current use are examined and the technical risks and inconveniences that limit any real economic advantage are pointed out. On the basis of these observations, a system of reutilization is proposed which does not call for any direct handling of the filter nor any special techniques for eliminating risks of transmitting infection, and cuts to the minimum extra work involving the use of hospital staff. The proposed equipment is illustrated in detail. It consists of a small accessory individual monitor which has opened the way to the concept of "weekly dialyser". Attention is called to the need for further research into the physiopathology of the regenerated membrane, particularly in relation to the type of filter, the number of reutilizations, and the behaviour of ultrafiltration and the various solutes.


[Studies on the ultrafiltration in coil-type dialysers for recirculation]. Ultrafiltration in recirculating coil dialysers is discussed. The difficulty of determining the exact transmembrane pressure is stressed. The data normally available are insufficient and take no account of the direction of recirculation, which may be a determining factor. Input and output dialysing fluid pressure were measured in vitro and the respective ultrafiltration values were compared with those observed clinically. Calculation of the mean blood pressure in the dialyser circuit is examined. If determined from the simple arithmetical mean between the input and output pressure, this does not reflect the real situation inside the filter. It is thus unreliable when used to calculate the real transmembrane pressure, and hence the ultrafiltration.


[Acrylic cement in the osteosynthesis of pathological fractures]. After outlining the problem of pathological fractures in patients suffering from malignant tumours, a recent acrylic cement osteosynthesis technique is presented. This makes immediate immobilization of the fracture possible, alleviation of pain and so early use of the fractured extremity. The personal series is illustrated and it is concluded that the technique also offers suitable prophylaxis when radiography of the skeleton points to osteolytic areas in which pathological fracture can be foreseen.


Secondary glaucoma due to inactive congenital syphilitic interstitial keratitis. (With 1 colour plate). 35 cases of secondary glaucoma due to congenital syphilitic interstitial keratitis have been surveyed. In four cases which had no opacities in the cornea, but with positive serologic reaction for syphilis, the characteristic goniscopical features such as peripheral anterior synechia, pigment deposits in the trabeculum, and irregularity of iris configuration as observed commonly in cases with inactive congenital interstitial syphilitic keratitis, were found. In the clinical course and goniscopical findings, they were divided into two types: one was the angle closure type with acute glaucomatous attack, and the other the wide open angle type with insidious course of the disease. The prognosis of this secondary glaucoma was very poor, although medical therapy was taken for the wide open angle type, and surgical therapy for the angle closure type. In the present study, the importance of gonioscopical examination, and careful attention to avoid the ufention to avoid the further formation of peripheral anterior synechia in the surgical procedure, was stressed for secondary glaucoma with congenital interstitial syphilitic keratitis.


Fluorescein angiographic behaviour of iris masses. 28 cysts and tumours involving the iris are studied by means of fluorescein angiography of the anterior segment. Iris cysts usually showed abnormally dilated and tortuous feeding vessels, but only exceptionally did they leak fluorescein. Inflammatory masses presented massive dye leakage from both tumour-involved and distant iris vessels. Benign stromal masses showed normal angiograms or dye leakage limited to the tumour site. Benign pigmented lesions were angiographically always silent, whereas malignant melanomata showed moderate to heavy leakage from the tumour. This leakage occasionally extended to apparently uninvolved iris areas, specially to the pupillary margin. Exceptionally, a malignant melanoma of the iris was angiographically silent. It is concluded that iris angiography is a useful but not error-free method for the evaluation of iris masses.


Ultrastructure of iris muscles in diabetes mellitus. Fine structure of iris muscles from 16 iris specimens in patients with diabetes mellitus were investigated by electron microscopy, and the results were compared with those of 10 specimens of senile cataract eye without diabetes of the corresponding age groups. Significant ultrastructural changes were extensively found at the regions of the dilator, sphincter muscles and of the nerves endings adjacent to them. To cytoplasm of the muscle cells was partly occupied by membraneous structures with concentric lamellar appearance. Cytoplasmic vacuolations were noted in the muscle cells. An increased number of the lipid droplets associated with pigment granules in the cells was found in all diabetic iris specimens. These three kinds of pathological changes (lamellar structure, vacuole, and lipid droplet) increased depending on the duration as well as the control of the disease. Althought these findings were noted both in the sphincter and dilator muscles, the latter seemed to be more severely affected. Degenerative nerve endings containing lamellar membraneous structures were observed in a few moderate cases. Nerve fibers frequently diminished in diabetic patients, especially in severe cases with longer duration together with poorly controlled cases. These findings suggest that diabetes involves the iris muscle cells as well as the nerves, and these changes might be a reason to produce a pupillary abnormality.


Anterior cerclage and accessory implants for post-equatorial breaks. The advantages of the anterior-cerclage accessory buckle technique over the posteriorcerclage technique for treatment of post-equatorial breaks are stressed. The former technique leads to less frequent occurrence of post-operative vitreous retraction, meridional retinal folds and less danger of iris prolapse, and vitreous loss if the globe is to be opened for intraocular surgery later.


Experimental morphological study on structure and function of the filtration angel of the rat eye. The chamber angle of the eye of pigmented laboratory rats was studied in normal structure and experimentally with the electron microscope. Their exists a circular, flattened canal which corresponds in its topographical position and in its ultrastructural construction to the canal of Schlemm in humans and primates. A trabecular meshwork, comparable to the trabeculum cribriforme in primate eyes, lies directly below the inner wall of Schlemm's canal. The endothelial cells of the trabeculae show phagocytotic activity. The trabecular meshwork is, however, far less intensive in the rat eye than in that of man and it extends up to the spaces of Fontana. Beside a few differences there exist great similarities in structure and function of the chamber angle of the rat eye compared to the corresponding area of eye of man and primates.


[First results of sportmedical examinations in children norm-values and influence of overweight on physical efficiency (author's transl)]. The individual physical efficiency was ascertained according to a method developed by RUTENFRANZ, where the criterion was taken as being the particular performance which resulted in a pulse rate of 170 beats per minute. This was termed the p.w.c. 170 (physical working capacity), and was measured on a bicycle ergometer, with increasing loading of 1, 2, and 3 watt per kilogram of body weight. During this loading the E.C.G. was watched telemetrically on an oscilloscope, and recorded each minute. The p.w.c. 170 was ascertained both graphically and arithmetically from the respective pulse rate in the 6th minute of each load level. Initially, twenty healthy children were tested, so as to arrive at normal values. The average reading for these children was about 5% below the normal values given by RUTENFRANZ. Subsequently, fifty five obese children were examined, so as to clarify the question as to whether there was a linear correlation between overweight and physical efficiency. Indeed, it was possible to establish a regression equation according to which each 10% of overweight lead to a decrease of physical efficiency of 5.8%. The results of further examinations will be reported in the next paper.


[Carbohydrate metabolism of infants with prenatal dystrophy and infants of diabetic mothers. Glucosetolerance and insulinsecretion in the first week of life (author's transl)]. Alterations of carbohydrate metabolism were studied in infants of insulin dependent diabetic mothers and in small for date babies with and without prenatal dystrophy. Glucose assimilation (Kt-value) and insulin secretion after i. v. glucose load were examinated on the 1st, 3rd, and 5th day of life. Infants of diabetic mothers showed the highest Kt-values, fasting insulin levels and insulin peaks of all patients examinated. Hyperinsulinism and Kt-values decreased from the 1st to the 3rd day and from the 3rd to the 5th day. In this group the infants of mothers with strictly controlled diabetes showed lower Kt-values, lower insulin peaks and less pronounced cushingoid facies. Small for date babies, on the other hand, had a reduced glucose tolerance on the first day, which normalised up to the 3rd day. The glucose tolerance in small for date babies with prenatal dystrophy, however, showed a tendency to deteriorate again from the 3rd to the 5th day with decreasing Kt-values as well as reduced insulin secretion, which was well documented in two cases. Deterioration of pancreas function and failing adaption to post partum nutrition is put forward as a tentative explanation.


[Anaphylactoid purpura schönlein-Henoch in infancy (author's transl)]. The outbreak, the progress and the treatment of the anaphylactoid purpura at an 8 months old infant are reported. It is referred to the rare outbreak of this disease at infants younger than one year. The differential diagnosis and the measurement of treatment are discussed.


Fetal neurohypophyseal arginine vasopressin and arginine vasotocin in man and sheep. Immunoreactive arginine vasopressin (AVP) and arginine vasotocin (AVT) were quantitated in 15 of 17 human fetal pituitary glands early in gestation (11-19 weeks) and in 8 of 9 ovine fetal pituitary glands late in gestation (109-137 days). In 14 of 15 human fetal glands, AVT content exceeded that of AVP. There was a significant rise of AVP (as a percentage of total AVP plus AVT content) with gestational age over the period of 12-19 weeks (P less than 00.01). The ovine fetal glands demonstrated a preponderance of AVP over AVT. The mean AVP and AVT content in the ovine glands was 5.7 +/- 2.9 and 0.8 +/- 0.2 mU/mg gland weight, respectively, compared with the values in the human fetal pitiutaries, 0.8 +/- 0.2 and 1.2 +/- 0.2 mU/mg gland weight, respectively. The relative percentage of AVP and AVT in the ovine fetal pituitaries was 76.0+/- 9.6% and 23.9 +/- 9.6%, respectively, as contrasted to the human fetal glands, 36.7 +/- 2.7% AVP and 63.3 +/- 2.7% AVT. The preponderance of AVT over AVP in the early gestational age mammalian fetus may represent a primative first step in molecular evolution of the neurohypophyseal peptides.


Metabolic studies on two patients with nonhepatic tyrosinemia using deuterated tyrosine loads. Metabolic studies on two patients with defects in the tyrosine oxidation pathway are reported. Serum tyrosine was greatly elevated in both patients (1.37 and 1.52 mmol/liter, respectively) and both excreted large quantities of p-hydroxyphenylacetic acid, p-hydroxyphenyllactic acid, and p-hydroxyphenylpyruvic acid. Deuterated tyrosine loads were administered to both patients, before and after lowering of the serum tyrosine concentration by dietary treatment, and to a normal adult control subject. In one patient the excretion of the deuterated (D2)-tyrosine load was more than 300 times that found in the control subject whether the test was done at high or low serum tyrosine level and the pattern of metabolites indicated a persistent defect in p-hydroxyphenylpyruvic acid oxidase. Enzyme assays on needle liver biopsy supported this finding. In the second patient excretion of the D2 label was 300 times that of the control at high serum tyrosine levels, but only 5 times normal at low serum tyrosine levels. This finding was interpreted as indicating substrate inhibition of p-hydroxyphenylpyruvic acid oxidase. The primary defect has not been established in this patient, but the findings are compatible with a defect in hepatic-soluble tyrosine aminotransferase.


Neuropathic Gaucher's disease with normal 4-methylumbelliferyl-beta-glucosidase activity in the liver. beta-Glucosidase activity was measured in control subjects and in five patients with neuropathic Gaucher's disease. In three patients with Gaucher's disease, methylumbelliferyl- and p-nitrophenyl-beta-d-glucopyranoside (4MU- and PNP-beta-glucosidase) activity was almost normal in the liver but markedly reduced in the spleen and fibroblasts. In the other patients with Gaucher's disease 4MU- and PNP-beta-glucosidase activity was also very much reduced in the liver, spleen, and fibroblasts. DEAE-cellulose column chromatography with a chloride gradient elution of the liver extract from a control subject and from two patients with Gaucher's disease, exhibiting normal 4MU- and PNP-beta-glucosidase activity, revealed the presence of two peaks of 4MU- and PNP-beta-glucosidase activity (fractions 1 and 2). pH activity curves of beta-glucosidases and Km measured with 4MU-beta-glucoside in fractions 1 and 2 from patients with Gaucher's liver were identical to those from the control liver. However, fractions 1 and 2 from infantile Gaucher's liver exhibited no activity measured with glucocerebroside whereas those from juvenile Gaucher's liver showed a considerable activity. Glucocerebroside was greatly accumulated in the liver, even though an almost normal activity of 4MU-beta-glucosidase was detected in three of the five patients studied.


Influence of fetal extracellular volume contraction on renal reabsorption of bicarbonate in fetal lambs. In order to determine the renal threshold for bicarbonate in the fetal lamb and factors that may influence renal reabsorption of bicarbonate in the fetus, 18 acute fetal lamb preparations (110-140 days of gestation) were studied. In the first series of experiments involving nine fetuses, the renal bicarbonate threshold of normal fetuses varied from 12.0 to 23.5 mM/liter with a mean value of 17.7 +/- 1.37 mM/liter. This is significantly lower (P less than 0.005) than the value measured in five adult sheep of 28.7 +/- 1.68 mM/liter. There was a significant and positive correlation between the fetal plasma bicarbonate at threshold level and the fetal kidney weight, as well as fetal age. In a second series of experiments, the excretion of bicarbonate and sodium was studied in nine fetuses before and after dehydration by peritoneal dialysis. After peritoneal dialysis there was a significant decrease in urinary pH (P less than 0.025), bicarbonate excretion (P less than 0.001), sodium excretion (P less than 0.001), fractional excretion of sodium (P less than 0.01). When glucose was replaced by mannitol in the peritoneal dialysis fluid the effects on bicarbonate reabsorption paralleled those when glucose was present in dialysis fluid. It was also shown that when glucose was given intravenously to the fetus, up to a plasma concentration of 200 mg/100 ml, there was no effect on the fetal renal reabsorption of bicarbonate. These data indicate that the low threshold for bicarbonate reabsorption by the fetal kidney is not due to a limited capacity to increase bicarbonate or sodium reabsorption and suggest that the fetal kidney is able to respond to volume depletion by increasing its reabsorption in bicarbonate and electrolytes.


Enzymic differentiation of human liver: comparison with the rat model. The quantitative pattern of enzymes in the second trimester human fetal liver is significantly different from that of adult liver. For some 20 enzymes, the activity quotient (AQ, i.e., activity of immature liver divided by that in adult liver) is appreciably different from 1.0. Most of the enzymes increase their concentrations with age but, as one would expect, some contribute to differentiation by diminishing in amount. In developing human liver the concentrations of the various enzymes tend to change in the same direction as they do in rat liver. Those that increase in rat liver have been classified into three main clusters, according to whether their rise begins on about the 17th day of gestation (B), the first neonatal day (C), or just before weaning (D), respectively. The distribution of these enzymes among these three clusters correlates with their AQ's in the human fetal liver. In general, enzymes with AQ around 0.5 belong to cluster (B) in rat liver whereas those with 0-0.16 belong to cluster C or D. Gross malformations resulting from the teratogenic action of drugs, hormones, or vitamins on the early embryo attract much attention. The harmful impacts of such agents at late stages of gestation are less spectacular. They may be more frequent, however, and manifest themselves in permanent inadequacies in metabolism or growth with a tendency to succumb to minor childhood diseases. The underlying causes may not be mirrored in the cytocomposition or even the subcellular morphology of autopsy specimens. Only deviations from the organ characteristic quantitative pattern of gene products would provide sensitive enough indictors of the metabolic lesions and of the aberrant aspects of differentiation that were responsible for them. In both the presence and absence of detectable morphologic abnormalities, the study of enzymes, this most varied and largest class of specific chemical constituents, would greatly extend the resolving power of the usual diagnostic procedures postmortem.


Cellular and humoral components of monocyte and neutrophil chemotaxis in cord blood. Monocyte and polymorphonuclear neutrophil (PMN) chemotaxis was studied in cord blood from healthy term infants. Monocyte chemotaxis was normal to increased (115-126%) whereas PMN chemotaxis was decreased (79%) in comparison with that of healthy adult control subjects. Generation of chemotactic factors from cord sera was impaired, being 55% of that generated by pooled normal human serum (PNHS). Cord serum was less inhibitory than pooled adult human serum for adult monocytes when the cells were suspended in 10% serum and tested for chemotaxis. No inhibition of chemotactic factors by either cord or adult sera was observed. The dissociation of chemotactic response of the two different phagocytic cells may represent a protective mechanism whereby one cell can compensate for a defect in the response of the other.


Patterns of cystine reduction by fibroblasts from normal and cystinotic children. The possibility that the enzymatic reduction of cystine involves a multi-enzyme system led to re-evaluation of cystine reduction by fibroblasts from normal and cystinotic patients. Lineweaver-Burk plots of data with extracts of a normal cell line, representative of seven normal cell lines, under conditions of increasing cystine with variable levels of reduced glutathione (GSH) resulted in a two-limbed curve above 100 micronM cystine. Two cell lines from children with nephropathic cystinosis containing 1-6 micronmol half-cystine/g protein gave a family of curves similar to those of the normal. With six fibroblast lines containing more than 6 micronmol half-cystine/g protein, increasing cystine resulted in a family of lines without two-limbed curves. Plots of the data as activity against increasing cystine concentrations at ratios of cystine to GSH of 1:2 and 1:1 showed that two of the three lines from cystinotic subjects reduced cystine at a faster rate than the normal line. The third line from a cystinotic patient reduced cystine at a slightly slower rate when the substrate concentration in the assay was less than 80 micronM cystine. When the cystine to GSH ratio was maintained at 2:1, normal cells showed a linear increase in the rate of cystine reduction up to 100 micronM cystine, no increase in the rate between 100 micronM and 200 micronM cystine, and an increase again when the concentration of cystine was raised above 200 micronM. Such a stepwise phenomenon was absent with six cell lines containing more than 6 micronmol half-cystine/g cellular protein. A possible mechanism of control of cystine reduction is discussed.


Lesch-Nyhan syndrome: the synthesis of inosine 5'-phosphate in the hypoxanthine-guanine phosphoribosyltransferase-deficient erythrocyte by alternate biochemical pathways. Erythrocytes, obtained from a normal adult male and from a patient with Lesch-Nyhan syndrome, were incubated with [8-14C]adenine and [8-14C]hypoxanthine (Table 1). The labeled adenine was utilized to about the same extent for the synthesis of AMP by the normal subject's and the patient's erythrocytes. Deamination of AMP to IMP occurred to about the same extent in both samples. In contrast, hypoxanthine was utilized extensively for IMP synthesis in the normal erythrocyte only. The amount of total label in the IMP was about 100 times that of the Lesch-Nyhan erythrocyte, a consequence of the deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT) activity in the syndrome. No significant labeling of the AMP occurred. When aliquots of erythrocytes from both sources were incubated with 4-amino-5-imidazolecarboxamide (AICA) and sodium [14C]formate, extensive labeling of the IMP occurred in normal and in Lesch-Nyhan erythrocytes. The data suggest that AICA serves as a substrate for the adenine phosphoribosyltransferase (APRT) of the Lesch-Nyhan erythrocyte and that the ribotide of AICA, 5'-phosphoribosyl-5-aminoimidazole-4-carboxamide (AICAR), undergoes formylation by labeled N10-formyl tetrahydrofolic acid formed from the reaction of sodium [14C]formate with the tetrahydrofolic acid of the cell. The formyl-AICAR undergoes ring closure to IMP by a series of reactions comparable to those described for the normal erythrocyte. When 5-amino-1-ribosyl-4-imidazolecarboxamide (rAICA) and sodium [14C]formate were incubated with erythrocyte suspensions, extensive utilization for IMP synthesis was also observed in normal erythrocytes and in erythrocytes from Lesch-Nyhan patients (Table 2). The reaction sequence is somewhat different from that of AICA. AICA is not a substrate for the purine nucleoside phosphorylase of rabbit or human erythrocytes. The mechanism of rAICA utilization is visualized as a direct phosphorylation of the ribosyl compound, possibly by the adenosine kinase of the human cell. The ribotide, AICAR, formed by this mechanism, undergoes formylation and ring closure, yielding IMP. The glutamine antagonist, diazooxonorleucine (DON), was added to aliquots of patients' cells incubated with rAICA and sodium [14C]formate. DON is an effective inhibitor of the conversion of IMP to GMP and its presence in an incubation suspension resulted in a somewhat greater radioactivity of the total cellular IMP. The extension of the current studies to Lesch-Nyhan cells in culture may serve to assist in the direct evaluation of the regulatory role of IMP in the de novo pathway of purine nucleotide biosynthesis. Because of the substrate requirements of the reactions, the metabolism of AICA and rAICA may also serve to differentiate the roles of purine nucleotides and of phosphoribosylpyrophosphate (PRPP) in the pathway regulation. The findings presented also offer a possible therapeutic approach to the early treatment of the disease in the afflicted neonate...


Influences of environmental conditions during infancy on final body stature. In the following article we shall investigate the Second World War with its consequences on nutrition and other living conditions for the German population to try to determine whether lack of nutrition plus other deficiencies, which infants were subjected to in Germany during this time, had any influence on their adult stature. The following data formed the basis of our investigation: (1) nutrition of infants and school-aged children during the years 1939-1948; (2) stature and weight of 6-year-old boys between 1907 and 1948; (3) infant mortality between 1935 and 1950; (4) stature of 19-year-old men who were born between 1938 and 1951. From Figure 5 it can be seen that the mean stature of 19-year-old men born between 1938 and 1951 (except for those born in 1944 and 1945) rose steadily (secular acceleration). The plot of the yearly rate of acceleration (Fig. 6) reveals a minimum in 1944-1945, and follows a general downward, U-shaped trend (P less than 0.05). On the other hand, infant mortality between 1941 and 1949 follows an upward U-shaped trend (P less than 0.05). For the 6- to 8-month-old infants during 1945-1948 nutrition was far worse than that during the preceding years. It is even likely that the nutrition for the infants had already begun to decrease in quality in 1942. We find, therefore, a close correlation between the years of high infant mortality and the growth deficiencies of the men born during these years. Since we must assume that the nutritional situation for babies and infants worsened steadily after 1942 until it is apparent that a number of environmental factors directly influence human growth. The conclusion of our analysis is that a deficit of growth occurring after the end of the fourth year can be compensated fully. We conclude, furthermore, that the growth deficits which arise before the fourth year, on the other hand, cannot be compensated fully even if good or excellent environmental conditions follow.


Why do human cancer death rates increase with age? A new method of analysis of the biology of cancer. 1. Cancers, viewed as escape from the normal "contact inhibition" of cells in tissues, can be considered to start at some given time and then to require a period of incubation before they cause death. The probability of a start may depend on age, described by a start function. The incubation period may be described by a lethality function of the period between start and the age at which death rates are measured. 2. It can be shown that, provided the loss of tumour-bearers (where cancer has started) in the population by deaths from other causes than cancer is in the same ratio as the loss of total population, the differential curve (dR/dA) of the rate versus age curves must give the product of these two functions (start function X lethality function). 3. The differential curves dR/dA for major sites of cancers are examined for WHO data on  deaths. The differential curves prove to be well described by normal Gaussian curves. The presence of more than one type of tumour or of physiological environment, included in a single category, is shown by multiple peaks in the differential curves. The outstanding exception is tumours of the "brain and other CNS" where the rate curve itself is Gaussian. 4. The results are consistent with a start rate that is random and independent of age (not exceeding three per 1,000 per year for the commonest tumour), and an astonishingly long incubation period of at least 20-50 years. For most sites, the curves indicate that from 20 to 40% of the cancers that have started do not cause death, because other causes supervene. 5. The implications as to the possibilities of control of cancer and of the relevance of experimental cancer research are discussed.


The development of a practicable method for deepfreezing of boar spermatozoa. The present study was made in order to develop the freezing method of Crabo & Einarsson (1971) into a practicable deep-freezing method for boar spermatozoa. Semen was concentrated before dilution and a dosewise thawing procedure for the pellet-frozen semen was utilized. Two fertility tests on altogther 68 gilts were performed. In the first trial the insemination doses contained 6x10(9) spermatozoa and the dilution rate before cooling was 3:2 with a total dilution before freezing of 3:7. In the second trial the insemination doses contained 4.5x10(9) spermatozoa, primary dilution was 3:3 and final dilution 3:7. The pregnancy rate in trial 1 was 53% and in trial 2 72%. Mean litter size in pregnant gilts was 6.5 in trial 1 and 9.7 in trial 2. The difference in ratio of foetuses to c.l. in pregnant gilts between the trials was highly significant. The different dilution procedures are discussed and the lower fertility of semen frozen in trial 1 is suggested to be due to a shortened fertile life of spermatozoa so treated. The freezing method utilized in trial 2 is considered to be practically acceptable and the results are concluded to be satisfactory. A detailed description of the method and the equipment utilized can be requested from the authors.


A decapitated sperm defect in two sterile Hereford bulls. Two almost identical cases of sterility in young Hereford bulls have been investigated. Semen samples sent to the laboratory showed normal sperm concentradition and abnormal sperm morphology. In 80-95% of the sperm cells, head and tail were separated, and similar to what has been found in the 'decapitated sperm defect' in the Guernsey breed, a high percentage of the loose tails were able to perform active movements. A third characteristic was a proximal bending or curling of the loose tail around the cytoplasmic droplet, a detail which by lower magnification might be mistaken for a mini-head. The possible heredity of the defect is discussed.


Congenital malformations in pigs in a post mortem material. Pigs which died during the preweaning period in 17 herds were examined post mortem over a 2-year period. In total 6,669 pigs, including 1,884 stillborn, from 2,936 litters died. The total number of pigs born constituted 29,886. Congenital malformations were registered in 410 pigs equalizing 1.4 per cent of the pigs born (Table I). The various malformations were analysed and related to a number of herd parameters. The herd to herd variation was 0.6--2.4 per cent, with a mean of 1.4 per cent. The incidence of affected litters was 11.8 per cent, showing a variation between the herds of 6.4 to 17.6 per cent. The frequency of malformed pigs was found to be higher in closed herds as compared to herds in which breeding stock was purchased (1.6 per cent versus 1.2 per cent). The relative importance of the various malformations is presented in Table II. The individual malformations are discussed, and it is concluded that the present investigation cannot contribute to a further genetical elucidation. Test matings with closely related animals, which is unrealizable in commercially run herds, are needed for that purpose. About 70 per cent of the recorded malformations appeared as phenotypic and could easily be recognized by a laid person. Malformations may therefore persist on a fairly low level as long as natural insemination is used. The present level of hereditary malformations may easily change with an increasing use of artificial insemination, and systematic monitoring of malformations becomes imperative in avoiding an unacceptable increase in the frequency of malformations. In processing collected data from sow/litter records and boar records, the data processing program applied in this study is supposed to be suitable.


A comparison of tetrathionate broth and Rappaport's medium as enrichment media for Salmonella. Tetrathionate broth (Müller-Kauffmann) and Rappaport's medium were compared in isolating Salmonella from meat- and bone-meal, receiving waters, sewage, and sludge. The results (Table I) show no difference in isolations from meat- and bone-meal, receiving waters, or sewage, while in studying sludge isolations were significantly less frequent from Rappaport's medium than from tetrathionate broth. The Salmonella positive plates, however, were easier to read when inoculated from Rappaport's medium than from tetrathionate broth.


Collagen fiber orientations in human secondary osteons. Scanning electron microscopy studies of decalcified human secondary osteons were conducted to determine correlations in fiber orientations in these osteons with their appearance under crossed polaroids. Using a new sample preparation technique, osteons were prepared to expose many of their lamellar interfaces. By studying many such samples, it was concluded that osteons which appear 'dark' under crossed polaroids contain fibers with orientations having little or no transverse component, whereas 'bright' osteons possess fiber orientations with transverse and longitudinal components. 'Intermediate' osteons have been found to contain fiber orientations richer in longitudinal component than in transverse.


Appearance of the wild boar brain.

Appearance of the wild boar brain. On eight brains of wild boars, the appearance of the exterior and interior brain structures was studied. The brain was preserved in the skull by formalin solution injection into the carotid artery. After having been set up for 4 months in a 5% formalin solution, the brain was removed in conjunction with the coverings. Subsequently, the brain was preserved in 5% formalin for 2 months. By careful dissection and elaboration of special preparations, the appearance of the grey and white substance of the brain, of the basal ganglia and of certain portions of the limbic system was studied. On the frontal and horizontal sections of the brain the appearance of the brain matter, of the basal ganglia and of the brain ventricles was studied. The exterior and interior morphology of the cerebellum was investigated on special preparations.


Coeliac disease with mild mucosal abnormalities: a report of four patients. In a routine adult gastroenterological practice, seventeen (15%) of 123 patients had small-intestinal biopsies which were neither normal nor were completely flat as found in classical coeliac disease. Some of these had a possible cause for the mild mucosal abnormality, but in six there was no other apparent cause and all four of these who were treated with a gluten-free diet responded morphologically and symptomatically. It is concluded that at least these four patients have coeliac disease in a mild form and that the classical flat biopsy is not a prerequisite for the diagnosis of coeliac disease.


Primary anorexia nervosa (weight phobia) in males. Ten cases of primary anorexia nervosa (weight phobia) in males (as against 196 females) have been treated in the United Birmingham Hospitals over 19 years. A discrete syndromes appears to exist with much to support the view that it is the counterpart of primary anorexia nervosa in the female. Six illustrative case histories are described briefly. The heavy loading with consistent abnormalities of psychiatric interest makes it very probable that weight phobia is primarily a psychiatric disorder.


Pharmacology of new 7-gamma-piperazino-beta-hydroxypropyl theophline derivatives. Part II. The effect on course and dynamics of delayed contact allergy produced with 2,4-dinitrochlorobenzene (DNCB) in guinea pigs. The action of three new 7-gamma-piperazion-beta-hydroxypropyl theophylline derivatives on the course and dynamics of development of skin reaction in delayed hypersensitivity produced by a potent sensitizing agent (DNBC) was studied. The preventive action, particularly of compound R6, against exudate and edema of the sites of depot of the antigen in the guinea pig is similar to the effect produced by classical antihistaminics, as mepyramine mepyramine or tavegyl. It has been found histopathologically that compound R6 does not change the localization and proliferation of mononuclear perivascular cells typical for delayed hypersensitivity.


Polymorphism of indomethacin. Part II. Identification and rapid determination of polymorphic forms of indomethacin by IR spectrometry. A procedure is described, which make it possible to determine the content of individual polymorphic forms of indomethacin in their mixture by IR spectrometry. IR spectra recorded in the range of 1600--1800 cm-1 have been used in the determinations. The method is especially useful for analytical control of the technological process of preparing the most pharmacologically active-gemma-form of indomethacin.


Neonatal barbiturate withdrawal.

Neonatal barbiturate withdrawal. An infant with neonatal barbiturate withdrawal syndrome is reported. The clinical features, diagnosis and treatment of this condition are discussed. A retrospective review of fifty-three infants of barbiturate-treated epileptic mothers indicated a high incidence of "jitteriness" (17%) and feeding problems (36%) in the immediate neonatal period.


Effect of atebrine on glucose blood levels and on flavinic nucleotides content in rat liver in deficiency state and in satisfied demand of riboflavine. Changes in glucose levels in blood, excretion of riboflavine in urine, FAD and FMN flavinic nucleotides and a total riboflavine content in liver homogenates were determined in rats. Both riboflavine deficiency and atebrine do not effect the glucose, blood levels. Atebrine (ATB) significantly inhibits the urinary excretion of riboflavine both in deficiency state and in satisfied demand of this vitamin. The lack of riboflavine in food results in a decrease of total riboflavine and FA- in liver, while during the first period of deficiency the amount of FMN increases. When the riboflavine demand is satisfied, low doses of ATP do not influence the total riboflavine and flavinic nucleotides content in the liver, while at high doses, the total riboflavine increases and the amount of FMN initially significantly exceeds the amount of FAD. ATB markedly inhibits the growth of rats both in the deficiency state and in the satisfied demand of riboflavine.


Management of prolonged hypoglycaemia in Beckwith's syndrome. A new-born baby with Beckwith's syndrome had severe hypoglycaemia, and was treated with glucagon and prednisone. Treatment was stopped at 1 month of age and his blood glucose levels were satisfactory for the ensuing 6 weeks. However, at 10 weeks of age, he had a hypoglycaemic convulsion and required large doses of diazoxide and prednisone for the next 2 months to maintain the blood glucose above 40 mg/100 ml. Insulin excretion was raised until he was 4 months old. Cases of Beckwith's syndrome which develop hypoglycaemia, should be treated with diazoxide and corticosteroids until insulin excretion is normal.


The effect of intrahippocampal injections of serotonin on bioelectrical activity of Gyrus cinguli and amygdaloid nucleus in the rabbit. The effect of injection of serotonin (5-HT), dissolved in 2 mul of bidistilled water, into hippocampus was studied in rabbits with chronically implanted electrodes and cannulas. Bioelectric activity of gyrus cinguli, amygdaloid nucleus, and dorsal hippocampus was recorded. 5-HT (10--20 mug) inhibited the electrical activity of the structures investigated, and this inhibition was accompanied by a suppression of locomotor activity or sleep.


Symptomatic hyponatraemia associated with tolbutamide therapy. A case of hyponatraemic coma occurring in a patient with diabetes mellitus treated with tolbutamide is described. Although chlorpropamide is known to cause water retention in some circumstances, this is a less well recognized complication of tolbutamide therapy.


The action of piracetam on 14C-glucose metabolism in normal and posthypoxic rat cerebral cortex slices. The stimulating effect of piracetam on the respiration and glycolysis was observed in rat brain cortex slices incubated under oxygen atmosphere. After preincubation of the slices under pure nitrogen atmosphere, piracetam infuenced also decarboxylation of the C1-glucose carbon, indicating stimulation of the pentose cysle. Any significant effect of piracetam on the lowered by anoxia incorporation of 14C from U-14C-glucose into macromolecular fractions was not observed. The results have supported a protective effect of piracetam against oxygen deficiency, caused mainly by stimulation of metabolic glucose pathways, connected with energy production in CNS.


Spontaneous rupture of the abdominal aorta. Fatal spontaneous rupture of the lower abdominal aorta in a previously healthy 61-year-old woman is reported; the possibility that she had the Ehlers-Danlos syndrome is discussed.


Acute appendicitis in association with non-obstructive carcinoma of the caecum. A case of carcinoma of the caecum is reported, which presented as acute appendicitis, although the carcinoma did not obstruct either the lumen of the appendix or the colon. The prognosis for caecal or proximal colonic neoplasm presenting as appendicitis is poor. This is in part due to the association being missed at the initial laparotomy. It is suggested that a more aggessive attitude should be taken in the pre- and post-operative management of any patient over 50 years of age who presents with appendicitis. The difficulties of identifying a small tumour at laparotomy even if the mucosa can be palpated are emphasized.


Nonscorbutic effects of vitamin C: biochemical aspects. There is a certain presumptive evidence for believing than AA has functions other than the simple prevention of classical scurvy; whether these extra-antiscorbutic functions are attributable to AA itself, or to one or more of its metabolites, is not known. Tissue saturation with AA would appear to provide a good insurance against defects in these extra-antiscorbutic areas. ttissue saturation is attainable by a daily intake of 100-150 mg in man; there are no compelling reasons for using megadoses of AA and the emphasis should be on the avoidance of chronic hypovitaminosis C. There is suggestive evidence that megadoses of AA could be physiologically disadvantageous--particularly with regard to in-utero exposure and in persons exposed to high environmental levels of toxic metals.


Current status of vitamin D metabolism.

Current status of vitamin D metabolism. In summary one can record that the biochemist has discovered a beautiful metabolic pathway for vitamin D which is probably as yet incomplete. Subsequently the medicinal chemist has provided numerous synthetic analogues. However, delays in the diagnosis and treatment of vitamin D disorders, due to lack of specific assays and inadequate supplies of therapeutic metabolites, still unfortunately exist. It is hoped that these problems will be rectified as soon as more plentiful supplies of the appropriate metabolites are available.


Toxicological problems associated with the manufacture of triazapentadienes. 1, 3, 5-triazapenta-1, 4-dienes are a new group of pesticides which are particularly effective against acarids. This report concerns various toxicological manifestations which occurred amongst the workforce of a small chemical processing plant engaged in the manufacturer of these substances. The toxic effects noted can be divided into three groups: (1) "Skin flushes", similar to those which have been observed amongst workers using dimethyl formamide. (2) Acute keratoconjunctivitis which occurred as a delayed reaction (between 6 and 12 hours after finishing work). (3) Intoxication following inhalation of isopropyl alcohol fumes. This is of special interest as reputable authorities discount this method of absorption as being a serious problem resulting from the use of isopropyl alcohol in an industrial situation.


Nontuberculous infection of the spine.

Nontuberculous infection of the spine. Fourteen cases of nontuberculous infection of the spine were presented, and compared with similar published series (172 cases). The ESR was very high in all cases except one. It returned to normal after recovery. The long delay (5-28 weeks) in diagnosis emphasizes the need for increased awareness of the condition, and the importance of repeated investigations, if these are initially normal. If diagnosed and treated in time the disease runs a relatively benign course. Open exploration is not necessary in all cases, and whether this speeds recovery is open to question. It is indicated to exclude tuberculosis doubtful cases, to obtain a positive culture if other evidence is lacking, and is an absolute indication in paraplegia.


Calcium metabolism in breast cancer.

Calcium metabolism in breast cancer. Patients with breast cancer and bone destruction were found to have a pattern of calcium metabolism which was broadly similar to that found in other malignancies, but different from that in primary hyperparathyroidism. Thus, they tended to have reduced absorption of calcium from the intestine, elevated endogenous faecal calcium and normal or reduced urinary cyclic AMP excretion. Since prostaglandin synthetase inhibitors have been shown to inhibit breast cancer-induced osteolysis in vitro we have attempted to reduce bone destruction and serum calcium in patients with hypercalcaemia complicating breast cancer using these agents. High doses failed to reduce the serum calcium or the urinary hydroxyproline: creatinine ratio in ten patients with skeletal metastases, four of whom had hypercalcaemia.


Adrenergic stimulation of the lateral hypothalamic area on sodium and potassium excretion. The effects of adrenergic stimulation of the lateral hypothalamic area on sodium and potassium excretion were studied in rats bearing implanted cannulae. When noradrenaline was injected into several points of the lateral hypothalamic area, a dose-related increase in natriuresis and kaliuresis was observed. Rats previously injected through the same cannulae with alpha (Regitine) or beta (Propranolol) blocking agents showed different natriuretic responses when injected with noradrenaline. It was observed that the normal noradrenaline-induced natriuresis was abolished by the alpha-adrenergic blockers, while beta-adrenergic blockers increased the response. Intrahypothalamic injection of Isoproterenol, and activator of the beta-adrenergic receptor, induced a decrease in natriuresis, kaliuresis and urinary volume. In contrast, injection of Metaraminol, an alpha-adrenergic agonist, caused an increase in sodium and potassium excretion and a reduction of urinary volume. Drugs blocking the destruction of noradrenaline or its reuptake by the presynaptic nerve endings potentiated 2-fold the action of 20 nmol of noradrenaline. These experiments provide good evidence for the existence of an adrenergic mechanism consisting of alpha and beta receptors which works antagonistically on the regulation of sodium and potassium excretion. The excretion on the two electrolytes is stimulated by the alpha-adrenergic system, and inhibited by the beta-adrenergic system.


Effects of diazepam on behaviour suppressed by extinction in pigs. Diazepam injected to pigs previously trained to perform an operant response for food according to a continuous reinforcement schedule significantly increased resistance to extinction compared to control pigs. In pigs submitted to a time-out procedure diazepam increased the number of nonreinforced responses at the beginning of the acquisition but was unable to disinhibit suppressed behaviour in the later stages of acquisition when the extinguished behaviour was well acquired. The results are discussed with respect to antiaversive or disinhibitory effects of benzodiazepines and an alternative interpretation, the strengthening of the prevailing behavioural tendency in the animal's repertoire at the time of test, is put forward.


Experiential input alters the phosphorylation of specific proteins in brain membranes. The effects of a training experience that involves foot shock on the endogenous phosphorylation of membrane-bound proteins from brain were studied. Crude membrane fractions were prepared from the cerebral cortex and neostriatum of animals that had been sacrificed by quick freezing. In vitro incubation of the membranes with gamma-32P-ATP, follwed by SDS-gel electrophoresis of the phosphorylated substrates, revealed that the phosphorylation of two protein components (designated F and H-I) increased in preparations from animals that were subjected to a training experience 24 hr prior to sacrifice. These effects were greater in preparations from the neostriatum than from the cerebral cortex, and were observed in experiments using both rats and mice. Although all trained animals showed a high phosphorylation of bands F and H-I, control animals showed a greater variability in the phosphorylation of these bands. The results indicate that the phosphorylation of specific proteins may play a mediatory role in the processing of experiential information.


Enhancement of pseudoconditioning and retardation of escape by low doses of ethanol. Independent groups of mature Wistar rats were injected intraperitoneally with 0.9% NaCl solution or 0.5 g/kg, 1 g/kg or 2 g/kg ethanol prepared from a 30% ethanol solution in 0.9% NaCl. Thirty min later each animal was placed in a two compartment shuttlebox and given 25 trials during which footshock was presented every 60 sec and tones of 8 sec duration were randomly programed. Shock-escape latencies and frequencies of intercompartmental (pseudoconditioned) responses to the tone were measured. The results showed that 1 g/kg and 2 g/kg ethanol significantly retarded escape performance but 2 g/kg ethanol significantly enhanced pseudoconditioning. These findings have implications for the design of experiments concerned with the effects of drugs on learning processes, and for theories of the effects of ethanol on behavior.


Acute stress and the brain norepinephrine uptake mechanism in the rat. The kinetic constants for norepinephrine uptake in cerebral cortical homogenates were determined in vitro immediately following an acute stress consisting of either forced immobilization, cold-wet exposure, combined cold-plus-restraint, swim stress, or electric footshock in the rat. The kinetic constants, apparent Km and Vmax, for uptake of 3H-l-norepinephrine were significantly increased only following 10 min swim at 22 degrees or following 5 min electric footshock. When severe hypothermia accompanied the stress, the findings suggested that a profound reduction in body temperature was associated with depressed responsiveness of brain noradrenergic mechanisms to stress including decreased uptake kinetic constants. In a series in which the duration of electric footshock was varied from 2 to 30 min, it was noted that the NE uptake kinetic constants were increased at 5 min, but were similar to paired controls at 2, 10 and 30 min following the onset of footshock. It was concluded that various acute stresses did not elicit a generalized response of the cortical NE uptake mechanism to stress in the rat. Furthermore, when uptake kinetic constants did change with stress, the values were often within the range of normal values seen in the rat.


Antagonism of etonitazene's effects in rats and pigeons. The effects of etonitazene were studied in the pigeon under a mult FR FI schedule of food presentation and in the rat under a continuous avoidance-escape schedule. A low dose of etonitazene increased rates of responding by pigeons under the FI component of the multiple schedule, whereas higher doses produced dose-related decreases in rates of responding under both components of the multiple schedule. These effects were blocked by cyclazocine. Under the continuous avoidance-escape schedule, etonitazene produced only dose-related decreases in rates of responding by rats, and these decreases were blocked by naloxone.


Examination of some factors that control the effects of septal lesions on lordosis behavior. Various experimental parameters related to the effects of septal lesions on the lordosis behavior of rats have been examined. First, the failure of septal lesions to facilitate lordosis behavior in male rats appears to be related to the degree of exposure to androgens neonatally. The normal facilitation in lordosis behavior associated with septal destruction in adult female rats does not occur if these female rats are treated with 1.0 mg of testosterone propionate (TP) on Day 1 of life. Yet female rats given 270 mug of TP on Day 3 of life respond the same as do normal females to septal lesions. Second, these sexually dimorphic effects of septal lesions can be modified in adult rats by chronic treatment with gonadal hormones following septal destruction. Whereas previous studies indicated that chronic estrogen injections permit a facilitation in lordosis behavior to occur in septal lesioned male rats, the present results showed that chronic injections of TP following a septal lesion attenuates the facilitation in lordosis behavior typically observed in adult female rats following a septal lesion. Third, examination of the time course for the facilitation in lordosis behavior following a septal lesion revealed a four to six day delay before the appearance of heightened female sexual behavior. Fourth, in support of the possibility that modifications in lordosis behavior by septal lesions may be mediated by a depletion or imbalance in brain amines, amphetamine was found to reduce the high levels of lordosis behavior of septal lesioned female rats to control levels. Finally, further evidence of a potential role for brain amines in the effects of septal lesions was provided by the observation of significantly lower content and turnover of dopamine in the amygdala of septal lesioned female rats, relative to sham operated controls.


Phenobarbital drinking curves after varied water deprivation. The phenobarbital dose-drinking response curves were obtained for 11 1/2 and 23 1/2 hr of water deprivation in rats. The results indicated that the same quadratic curve was found in both cases displaced as a function of degree of deprivation. These results are explicable by regarding phenobarbital as an adequate stimulus for drinking or by disinhibiting drinking if level of inhibition is not directly concerned with regulation of water ingestion per se. The response to phenobarbital upon the days following injection is similar for both degrees of deprivation investigated.


The shelf life of some antibiotic preparations stored under tropical conditions. Accelerated storage tests have been carried out to predict the shelf life of several commercial preparations stored directly under temperate and tropical climatic conditions. Two brands each of sulphathiazole tablets, tetracycline hydrochloride capsules and chloramphenicol capsules were studied over a period of three months. Shelf lives ranging from 6.2. to 29.7 months were predicted for temperate storage conditions (20 degree C/31% R.H.), whilst these periods were reduced giving values from 3.8 to 13.9 months for tropical conditions of 30 degree C/31% R.H and from 2.5 to 9.2. months when stored at 30 degree C/75% R.H. A decrease in the rate of drug dissolution was also observed for preparations stored directly under conditions of elevated temperature and humidity. The results indicate the need for stringent control over storage conditions for antibiotic preparations in tropical climates to ensure adequate drug stability and dissolution characteristics.


Synthesis and properties of new cyclic derivatives of succinic acid with anticonvulsant activity. The synthesis and pharmacological screening of a series of new phenylsuccinimide derivatives are described. Seven compounds of that series elicited a marked anticonvulsant activity. Among the compounds tested, interesting structures were those metasubstituted with bromine, fluorine or trifluoromethyl group. The most interesting drug seems to be the N-morpholinemethyl derivative of mbromophenylsuccinimide, which has a long duration of activity, elicits a very strong antipentetrazole action, and gives good protection against maximal electroshock seizures.


Quantitative determination of drugs by means of densitometry of thin-layer chromatograms. Part 6 Determination of 1-benzhydril-4-allypiperazine dihydrochloride in biological media. A quantitative method for determination of 1-benzhydril-4-allypiperazine dihydrochloride (As-2) in blood is proposed, based on direct densitometry of t.l.c. plates. The main advantage of the method consists in the fact that it can be applied for determination of As-2 in biological samples in the presence of its metabolites and other components of the investigated samples. The statistical treatment of results obtained from ten analyses shows that the method has no systematic error and the relative percentage error is +/- 8.5%. The lowest concentration which can be determined is 5 microng/1 ml plasma. It has been established that As-2 administered intravenously in the maximally tolerable dose of 22 mg/kg can be detected in the blood after the first min (RF = 0.45). Ten min after application one major metabolite (RF = 0.35) is observed under UV-light. When administered per os in the maximally tolerable dose of 100 mg/kg, As-2 is established in the blood after 15 min while the metabolite mentioned above is detected by the thirtieth min.


The surgical treatment of drooling. A ten-year review. We report a 10-year experience with 123 patients who had the surgical treatment for drooling originally described by Wilkie. All have been followed for at least 1.5 years, and in 86 percent a good or excellent result was obtained. We believe this procedure is indicated for persistent, severe drooling in any patient in whom non-operative methods have failed, and for whom general anesthesia is an acceptable risk. Severe intellectual impairment is not a contraindication, for the care of these patients may be made far easier. Bilateral removal of the submandibular glands is an integral part of the operation on all patients, and should be done at the same time the parotid ducts are rerouted. The complications have been few and most of them respond to secondary procedures.


Use of dermal-fat suspension flaps for thigh and buttock lifts. A new technique for the correction of trochanteric bulges is described. A buried dermal-fat flap is used as a suspensory mechanism to hang the weight of the thigh skin and subcutaneous tissues on the deep fascia, rather than on the upper skin flap. This technique is particularly applicable to patients with asymmetry of the buttocks and thighs as well as those with ptosis of the buttocks. Another advantage is that it creates a new gluteal fold at a predetermined higher level.


Logic as a tool for clinical training in social work. The paper is an attempt to illustrate the usefulness of logic as a technique in the clinical training of mental health professionals. The specific concepts that are examined include the nature of deductive and inductive reasoning, hypothesis testing, necessary and sufficient conditions, "if-then" propositions, and the nature of clinical evidence. Knowledge and use of these concepts was tested in a tutorial program directed toward students who were beginning graduate studies in the field of social work. Some of the difficulties encountered by these students, especially in the clinical aspects of their training, were directly related to an inadequate understanding of these logical forms of reasoning. It is suggested that a portion of the clinical training in mental health fields be directed towards a deeper understanding and utilization of these basic concepts.


A psychological theory of child abuse.

A psychological theory of child abuse. This paper presents a detailed study of two patients hospitalized in a closed psychiatric unit on which the treatment program emphasized dynamically oriented individual psychotherapy and family therapy. The first patient was hospitalized following physical abuse of her four-year-old daughter, while the second was hospitalized for a postpartum depression eight weeks following the birth of her first child, a girl. Although the presenting pictures in these two patients were markedly different, the psychodynamic patterns were so similar that a detailed comparison of the two cases seems to offer useful insight into some of the psychological causes of child abuse.


Affective disorders in university student psychiatric patients. Two hundred and sixty-four student psychiatric referrals were evaluated by the same interviewer using a detailed, precoded questionnaire based on the diagnostic critieria of Feighner et al. (1972). Female sex was associated with secondary and unipolar primary affective disorders. Greater age (over 23 years) was associated with the unipolar primary affective disorder. Race and marital status were not associated with affective disorders.


Social class in the mental health center. To test whether the preference for middle and upper class clients, found in psychotherapeutic clinics during the 1950s and early 1960s, exists in mental health centers, the relationships between social class and various aspects of psychiatric treatment are investigated in forty mental health centers which vary in several organizational dimensions. In general, clients are given treatment with little or no regard to social class. The variables that account for the different patterns of treatment in the two types of psychiatric treatment organizations are (1) the composition of the staffs; (2) the types and amount of individual  psychotherapy given; and (3) the primary organizational goal.


Loneliness: an interdisciplinary approach. Psychological motivations, reasons why human nature is what it is, principles by which we may 'explain', understand, sympathize, or empathize with other human beings--and ourselves--what a variety of possible principles has been offered by philosophers and psychologists! All men seek happiness, announces Aristotle (Ethics). Just as all men delight in imitation (Poetics), and human beings universally take pleasure in knowing (Metaphysics), in that same sense it may be said that the arche of human conduct or action derives from the self-evident fact that all men desire to be happy. According to Hobbes, each human atom is motivated by self-interest, not to say selfishness, and every individual strives for his own 'good' through power over others. Bentham, on the other hand, regards man as under the sovereign twin masters of pleasure and pain, whose dominion extends over the entirety of human conduct. Freud retraces the path of our problematic symptoms to a fund of repressed sexual and libidinal energy, whose fettered strivings results in overt neuroses. Adler employs a Schopenhauerian and Nietzschean 'will to power' as a model for understanding a universal feeling of inferiority, whose ultimate origin is grounded in the inadequacy of the infant. And Jung cavalierly splits the human race into the extrovertish and the introvertish, the cosmopolitans and the islanders. What I have chosen as my concern, in the foregoing, is not a rough survey of conceptions of human nature--whether man is good, bad, or indifferent; a rational creature or essentially a sentient one; whether man's nature has ever been the same' or whether 'man makes himself', creatively. Rather, I am interested in what 'motivates' man, I am searching for a universal principle through which we may 'understand' why man does what he does, why man is what he is. Obviously, however, the commitment we make in regard to a theory of human motivation will itself necessarily be found to entail a corresponding view of human nature. Confronted with this impressive variety of interpretations, I don't know if I am able to offer a comparable general principle, but I shall try. In a word, that principle is loneliness. Thus, I wish to hold that once man has satisfied his more obviously physiological and biologic drives and comfortably secured the necessities of air, water, and food, he then strives to alleviate his desperate loneliness. It is not so much, then, a fact--correcting Jung, for instance--that we are to be dichotomized into extroverts and introverts, but rather that we all begin by aspiring toward human communion and affection and friendship but that, unfortunately, many of us fail; we who fail are the frustrated extroverts, the retreating introverts; if we cannot enjoy the company of others and command from them the recognition we (abnormally) feel for ourselves, well, then we shall cultivate our own company.


Creative potential in schizophrenia.

Creative potential in schizophrenia. The purpose of this paper is to demonstrate the presence of creative potential in a group of hospitalized persons who have been categorized as schizophrenic. Previous work (Buck and Kramer, 1973, 1974) has made it obvious that considerable poetic skill exists in this group of people. While creative potential was apparent in large numbers of those we have worked with, it is unnecessary to claim that our present data represent all (or even a majority) of the hospital population. However, we are concerned with providing a more balanced perspective on the ego strength and creativity which are retained in people who are labeled schizophrenic-even those considered to be regressed. In the following selections, we will attempt to demonstrate, first, an openness to fantasy and an access to primary-process thought which is molded by sufficient technical skill to warrant being labeled poetry, and second, an active, reconstructive capacity which includes a clear intention of communicating with an audience. The technical skill and the reconstructive capacity are critical in substantiating the retention of ego strength necessary for the mobilization of secondary-process cognition. We are interested, therefore, in exploring poetry written with clarity, intelligibility, and cohesiveness, where the visual can be translated into the verbal, where the effort is directed toward communication rather than sorcery, and where sponteneity replacesstereotypy. In the case of originality of style-that is, artistic license-these distinctions may not always be clear; but where questions arise, the artist's ability to justify his own intentions becomes critical.


Children of imprisoned fathers.

Children of imprisoned fathers. John Bowlby's influential 1951 World Health Organization monograph, Maternal Care and Mental Health, pointed to a causal relationship between loss of maternal care and disturbed personality development, and had a profound effect on psychiatrists' thinking about antisocial behavior in particular, and character formation in general. More recently, psychiatric investigators have been increasingly interested in the effects of a child separation from his father. This has been stimulated by sociological concerns for one-parent, fatherless families (Adams, 1973) and by our realizing how historically neglected has been the paternal role in theories of child development. Herzog and Sudia (1971) have recently compiled an extensive bibliography of the fatherless family. Numerous clinical studies of loss of the father, through death (Nagera, 1970; Wolfenstein, 1966; Bonnard, 1964), suicide (Cain and Fast 1966), divorce (McDermott, 1970), military service (Crumley and Blumenthal, 1973), occupations (Rosenfeld et al., 1973), desertion (Thomes, 1968), and mental hospitalization (Schiff, 1965), have all reported various adverse effects, particularly on male children. It has been difficult, however, to sort out the effects of the loss itself from more general prevailing and prior family relationships. My interest in this subject was quickened when I began to see boys brought to a neighborhood clinic for aggressive and antisocial behavior soon after their fathers were imprisoned. I was impressed by the lack of reports in the literature on this form of father separation. I am presenting here my clinical observations of six families seen over a three-year period as part of a general child psychiatric experience at a comprehensive neighborhood health center sponsored by the Massachusetts General Hospital in Boston. Although there are obvious selection biases that limit generalization when families referred to psychiatrists are the only source of information, it seems a useful place to begin an examination of the consequences for children of father-separation as a result of imprisonment.


The mid-life transition: a period in adult psychosocial development. For the past nine years my colleagues and I have been working on a theory of adult psychosocial development in men (Levinson et al., 1974, 1977; Levinson, 1977). We have started some research on women (Stewart, 1977), but it is too early yet to report definitive theory or findings. Our aim is to encompass the many components of a man's life-all of his relationships with individuals, groups, and institutions that have significance for him. The components of life include his occupation and its evolution over the years, his love relationships, marriage, and family life, his various other roles and careers in numerous social contexts. This psychosocial approach includes the man's personality and the ways in which it influences and is influenced by the evolution of his careers in occupation, family, and other systems. The resulting theory is not a theory of personality development, nor of occupational development, nor of development in any single aspect of living. It deals, rather, with the development of the individual life in the broadest sense, encompassing all of these segments. This theory provides a context within which we can study in more detail the development of personality and of particular careers. I shall briefly describe the developmental periods we discovered in early and middle adulthood, giving major emphasis to one period, the Mid-life Transition. Like childhood and adolescence, these periods are found in the lives of all men. Of ourse, men traverse them in myriad ways, as a result of differences in class, ethnicity, personality, and other factors. My primary aim is to present some of our major concepts, hypotheses, findings, and ways of thinking about adult development. None of them have been fully validated. Together, they comprise a framework for the analysis of adult development. No doubt the theory will be modified an extended as a result of further investigation.


Split brains and psychoanalysis.

Split brains and psychoanalysis. Modern neuro- and psychophysiological findings on commissurotomized ("split-brain") patients seem to confirm psychoanalytic theories. Twelve commissurotomized patients and one patient who had a right hemispherectomy showed an impoverishment of dreams, fantasies and symbolization. This might have been due to an interruption of the preconscious stream between the two hemispheres, which causes a separation of word-presentations from thing-presentations, as well as to a predominance of a feedback-free primary process in the right hemisphere. The similarity in operational thinking of psychosomatic and split-brain patients leads the author to hypothesize a "functional commissurotomy" in cases of severe psychosomatic disturbances.


The dream screen: phenomenon and noumenon. The dream screen as described by Lewin may have been confused at times with the phenomenon of functional symbolism portraying heightened repressive resistance, and at other times with a negative hallucination in secondary revision. In some dreams, when the sleep-guarding function of the preconscious is heavily threatened and requires reinforcement, a screen certainly appears. Its essential shielding function has evolved from oral fantasies of gratification at the breast, and this origin places it in the context of other phenomena, including the Isakower phenomenon. It is contended that Lewin's assumption that reported dreamless sleep indicates the presence of the screen without projections on its surface transcends development from the perceptual to the conceptual, to the noumenal. The manifest screen is shown to be part of the dream work to achieve pleasurable repose conducive to continued sleep; disturbing traumatic narcissistic injuries revisited under its shield are sometimes reworked in extravagant megalomanic efforts at repair.


Psychoanalytic methodology in Helene Deutsch's the psychology of women. Although Helen Deutsch's The Psychology of Women contains a wealth of descriptive material about women's problems, the methodology employed by Deutsch in reaching her conclusions about femininity is marred in several ways. Her evolutionary-adaptational bias and natural science approach led to the attribution of questionable biological bases to behavior and to the neglect of social factors and learning. Her concepts and language reveal an unquestioning adoption of Freud's metapsychology and lead to a perception and interpretation of psychological events according to the specific cast of that approach. She confuses her values with definition and observation. A re-examination of the thought of Deutsch seems fitting in these days of ever more extensive reconsideration of the views of Freud and other major psychoanalytic thinkers on the psychology of women. In addition to furthering our understanding of her insights, the study of Deutsch's methodology and its pitfalls contributes to a more critical understanding of the values and preconceptions that influence popular thinking about women and to a deeper grasp of problems inherent in psychoanalytic methodology.


The NHS practice of forensic psychiatry in one region. The present paper outlines the number and distribution of forensic patients within one region. In addition, attitudes to both available services and existing legislation are described. Regional and national data are compared so that the results can be used by other regions which are currently planning a development of their own forensic services.


Biogenic amine-related enzymes and personality variations in normals. Altered activities of biogenic amine-related enzymes have been reported in some studies of patients with affective disorders and chronic schizophrenia. To evaluate whether any relationship between personality variations, including non-diagnosed psychopathology, and these enzymes might occur in non-psychiatric patients, 95 young adult volunteers were studied. Higher MMPI and Zuckerman sensation--seeking scale scores were found in male, but not female, volunteers with lower platelet and plasma amine oxidase activities. Males generally exhibited negative correlations, while females had positive correlations between the psychological test scores and amine oxidase activities. In contrast to the amine oxidase results, no associations were observed between plasma dopamine beta-hydroxylase activities and the personality variables.


Two kinds of cognitive deficit associated with chronic schizophrenia. The performance of 21 chronic schizophrenic patients was investigated on two tests of feature selection. It was found that patients with negative symptoms (muteness, withdrawal, etc.) were characterized by an extreme lack of persistence, but selected usual features; whereas patients with positive symptoms (hallucinations, delusions, etc.) had a normal degree of persistence, but selected unusual features.


Measuring gesture: its cultural and clinical correlates. An ultrasonic system for measuring psychomotor behaviour is described, and then applied to compare the extent to which English and French students gesticulate. The findings supported the hypotheses that: (1) French students gesticulate more than the English both when using descriptive speech and when discussing their feelings; (2) descriptive speech elicits more gesture then affectively-toned speech; (3) when verbal expression is more difficult the use of gesture increases; (4) individuals tend to maintain a characteristic level of gesturing. We concluded the ultrasonic system provides a reliable and sensitive method for measuring gesture activity and can be applied clinically to the study of psychomotor behaviour.


Plasma nortriptyline and clinical response--a study using changing plasma levels. In a 5-week study of 22 depressed patients treated with nortriptyline, significant changes in plasma levels, both elevated and reduced, were deliberately produced in the third and fourth weeks of each patient's treatment. Correlation of plasma nortriptyline levels and changes in the severity of depression, as measured by the Hamilton Depression Scale, showed no significant relationships. The implications of the study are discussed.


[Axial computer tomography in acute and chronic pancreatitis (author's transl)]. The diagnostic value of the whole body computer tomography for evaluation of pancreatic disease is reported. In 64% of the cases with pancreatitis anomalies were detected. In pancreatitis an increase as well as a diminution of the volume of the pancreatic gland can be encountered; both features can be detected by computer tomography. Detection of pancreatic tumors in the initial stage and differentiation from pancreatitis by computer tomography remains difficult.


Omissions in radiology: faulty search or stringent reporting criteria? Selected difficult chest radiographs were interpreted by 10 radiologists and then reread  in a Focused Search condition that directed readers' attention to film regions containing frequently omitted findings. The percentage of true abnormalities reported at any level of confidence increased from 49.3 to 68.3 between the usual and Focused Search conditions. However, the corresponding percentage of significant false positives also increased from 4.6 to 10.6. The separate ROC curves from each condition could be superimposed and the data fit by a single ROC curve. Thus, the reduced omissions in Focused Search were the result of less stringent criteria for reporting the presence of abnormal findings, rather than an enhanced ability to detect abnormalities. There was no evidence that the original omissions were abnormalities simply overlooked in faulty initial searches.


Duodenal compression defect and the "superior mesenteric artery syndrome" 1. Forty-two cases of progressive systemic sclerosis were reviewed. A compression defect of the duodenum was found at the site where the superior mesenteric artery crossed the duodenum in all patients with duodenal dilatation. A similar observation was made in patients with small-intestinal obstruction and pancreatitis. Both the defect and dilatation may spontaneously disappear and return. The author concludes that in the cases studied, the compression produced by the superior mesenteric artery is secondary to dilatation and loss of muscle tone of the duodenum. It does not cause obstruction, and its presence per se does not warrant a diagnosis of "superior mesenteric artery syndrome."


Solitary renal plasmacytoma with palisading tumor vascularity. A solitary extramedullary plasmacytoma of the kidney associated with contralateral myeloma kidney is reported. The tumor demonstrated extensive palisading tumor vessels, heretofore thought to be characteristic of renal lymphoma. Plasmacytoma as the etiology of a renal mass should be considered when there is nonfunction of a normal-appearing contralateral kidney.


The catheter wall simulating thrombus formation seen on pullout angiograms: an experimental study. The authors investigated the nature of a radiolucent line that was seen paralleling the radiopaque catheter wall on more than 70% of 176 pullout angiograms. Although this line may indicate a thrombus sleeve, accumulation of thrombus was rarely seen at the puncture site. A series of experiments demonstrated clearly that (a) an identical line could be reproduced in a bloodless model; (b) the width varied directly with the thickness of the catheter wall and appeared irregular in contour with 6.5, 7, and 8 French catheters: and (c) this line represented the outer third of the catheter wall.


Roentgenologic aspects of bone islands.

Roentgenologic aspects of bone islands. A review of radiographs of 143 Adult Health Study and 46 non-sample subjects made over a period of 23 years established sites, sizes, ages at detection, and prevalence of 209 bone islands in 189 subjects. Except for 18 new bone islands, all appeared during the period of observation. Twenty-six of them changed: of these, 21 enlarged, 4 became smaller, and 1 disappeared. There was no association with atomic bomb radiation dose. Bone islands were more frequent in the pelvis and femora but often occurred in the ribs. Five bone islands in adolescents enlarged proportionally to bone growth, suggesting that they often participate metabolically in the normal osseous system. Bone islands must be differentiated from osteoblastic metastases.


Use of signal detection theory in examining the results of a contrast examination: a case study using the lymphangiogram. The receiver operating characteristic curve is an unbiased technique useful for quantitating the extent to which varying modalities differ in their ability to identify pathological processes. It was applied specifically to a radiographic contrast examination--the evaluation of the lymphangiogram in patients with Hodgkin's disease.


Radiographic artifacts caused by the laundering of flame-retardant materials. Federal law now mandates the use of flame retardants in children's sleepwear, and regulations are pending in several areas to require their use in all hospital fabrics. These flame retardants produce radiographic artifacts due to their alteration of fabric surface properties. Knowledge of the cause of these problems and their solution should be of help in radiographic interpretation and should save patient expense and radiographic exposure.


The tentorium in axial section. I. Normal CT appearance and non-neoplastic pathology. Bands of increased density representing the free edges and lateral margins of the tentorium were routinely identified on 100 sequential, normal, contrast-enhanced axial CT scans of good quality. Because the tentorium has a complex shape, the exact configuration of these bands varies with the level and the angle of the CT section. Comparison of CT scans with anatomic specimens permits an understanding of these varying configurations, and  provides a means to estimate the position of the tentorium on non-contrast CT studies. The CT manifestations of diverse non-neoplastic diseases including subarachnoid hemorrhage, arteriovenous malformation, venous sinus thrombosis and Dandy-Walker malformation may be understood, in part, in terms of the configuration and density of these tentorial bands.