The role of repeat transurethral biopsy in stage A carcinoma of the prostate. There is a significant difference in survival of patients, with stages A1 and A2 prostatic adenocarcinoma. Therefore, it is important to distinguish focal occult adenocarcinoma from diffuse occult adenocarcinoma. However, that may be impossible from a single transurethral resection of the prostate. This study was designed to determine if repeat transurethral biopsy would be helpful in defining the extent of stage A disease. Between January 1970 and January 1976, 27 of 6) patients with stage A adenocarcinoma of the prostate were selected for repeat transurethral biopsy of the prostate 3 months after the initial diagnosis. All 27 patients had a focus or focal adenocarcinoma of the prostate at the initial resection. Seven patients (26 per cent) were found to have significant residual tumor at repeat resection and were reclassified as stage A2. Three patients were found to, have a single focus of adenocarcinoma on repeat biopsy. Thus, 37 per cent of the study group of patients had residual carcinoma after initial diagnosis by transurethral resection. Repeat transurethral biopsy is helpful in defining the extent of stage A disease and formulating a rational plan of therapy.


Primary transitional cell carcinoma of the prostate. The symptoms and physical findings in patients with transitional cell carcinoma of the prostate were similar to those in patients with prostatic adenocarcinoma. Usually the neoplasm was poorly differentiated and advanced when the diagnosis was first established. Osseous metastases were commonly osteolytic. Frequently, elevations of serum alkaline or acid phosphatase levels were associated with metastasis. Tartrate-inhibited fractions of the serum acid phosphatase were not elevated. The best form of treatment is radical ablation of the prostate and radiation therapy is next best. Because these neoplasms are not hormonally dependent, hormonal manipulation is not indicated. Prognosis for patients with this malignancy is guarded.


Results of 89strontium therapy in patients with carcinoma of the prostate and incurable pain from bone metastases: a preliminary report. The therapeutic application of 89strontium for the relief of pain in 11 cases of carcinoma of the prostate with skeletal metastases is reported. A significant clinical improvement could be observed in 8 of the 11 patients with generalized osseous metastases of prostatic carcinoma after the application of 30 muCi. 89strontium per kg. The effect was long lasting. At the same time an increase of alkaline phosphatase was observed, which was interpreted as an indication of the reactivation of osteoblasts and osteoid peripheral zones owing to beta-emission of the radioisotope in the affected areas. The indications for such therapy are discussed.


New approach to myelodysplasia.

New approach to myelodysplasia. Data from 60 patients with myelodysplasia are presented. Electromyography of the periurethral striated muscle in conjunction with simultaneous cystometry allows prediction of those patients at risk from urinary tract infection in 100 per cent of the cases. Intermittent self-catheterization is an effective form of therapy for bladder dysfunction in patients with myelodysplasia. An orderly approach to the evaluation and management of bladder dysfunction is outlined.


The controversy of treatment of asymptomatic bacteriuria in non-pregnant women--resolved. Data derived from longitudinal studies demonstrate that asymptomatic bacteriuria in non-pregnant women without stones or obstructive uropathy is a benign pathological condition. Evidence has accumulated that untreated asymptomatic bacteriuria in otherwise healthy women does not result in hypertension and/or a decline in renal function, and that this condition required neither detection nor antimicrobial therapy.


Genitourinary candidiasis: diagnosis and treatment. Candida in the urine or surgical wound is a potentially lethal pathogen. Management of 82 patients has provided a rationale for the treatment of these infections. Urine colony counts, serologic findings and clinical observations determine therapy. Amphotericin B irrigants are effective for local infections. Disseminated infections require flucytosine and/or intravenous amphotericin B.


Significance of urinary cytology in the early detection of transitional cell cancer of the upper urinary tract. Cytologic study of urine from 100 patients with transitional cell cancer of the upper urinary tract revealed that findings on the voided and catheterized specimens correlated well with grade and stage of the tumor. However, there was a significantly greater positive yield with urine specimens obtained by ureteral catheterization than by voiding. Consequently, because concomitant bladder tumors, diagnosed or not, can give questionable positive results ureteral catheterization specimens should be used for cytologic study.


Unilateral renal agenesis presenting as anuria. The most common cause of sudden and total cessation of urine output is obstructive uropathy, usually at the bladder outlet. Bilateral ureteral obstruction is a much less common cause of anuria. In additioh, unilateral obstruction in the presence of a solitary kidney must be considered in the differential diagnosis. Primary renal parenchymal disorders and pre-renal azotemia occasionally may be anuric but more commonly are oliguric. A case of unilateral renal agenesis presenting as anuria and obstruction of the solitary kidney is described.


Credé expression of the bladder: a sometimes useful maneuver. Two children with neurovesical dysfunction are described. The upper tract changes were resolved following the initiation of the Credé expressions of the bladder. It is suggested that the Credé maneuver has a place in the management of selected children with neurovesical dysfunction, particularly when temporization is needed.


Linear straited vascular pattern: its implication on a renal angiogram clinical importance and pathologic verification. A case of hypernephroma with neoplastic extension to the renal vein showing a characteristic linear striated vascular pattern on a renal angiogram is presented. A nephrectomy specimen was examined pathologically and angiographic correlation subsequently was inferred. Implication of this unusual pattern on the renal angiogram is emphasized through our experience and review of relevant literature in order to predict the prognosis and to prepare for radical treatment.


Polycystic horseshoe kidney.

Polycystic horseshoe kidney. It is not uncommon for urologists to be involved in the care of patients with either adult polycystic kidney disease or horseshoe kidney. Personal clinical experience indicates that it is most unusual to have these 2 congenital disorders simultaneously in the same patient. The first known report of such a situation describing removal of a kidney so involved in preparation of renal transplantation is presented.


Spontaneous remission of solitary bony metastasis after removal of the primary kidney adenocarcinoma. The second case of spontaneous remission of a biopsy-proved osseous metastasis from a renal carcinoma is reported. The unusual feature of the patient presenting with a right varicocele and no hematuria is extremely rare.


Priapism caused by glucose phosphate isomerase deficiency. A case of congenital non-spherocytic hemolytic anemia of unknown etiology is described. The patient had priapism and further hematologic evaluation revealed a glucose phosphate isomerase deficiency. This is the first report of priapism secondary to a defect of erythrocyte metabolism.


Primary carcinoid of testis.

Primary carcinoid of testis. A patient with primary solid carcinoid of the testis is described and 8 previous cases are reviewed. Ultrastructural study of our case disclosed pleomorphic granules, typical of the insular type carcinoid of the intestine of midgut derivation. Primary solid testicular carcinoid appears to behave as a benign neoplasms. None of these patients had evidence of metastases or the carcinoid syndrome for periods ranging from 20 months to 25 years.


Mixed testicular tumor in immunosuppressed patient: case report. A 30-year-old man who was maintained on immunosuppressants following renal transplantation had seminoma with teratoma of the right testis 3 months postoperatively. The temporal relationship in the development of the tumor in the presence of immunosuppressants strongly suggests the importance of the immunodefense mechanism in the control, development or growth of the neoplasm.


Bilateral fat necrosis of the scrotum.

Bilateral fat necrosis of the scrotum. The typical patient with fat necrosis of the scrotum is a prepuberal heavy set male subject who has extratesticular scrotal masses, usually bilateral, with mild to moderate pain but no systemic complaints or symptons related to voiding. The masses are firm, tender and do not transmit light. With a firm diagnosis expectant treatment will allow spontaneous resolution of the lesions. If doubt exists appropriate surgical intervention is advocated. Hypothermic injury, such as swimming in frigid water, is the most probable etiologic agent.


Appendicitis simulating torsion of the spermatic cord: a case report. A case of acute non-perforated appendicitis presenting as acute scrotal swelling and erythema is reported. A communicating hydrocele containing serous cloudy fluid was encountered on examination, suggesting the intra-abdominal pathology.


Malacoplakia of the prostate confused with clear cell carcinoma. Primary malacoplakia of the prostate is a rare benign disease, which is frequently mistaken for carcinoma and granulomatous prostatis. The surgical and clinical course of a patient with obstructive hypertrophy of the prostate is reviewed after an initial incorrect diagnosis of clear cell carcinoma. Experience in defining the lesion during the transurethral resection is presented. The pathogenesis, morphological structure and unique microscopic appearance of malacoplakia, characterized by large mononuclear cells associated with small laminated concretions, are described and illustrated.


Cyst of seminal vesicle with ipsilateral renal agenesis and ectopic ureter: case report. A 24-year-old man had a cyst of the seminal vesicle and ipsilateral renal agenesis with an ectopic ureter. Nineteen other patients with similar anomalies are reviewed. The usual age at the onset of symptoms is between 20 and 28 years, during the time of maximal reproductive activity. Usually, diagnosis is established by history, the finding of a mass in the area of the seminal vesicle and an excretory urogram. Treatment consists of excision, aspiration or transurethral unroofing of the cyst.


Klinefelter's syndrome and bladder cancer. A patient with Klinefelter's syndrome is described who also had transitional cell carcinoma of the bladder. His mother and maternal grandfather died of neoplasms. It is suggested that neoplasm and aneuploidy in the same family could have been caused by an inherited chromosomal instability rather than coincidence.


Antitrichophyton activity and dermal tissue concentration of pyrrolnitrin. Though pyrrolnitrin is surpassed by clotrimazole in in vitro antitrichophyton activity against Trichophyton sp., the therapeutic effect of pyrrolnitrin against experimental trichophytosis in guinea pigs was more potent than that of clotrimazole. The detection of antifungal activity from topically treated guinea pigs suggests that pyrrolnitrin obtains higher concentrations than clotrimazole in dermal tissue.


[Administration of cephradine to dermatoses by injection (author's transl)]. Ten cases of various kinds of dermatoses underwent cephradine by injection. Two cases injected cephradine intramuscularly resulted in severe pain. Three of 4 cases with pyogenic skin infection revealed excellent results. Three cases were prevented from secondary infection. Adverse effects such as vertigo were avoided by lowering the speed of intravenous injection. No abnormal findings of serum GOT and GPT levels after the completion of the treatment was noted in 7 of 8 cases, but one case which was administrated large dosis of corticosteroid concomitantly revealed elevated level in this finding.


[Ophthalmic application of intravenous cephradine (author's transl)]. Basic and clinical experiments were performed on intravenous cephradine (CED) in ophthalmological field. The results are summarized as follows. 1. Serum concentration: After intravenous injection of 1.0 g CED, in a single dose, to a healthy adult, the peak of serum level (34.0 mug/ml) was attained at 15 minutes, then decreased quickly to 2.3 mug/ml by 6 hours. 2. Ocular penetration in rabbit eye: (1) Aqueous humor concentrations: The peak level of aqueous humor (13.45 mug/ml) was obtained at 30 minutes after intravenous injection of 50 mg/kg, in a single dose. Aqueous/Serum ratio was 38.07%. After instillation of 5 mg/ml solution of CED, 5 times every 5 minutes, the aqueous level was recognized 30 minutes and 1 hour, and no detectable 4 hours. After 50 mg/0.5 ml CED subconjunctival injection, in a single dose, the high aqueous levels were observed at 30 minutes and 1 hour, and still detectable 4 hours later. (2) Ocular tissue concentrations: The ocular tissue concentrations at 30 minutes after intravenous injection of 50 mg/kg CED were high in both outer and inner parts of the eye. After 4 hours, the tissue levels remained relatively high concentrations. (3) CLINICAL RESULTS: Intravenous administration of 0.5, 1.0 or 2.0 g CED 1 or 2 times daily revealed excellent or good effects in 8 of 12 cases, such as external hordeolum, internal hordeolum, lid abscess, chronic dacryocystitis, orbital abscess and corneal ulcer. (4) Side effects: Three cases out of 12 complained burning sensation by intravenous injection of CED, but in neither case was it found necessary to withdraw the drugs. No severe side effects such as allergic reactions were observed. No abnormal findings in hepatic and renal function tests were observed.


[Studies on cephradine for intravenous injection (author's transl)]. 1) The half-life of serum concentration of cephradine (CED) in patients with normal renal function, was 30 minutes and it prolonged to 83 minutes when combined with probenecid. 2) In the patients with severely impaired renal function, mean serum concentration of CED was 33 mcg/ml 24 hours after 1 g intravenous injection. 3) In clinical observations of 17 cases with infections of lung, urinary tract, and bile duct, the treatment with CED showed excellent results in 5 cases, good in 6, undetermined in 1. No remarkable side effect was observed.


[Application of parenteral cephradine in urinary tract infections (author's transl)]. A new antibiotic cephradine was administered intravenously for 3 approximately 7 days at daily doses of 1.0 approximately 2.0 g to 56 patients, including 39 cases of acute urinary tract infections, 13 of chronic urinary tract infections and 4 for postoperative prophylaxis. Of 39 cases with acute urinary infections, definite response was seen in 35 cases and no definite response in 4 cases. Of 13 cases with chronic urinary tract infections, definite response was seen in 7 cases and no definite response in 6 cases. Good results were obtained clinically in 4 cases for prophylaxis of postoperative infections. No side effect was observed with cephradine with cephradine throughout the experiment.


[Clinical studies on cephradine (CED) (author's transl)]. Cephradine (CED) was administered intravenously to the patients with respiratory infection or urinary tract infection with the dosage of 1.0 approximately 4.0 g daily and their clinical effects were investigated. Good clinical effects of CED were obtained in 5 of 8 cases with respiratory infections and in 2 of 5 cases with urinary tract infections. Side effects were noted in 2 cases, but they improved rapidly by the cessation of the drug administration. One case developed skin eruption and the other case complained general burning, palpitation after intravenous injection and slight insomnia. CED is seemed to be effective antibiotic for the respiratory as well as urinary tract infections clinically. However it was advisable that careful attention should be paid when CED is administered to the patient having drug allergy or nephropathy.


Studies on physiological responses of residents in Okinawa to a hot environment. In an attempt to reconfirm Kuno's observation that changes in sweating reaction during long-term heat acclimatization differ from those during short-term heat acclimatization, Ohara's sweating test was performed in summer in Okinawa on 37 male subjects, including 19 residents born and raised in Okinawa (group O) and 18 residents born and raised on one of the main Japanese islands (group M). Seasonal variation of adaptability to heat was also studied in some subjects of both groups. Group O showed significantly less sweat loss, lower Na concentration in sweat and a longer latent period for onset of sweating than group M. Group O showed no seasonal variation in sweat loss, while group M showed considerably greater sweat loss in summer than in winter. In both groups, lower Na concentration in sweat, lower rise in rectal temperature and lesser increase in heart rate in summer than in winter were observed. Seasonal difference in physiological responses of group O to heat exposure was less than that of group M. In conclusion, it was assumed that acclimatization to heat of group O had advanced further than that of group M and this was the reason for longer latent period of sweating and lesser sweat loss in group O in spite of the same rise in rectal temperature in both groups. Discussions were carried out to explain how the sweating pattern and mechanism of acclimatization in group O were different from those in group M.


Ventilatory responses to CO2 rebreathing at rest and during exercise in untrained subjects and athletes. Ventilatory responses to CO2 during rest and exercise were studied in 10 marathon runners and 14 untrained subjects by the rebreathing method. The average responses of the untrained subjects and athletes at rest as meausred by the slope of VE-PACO2 curves were 1.86 and 1.12 liters/min-mmHg, the difference being statistically significant (p less than 0.05). During exercise the slope of VE-PACO2 decreased from 1.86 to 0.62 in the controls, and from 1.12 to 0.62 in the athletes (p less than 0.01). The mean slope obtained in the athletes, at rest and during exercise, was about 50-60% of that in untrained subjects (p less than 0.05). The difference in the VE-PACO2 curves between the athlete and the untrained group may be due to a reduced exitability of the respiratory center and/or by a reduced input signal.


Frequency-dependency of pulmonary compliance and its relation to airway conductance. Dynamic compliance was determined in patients with 6 chronic obstructive lung diseases, 2 sarcoidosis and in 4 control healthy subjects at several breathing frequencies ranging between 0.2 and 1.3 Hz. The compliance exhibited an apparent fall with the increase in frequency of the patients, while it remained unaltered in the controls. A significant correlation was found between the frequency-dependency of compliance and the airway conductance determined plethysmographically. A similar relationship was also found in previous data appearing in the literature. Mathematical simulation based on the time constant theory revealed that the above correlation might be expected when airway obstruction occurred inhomogeneously in the peripheral region, of the lungs leaving the central airways intact.


Effects of noradrenaline injected into the brainstem on reflex vasodilatation in the pinna of rabbits. Reflex vasodilation in one ear of a rabbit following radiant heating of the opposite ear was observed by measuring the heat loss by a change in the heat flux when either noradrenaline or porcaine hydrochloride was administered locally into various diencephalic or mesencephalic loci in the brain. Hypothalamic cooling resulted in less reflex vasodilatation, while no vasodilatatory effect was observed immediately after an intravenous administration of atropin sulphate (0.5 mg). Five mug of noradrenaline injected intrahypothalamically either eliminated or reduced the development of reflex vasodilatation to the same extent as did an injection of procaine hydrochloride (0.5 mg). On the other hand, the magnitude of the reflex vasodilatation increased markedly with an injection of either procaine hydrochloride (1.5 mg) or noradrenaline (10 mug) into the reticular formation of the midbrain. Increased reflex vasodilatation was also obtained with a localized administration of procaine hydrochloride into the medial forebrain bundle of the hypothalamus. The results suggest that the noradrenaline in the preoptic/anterior hypothalamic (PO/AH) area and the midbrain reticular formation exerted an inhibitory effect on the action of the neural structure in connection with the heat dissipation system.


Mechanism of thyroid-induced creatinuria in rat, with special reference to creatine synthesis in liver and creatine loss from skeletal muscle. Mechanism of thyroid-induced creatinuria was investigated in rats. The rats were injected with triiodothyronine (T3) (100 mug/100g, sc) at 9.00 hr. Oxygen consumption increased 12 hr after T3 injection, reaching peak value 48 hr after the injection and decreasing to the pre-injection level at 96 hr. Urinary creatine excretion also increased during the first 10 hr after the injection, approaching maximal value 34-48 hr after the injection, and decreasing to the pre-injection level 72-82 hr after the injection. Throughout the experimental period, urinary creatinine decreased with time after the injection, although the difference between the groups was not significant. A decreased creatine tolerance was also observed after T3 injection. Beta-Guanidinopropionic acid (beta-GPA), a competitive inhibitor of creatine transport into skeletal muscle, as well as partial hepatectomy, caasing inhibition of creatine synthesis, were without effect on the difference in urinary creatine excretion between T3-treated and control animals. T3 increased the plasma creatine level both in bilateral nephrectomized and in bilateral nephrectomized plus beta-GPA administrated groups. These results suggest that increased creatine loss from skeletal muscle in addition to decreased creatine uptake of skeletal muscle rather than increased hepatic synthesis of creatine play an important role in T3-induced creatinuria.


Innervation and properties of the smooth muscle of the dog trachea. The membrane potential of dog tracheal muscle was stable at -59.2 mV. The length constant of the muscle tissue was 3.2 mm and the time constant of the membrane was 449 msec. Outward current pulses could not evoke a spike and showed marked rectification of the membrane. Tetraethylammonium, TEA, depolarized the membrane, suppressed the rectification of the membrane, and increased the membrane resistance, and in the presence of TEA outward current pulses could evoke a spike. Acetylcholine and histamine depolarized the membrane but could not evoke a spike. Mechanical response could be evoked by field stimulation via either nerve stimulation or direct muscle stimulation. The mechanical response induced by nerve stimulation was markedly suppressed by atropine. Phentolamine suppressed the contraction which was produced in the presence of atropine, and propranolol suppressed the relaxation. It is unlikely that nonadrenergic-non-cholinergic inhibitory nerves played an important role in the mechanical response. It is concluded regarding the neural actions to the dog trachea that a constriction is induced by cholinergic and adrenergic alpha-action and a dilation is induced by adrenergic beta-action. The relationship between the membrane potential and tension was measured in various [K]o. The mechanical response was triggered by only 5 mV depolarization. The physiological evidence and histological finding were compared in relation to nerve activity on the tracheal muscle activity.


Uptake of sodium into rat isolated seminiferous tubules in vitro. The rate of 22Na uptake into isolated rat seminiferous tubules has been studied in vitro. The intracellular sodium exchanged rapidly with the outside sodium and within 26 min exposure to radiosodium, isotopic equilibrium was reached. The relationship between sodium influx at 2 min and external sodium concentrations was found to be linear suggesting that the entry of sodium into the seminiferous tubules is by simple diffusion. The intracellular Na+ concentration as measured by the 22Na taken up into the tubules at equilibrium condition was elevated in the absence of peritubular K+ and Ca2+ ions and treatment of the tubules with ouabain. No effects of amiloride and acetazolamide on the intracellular Na+ concentration were found. The significance of the 22Na uptake in relation to fluid secretion in the isolated seminiferous tubules was discussed.


Depolarization and contraction of skeletal muscle induced by intracellular stimulation -role of T-tubules in electro-chemical coupling. Response of skeletal muscle fibers upon intracellular stimulation was investigated to elucidate the role of the T-system in the electro-chemical coupling process. Upon stimulation, the fiber generates twitch and tonic tension which is independent of the excitation of the membrane (not inhibited by TTX). The fiber placed in low Ca2+ medium (10(-7) M, controlled by EGTA-Ca) for more than ten minutes, exhibited explosive contraction; this phenonomenon was not observed in Na-free choline Ringer or glycerol-treated (T-tubule disrupted) fibers. Injection of a small amount of Mn2+ into the muscle cells produced strong, long lasting contraction without excitation of the membrane. Glycerol-treated fibers failed to respond to the stimulus using a Mn2+ electrode. These facts suggest that Ca2+ release or entry which probably caused by depolarization of T-tubule membrane in the presence of Na+, may be essential for the initiation of Ca2+ release from sarcoplasmic reticulum.


Influence of a new antiulcer agent, ammonium 7-oxobicyclo (2, 2, 1) hept-5-ene-3-carbamoyl-2-carboxylate (KF-392) on gastric lesions and gastric mucosal barrier in rats. Antiulcer effects of KF-392 were studied in several experimental gastric ulcer models in rats. It was found that KF-392 given orally at 1.0 to 5.0 mg/kg had a marked suppression on the developments of Shay ulcer as well as the aspirin-, stress-, and reserpine-induced gastric lesions. The influence of KF-392 on gastric mucosal barrier was also studied. A back diffusion of H+ into the gastric mucosa and a fall of transmucosal potential difference were induced with KF-392 given orally at the above mentioned doses. KF-392 given s.c. at 5.0 mg/kg showed no inhibition of Shay ulcer and no induction of back diffusion of H+ into the gastric mucosa.


Effects of chronic administration of kanamycin on conditioned suppression to auditory stimulus in rats. The conditioned suppression technique was employed to study the ototoxic effects of chronic administration of the antibiotic, kanamycin. Lever pressing behavior for food reinforcement of rats was suppressed in the presence of an auditory stimulus (sound) or visual stimulus (light) that had been previously paired with electric shocks. Repeated administration of kanamycin at the dose of 400 mg/kg/day for more than 50 days significantly attenuated the conditioned suppression to auditory stimulus but did not attenuate the conditioned suppression to visual stimulus. This finding suggests that the attenuating effect of chronic administration of kanamycin on conditioned suppression to auditory stimulus can be interpreted in terms of the selective action of the drug on the auditory system.


Simultaneous assessment of effects of coronary vasodilators on the coronary blood flow and the myocardial contractility by using the blood-perfused canine papillary muscle. Effects of 6 coronary vasodilators on the coronary blood flow and the contractile force of the ventricular muscle were examined simultaneously by injecting these drugs to the arterially blood-perfused canine papillary muscle preparation. All compounds produced a dose-dependent increase in blood flow rate, and relative potencies determined on the basis of doses producing a 100% increase in blood flow rate, ED100, were in the descending order : nifedipine greater than verapamil greater than diltiazem greater than dilazep greater than dipyridamole greater than carbochromen, and approximately 1 : 1/12 : 1/26 : 1/100 : 1/300 : 1/500. All drugs except for dipyridamole caused a dose-dependent decrease in the developed tension of the papillary muscle, although nifedipine and diltiazem in low doses produced a slight increase. Relative potencies determined on the basis of doses producing a 50% decrease in developed tension, ID50, were as follows: nifedipine (1), verapamil (1/13), diltiazem (1/40), dilazep (1/100), and carbochromen (1/270). Ratios of the ID50 to ED100 were as follows: diltiazem (5.2), nifedipine (3.5), verapamil (3.5), dilazep (2.5), and carbochromen (1.8). The higher the value the more predominant on the coronary vascular bed or the less depressant on the myocardial contractility were their actions.


Comparison of local anesthetic activities between optical isomers of cis-1-benzoyloxy-2-dimethylamino-1,2,3,4-tetrahydronaphthalene. The optical isomers of cis-1-benzoyloxy-2-dimethylamino-1,2,3,4-tetrahydronaphthalene (YAU-17) were compared for their local anesthetic activity, acute toxicity, spasmolytic activity, and partition coefficient between chloroform and phosphate buffer. 1-YAU-17 was more active than d-YAU-17 in blocking the conduction of action potentials in isolated frog sciatic nerves. The difference in local anesthetic activities  between the optical isomers was further substantiated by in vivo tests for corneal anesthesia, intracutaneous anesthesia and sciatic nerve block in quinea-pigs. Similarly, the i.v. injection to mice revealed a higher toxicity for 1-YAU-17 as compared to its d-isomer. In these tests, the potency ratios of the enantiomers ranged from 2 to 4, and the racemate had an intermediate potency. On the contrary, no difference among the compounds was found in their liposolubility, partition coefficient, and spasmolytic activity examined with isolated guinea-pig ileum. These results indicate that the steric factors play an important role in the production of different local anesthetic activities between the optical isomers of YAU-17, and their local anesthetic potency tends to be correlated to their intravenous acute toxicity but not to their spasmolytic activity.


Antitumor agents. I. Effect of 5-fluorouracil and cyclophosphamide on liver microsomes and thymus of rat. Effects of antitumor agents on rat liver microsomal drug-metabolizing enzyme activities and thymus lymphocytes were studied in male Wistar rats. High doses of 5-fluorouracil (5-FU) and cyclophosphamide (CP) given parenterally for 6 days caused a partial decrease in whole body weight and the microsomal enzyme content such as cytochrome P-450 and cytochrome b5. Aniline p-hydroxylase and aminopyrine N-demethylase activities also decreased in rats dosed for 5 days decreased compared with the control. Both compounds in the high concentrations produced spectral change of "modified type II". However, the magnitude of the spectral changes observed was independent of the the concentration of substrate added. The addition of NADPH to the microsomes-substrate mixture modified the spectral change. Both drugs caused a considerable decrease in thymus weight and the number of thymus lymphocytes, while the alkaline phosphatase activity was enhanced in 5-FU groups, indicating that the agents cause a significant involution of the thymus. Decrease in the total number of the lymphocytes was greater than that in the blood leucocytes.


Pharmacological studies on root bark of mulberry tree (Morus alba L.). Pharmacological studies were done on the root bark of mulberry tree and pharmacological effects were compared with the clinical effects of "Sohakuhi" in Chinese medicine. n-Butanol- and water-soluble fractions of mulberry root had similar effects except for those on the cadiovascular system. Both fractions showed cathartic, analgesic, diuretic, antitussive, antiedema, sedative, anticonvulsant, and hypotensive actions in mice, rats, guinea pigs and dogs. There appears to be a correlation between the experimental pharmacological results and the clinical applications of mulberry root found in the literature on Chinese medicine.


Anti-ulcer effects of 4'-(2-carboxyetyl) phenyl trans-4-aminomethyl cyclohexanecarboxylate hydrochloride (cetraxate) on various experimental gastric ulcers in rats. Anti-ulcer effects of cetraxate, a new compound possessing anti-plasmin, anti-casein and anti-trypsin actions were investigated by using experimental gastric ulcer models in rats. Cetraxate, 300 mg/kg p.o. showed significant inhibitory effects of 65.3%, 70.0%, 30.2%, and 67.1% against aucte types of ulcers producing by aspirin, phenylbutazone, indomethacin, and pyloric ligature (Shay's ulcer), respectively. These effects were greater than those obtained by gefarnate and aluminum sucrose sulfate may be mainly attributed to the protecting action of this drug on gastric mucosa. Ctraxate further revealed remarkable inhibitory effects on chronic types of ulcers produced by acetic acid, clamping, and clamping-cortisone. In acetic acid ulcer in particular, cetraxate was found to have a dose-dependent inhibitory effect at doses over 50 mg/kg. Of test drugs including L-glutamine and methylmethionine sulfonium chloride, cetraxate showed the most remarkable inhibitory effect on beta-glucuronidase activity in ulcer tissue of these three types of ulcers. These findings suggest that cetraxate may prevent the connective tissue in the ulcer location from decomposition due to lysosomal enzymes such as beta-glucuronidase, thereby accelerating the recovery from ulcer.


A possible mode of cardiovascular actions of dopamine in dogs. A possible mode of cardiovascular actions of dopamine was studied using ephedrine. In the dog pretreated with repeated administrations of ephedrine (total dose, 40 or 80 mg/kg, i.v.) or with combined administrations of ephedrine (total dose, 90 mg/kg, s.c. and i.v.) and reserpine (2 mg/kg, s.c., 24 hr previously), pressor responses to dopamine were eliminated and reversed to depressor responses whereas depressor responses to dopamine were potentiated. Positive chronotropic effects of dopamine were almost eliminated. Pressor and positive chronotropic effects of tyramine were almost abolished. Sympathomimetic effect of noradrenaline and adrenaline were potentiated while those of isoprenaline were inhibited. In the heart-lung preparation of ephedrine-treated dogs (total dose, 40 mg/kg, i.v.), cardiac stimulating effects of dopamine and tyramine were strongly depressed, and those of noradrenaline, adrenaline and isoprenaline were reduced to some extent. In the open-chest dogs, after pretreatment of cocaine (4 mg/kg, i.v.), pressor, positive inotropic and chronotropic effects of noradrenaline were potentiated, whilst those of tyramine were inhibited. Those of dopamine were not visibly altered, but depressor, negative chronotropic and inotropic effects of dopamine appeared at small doses. In the ephedrine-pretreated dogs, these sympathomimetic effects of dopamine and tyramine after cocaine were strongly depressed and those of noradrenaline were inhibited to a certain degree. The results obtained with ephedrine suggest that dopamine differs from other catecholamines and tyramine in the mode of cardiovascular actions.


Effect of psychotropic drugs on caudate spindle in cats. To ascertain whether neuroleptics act on the caudate nucleus itself, the effects of these compounds as well as other centrally acting drugs were examined in relation to caudate spindle and EEG arousal responses (sciatic nerve stimulation) in gallamine-immobilized cats. Haloperidol and chlorpromazine enhanced the caudate spindle at a dose which had no effect on the EEG arousal response. On the other hand, clozapine and a higher dose of chlorpromazine enhanced the caudate spindle, but depressed the arousal response. High frequency stimulation of the sciatic nerve suppressed the caudate spindle. Pentobarbital, biperiden and diazepam, while depressing the arousal response, caused an enhancement of the caudate spindle. Imipramine at a low dose had no effect on either response, whereas at a high dose this drug enhanced the caudate spindle with concomitant depression of the arousal response. From these results, it may be concluded that the enhancing action on the caudate spindle induced by haloperidol and a low dose of chlorpromazine is due to an increase in susceptibility of the caudate nucleus itself. In addition, it is suggested that depression of the activating system is involved in an appearance of the caudate spindle.


Bound forms of Ca taken up by the synaptic plasma membrane. Temperature dependent Ca-binding by the synaptic plasma membrane was increased in the presence of ATP and Mg++. Apparent Km for ATP was about 2.8 X 10(-5) M and optimal concentration of Mg++ was 2 mM in the presence of 2 mM ATP. After preincubation with nonradioactive Ca++, ATP and Mg++ to attain a steady state, addition of 45Ca resulted in remarkable labelling of the membrane, indicating rapid turnover of most of the membrane bound Ca. The presence of oxalate (60 mM) greatly increased Ca up-take on prolonged incubation. The Ca uptake in presence and absence of oxalate had similar substrate specificity and was similarly influenced by various monovalent cations. Furthermore, activities for Ca-uptake in the presence and absence of oxalate could not be separated by sucrose density gradient centrifugation of the synaptic plasma membrane fraction. Accordingly, it was considered that Ca++ in the medium was taken up by surface of the membrane, ATP- and temperature-dependently and then transferred into a cavity where the Ca-oxalate complex is formed.


Electrical and mechanical responses to diltiazem in potassium depolarized myocardium of the guinea pig. Effects of diltiazem on the electrical and mechanical activities of guinea pig papillary muscle were investigated in K-rich Tyrode's solution (Kc1 12.7 mM). The electrical properties of cell membrane in K-rich solution were also examined in the ventricular muscle fibers. It was found that the overshoot as well as the maximum rate of rise (Vmax) of the action potential were highly sensitive to the extracellular concentration of CaC12 in K-rich solution. Vmax was also affected by NaC1. Diltiazem at a lower concentration (1.1 X 10(-7) M) caused a reduction in the contractile force of K-depolarized papillary muscle without producing significant changes in the resting and action potentials. In the presence of a higher concentration of diltiazem (1.1 X 10(-5) M), the contractile force decreased concurrently with the change in the action potential. Addition of CaC12 restored the original strength of contraction in parallel to the recovery of the action potential, especially in its overshoot and Vmax. From these results, it is inferred that diltiazem may decrease the contractile force of guinea pig papillary muscle either by interfering with the intrasmembrane calcium influx or by intracellularly reducing the free calcium ion concentration in the myoplasm.


Pharmacodynamic actions of (S)-2-[4,5-dihydro-5-propyl-2-(3H)-furylidene]-1,3-cyclopentanedione (oudenone). The pharmacodynamic actions of (S)-2-[4,5-dihydro-5-propyl-2(3H)-furylidene]-1,3-cyclopentanedione (oudenone) were studied in both anesthetized animals and isolated organs. Oudenone (10--40 mg/kg i.v.) induced an initial rise in blood pressure followed by a prolonged hypotension in the anesthetized rats. In unanesthetized spontaneously hypertensive rats (SHR), oudenone (5--200 mg/kg p.o.) caused a dose-related decrease in the systolic blood pressure. The initial pressor effect was diminished by pretreatments with phentolamine, guanethidine, hexamethonium and was abolished in the pithed rats. In addition, intracisternal administrations of oudenone (100--600 mug/kg) showed a marked increase in blood pressure in the anesthetized rats, suggesting that the pressor effect may be due to centrally mediated actions. Oudenone, given intra-arterially into the femoral artery (400--800 mug/kg), caused a long-lasting vasodilation in anesthetized dogs. At a relatively high dose (40 mg/kg i.v.), oudenone antagonized all pressor responses to autonomic agents and central vagus nerve stimulation in anesthetized rats and dogs, however, oudenone showed no anti-cholinergic,-histaminergic, beta-adrenergic and adrenergic neuron blocking properties.


Mechanisms of fluid absorption during proximal tubule development. Passive permeation characteristics and paracellular pathway ultrastructure were studied in vitro by perfusion of rabbit isolated proximal convoluted tubules during postnatal ontogenesis. The influence upon net volume flow (Jv) of transepithelial hydrostatic and protein osmotic pressure was significantly higher during early postnatal maturation than in the mature tubule. Hydraulic hydrostatic conductance (X10(-3) ml - cm-2 - min-1 - cm H2O-1) was 0.0367 +/- 0.0048 during early postnatal maturation (N = 99) and 0.0052 +/- 0.002 at maturity (N = 78). Hyperoncotic serum (12.7 +/- 0.4 g/100 ml) in the bath increased Jv by 67.5 +/- 21.1% from 0.31 +/- 0.06 to 0.52 +/- 0.08 nl-mm-1-min-1 in the neonatal proximal tubule, whereas an increase of only 25.7 +/- 20.4% from 1.08 +/- 0.15 to 1.32 +/- 0.18 nl-mm-1-min-1 was noted in the mature proximal tubule during this elevated bath protein-osmotic pressure. Electron microscopic observations showed that microperoxidase passed from tubule lumen through the basement membrane via intercellular spaces in immature tubules perfused at an increased transtubular pressure gradient. This suggests that a transepithelial shunt pathway may participate in changes of conductance during ontogenesis, although length and ultrastructural configuration of tight junctions did not vary with these variables. 1) Hydrostatic and oncotic water conductance of the rabbit proximal tubule changes with postnatal development. 2) Ultrastructural tracer studies suggest that the change in conductance is due to alteration of the paracellular pathway. 3) Isotonic absorption of the neonatal proximal tubule may depend more on transepithelial pressure gradients than in the mature tubule.


Enhanced end-organ responsiveness of the uremic kidney to the natriuretic factor. In chronic renal disease, the addition of a fixed quantity of Na to the extracellular fluid (ECF) will evoke a natriuretic response per nephron which is inversely proportional to the glomerular filtration rate (GFR). One factor that could contribute to this "magnification" phenomenon is an increased sensitivity of residual nephrons to physiologic natriuretic forces. The present studies were designed to examine this possibility. Natriuretic urine fractions from uremic patients, infused into one renal artery of normal rats, produced a small but significant unilateral natriuresis. Infusion of the same fractions in identical amount into remnant kidneys of stage II nonuremic rats (i.e., rats with a contralateral normal kidney in situ) produced a natriuresis in the remnant kidney only which was equivalent to that observed in the normal kidneys. The i.v. infusion of natriuretic fractions into stage II rats produced comparable increments in the fractional excretion of sodium (FENa) bilaterally. However, when the natriuretic fractions were infused into remnant kidneys of stage III rats (no contralateral kidney), deltaFENa was significantly greater than in the foregoing groups.  Because stage III rats have increased control values for FENa, baseline FENa was increased to an equivalent level in normal rats by unilateral renal denervation. Natriuretic factor was administered into the ipsilateral renal artery. Although the natriuretic response was increased, it was significantly less than in the stage III remnant kidneys. The data support the view that the uremic state per se is associated with an enhanced responsiveness of the residual nephrons to the natriuretic factor found in the urine (and blood) of uremic patients.


Influence of bicarbonate on parathyroid hormone-induced changes in fluid absorption by the proximal tubule. Segments of the proximal tubule of the rabbit kidney were perfused in vitro in order to examine the influence of bicarbonate on the reduction in fluid absorption that occurs following the acute administration of parathyroid hormone (PTH). Studies were performed using either normal ultrafiltrate as perfusion fluid and normal rabbit serum as bath or low bicarbonate ultrafiltrate as perfusion fluid and low bicarbonate rabbit serum as bath. Low bicarbonate fluids were prepared by replacement of bicarbonate with chloride. In the presence of normal concentrations of bicarbonate, the addition of PTH to the bath (1 U/ml) resulted in a decrease in the fluid absorption rate (Jv) from 1.13 +/- 0.08 to 0.60 +/- 0.04 nl/mm X min (p is less than 0.001) in 23 convoluted segments and from 0.64 +/- 0.05 to 0.46 +/- 0.05 nl/mm - mm (P less than 0.01) in ten straight portions. Simultaneous with the PTH-induced reduction in Jv, the chloride concentration in the collected fluid changed from 119.0 +/- 2.0 to 113.4 +/- 1.1 mEq/liter (P less than 0.01) in the pars convoluta and from 117.7 +/- 0.6 to 114.0 +/- 1.9 mEq/liter (P less than 0.01) in the pars recta. However, there was no change in the net flux of chloride which averaged 42.58 +/- 5.00 pEq/mm - min during the control periods. Additional studies were performed in eight convoluted segments during perfusion on a randomized basis with low bicarbonate fluids as well as during perfusion with fluids having normal levels of bicarbonate. As before, in the presence of normal levels of bicarbonate, PTH reduced Jv from 1.16 +/- 0.15 to 0.68 +/- 0.07 nl/mm - min (P less than 0.001) and the chloride concentration in the collected fluid ([Cl]o) from 118.6 +/- 2.9 to 111.6 +/- 1.3 mEq/liter (P less than 0.005). Substitution of low bicarbonate fluids for normal bicarbonate fluids resulted in a decrease in Jv from 1.16 +/- 0.15 to 0.74 +/- 0.10 nl/mm - min (P less than 0.001). In the presence of low bicarbonate fluids, the addition of PTH resulted in no further decrease in Jv (0.74 +/- 0.10 vs. 0.72 +/- 0.10 nl/mm - min). These data indicate that in the proximal tubule the PTH-induced reduction in fluid absorption may be mediated by changes in bicarbonate absorption.


Two natriuretic substances in extracts of urine from normal man when salt-depleted and salt-loaded. When the extra-cellular fluid volume is expanded, the subsequent rise in urinary sodium excretion that occurs is due in part to a change in the concentration of some circulating natriuretic substance. Two natriuretic substances with different characteristics on Sephadex chromatography have been previously been identified separately by different workers. Extracts prepared from the urine of 31 normal subjects were tested for these two natriuretic materials in the normal conscious water-loaded rat. Two natriuretic fractions were found. The larger of the two was prepared on G50 Sephadex, and the smaller on G25 Sephadex. The natriuresis produced by the larger material was slow to develop and persisted for two hours. The natriuresis produced by the smaller material was maximal in the first 20 min, declined rapidly within the next 40 min, and tended to rise again during the subsequent 60 min. The amount of natriuretic activity that could be extracted from the freeze-dried urine was diminished by high concentrations of sodium chloride. The natriuretic activity of both materials was greater in the urine of the subjects when they were salt-loaded than when they were salt-depleted. The urine of salt-depleted subjects contained significant amounts of natriuretic material.


Factors in the dialysis regimen which contribute to alterations in the abnormalities of uremia. While hemodialysis therapy in its present form is capable of sustaining life, dialysis patients are not metabolically normal and we are unable to say what technical factors contribute adequate therapy. Recent efforts to resolve these problems have led to the assumption that substances in the molecular weight range of 800 to 3000 daltons may be pathogenic in uremia and these may not be effectively removed by dialysis. Accordingly, four groups of patients (ten each) underwent changes in their routine which were theoretically designed to alter independently the concentration of small (urea) and "middle" molecules in the blood. In two groups, the concentration of urea was theoretically increased or decreased while the concentration of so-called middle molecules was maintained unchanged. In the remaining two groups, middle molecule concentration was theoretically increased or decreased while small molecule concentration was unchanged. Patients were evaluated prior to and after completing altered dialysis therapy. The results suggest three related conclusions. First, the uremic syndrome may be viewed as a constellation of abnormalities which can be subgrouped by association so that azotemia may be correlated with neuropathic disease and hypertension with weight gain or body size, for example. Second, those physiologic variables which changed after altered dialysis tended to deteriorate with increasing concentration of small molecules in the blood and remained independent of theoretical changes in middle molecules. Finally, when patients are relatively under-dialyzed, they may spontaneously modulate the reduced removal of metabolites such as urea by decreasing the dietary intake of nutrients.


[Visual properties of unilateral aphakics corrected with spectacles (author's transl)]. A study of visual habits consisting of a questionaire and an examination was carried out on 70 unilaterally aphakic patients. These patients wore correcting glasses and had better vision in the cataract operated eye. It was observed that the patients, aided by senile convergence weakness on one side and senile divergence weakness on the other, were able to develop a form of monocular vision without complications and in particular without double vision. These patients who wore glasses developed a type of "multiple choice" vision, which was dependent on the intelligence and the determination of the individual.


[Biometrics and aphakia (author's transl)]. The combination of long axis measurement (ultrasonic) and corneal measurement is well adapted to determination of refraction in aphakia. In a group of 35 persons the results of this method were compared with subjective refraction measurement and skiascopy. "Ultrasonic" refraction was less than one dioptre different from subjective refraction in 62% of cases. We found that ultrasonic-determined axis length was consistently 0.4 mm shorter than the axis length calculated from subjective refraction measurements. The clinical application and accuracy of the method are described. With the help of a nomogram one can read off the refraction, when axis length and corneal curvature are known.


[Contact lenses in the treatment of badly injured eyes (author's transl)]. Serious eye injuries occur mostly in the spheres of traffic, work and play. There is an inverse relationship between the length of the wound and the visual acuity. Various authors' groupings according to the type of injury, and the relationship between severity and acuity obtained are given and comprehensively described. With respect to the type of injury an approximate division can be made as regards the choice of corneal or scleral lens. If, due to pronounced deformation, it is not possible by measurement to obtain a corneal profile, then a special impression technique must be used. A lens with the necessary optical data, corresponding to the impression is made. With the aid of individually fitted scleral lenses, a better tolerance is achieved in the majority of cases. Generally an acuity improvement of several lines is attained.


[Phenylephrine as an adjuvant in the treatment of glaucoma (author's transl)]. Due to the fact that pilocarpin, which is predominantly used as a local therapeutic in glaucoma, is not satisfactory in all cases and has certain well-known disadvantages such as miosis, ciliaryspasm etc., great hope was set on adrenaline. Besides tachyphylaxis, its sensitivity to light and oxygen, and the danger of angle block glaucoma in eyes with a narrow iridocorneal angle the therapy was limited. Combinations of both substances would theoretically reduce the rate of adverse reactions and at the same time increase the therapeutic effect; however again stability is often a problem. Pilocarpin was therefore combined in a galenic form with phenylephrine, which, as well as possessing an effect of long duration, also confers an improved stability on the eyedrops. The substances were combined in 6 different ratios and tested clinically. With one exception a significant reduction in i.o. pressure could still be shown 8 and 24 hours after a single application. It has been demonstrated that more patients can be sufficiently controlled using the combination than with pilocarpin alone, and that concomitantly the therapeutic safety appears to be better than with the previously well-known bivalent combination-substances.


[Herpes therapy and prophylaxis. I. A critical review (author's transl)]. This critical review is based upon controlled experimental and clinical data. Dendritic keratitis initially should be treated by debridement of the diseased epithelium followed by antiviral medication. The advantages and disadvantages of different debridement techniques and different synthetic antivirals are discussed. Rational treatment of other forms of herpetic eye disease with antivirals, steroids, therapeutic soft lenses, collagenase inhibitors etc. necessitates first of all an exact diagnosis (disciform edema, interstitial herpetic keratitis, herpetic (kerato-)uveitis, metaherpetic erosion, metaherpetic ulcer). Therapeutic or prophylactic measures which as yet have found no valid experimental or clinical basis are discussed as well as further developments. Special interest is laid upon the application of human interferon.


[Electro-ophthalmological observations on the course of unilateral tapetoretinal degenerations (author's transl)]. A 32-year-old female patient suffering from a unilateral tapetoretinal degeneration for at least 7 years was investigated. The affected eye exhibits a typical fundus, concentric reduction of visual field, and a monophasic course of dark adaptation. The electroretinogram of the affected eye is extinguished; the electrooculogram does not show a light peak. The visual evoked cortical potential of both eyes shows a normal amplitude-stimulus intensity function. However, the first negative deflection exhibits a small difference of implicit time between the normal and affected eye. The normal eye does not show any pathological alteration.


[On the appearance of the eye fundus in polycythaemia vera (author's transl)]. The authors discuss the ophthalmological and physical symptoms of polycythaemia vera. They established that the severity of the changes in the fundus depend in the same way on the red cell count and the duration of the illness. In an attempt to find the cause of the complications communicated in the literature in arterial spasm and venous stasis, the authors compared statistically the less severe cases and those cases with arterial stenosis which can also be found in uncomplicated cases, and the cases with venous stasis. In the group with arterial stenosis they showed that its occurrence was not associated with the hypertension often found in polycythaemia vera.


[Vision against the light as an aid to indication for cataract operation (author's transl)]. The examination of visual acuity against the light may help the decision, whether or not a senile cataract should be operated on. We examined 84 eyes with different lens opacities, the visual acuity was analysed in relation to the axial, cortical and capsular cataract. We found in all cases a marked reduction of the visual acuity against the light. This has been general ophthalmological experience especially in the capsular cataract. This additional examination, we propose, is easily performed, and was given helpful information for all kinds of cataracts, where the indication for surgery was not clearcut.


[Malignant chorioidal melanoma of the "Knapp Rønne" type (author's transl)]. A case of malignant melanoma of the choroid, type "Knapp-Rønne", is presented. Typical clinical features of this tumor are its situation close to the papilla and its tendency to early penetration of Bruch's membrane and the retina. Histopathologically numerous dilated vascular and avascular cavities, probably caused by disturbances in the blood circulation due to the strangulating effect of Bruch's membrane, constitute the distinguishing features. Clinical and histological details are discussed.


[Luxation and evulsion of the eyeball by car accidents (author's transl)]. The following unusual lesions have been seen, caused by splintered motor-car windscreens: 1. complete evulsion of the globe in combination with a visual field defect of the upper temporal quadrant of the other eye, 2. luxation of the globe, where an alleged lost big portion of the upper lid was dislocated deep into the orbit by glass splinters.


[Occlusion by means of soft contact lenses for the treatment of amblyopia (author's transl)]. A particular soft contact lens with a central black spot of 4 to 6 mm diameter is proposed as occlusion for the treatment of amblyopia. This method is particularly suited for adults who refuse a conventional occlusion.


[Ektomia of the anterior lens capsule in extra-capsular cataract operations (author's transl)]. A technic is described to show how to excise the anterior part of the capsule of the lens without defluction of the aqueous humor, in order to make possible a complete irrigation and aspiration of the equatorial lens material by extracapsular cataractsurgery especially by Lens Aspiration and by Kelman Phakoemulsifikation (KPE). By this the resorption of possible lens remains is revealed. Later turbidity of the posterial capsule by remains of the anterior capsule, coming into contact with the posterior capsule are prevented. This excision of the anterior capsule makes easier dislocation of the nucleus of the lens into the anterior chamber which is necessary for KPE.


[Nyktometric examinations on eye function in diabetic retinopathy (author's transl)]. By means of nyctometry we examinated in a group of normal persons and in a group of juvenile diabetics if the adaptability of the adaptation system in possible under various conditions of initial adaptation. It appears, that nondiabetics possess a sufficiently reactive functional system, while in diabetics, we found a defective functional reaction of the adaptation system because of beginning retinopathy.


[The clinical picture and histology of Marfan's syndrome (author's transl)]. In two tall, mentally subnormal patients (brother and sister) with long extremities and fingers, fine fair hair and subluxation or luxation of lenses Marfan syndrome was suspected originally. The male patient died aged 13 after an ophthalmic operation of thrombosis of cerbral sinuses. The correct diagnosis of homocystinuria was assumed subsequently and verified. Characteristic histologic changes of the vessel walls were found in the deceased male patient's histologic specimens won 13 years ago: fibrosis of intima, fragmantation of elastic fibres, accumulation of intercellular matter in media and defects in membrana elastic interna.


[A test-instrument for routine diagnosis in visual schools (author's transl)]. A report is given on a test-instrument which enables us to check the following functions: 1. Visual acuity (Line-E-acuity), 2. Binocular vision by Worth-4-dot-test, 3. Optical correction by Red-Green-test. 4. Stereoacuity by Polaroid-test.


[Some remarks on the early treatment of infantile squint (author's transl)]. It is generally accepted that there is also another factor necessary besides hypermetropia to cause squint. This is called by Quere "facteur tropigene causale", this being fully right, if the conception "tropie" comprises all tropic factors, including orthotropia. This factor is the mechanism of binocular vision, which informs us reliably also in case some abnormalities would occur in the receptor organs. The rule of early treatment that biretinal function is not to be allowed as long as there is squint present, cannot be approved by the author. According to him, the correct causal early treatment cannot be anything else than immediately given spectacles. He describes his method, by which this can be attained in the first and second years of life. The advantages as well as the drawbacks of some other methods (supercorrection, occlusion, penalisation, early and postponed operation) are discussed from the viewpoint of the causality and instantaneous acting.


[Problems in treatment of ocular and cerebral vascular disturbances (author's transl)]. With regard to a paper of Leydhecker the basic principles of a combined treatment of ocular and cerebral vascular disturbances with Strophanthin, resp. Digitalis, Vasodilatators, and Hydrocortisone medicaments are again discussed. The influence of hypoxia in vasodilatation, the confirmation of alterations in visual field, as well as the effect of decreased blood viscosity on the circulation are discussed. The most important item, cardiotherapy, is emphasized once again. The peripheral effects of Strophanthin, especially on the brain, are confirmed by communications of other authors. The prognosis of this polypragmatic therapy in long-term observations is also limited.


[A method of closing fistulae from drainage blebs to the out-side after glaucoma operations (author's transl)]. A method for closing fistulae in drainage blebs after anti-glaucoma surgical procedures is described. Its aim is to line internally and support the wall of the bleb, including the fistula, with subconjunctival tissue. The decisive factor in achieving this is the firm anchoring of the subconjunctival tissue pulled down between the corneo-scleral opening and the thin conjunctival tissue layer.


[Preventive surgery in the treatment of severely injured eyes: late results, complications, postoperative care (author's transl)]. Definitive reconstruction of the eye is the main objective of surgery in severe trauma. Therefore the damaged lens and vitreous have to be primarily removed in combined injuries to the anterior and posterior segments. 81 cases, treated according to this, have been followed-up from 6 months to 6.2 years. 43 have a VA of 0.1 or better, 18 at least a useful visual field. Main causes of blindness in 20 eyes are retinal detachment in 10, hemosiderosis in 4, phthisis in 3 eyes. 8 of the eyes lost through retinal detachment had a massive intraocular hemorrhage during the post-traumatic period. This hemorrhage is discussed as a main factor in development of retinal detachment with a poor prognosis. In 9 other cases of severely injured eyes with a massive posttraumatic intraocular hemorrhage the blood was removed from the vitreous cavity by intraocular irrigations with Ringer's solution. In 4 of these cases visual function could be retained.


[First communication: normal values of horizontal breadth fusion for distance vision (author's transl)]. Binocular fusion at 33 cm needs a fusion force of about 18 pdpt (delta) in convergence. In serial investigations on more than 2500 patients with normal binocular vision the fusion force is found to be limited to: in convergence max. 15.8 +/- 7.4 delta, in spontaneous convergence +18.8 +/- 5.3 delta, in divergence-5.6 +/- 2.3 delta. That seems to demonstrate, that in normal binocular vision with normal fusion force and without any subjective trouble the visual point must not be exactly in the foveolae of both eyes.


[Results of a-scan echography investigating intraocular tumors (author's transl)]. 63 patients suspicious of having intraocular tumors underwent ultrasonic investigations. An A-Scan Unit 7200 MA (Kretztechnik, Zipf/Austria) was used, standardized by the citrated-blood method recommended by Ossoinig. Out of the 63 eyes investigated 45 were enucleated and studied histologically. Here ultrasonic diagnosis of uveal melanoma could be prouved histologically in 14 cases. In 31 cases the ultrasonic method failed to give detailed information about type of tumorous tissue. Here histology revealed 22 melanomas of the uveal tract, 4 retinal dysplasias, 4 retinoblastomas and one case of Coats disease.


[Histological examination of resected eye muscles in concomitant squint (author's transl)]. The changes of muscle tissue are found as well in convergent as in divergent squint, especially in insufficiency of convergence. The histological changes are more pronounced in monocular strabism but they can also be found in alternating squint. They are observed in early occuring strabismus, but especially frequently in patients with a large angle of squint, in cases of severe amblyopia and defective binocular vision. The errors of refraction make no influence. All histological changes, described in this paper, have been already found in eye muscles of little children.


[Spontaneous regression of diabetic retinopathy (author's transl)]. A report is given on seventeen cases of spontaneous regression of diabetic retinopathy. The diabetes became manifest, without exception, at an early age, particularly in childhood. Regression came on slowly and inconspicuously, retinopathy disappearing completely in two thirds of the cases. Of the other forms of diabetic angiopathy only arterial hypertension was found. No case of specific nephropathy, but frequently chronic infections of the urinary tract, and intermittent proteinuria were observed.


[Macular coloboma. Casuistic contribution (author's transl)]. A case report is given of a 37-year-old women. In her left macula there was an outlined whitish defect about. 1.0 of disc diameter. There is no indication of intrauterine or infantile inflammation, birth haemorrhage or other possibilities.


[Serous choroidal detachment - a rare complication following light coagulation in diabetic retinopathy (author's transl)]. A 42-year-old male with beginning proliferative diabetic retinopathy developed a serous choroidal detachment as a complication following excessive light coagulation (retinal ablation); under conservative antiphlogistic treatment the choroidal detachment disappeared within one week.


[Symmetrical carotid aneurysm on both sides (author's transl)]. The case of a 44-year-old female patient with angiographically established symmetrical aneurysm of the internal carotid artery on both sides near the origin of the arteria ophthalmica is reported. The right ophthalmic artery is not perceptible for a distance of 2 mm in its early upper portion. The left ophthalmic artery is well filled. The visual capacity of the right eye is reduced to 1/24, the left eye has one of 1.0. The lower half of the visual field including the fixation point fails. The left visual field is characterized by a pronounced irregular concentrical narrowing with preserved fixation point. The different filling of the ophthalmic arteries is responsible for the difference in the visual capacity and in the visual fields of both eyes. Because, neurosurgically, only a resection of both aneurysms comes into question, one desists from this proceeding because of the extraordinary high risk of such an operation.


[An attempt at surgical management of haemorrhagic glaucoma (author's transl)]. A surgical method for the treatment of haemorrhagic glaucoma is discussed here. The operation implies Scheie's procedure without peripheral iridectomy, and the insertion of a silicon catheter. Prior to intraocular surgery cyclocryotherapy is employed in order to improve the basic condition. The long term mode of action of this surgical technique may be due to creating a favorable outset for the formation of secondary aqueous veins.


[Chronic lupus erythematodes of the eye lids and conjunctiva. A case report (author's transl)]. A report is given on a 33-year-old female with periorbital changes of the skin; based upon histological and immunofluorescence-optical examinations, the diagnosis of a chronic lupus erythematodes could be made. Following direct infiltration with a crystalline suspension of corticosteroids prompt improvement of the lesions was observed.


[Occurrence and frequency of orbital tumors in ethiopia (author's transl)]. Orbital tumors are more frequent in Africa than in Europe. Children are more often affected than adults. The most frequently observed tumors are the epithelioma of the conjunctiva in adults, and the retinoblastoma and Burkitt's lymphoma in children. Melanoblastomas and lid basal cell carcinomas are fairly rare. Findings from Ethiopia are demonstrated.


[The application of the redfilter by amblyopia to avoid a temporal fixation (author's transl)]. The treatment of amblyopia with the redfilter ought to be applied when there is a risk that the fixation will deviate to the temporal side. The better eye is occluded and the redfilter is given before the amblyopic eye so that only the fovea will be stimulated. Discussion of the own results.


[Orbitotomy by means of ultrasound-instruments (author's transl)]. A surgical ultrasound-instrument was tested experimentally as well as clinically in the operative treatment of 48 patients with various orbital tumours. The transducer was shaped either as a scalpel or as a saw. The device worked on a frequency of 44,000 cps, the transducer-amplitude was 15 to 30 microns. This tool facilitates cutting of bony tissue and the incision of soft parts, it stops also bleeding of smaller and middle-sized vessels.


[Chloramphenicol in ophthalmic practice (author's transl)]. The use of chloramphenicol is the cause of much controversy. In general medical practice this antibiotic is considered toxic and dangerous therefore its indications are very narrow and limited. In ophthalmic practice chloramphenicol is used very often and with considerable beneficial effect. Its main advantages are a broad spectrum and a very high intraocular concentration. A series of 34 acute conjunctivitides were treated with chloramphenicol solution with succes. The causative organisms were Pneumcoccus and Staphylococcus aurels.


[Perimetric diagnosis of chiasmal injury after contusion of skull and brain (author's transl)]. After a discussion of the pathomechanism of skull trauma by a blow leading to chiasmal lesion, frontobasal injuries of the skull are considered; it is shown that typical defects of the visual field resulting from chiasmal damage can be revealed not only in cases of serious industrial or traffic accidents with brain concussion and skull base fracture, but also following minor injuries without unconsciousness and radiologically visible bone fractures.


[Assessment of eye damage in private accident insurance (author's transl)]. In the private accident insurance practice eye damage has to be judged on specifications in the insurance policy. To explain this specifications important for an experts opinion are shown below.


[A new magnifying visual instrument for ophthalmic surgery (author's transl)]. A binocular loupe on the principle of the prismatic telescope, small in size and light in weight, and which can be firmly by straps to the head of the doctor, has been developed for use in operative ophthalmology, for the clinical visit, consultation and in the office. Its optic properties greatest possible distance from the work which can be varied with additional lenses, variable magnification even into the region of the smallest biomicroscopes with a relatively large angle of vision, good mobility with regard to the object of vision with unchanged adjustment, simultaneous possibility of using semispectacles for presbyopia and easy swinging of the instrument out of and into the line of vision with one hand movement make this instrument very appropriate for the reasons for which it was developed and makes possible also - especially in the surgery of injured eyes, exact observation and assessment of the eye and performance of operations where no operating microscope is present with much greater magnification as that obtained with a customary loupe. This instrument occupies the spare between the possibilities of use of the loupe and the biomicroscope and can in addition be used in the boundary areas of use  of the other instruments with great advantage.


[Stereoscopic microscope-spectacles for use in eye operations (author's transl)]. A magnification system newly developed by Zeiss on the basis of a Keplerian telescope permits, in connection with a direct-vision erecting prism, the design of stereoscopic surgical spectacles and thus a break into the microsurgical range. The magnification of 8.3X is just about the limit up to which muscular movement of the head is not disturbing, but on the other hand routine microsurgery, especially cataract and glaucoma surgery, is rendered possible.


[The significance of histologic assessment of the bone marrow in Hodgkin's disease]. The spreading of Hodgkin's disease in the bone marrow is of primary diagnostic significance in respect of its quantity as well as its quality, and therefore has to be taken into account from the initial staging procedure. The iliac crest is the most suitable site of the biopsy, the diagnostic significance of which depends on the adequate size of the specimen and on the technical standard of the histologic embedding with methacrylate, affording perfect semithin sections without decalcification. The prognostic value of the statement of Hodgkin's disease spreading in the marrow deserves further careful evaluation. A nonspecific reaction of the marrow against extramedullary lymphogranulomatosis closely resembling to the so-called tumor myeopathy has to be distinguished from the localized marrow changes due to the tumor itself. The former is depending primarily of the progress of the disease, the latter of its type as well. The well-known histologic classification covers the changes of the bone marrow due to Hodgkin's disease also. The different histologic types however exhibit a varying tendency of expansion within the bone. Generally the marrow involvement is accompanied with more severe clinical and hematological symptoms. The bone is altered mostly in the very region of the infiltration. This is not the consequence of direct tumorous destruction but of stimulation of environmental mesenchymal activities. Parenchymal and mesenchymal changes of the bone marrow, either directly or indirectly connected with the lymphogranulomatosis, are considered primarily as sequelae of the basic disease. The very close structural relationship between the original lymphogranulomatosus growth and these changes is one of the characteristics of Hodgkin's disease. As yet, there is no unequivocal pointer to structural characteristics whose appearance can exert an obstructive or stimulating effect on the lymphogranuloma tissue, apart from the number of lymphocytes and normal histiocytes in the specific infiltrate itself. Our observations of a special role of megakaryocytes in this connection deserve further attention.


[Effect of the beta-receptor-blocker prindolol on renal hypertension (author's transl)]. Under standardised conditions Prindolol-therapy (3 X 5 mg/die) was carried out in patients with renal hypertension in addition to the preexisting anti-hypertensive treatment during a period of 8 weeks. After administration of Prindolol for 4 and 8 weeks a significant (p less than 0.05) reduction of blood pressure (systolic and diastolic) was observed. 3 weeks after discontinuing the Prindolol-therapy blood pressure rose again, but it clearly remained below pretreatment level. Peak values of blood pressure during the day were markedly lowered. Antihypertensive efficacy was age-related. Lowering of blood pressure occurred in 70% of our patients. There existed no relation between plasma-renin-level and reactivity of the patients to the antihypertensive effect of Prindolol. Renal function (creatine-clearance) did not alter significantly by Prindolol-treatment.


Decrease in plasma noradrenaline levels following long-term treatment with prindolol in patients with essential hypertension. 15 patients (4 females, 11 males, 21 to 55-year old) with mild to moderate essential hypertension (EH) were treated with placebo for two weeks and thereafter with increasing doses of prindolol (15 to 38 mg/day in the mean) and kept on a mean maintenance dosage of 32 mg/day for an average of 16 weeks in all. Blood pressure (BP), heart rate und plasma noradrenaline (PNA) concentrations were measured under standardized conditions (supine, standing, walking) at the end of two weeks on placebo and after the experimental treatment period. The results were compared to those of a group of 15 normotensive untreated control subjects (NS): after an average of 16 weeks on prindolol BP fell from 163/113 mm Hg to 129/91 mm Hg in the mean. PNA levels in EH before prindolol were significantly higher than in NS (supine: 272 +/- 22.0 ng/l (mean +/- SEM) vs. 135 +/- 15.1 ng/l, standing: 448 +/- 31.9 ng/l vs. 359 +/- 18.4 ng/l, walking: 388 +/- 22.5 ng/l vs. 234 +/- 22.1 ng/l). In EH chronic administration of prindolol led to a significant decrease in PNA concentrations under all the three test conditions to levels which did not differ significantly any more from those derived from NS. The adrenergic response to upright posture reflected in the percentage increase in PNA was significantly less in EH before prindolol when compared to the percentage increase in NS. On prindolol the adrenergic response was not abolidhed, yet it tended to approach the values found in NS. Before prindolol under resting conditions diastolic BP correlated closely with the corresponding PNA levels (p less than 0.01, r = 0.66, n = 15). This correlation could not be reestablished after prindolol treatment. The decrease in PNA after long-term treatment with prindolol was not correlated to the fall in blood pressure. The decrease in PNA indicates a lower activity of the sympathetic nervous system which may contribute to the antihypertensive effect of prindolol.


[Mitochondrial morphology and metabolism in extrahepatic obstruction (author's transl)]. Corresponding to the increased activity of mitochondrial Glutamate-Dehydrogenase (GLDH) in serum in extrahepatic cholestasis a swelling of hepatic mitochondria could be shown on ultrastructural morphometric analysis. The morphometric alterations parallel the serochemical findings. A significant correlation could be calculated between the swelling of mitochondria and the activity of GLDH in serum.


[Alterations of bile acid metabolism during treatment with chenodeoxycholic acid. Studies of the role of the appearance of ursodeoxycholic acid in the dissolution of gallstones (author's transl)]. Nine patients with radiolucent stones in the gallbladder were investigated before and during treatment with chenodeoxycholic acid (CDC). During treatment the biliary composition of bile acids changed considerably. Before the ingestion of CDC,bile acids consisted predominantly of cholic acid, deoxycholic acid and CDC; lithocholic acid was present in small amounts only. In the course of treatment CDC or this bile acid together with ursodeoxycholic acid (UDC) became the major biliary bile acid. The content of CDC increased from 47.5 +/- 4.21 to 79.2 +/- 6.37 SEM %, whereas that of UDC increased from 2.7 +/- 1.15 to 13.4 +/- 6.4%. The unsulfated lithocholic acid increased slightly from 0.7 +/- 0.22 to 2.7 +/- 0.41%. The bile acid pool expanded by an average of 130%. The degree of expansion of the pool varied considerably among the different patients. The largest increase in the pool size, however, occurred in the patients with the largest content of UDC in bile. Gallstone dissolution was observed in five patients. Among these five were those patients with the highest content of UDC, Corresponding 8.6, to 29.4 and 51.7%, respectively. These findings suggest that, in addition to CDC, UDC has a cholelitholytic effect in vivo. Of interest also was the observation that the patients in whom the size of the bile acid pool increased only very little showed no dissolution of gallstones. Both the stool weight and the fecal excretion of the isotopes, after the administration of radioactively labeled bile acids, increased only slightly during the treatment with CDC. The cholelitholytically efficacious dose of 20 mg/kg/day of CDC applied in this study appears to be useful in that 94% of it was abosrbed.


[Adenosine deaminase deficiency in primary immunodeficiencies (author's transl)]. The occurrence of severe combined immunodeficiency (SCID) with adenosine deaminase (ADA) deficiency in erythrocytes has been reported in 14 patients. Enzyme deficiency may result in early depression of the lymphatic system. ADA is detectable in different tissues by photometric and electrophoretic methods. The gene locus for ADA has been localised on chromosome 20. Studies on the enzyme defect in different forms of primary immunodeficiencies led to the description of a well defined nosological entity. New aspects can be expected in the fields of pathogenesis, prenatal diagnosis, genetic councelling, and possibly therapeutic trials.


[Prospective study in posttransfusion hepatitis in patients with open heart surgery (author's transl)]. In a prospective study in posttransfusion hepatitis 54 patients with open heart surgery received 220 blood units which were negative for HBS Ag by radioimmunoassay. 15 of these units contained anti-HBS and were given to 13 antibody negative patients. In a half year follow up period neither clinical nor biochemical (SGOT, SGPT, gamma-GT) signs of hepatitis could be found in these patients and neither HBS Ag nor anti-HBS developed. At the same time a screening for HBS Ag of hospital staff in contact with these patients revealed no carrier of the antigen. Therefore, the lack of any hepatitis in our relatively small study group may be attributable to two facts: the relative safety of blood screened by highly sensitive methods for the detection of HBS Ag and the noninfectious environment of these patients in the hospital during the observation period.


[The influence of insulin, glucose and other monosaccharides on the platelet functions (author's transl)]. In vitro investigations were carried out on the action of insulin, glucose, xylose, galactose, fructose and sorbitol on the platelet aggregation test according to Breddin, on the ADP- and collagen-inducced aggregation and the release of platelet factor 4 as well as on the retraction. When incubating platelet-rich plasma with insulin and glucose simultaneously, a marked inhibition of the ADP- or collagen-induced platelet aggregation and release reaction results. Insulin as well as glucose impaired the platelet function only at high concentrations, this inhibition however did not reach that of a combination of both. Fructose, xylose and sorbitol exerted no significant inhibitory effects. In contrast to the prevented aggregation, the retraction was enhanced. As the causal mechanism for the inhibition of the platelet function the Crabtree effect is discussed.


Bias in counting procedures for white blood cells. To increase the precision of low white blood counts with traditional counting procedures often an initial count is performed in 0.1 cu. mm. Only if this pilot count is low, additional zones of 0.1 cu. mm. are counted and the results of the pilot count and the additional count then averaged. This counting procedure should be avoided as it gives biased estimates of the white blood count. The bias is avoided if the result of the initial count is discarded and an independent count is performed in a larger volume. In analogous counting situation-such as radioactivity counts - bias can arise and be prevented in analogous ways.


[NBT reduction capacity of polymorphonuclear leukocytes in cord blood and in blood of parturients (author's transl)]. Polymorphonuclear leukocytes in cord blood and in blood of women at delivery and six weeks after delivery were examined by means of a modified NBT-test. The results were compared with those of healthy controls. It is shown that the increased NBT-positivity of the polymorphonuclear leukocytes of the examined groups is due to increased ingestion capacity, while NBT reduction capacity of the polymorphonuclear leukocytes is not increased.


[Preventive screening in two factories. I. Methods and results (author's transl)]. A screening study for coronary disease, chronical bronchitis, diabetes mellitus, hypertension, peripheral circulatory disturbance and overweight is described. 2429 persons aged over 40 years and working in two factories were studied. Typical laboratory tests, a short standardised examination by a physician and a questionnaire were used. In a 10 per cent sample the questionnaire was repeated by an interview and the serum was sent to the laboratory not only by mail, but also by a special car transport in a cooled transport box. The results of the laboratory tests are presend according to age, sex and factory. The family doctor had to be informed in nearly 70 per cent of the men and about 60 per cent of the women because of at least one suspicious symptom or sign. There was a pathological value of glucose in the urine in 14.7 per cent, a rise of glucose in the blood (above 113 mg per cent) in 5.7 per cent, of triglicerides (above 181 mg per cent) in 12.6 per cent, of cholesterol (above 264 mg per cent) in 15.4 per cent, of uric acid (male above 7.7 mg per cent, female above 7.1 mg per cent) in 6.8 per cent, of creatinine (above 1.3 mg per cent) in 6.4 per cent and the presence of albumin in urine in 2.2 per cent of the cases.


[Preventive screening in two factories. II. Exactitude of laboratory tests and questionnaire (author's transl)]. The exactitude of some widely used laboratory tests (triglycerids, cholesterol, glucose, uric acid, creatinine) is examined in a situation relevant for practising physicians. Different statistical methods for reporting errors are compared. Accuracy and precision are useful measures for the quality of analytic procedures. They are not sufficient for medical judgement for a single patient, since sampling procedures, type of sample or transport and storage of sample are not considered in accuracy and precision. Such sources of error can largely devaluate the quality of accuracy and precision and of the analytic procedures. Error coefficients are proposed as a new method of reporting laboratory errors. The mathematical model starts with an analysis of variance and total error, technical error and transport error are defined. The study shows that the error introduced by transporting serum via postal service compared to that conveyed in a cooled transport box by a special car is considerable. It is nearly impossible for a physican to use single laboratory value for a rational decision "normal-not normal" if the values are based on samples which are sent by postal service and if the values lie in the broad borderline between the normal and pathological area. This is especially true for creatinine (transport error 47.0 per cent) and uric acid (transport error 38.7 per cent), but not so much for cholesterol (22.9 per cent), triglicerids (14.3 per cent) and glucose (13.3 per cent). Variables with high transport error like creatinine should not be used in screening programs, as long as the transport is made by postal service and the method is not improved. The agreements between the answers of a questionnaire and of an interview are analysed with the same patients (n=235). These agreements lie between 98.7 per cent and 61.7 per cent depending on the single question. The exactitude of medical questionnaires is in the same size order as the exactitude of laboratory tests-at least when the sample is sent by postal service.


[Preventive screening in two factories. III. Relations between quantitative variables and questionnaire-items (author's transl)]. In the preceding articles a preventive screening model in two factories was described, the results were given and the exactitude of laboratory tests presented. In this paper the relations are studied between all the observed variables. Contingency-tables and the x2-statistic are used. For the 57 observed variables-(laboratory variables, e.g. triglicerides, cholesterol, glucose, uric acid, creatinine and questionnaire-items designed to screen for angina pectoris, myocardial infarction, claudicatio intermittens and bronchitis)-all possible contingency tables between two variables were calculated (1596 tables). The significant connections are reported in form of a hypothesis-matrix. There exists no statistical correlation between laboratory tests and questionnaire-items. The anamnestic questionnaire cannot be replaced by laboratory tests and vice versa. Nearly all items of the questionnaire are correlated. There are some correlations between laboratory tests, blood pressure and smoking habits.


Psychometric functions for loudness discomfort and most comfortable loudness levels. Adaptive procedures were used to determine psychometric functions for loudness discomfort level (LDL) and most comfortable loudness (MCL) for pure tones and speech using normal and hearing-impaired listeners. For the LDL, both groups demonstrated steeply rising functions with the 50% point at approximately 100 dB SPL. The MCL data resulted in two functions, one (Function A) differentiating MCL from less intense stimulus levels and the second (Function B) differentiating between MCL and more intense levels. Function A may be considered a lower bound and Function B an upper bound for MCL. For the normal listeners, the difference between the functions at 50% response ranged from 9.9 to 19.9 dB depending upon the experimental condition. For the hearing-impaired subjects, this range was restricted to approximately 4.5 dB, primarily as a result of a shift in Function A toward higher sound pressure levels.


Information processing of visually presented picture and word stimuli by young hearing-impaired and normal-hearing children. Eleven hearing-impaired children and 11 normal-hearing children (mean = four years 11 months) were visually presented familiar items in either picture or word form. Subjects were asked to recognize the stimuli they had seen from cue cards consisting of pictures or words. They were then asked to recall the sequence of stimuli by arranging the cue cards selected. The hearing-impaired group and normal-hearing subjects performed differently with the picture/picture (P/P) and word/word (W/W) modes in the recognition phase. The hearing impaired performed equally well with both modes (P/P and W/W), while the normal hearing did significantly better on the P/P mode. Furthermore, the normal-hearing group showed no difference in processing like modes (P/P and W/W) when compared to unlike modes (W/P and P/W). In contrast, the hearing-impaired subjects did better on like modes. The results were interpreted, in part, as supporting the position that young normal-hearing children dual code their visual information better than hearing-impaired children.


Stuttering and sentence length.

Stuttering and sentence length. The purpose of this study was to determine whether sentence length influences the frequency of stuttering. Fourteen stutterers read, in random order, 20 long and 20 short sentences. The long sentences were constructed by means of additions to the short ones: for example, She learned to swim and She learned to swim in the clear water of the lake. Only the words that the pairs of sentences had in common were compared for occurrence of stuttering. Significantly more stuttering was found on the same words when they served as the initial segments of long sentences than when they stood alone as short sentences. The results seem to give evidence of the role of motor planning, or anticipated motor complexity in stuttering.


Imitative modeling as a theoretical base for instructing language-disordered children. A modification of Bandura's social learning theory (imitative modeling) was employed as a theoretical base for language instruction. This approach was experimentally compared to an alternative technique which required the subject to literally match each stimulus statement made by che clinician (mimicry). The results support the prediction that modeling is more effective in teaching the subject the appropriate grammatical rule, which he or she initially lacked. Moreover, subjects in the modeling condition exhibited both greater retention of the rule and a more successful generalization of it to novel contexts. The results are explained in terms of an "interference hypothesis," which suggests that a client's overt verbalization may interfere with the cognitive processing necessary to learn an abstract language rule.


Divergent semantic behavior in aphasia.

Divergent semantic behavior in aphasia. The purpose of the present study was to examine the divergent semantic behaviors of 30 persons with aphasia in comparison to these same behaviors in a group of 30 normal individuals. Specifically, this study examined fluency or the number of ideas produced, flexibility or the variety of ideas produced, and communality within each subject group and between the two groups. Results support the existence of the divergent mental operation and indicate that persons with aphasia are impaired in their ability to generate semantic responses under this operation. Therefore, speech pathologists may wish to include divergent tasks in their evaluation procedures and plan therapy directed toward the retrieval of divergent responses.


Vowel duration characteristics of esophageal speech. The duration of a large number of representative vowels produced by 10 esophageal and nine normal speakers were measured. Overall vowel durations of esophageal speakers were consistently longer than those of normal speakers, indicating that esophageal speakers do not compensate for their striking diminution in air supply for speech by decreasing vowel duration. The differences in the vowel duration characteristics between normal and esophageal speakers were observed to vary systematically as a function of the voicing features of their consonant environments. Specifically, the durations of vowels of esophageal speakers spoken within voiceless consonant environments were consistently longer than those spoken in similar contexts by normal speakers. There were no significant differences between the average durations of vowels spoken by normal and exophageal speakers within voiced consonant speakers differed significantly as a function of the voicing features of their consonant context was interpreted to support the belief that inherent, rule-governed durational features of English are retained following laryngeal amputation.


Recognition of verbal labels of pictured objects and events by 17- to 30-month-old infants. A technique for efficiently presenting a large number of vocabulary items was developed for the testing of vocabulary comprehension in children younger than two years. The technique, incorporating slides of real objects, had the advantages of maintaining the child's attention, motivating task continuation, and overcoming the extraneous contextual cues of test materials. The subjects were 106 children aged 17 to 30 months from a wide range of social status groups, and from both English and Spanish language families. Results indicated significant stability over time as well as a significant relationship to maternal report. Analysis of errors suggested that comprehension develops similarly to production, in that simple nouns were the easiest items, verbs were more difficult, and modifiers and locatives were the most difficult. There were no significant main effects of sex or social status. However, specific environmental variables such as parental attitudes and playmate patterns were significantly correlated with test performance. More flexible family control systems and more interaction with peers were both associated with better vocabulary comprehension in first born children.


The function of imitation in child language. The use and function of imitation were examined for seven children in the early syntactic period of language acquisition. The use of imitation was determined by the percent of syntactic imitation out of total syntactic output. Based on this measure, the children were divided according to whether they used imitations minimally, moderately, or extensively. The function of imitative repertoires was investigated by examining the lexical, syntactic, semantic, and communicative-interactional aspects of language as they were reflected in imitation. The analyses revealed that degree of imitation interacted with function of imitation in the acquisition process. Management implications are discussed.


Consonant confusions in patients with sensorineural hearing loss. Consonant confusion matrices were obtained from 22 outpatient listeners with sensorineural hearing loss for four sets of CV and VC nonsense syllables, presented monaurally at SRT + 40 DB. Testing was typically conducted for six hours on each of two separate days. Overall performance and patterns of confusions were stable over time. Analysis of the matrices in terms of phonological features indicated that the patterns of consonant confusions varied both with degree and configuration of the subject's loss. Scaling of intersubject similarity using a pairwise multidimensional scaling analysis resulted in consistent classification of subjects according to audiometric configuration into three groups-essentially normal hearing, flat or rising audiograms, and high-frequency hearing losses.


Time-intensity trade for speech: a temporal speech-Stenger effect. Time-intensity trade for selected spondaically stressed words was investigated using a centering method for interaural time delays of 0.00, 1.00, 2.00, 2.25, 2.50, and 2.75 msec at five levels of presentation: 0-, 25-, 40-, 55-, AND 70-DB HL (ANSI, 1969). Lateralization effects increased with level of presentation, with a maximum lateralization effect of between 22 and 30 dB occuring with an interaural time delay of 2.25 msec. Multiple images were perceived by all subjects with an interaural time delay of 2.75 msec and by some subjects with an interaural time delay of 2.50 msec at high levels of presentation. No "ear effect" was observed for any of the listeners. A potential clinical application is discussed for this temporal speech-Stenger effect.