Differences in chemical composition between the epithelial glycoproteins of the upper and lower halves of rat colon. Analysis of the apparently homogeneous sulfated sialoglycoproteins isolated from the epithelial cells of the upper (proximal to the ileum) and lower (proximal to the rectum) halves of Wistar rat colon showed that whereas they were similar in overall carbohydrate and amino acid composition, they differed significantly in the O-acetyl substitution pattern of their constituent sialic acids. The glycoprotein from the upper half of the colon was found to contain a larger percentage of sialic acid substitued at C7 and/or C8, as well as at C4 and C7 and/or C8; it contained less sialic acid which was unsubstituted as well as less subsituted at C4 alone. It has been shown that differences in substitution at C7 and/or C8 can be detected by analysis of the 105 000 g supernatants prepared from homogenates of isolated epithelial cells or fresh or formol calcium fixed whole colonic tissue.


17-oxidoreduction of 17beta estradiol, estrone and their 3-sulfates by kidney slices from guinea pig and human. Slices of whole kidney and kidney cortex from the female guinea pig catalyzed a marked reduction of estrone 3-sulfate (E13S) and estrone (E1) to 17beta-estradiol 3-sulfate (E23S) and 17beta-estradiol (E2), respectively, as well as the reverse (dehydrogenation) reactions. Slices of medulla did not appear active in E23S-E13S interconversion but did possess the ability to interconvert E2 and E1, besides possessing considerable sulfatase activity. The use of [3H-55S]E13S and [3H-55S]E23S as substrates, together with a demonstrated lack of estrogen sulfate synthesis by the tissue slices, provided ample evidence that the intact sulfates were involved in direct oxidoreduction. Slices of human kidney cortex catalyzed the reduction of E13S to a very limited extent. Slices of whole kidney and of cortex from guinea pig formed small amounts of estrogen glucuronide(s).


Hormonal stimulation of ribosomal RNA synthesis in Achlya ambisexualis. The experiments reported show that one of the early effects of the steroid sex hormone antheridiol is on the synthesis of rRNA and ribosomes. This is demonstrated in hormone treated cultures of Achlya ambisexualis (strain E87) by an enhancement of the incorporation of [3H]uridine into 26S and 18S rRNA and by an increase in measurable amounts of ribosomes per milligram dry weight of mycelium. Furthermore, since the hormone does not significantly alter the pool size or the specific activity of uridine triphosphate, this effect appears to represent an increased rate of RNA synthesis.


The probable 'capping' of wheat leaf messenger ribonucleates by 7-methylguanosine. Experiments have been designed to test the possibility that, as with messenger RNA from animal cells, 7-methylguanosine may be bonded through a pyrophosphate bridge to the 5'-termini of messenger RNA molecules from the cells of a higher-plant organism. It is concluded that 7-methylguanosine is probably bonded through a pyrophosphate bridge to the 5'-termini of messenger RNA molecules from wheat leaves.


Demonstration of the isolation of non-infective Alnus crispa var. mollis Fern, nodule endophyte by morphological immunolabelling and whole cell composition studies. Two filamentous, branched, and septate actinomycetes were isolated from field-collected and from axenic in vitro produced root nodules of Alnus crispa var. mollis Fern. host plant. After their transfer to a chemically defined medium, these nodule isolates could not be distinguished from each other on the basis of morphology, cultural reactions, and whole cell composition and were considered to be the same species. They were morphologically similar to the root nodule endophyte, but were incapable of nodulating aseptic host plants growing in a nitrogen-deficient substrate. Whole cells of the nodule isolates were used for the production of rabbit antibodies. The resulting specific antiisolate antibodies were conjugated with fluorescein isothiocyanate and used in staining tests of the nodule endophyte. The immunofluorescence reactions demonstrated the homology of the nodule isolates with the nodule endophyte. After pectinase degradation of the endophyte capsule, the indirect immunoferritin method corroborated the fluorescent anti-body (FA) staining reactions. There was no antigenic relationship between the nodule isolates and 13 known strains of actinomycetes as determined by the FA techique. Fluorescent antibody reactions of adsorbed conjugates suggested that endophytes of both Alnus crispa var. mollis Fern. and Alnus rugosa (DuRoi) Spreng. root nodules belong to a common serotype. The LL and mesoisomers of diaminopimelic acid were present in similar proportions in the nodule endophyte and in the nodule isolates. Glucose, mannose, and an unknown sugar were the predominant whole cell sugars in the nodule isolates, although trace amounts of arabinose and rhamnose were also displayed. The unknown sugar found in the nodule isolates was also present in trace amounts in the endophyte-suspension hydrolysate.


The fine structure of conidial development in the genus Torula. II. T. caligans (Batista and Upadhyay) M. B. Ellis and T. terrestris Mistra. Conidia of Torula caligans (Batista & Upadhyay) M. B. Ellis comb.nov. and T. terrestris Misra were examined by transmission- and scanning-electron microscopy. Torula caligans produced four-celled conidia in which the central cells were distinctly larger than the basal and apical cells. Conidia of T. terrestris were 4- to 7-celled long and ellipsoidal in shape. Conidiogenous cells in both species developed melanin only within the lowermost part of the lateral walls while the other cells of the conidium were uniformly melanized around the circumference of the cell; melanin in these cells being deposited within, at least, half the width of the cell wall. In both species new conidia arose from evagination of the hyaline apex of the conidiogenous cell and are therefore blastoconidia. The systematic relationships between T. caligans and T. terrestris and other species of the genus Torula are discussed.


Electron microscopy of vesicular-arbuscular mycorrhizae of yellow poplar. III Host-endophyte interactions during arbuscular development. Scanning- and transmission-electron microscopy were used to examine developing and mature functional arbuscules in mycorrhizal roots of yellow poplar. Arbuscules developed from intracellular hyphae which branched repeatedly upon penetration into the host cells. Intermediate and late stages of developemnt were characterized by the production of numerous, short, bifurcate hyphae throughout the arbuscule. Mature arbuscules exhibited a coralloid morphology which resulted in a considerable increase in the surface area of the endophyte exposed within the host cells. Distinctive ultrastructural features of arbuscular hyphae included osmiophilic walls, nuclei, abundant cytoplasm, glycogen, and numerous small vacuoles. All arbuscular components were enclosed by host wall material and cytoplasm during development and at maturity. In infected cells, host nuclei were enlarged and the cytoplasm associated with the arbuscular branches typically contained abundant mitochondria, endoplasmic reticulum, and proplastids. Ultrastructural observations suggested that nutrient transfer may be predominantly directed toward the fungal endophyte during arbuscular development and while mature arbuscules remain functional.


Nutrition of Vitreoscilla stercoraria.

Nutrition of Vitreoscilla stercoraria. The present study has shown that the glutamate or aspartate families, plus the aromatic amino acid family are required for growth of Vitreoscilla stercoraria. Furthermore, glutamine can substitute for the glutamate family, asparagine and methionine can replace the aspartate family, and tyrosine can substitute for the aromatic family. Amino acids which are easily oxidized by this organism, particularly serine and cysteine, stimulated growth. From these data, a defined medium was devised, which contained the fewest amino acids that could support good growth of V. stercoraria.


Cellular and free lipopolysaccharides of some species of Neisseria. Cultures of eight non-pathogenic species of Neisseria grown in simple defined media released lipopolysaccharide (free lipopolysaccharide) by a process distinct from cellular autolysis. Analyses of the pure cellular and free lipopolysaccharides obtained from six species of Neisseria revealed that they were remarkably similar and were devoid of detectable O-antigen side chains. Three distinct types of core-oligosaccharides were demonstrated. Type I core-oligosaccharide was a branched structure of alpha-D-glucopyranosyl units (7 mol) terminated by a reducing end group of 3-deoxy-D-manno-octulosonic acid. Type II core-oligosaccharide contained D-glucose, 2-deoxy-2-amino-D-glucose, L-rhamnose, L-glycero-D-manno-heptose, 3-deoxy-D-manno-octulosonic acid, phosphate, and ethanolamine in a molar ratio of 3:2:1:1:1:1:1. Type III coreoligosaccharide was composed of D-glucose, L-glycero-D-manno-heptose, 3-deoxy-D-manno-octulosonic acid, and phosphate in a molar ratio of 3:3:1:1. Lipopolysaccharides of N. caviae and N. sicca contained type I core-oligosaccharides exclusively, while those of N. flava and N. perflava contained only type II core-oligosaccharide. Cellular lipopolysaccharide from N. cinerea contained core-oligosaccharides of types I and II in a ratio of 27:73, while the analogous preparation from N. flavescens contained core-oligosaccharide types II and III in a ratio of 21:4. Free lipopolysaccharides from these two organisms contained only one type of coreoligosaccharide. Lipid A components of all the lipopolysaccharide preparations were very similar being composed of about 25% by weight of dodecanoic acid, 3-hydroxy-dodecanoic acid, and 3-hydroxy-tetradecanoic acid.


Degradation of ioxynil and bromoxynil as measured by a modified spectrophotometric method. A modified spectrophotometric method was developed to estimate ioxynil and bromoxynil residues. The method when compared with a 14C-tracer method was less sensitive but allowed rapid and accurate estimation of the herbicides. A clay loam soil with high organic matter content, which degraded ioxynil completely to CO2, also degraded bromoxynil completely. Bromoxynil degradation proceeded at a faster rate than that of ioxynil. The half-life of degradation was estimated to be 7 days for bromoxynil and 9-10 days for ioxynil. However, soil microorganisms which degraded ioxynil either completely to CO2 or partially did not seem to completely degrade bromoxynil. Degradation products from bromoxynil were detected on thin-layer chromatograms of extracts from pure cultures containing an exogenous carbon source. Complete degradation of bromoxynil and ioxynil in soil could be due to the action of different microorganisms.


SDS-polyacrylamide gel electrophoresis of lipopolysaccharides. Lipopolysaccharides (LPS) prepared from four different species of Neisseria have been separated by SDS-polyacrylamide gel electrophoresis. Each LPS possessed a characteristic mobility on gels. Examination of the effect of acrylamide concentration on migration illustrated that the basis of the separation was molecular size and not intrinsic charge.


Quantitative assessment of the bacterial rhizosphere flora of Pinus contorta var. latifolia. The bacterial flora associated with root systems of young and mature lodgepole pine was investigated by sampling forest-grown trees. Counts were performed and expressed on a surface-area basis to give a more realistic comparison of organism density or activity within the control soil, rhizosphere soil, and rhizoplane. On this basis, densities increased by an order of 10(4)- to 10(6)-fold from control soil to rhizoplane, with the degree of stimulation being inversely related to root radius.


Microcycle conidiation in Penicillium urticae: an ultrastructural investigation of spherical spore growth. A cultivation system has been developed for Penicillium urticae (NRRL 2159A) which yields 'microcycle' conidiation in submerged culture. Spherical growth of spores was initiated by incubation at 37 degrees C in a growth-favoring medium. Transfer of these enlarged spores to a nitrogen-poor medium at 35 degrees C resulted in synchronous germination and limited outgrowth followed by roughly synchronous conidiation. An ultrastructural study of the spherical growth stage indicates a significant loss of cell envelope fine structure and a general increase in the number of cellular organelles. Loss of the complex pattern of rodlets on the spore surface, and the trench-like invaginations of the plasma membrane were most prominent. From an ultrastructural point of view these large spores (about 6 mum in diameter) appeared to be perfectly normal.


Microcycle conidiation in Penicillium urticae: an ultrastructural investigation of conidial germination and outgrowth. A cultivation system has been developed for Penicillium urticae (NRRL 2159A) which yields 'microcycle' conidiation in submerged culture. Spherical growth of conidia was initiated by incubation at 37 degrees C in a growth-favoring medium. Transfer of these enlarged conidia to a nitrogen-poor medium at 35 degrees C resulted in synchronous germination and limited outgrowth followed by roughly synchronous conidiogenesis. An ultrastructural study of the germination stage indicated nuclear migration into the emerging germ tube whose new cell wall was an extension of the parent conidium's innermost cell wall layer. Septal formation at the neck of the germ tube followed. The septal pore was filled with particulate material and the septal membranes possessed unusual linear elements in their median hydrophobic zones. The germ tube, which possessed a smooth-surfaced plasma membrane, continued to elongate with periodic septum formation. The parent conidium and later the proximal germ tube showed progressive vacuolation and the cytoplasm became largely occupied by electron-translucent material. In older cells the septal pore was blocked by Woronin bodies. Compared with normal conidial germination this microcycle' germination is far more synchronous and the resultant germling is morphologically simpler. In ultrastructural terms, however, germination appears to be identical with that obtained at 28 degrees C.


Microcycle conidiation in Penicillium urticae: an ultrastructural investigation of conidiogenesis. A cultivation system has been developed for Penicillium urticae which yields 'microcycle' conidiation in submerged culture. Spherical growth of spores was initiated by incubation at 37 degrees C in a growth-favoring medium. Transfer of these enlarged spores to a nitrogen-poor medium at 35 degrees C results in synchronous germination and limited outgrowth followed by roughly synchronous conidiation. A study of the conidiation stage showed that a phialide and an immature conidium began to form at the tip of all germ tubes 18 h after the temperature shift. By 24 h additional phialides commonly appeared as a branch near the tip of the germ tube and the more mature conidia exhibited increasing refractility. The earliest ultrastructural signs of conidiation were various round invaginations in the plasma membrane and a thickening and rounding of the new spore wall which appeared as an inner extension of the phialide cell wall. Upon segregation of the conidium from the phialide cell by conidial wall formation, 'trench-like' invaginations gradually appeared in the plasma membrane and a disorganized rodlet pattern was formed on the outer surface of the maturing conidial wall. Continued maturation involved the formation of chains of conidia and phialide senescence which was characterized by a general degradation of intracellular structure. A comparison with standard surface and submerged culture conidiation indicated that 'microcycle' conidiation, while less prolific, was essentially identical.


Induction of microbial variants of Pseudomonas pseudomallei in cultured rabbit alveolar macrophages. Cultured alveolar and peritoneal macrophages obtained from normal and immunized rabbits were used to induce wall-defective microbial variants of Pseudomonas pseudomallei. Variants were iduced only by normal alveolar macrophages. The variants reverted to typical Pseudomonas forms either spontaneously or upon transfer into broth or agar.


Ruptured aneurysms of the aortic sinus of Valsalva. Aneurysms of the aortic sinus of Valsalva (ASV) are uncommon. This study describes eight cases of ruptured aneurysms of the congenital variety observed over a 10-year period in Singapore. Although ASV is classically diagnosed at the time of rupture, only one patient in this series presented with acute chest pain and dyspnea. All eight patients had continuous murmurs. The clinical diagnosis was confirmed by cardiac catheterization and angiography in eight patients and by thoracotomy in six. In six patients, the aneurysm had ruptured into the right ventricle and in two into the right atrium. In the five patients where the site of the aneurysm could be definitely determined, four arose from the right coronary and one from the noncoronary sinus. This marked preponderance of right coronary sinus over noncoronary sinus aneurysm in Singapore is more in accordance with the Japanese rather than the Western experience. A systolic gradient due to the aneurysm pressing on the right ventricular outflow tract was established in four patients during cardiac catheterization and angiography and confirmed in three patients at thoracotomy. Six patients underwent operation and were alive and well from 7 months to 3 years later.


Aortometric estimation of stroke volume in the presence of aortic insufficiency. A formula has been derived for estimating the left ventricular stroke volume (SV) from measurements of the difference between maximum and minimum cross-sectional area of the ascending aorta (am), ascending aorta pulse wave velocity (c) and systolic period (TS): SV=0.54 Ts c am. In open chest dogs, this 'aortometric' formula for estimating SV compared favorably with measurements by the electromagnetic flowmeter method both with and without aortic regurgitation. This suggests that in the presence of aortic regurgitation, the aortic backflow may be estimated from the difference between the aortometric SV measurement and the systemic blood flow estimated by an independent technique.


Coronary arterial mapping in hypertrophic cardiomyopathy. The diameters of the coronary arteries and their peripheral branches were measured on coronary angiograms obtained from 9 patients with hypertrophic obstructive cardiomyopathy (HOCM), 6 patients with hypertrophic non-obstructive cardiomyopathy, and 6 normal controls. There was a marked increase in the diameters of the main coronary arteries in the patients suffering from cardiomyopathy but no significant difference in the peripheral branches between the three groups. This discrepancy between the 'run-in' and 'run-off' components of coronary circulation could explain anginal symptoms during exercise in HOCM, but in the absence of direct coronary flow measurements this theory remains to be tested. HOCM was associated with the widest arteries whereas hypertrophic non-obstructive cardiomyopathy occupied an intermediate position between HOCM and the control group.


Acute primidone overdosage with massive crystalluria. A patient admitted to the hospital in coma was found to have massive primidone crystalluria. Gas chromatographic analysis of blood and urine for primidone and phenobarbital showed high urine primidone levels and high blood phenobarbital levels. The primidone levels suggest that primidone is rapidly cleared into urine. The high blood phenobarbital levels within 12 hr of overdosage with a history of diphenylhydantoin therapy and without phenobarbital therapy or overdosage suggests that diphenylhydantoin may influence the metabolic conversion of primidone to phenobarbital. The relationship of clinical symptomatology to high levels of primidone and phenobarbital is unclear. Analysis of blood and urine for primidone and phenobarbital and urine for crystals is of value in establishing diagnosis and prognosis in cases of suspected primidone overdosage.


Blood codeine concentrations in fatalities associated with codeine. The toxicologic findings in eight cases of death due primarily to codeine overdosage are presented. Blood codeine concentrations ranged from 1.4 to 5.6 mug/ml as determined by gas-liquid chromatography. Morphine was found in only two of the blood samples, at concentrations of 0.2 and 0.6 mug/ml, and may have resulted from heroin usage rather than codeine metabolism. A case of death of a codeine user by violent means is also presented in which the blood codeine concentration was 2.6 mug/ml.


Treatment of genitourinary infections.

Treatment of genitourinary infections. The diagnosis of urinary tract sepsis is being made more often today because of increased awareness of the condition and improved techniques in the detection and management of genitourinary disorders. Patients developing urinary tract sepsis (bacteremia or septicemia) usually demonstrate certain predisposing factors: underlying chronic disease, advanced age, general debility, or recent urinary tract sepsis is easily made in a patient who has a sudden onset of fever, chills, malaise, nausea, and vomiting, along with tachycardia and a drop in blood pressure. Cultures should be taken from urine and blood samples, but therapy should be instituted immediately rather than after obtaining the results of cultures.


Breast examination and clinical aspects of cyst aspiration. Aspiration of breast cysts is now a well-established procedure that has saved countless operations, with a monetary benefit to patients and the saving of use of hospital beds. It has provided profound relief to the patient. The technique is simple, requiring but a few moments to perform, and is accompaned by little or no morbidity. Those who perform aspiration must be familiar with the indications for biopsy, so that adequate and early treatment may be provided.


New concepts in the immunotherapy of neoplasms. Elucidation of immunobiologic mechanisms, both in general and particularly as they relate to tumors, is a relatively new endeavor. Clinical application of immunotherapeutic principles has followed tentatively behind the leading edge of research information. Evaluation of this type of therapy is on-going, and results are quite variable. Certainly the major application of immunotherapy must be as an adjuvant, for it is ineffective, both in research and clinical settings, where there is discernible tumor burden. To be properly utilized, immunotherapy must be properly sequenced and not used with other modalities of therapy in such a way as to render it useless. It must be applied with the realization that its effects might be supportive of tumor growth; therefore, frequent assays of tis effects must be carried out both during and after treatment. At the present time, active nonspecific immunotherapy using BCG and active specific therapy using altered autochthonous cells are most in vogue. This is, however, a rapidly changing field and one can anticipate frequent new directions in therapy.


Current concepts of cell kinetics in the treatment of leukemia. In a relatively brief time, considerable information has been accumulated concerning the relationship of the cell proliferation characteristics of acute leukemia and response to chemotherapy. Much remains to be learned, but we are now able to approach the problem of therapeutic regimen design based on observed patterns of in vivo cell response.


Antibiotic-associated colitis.

Antibiotic-associated colitis. Patients receiving antibiotics or having just completed a course of antibiotics should be observed for the development of diarrhea. The diagnosis of antibiotic-associated colitis can be made by careful proctoscopic examination. If colitis is found, the antibiotic should be discontinued, vigorous supportive therapy should be instituted, and the patient should be observed carefully. Following these guidelines, the prognosis for antibiotic-associated colitis should be favorable.


Some facets of clinical virology.

Some facets of clinical virology. The availability of virus diagnostic laboratories now makes possible improved diagnosis of viral infections. Some of the benefits to the patient of diagnosing a viral infection are that further diagnostic procedures can be stopped with a saving of money and avoidance of discomfort, that unneeded therapy can be stopped, and that the prognosis of the disease can be more accurate. New developments in clinical virology are leading to a clearer definition of the role of viruses in both infectious and non-infectious diseases, and they hold out the promise of rapid diagnosis and specific antiviral therapy.


Diagnostic and therapeutic blocks in pain therapy. The skillful use of nerve blocks is important as a diagnostic, prognostic, and therapeutic tool in the management of chronic and acute pain problems. It is important that these blocks be performed not as technical exercises, but with responsibility, skill, and understanding--and in collaboration with both the patient and fellow physicians, so as to minimize or avoid harmful side effects and give the earliest possible relief from suffering.


Chromosome polymorphism in a human newborn population. II. Potentials of polymorphic chromosome variants for characterizing the idiogram of an individual. Replicate chromosome preparations of umbilical-cord-blood leukocytes from 376 neonates born at the Albert Einstein College Hospital, Bronx, New York, were stained with C-, Q-, and G-banding methods to determine the frequencies and distributions of the variable chromosome bands. The C-band variants of primarily chromosomes 1, 9, and 16, as well as those of the remaining C, E, and F-group chromosomes, and the brightly fluorescing Q-band variants of chromosomes 3 and 4 and all of the acrocentrics, including the Y, were similarly analyzed. Polymorphism of these chromosome regions was so extensive that the idiogram of each of the 376 newborns of this study had a unique variant pattern, even when only the C- or only the Q-band patterns were compared. The distribution of polymorphic Q-bands in the population sampled was consistent with the expectations of the Hardy-Weinberg law, with the exception of chromosomes 3 and 22, where some deficiency of individuals with "homozygous" Q-band patterns was found. The baseline data presented here reinforce the view that polymorphic chromosome characteristics are very useful markers for characterizing the karyotype of an individual, for pedigree studies, for prenatal chromosome analyses, for population studies, for attempts at gene localizations, and for identifying specific cells or their chromosomes in somatic cell genetic studies.


Mitotic association patterns of nucleolar organizing chromosomes in the mouse. Following the report of localization of nucleolar organizer regions to chromosome pairs 15, 18, and 19 of the mouse, a study was undertaken to test these chromosomes for association during mitotic metaphase. Cells from sevel strains of mice were analyzed, and no strong evidence was found for any significant association patterns.


[Serum phenobarbital levels in epileptics]. The results of serum level determination in 250 epileptics confirm previous papers. Phenobarbital: --Is a "safe" anticonvulsant: steady serum level during 24 hours periods in chronic treatment and rather stable relationship between ingested dose and serum level. It can therefore be given as in the past, without blood level control. --Must always be prescribed according to the patient's weight, because serum level and therefore cerebral concentration depends on the dose per kilogram and not on the absolute dose. --Must be given in relatively higher dosage to children on account of a faster catabolism. --Is interfered with in its kinetics by other anticonvulsants and this fact must be taken into consideration for drugs associations. --Has no predetermined blood level for the control of every epilepsy. Some patients no longer have seizures with a theoretically too low serum level, while others still have seizures in spite of very high serum levels.


[Pilot study on the effects of an antiparkinson anticholinergic agent during depressive conditions]. This pilot stuyd was made in order to search for the efficiency of an anticholinergic antiparkinsonian drug, orphenadrine, at high doses (300 to 500 mg/day, orally) in 10 depressed patients. This efficiency seems to be clear and appears quickly: with melancolic patients in particular, we observed 4 very good results in less than 5 days. Nevertheless, besides peripheral anticholinergic side-effects a transitory but very marked spatio-temporal disorganization, with increase of locomotor-activity and sometimes hallucinations, was observed in most patients. Nevertheless, it seems that this therapeutic should be carried on whenever other antidepressant therapeutics failed.


[Electroshocks, antidepressive agents, and anesthesia]. During 12 years, we have effected 6,982 electroshocks with anesthesia and celocurine (N.D.) on 713 patients, i.e. 7.25% of the total hospitalized patients. 62% of them (440) were all this time under antidepressant drugs and 38% (273) were not. We observed 16 minor incidents ten (2.27%) among those under treatment and six (2.19%) among the others; of these 16 incidents, 11 led to an interruption of the treatment for safety. The association of antidepressant drugs with electroshock  under anesthesia and celocurine (N.D.) does not present any real danger.


Normal serum gastrin levels in patients with liver cirrhosis. In 28 patients with cirrhosis of the liver, histologically confirmed by liver biopsy, serum gastrin concentrations were determined radioimmunologically afer an overnight fast. Mean value and standard deviation in the patients with cirrhosis (30.1 +/- 19.3 pg/ml) was not found to be significantly different from the mean value established in 275 normal subjects (39.7 +/- 21.3 pg/ml).


Effect of secretin on intestinal monosaccharide absorption and new water movement in the rat. Repeated intravenous injections of 2.0 clinical units (CU) secretin per kg body weight showed no effect on jejunal glucose absorption and net water movement in perfusion studies in vivo. The in vitro uptake of galactose and 3-O-methylglucose was not altered by a secretin load given 12 min before sacrifice. The values for Km and Vmax were identical after secretin and in a control group. The conflicting results of different authors concerning the effect of secretin on net water movement and solute absorption may be due to differences in experimental techniques, different, mostly pharmacological doses of the hormone, and a diverse response of heterogeneous species.


Peroxisomes in liver tumors of rats induced by 3'-methyl-4-(dimethylamino)azobenzene. Peroxisomes were present in trabecular carcinoma and adenocarcinoma induced by 3-methyl-4-(dimethylamino)azobenzene in the liver of rats. Peroxisomes in well-differentiated trabecular carcinoma (type I) resembled more or less those in hepatocytes in their electron microscopic features, but were considerably small in number. Poorly differentiated trabecular carcinoma (type II) and adenocarcinoma contained peroxisomes in far smaller number than in the well-differentiated trabecular carcinoma, or frequently showed no peroxisomes. Peroxisomes in poorly differentiated trabecular carcinoma and adenocarcinoma were small in size, contained scanty matrix in general, and almost lacked crystalloid nucleoids; however, they were easily identified by electron microscopic cytochemistry of catalase. Catalase activity of these tumors was significantly lower than in the liver tissues. These tumors did not respond to ethyl chlorophenxyisobutyrate either by proliferation of peroxisomes or by elevation of catalase activity. It is thus suggested that the cellular mechanisms for regulating the formation of peroxisomes and synthesis of the enzyme involved are impaired in the tumor cells.


Effect and toxicity of combination treatment including cyclocytidine or cytosine arabinoside in L-1210 and sarcoma-180 systems. Combination effect of antitumor agents, including cyclocytidine and cytosine arabinoside, was evaluated on the conception of pharmacological synergism and not of therapeutic synergism. Ascites sarcoma-180 and L-1210 leukemia were used as tumor systems. In sarcoma-180 system, combinations of cyclophosphamide plus cyclocytidine or cytosine arabinoside by simultaneous administration and cyclocytidine plus Daunorubicin or Vinblastine by alternate administration provided synergism. In L-1210 system, many compounds in combination with cyclocytidine or cytosine arabinoside in both simultaneous and alternate administrations provided synergism. Combination effect of agents was affected by the schedule of drug administration. It was found that the combination effect of drugs in one tumor system cannot be generalized to that in other tumor systems, even though equally effective doses of agents were administered in both tumor systems. Toxicity of cytosine arabinoside in combination with other drugs was affected by the schedule of administration. Compounds which provided synergism in simultaneous administration provided antagonism in alternate one. As a result, it was found that alternate administration of drugs is advantageous for the activity and diminution of toxicity of the host animal.


A kinetic aspect of the antibody production against Ehrlich tumor cells in mice bearing Ehrlich solid tumor. The number of cells producing the anti-Ehrlich tumor antibody (antibody against Ehrlich tumor cells) in the spleen of mice bearing Ehrlich solid tumor was counted by the modified Cunningham method, in which the sheep red blood cells were conjugated with extracted specific Ehrlich tumor antigen and used. The antibody-producing cells appeared 6 days after the subcutaneous transplantation of Ehrlich tumor cells and increased in number with a peak around the 15th day. Humoral anti-Ehrlich tumor antibody estimated by immune adherence gradually increased in the tumor-bearing mice, reached the maximum 15 days after the transplantation or later, and maintained the high level for a long period. The subcutaneous solid tumor grew and reached the maximum in weight around the 15th day and regressed thereafter.


[Anesthesia for ambulatory patients].

[Anesthesia for ambulatory patients]. The specific problems of outpatient anesthesia are discussed with respect to the patient's condition, the anesthesist's qualification and pharmacological properties of anesthetics used. Methohexitone seems to be the best choice for induction. Problems may arise from the use of Propanidid, Ketamin and Diazepam. Nitrousoxide and Enflurane are a suitable completion. Endotracheal intubation, if needed, is facilitated by Suxamethonium, which is rapidly eliminated. Practical aspects of timing, premedication, induction, maintenance and ending of anesthesia are pointed out. After 1-2 hours the patient can be allowed to leave the hospital accompanied by a responsible person. Driving a car is not recommended before 24 hours have elapsed since anesthesia.


[Therapy of progressive scleroderma. Collagen-like protein in progressive scleroderma under D-penicillamine therapy]. The collagen-like-protein (CLP) in sera of patients with scleroderma (n = 20) and controls with (n = 25) this disease as well as in scleroderma-patients under treatment with D-penicillamine (DPA) was determined. The increase of collagen-like-protein roughly parallels the activity of the disease and secondly parallels the therapy. A relationship to collagen biosynthesis or metabolism is discussed.


[Bladder stones as a complication of gynecologic surgery]. Two cases of urinary bladder-stone-formation after surgical treatment of a prolapsed uterus and an uterus-antefixation according to Kocher are reported. In  both cases of synthetic, non absorbable suture was found. The patients suffered for several years from pollakisuria and dysuria although laboratory findings on the urine sediment were at least in an early stage not suspicious. The presence of urinary-bladder-stones was verified cystoscopically and the clinical symptomatology ceased promptly after removal of the concrements. Although formation of bladder-stone as described above seems to be quite rare, it should be prevented by the exclusive use of absorbable material in sutures in the region of the urinary bladder.


[Treatment of postoperative and post-traumatic hematoma in pediatric surgery]. Despite the extreme care during operative procedures bleeding from wound regions cannot be completely avoided especially where children are concerned. This may be due to vulnerability of tissues of injuries. Postoperative and posttraumatic hematoma often lead to delayed wound healing and at the same time increase the danger of infection to the loose and infiltrated subcutaneous tissue. Thus a swift and effective therapy of hematoma and seroma is desirable. 20 patients with postoperative and 10 patients with post-traumatic hematoma were treated with Tanderil Creme. Fifteen untreated patients formed a control group. Reduction of swelling and coloration of hematoma took approximately 4 days in patients with Tanderil Creme, in the untreated control group there persisted at least 8 days.


Moral development and perceptual role-taking egocentrism: their development and interrelationship across the life-span. Moral judgments and perceptual role taking egocentrism were assessed in seventy-two middle-class people whose age range encompassed a significant portion of the life span. Findings support the anticipated curvilinear relationship between moral development and age, and egocentrism and age. However, the close conceptual development and age, and egocentrism and age. However, the close conceptual relationship between moral development and egocentrism throughout life received only slight statistical support, which attained significance only in the fifteen- to nineteen-year-old age group. The existence of "self-involving" egocentrism was postulated to be an important determinant or moral development during adulthood.


Primary group interaction of residents in a retirement hotel. The interaction patterns of sixty-three residents age 55 and over living in a retirement hotel for three types of primary groups-kin, friends, and neighbors-were studied. Almost all residents voiced high housing satisfaction and were involved to various degrees in their primary group network. The relative with whom visited the most, usually the adult child, influences the primary group interaction the most, but at the same time may contribute to feelings of uselessness on the part of the retired residents of the apartment complex.


Structural effects and life satisfaction among the aged. This study investigates whether adjustment, or life satisfaction, is a function of the structural effect of community age density, the behavioral varaibles of total social interaction and age-graded interaction, or both. The sample contains one hundred eight-five persons seventy years of age and older in a midwestern state who have resided in their community at least five years. Thus, the study examines the influence of community structure on life satisfaction, age-graded interaction, and total interaction in a "real world" setting by using a relatively non-mobile sample. The findings suggest that no significant relationship exists between community structure and either total or age-graded interaction. Age-graded interaction, however, is significantly correlated with life satisfaction in large communities.


The aged and diachronic solidarity in modern society. Theory in social gerontology has mostly taken the individual as the main unit of inference. But one may learn more about the conditions of older people through a focus on diachronic solidarity conceptualized as a societal requisite. For this suggests that industrial societies have varying needs for older people. Depending on the stability of their institutions, identification with them, and presumptions about their stability, older people may or may not be accorded an important role in the symbolization of societal continuity. Limited evidence on the relation between income stratification by age and regime stability supports this hypothesis.


Partial learning and recognition memory in the aged. A recognition-memory paradigm was used to test two hypotheses, storage and retrieval, which account for the adult age decrement seen in recall. Partial storage was minimized by using items in the recognition list which were similar to the to-be-remembered items. Recognition performance was unaffected by adult age differences, thereby supporting the retrieval hypothesis. However, older persons made a greater number of semantic errors in the recognition test list supporting the storage hypothesis. While the error difference did not affect overall recognition performance, the result does indicate some caution is necessary in interpreting age-recognition interactions.


Public interest report No. 17. "Man does not die, he kills himself". The generalization that to be long-lived one must have long-lived ancestors is becoming increasingly less valid as knowledge of disease prevention and control increases. Leading causes of death for older people are briefly reviewed in terms of current incidence, knowledge, and control efforts. Particular attention is given to arteriosclerosis, hypertension, and alcoholism.


The role of cognitive process in social interaction. This paper reports on a series of studies designed to investigate the hypothesis that the success of a social interaction is function of the compatibility among the participants in complexity or degree of differentiation of their cognitive structure. Patient-therapist cognitive compatibility is shown to predict the success of treatment outcome. Its role in the teacher-student relationship in mental health training is more complex: the teacher's cognitive structure appearing to be a primary variable. In community action groups, cognitive compatibility determines the nature and type of decisions or behaviors carried out by the group. The resarch emphasizes the need for increased familiarity with cognitive research among social psychiatrists.


Attitudes and perception of attitude changes within the interdisciplinary staff of an evening mental health clinic. A study was made of the attitudes of a multidisciplinary staff of an evening mental health clinic. The focus of the clinic is on short-term treatment, and one of the main purposes of the study was to investigate the reactions of staff members to this type of treatment orientation. Results indicated that staff members, when considered as a whole felt that their confidence in their short-term treatment skills and their belief in the effectiveness of a short-term, interdisciplinary treatment center increased over the course of the first year the clinic was open. These results were not consistent across disciplines, and possible reasons for this inconsistency were discussed.


Mental health patients in a Barrio health center. Utilization by Mexican Americans of Mental Facilities of a Barrio area neighborhood health center, and demographic and symptom characteristics of this population were investigated. The findings suggest that contrary to other studies this program was able to reach a high risk Mexican American population frequently missed by mental health programs. The barrio location, the relationship to a neighborhood health clinic and a large proportion of Spanish speaking and local personnel, seemed to be factors in this result. The patients tended to be young adult women with marital problems, somatic complaints and depressive symptoms.


Volunteer case aides in the U.S.A.

Volunteer case aides in the U.S.A. Mrs. Jeanne Lewington was awarded a 1973 Winston Churchill Fellowship to visit the U.S.A. and look at the way volunteers are used, particularly in the field of mental health. She studied projects at State and Private Mental Hospitals and Community Health Centres. She was particularly impressed with the contribution of Volunteer Case Aides in one to one work with psychiatric patients and describes this principle in some detail. On her return Mrs. Lewington approached the King's Fund London and has been given a grant to finance the establishment of a two year Volunteer Case Aide Programme based at St. Crispin Hospital, Northampton, England, evaluation of which will take place during 1975.


Insanity proceedings and black-white state hospital admission rate differences. This study attempted to determine if the higher state hospital admission rates of blacks are due to greater proportions of blacks being adjudicated incompetent at county insanity hearings. The records of 2,264 cases from 12 Florida counties in 1969 and observations and interviews in the county courts were used to answer this question. With the exception of a slight difference in middle-sized counties, the higher rates of state hospital admission were found to be due to initial differences in petitioning to the court rather than to adjudication differences. The lack of difference is due to the fact that the proportion competent, when refined, proves to be very small for both blacks and whites, thus allowing for little variation by ethnicity. The operation of a racial stereotype was, however, demonstrated in a detailed analysis of one large county.


Extraction of sleep-promoting factor S from cerebrospinal fluid and from brains of sleep-deprived animals. Sleep-promoting factor (factor S) was extracted, partially purified, and concentrated from cerebrospinal fluid and from acid-acetone extracts of brain stem anc cortex of sleep-deprived goats and sheep. 2. Solutes greater than 500 daltons were largely removed by serial ultrafiltrations through molecular sieves (Amicon membranes UM10 and UM05); solutes less than 350 daltons were largely eliminated by gel filtration through Sephadex G10 columns. Sleep-promoting activity was found in a fraction eluted prior to [14C] sucrose marker. 3. Concentrated fraction were infused intraventricularly in rats (0.1 ml in 30 min just prior to 12-h dark cycle) and in rabbits (0.3 ml in 90 min in morning). Sleep-promoting activity was assayed by decrease in nocturnal locomotor activity of rats and by duration and amplitude of slow-wave cortical EEG in rabbits.


Morphology and distribution of muscle spindles in dorsal muscles of the cat neck. Silver-stained sections have been examined from the five dorsal neck muscles splenius, biventer, cervicis, complexus, rectus capitis major, and occipitoscapularis. Every serial section was examined for at least one muscle of each type so that a complete description of the spindle distribution and morphology could be made. With the exception of occipitoscapularis (whose prime function is probably in scapula rotation and not in head movement), neck muscles have a remarkably high spindle density. Occipitoscapularis has a spindle density similar to that of hindleg locomotor muscles (13-19 per gram), but splenius has a density of 46-66 per gram, biventer cervicis 74-96 per gram, complexus 71-107 per gram, and rectus capitis major 48-84 per gram. Such high densities have only previously been seen in small muscles whose total spindle population is not large. Because of the relatively large size of some neck muscles, individual muscles with a spindle content of up to 254 spindles have been found.


Electrophysiological study of formation of new synapses and collateral sprouting in red nucleus neurons after partial denervation. Intracellular recording was made from cat's red nucleus after chronic lesion of the nucleus interpositus (IP) of the cerebellum and the properties of the corticorubral EPSPs were examined. 2. It was found that the time to peak of the corticorubral ESPSs induced from cerebral peduncle (CP EPSP) of chronic cats was much faster than that of normal cats. There was no simple decay following the rapid rise and early summit; instead there was another peak as if the slow normal CP EPSPs were superimposed on the fast ones. 3. By stimulating two loci, sensorimotor cortex and the cerebral peduncle, the conduction velocities of the fibers responsible for the newly appeared fast-rising component of the corticorubral EPSPs were measured. They were almost the same as those of normal corticorubral EPSPs.


Receptive-field characteristics of single neurons in lateral suprasylvian visual area of the cat. The visual receptive fields of 213 cells in the lateral suprasylvian visual cortex (LS, or Clare-Bishop area) were studied in cats anesthetized with nitrous oxide. Eighty-one percent of the cells were directionally selective. They responded poorly to stationary stimuli flashed on or off, but gave a directionally selective response to stimuli moving through the receptive field. Most of these had a single preferred direction and an opposite null direction. They typically responded to a range of directions of stimulus movement from 45 to 90 degrees to either side of the preferred direction. Small stimuli (1-2 degrees or smaller) typically were effective and 87% of the directionally selective cells showed spatial summation. About 32% had inhibitory mechanisms which decreased the response of the cell if the stimulus exceeded a maximum size. There was little or no evidence that LS area cells were orientation selective or sensitive to variations in stimulus shape independent of size.


Properties of projections from vestibular nuclei to medial reticular formation in the cat. In one series of experiments, vestibular neurons that could be activated antidromically by stimulation of the contralateral medial reticular formation were studied with extracellular recording in cats under pentobarbital anesthesia. These neurons were found in all of the four main vestibular nuclei, but were less prevalent in dorsal Deiters' nucleus and in the central region of the superior vestibular nucleus than elsewhere. Regions of the pontine and medullary reticular formation from which neurons in different vestibular nuclei were activated corresponded to the pattern of vestibuloreticular projections described by neuroanatomists. 2. Latencies of antidromic responses to stimulation of the contralateral reticular formation ranged from 0.6 to over 3 ms, indicating a relatively slow transfer of activity from vestibular nuclei to reticular formation.


Awareness of knee joint angle under static conditions. The ability of subjects to match the angle of a passively positioned knee joint by active positioning of the opposite leg is nearly constant with time from 15s to 3 min. However, their ability to match this angle from memory is equally good. Thus, knowledge of joint angle after movement has ceased does not necessarily require ongoing input from tonic peripheral receptors.


Slowly adapting receptors in cat knee joint: can they signal joint angle? Afferent activity in the lateral (LAN), medial (MAN), and posterior (PAN) articular nerves supplying the cat knee joint was studied at intermediate positions of the joint that included most of its working range. The discharge was analyzed only while the joint was stationary. The small LAN showed negligible tonic activity at intermediate angles (as determined by gross recording) and was not studied further.


Information signaled by sensory fibers in medial articular nerve. Responses of 331 individual medial articular nerve fibers innervating the cat knee joint were tested to bending the joint over its entire range and to pressing on the tissues of the joint. The 331 fibers were classified into five groups on the basis of their discharge characteristics: slowly adapting (64), phasic (103), Pacinian corpuscle-like (12), weakly activated (39), and nonactivated (113). Five of the slowly adapting and all twelve of the Pacinian corpuscle-like receptors responded at intermediate joint angles. The remainder responded, if at all, only near the extremes of joint bending or twisting. Many of these same receptors could be activated by pressing about the knee. Sometimes gentle pressure on the focus sufficed to produce a vigorous discharge. The properties of these receptors are considered to be consistent with the hypothesis that articular mechanoreceptors do not signal joint angle but are involved in deep-pressure sensations.


Mechanical factors influencing response of joint afferent neurons from cat knee. The responses of 67 slowly adapting joint afferent neurons in cat posterior articular nerve (PAN) were studied in relation to mechanical stimulation of the knee. The response of most neurons could be interpreted in terms of the stretching of joint tissues resulting from angular displacement of the knee. No neurons discharged at angles intermediate between the limits of movement of the joint. The limits of movement of the joint were operationally defined in terms of displacements resulting from applied torques.


Stereopsis in normal domestic cat, Siamese cat, and cat raised with alternating monocular occlusion. Normal cats, cats raised with alternating monocular occluders, and Siamese cats were tested for stereoscopic vision using a shadow-casting technique that produced line stereograms. Human subjects were tested with the same apparatus. 1. Normal cats had stereoscopic vision, but AO and Siamese cats did not. 2. Normal AO cats, and Siamese cats all had equal visual activity (about 6 feet of arc) and all could make accurate judgments about the depth of real objects. 3. Normal cats could fuse crossed disparities as great as 50 feet of arc and uncrossed disparities as great as 30 feet of arc. 4. Normal cats could make stereoscopic discriminations with stimulus disparities greater than 1 degree, even though they could not fuse disparities of this magnitude. 5. Both the AO and the Siamese cats exhibited a convergent squint. 6. Human subjects viewing identical stimuli could not fuse stimuli having disparities greater than 10 feet, although they could make depth judgments for crossed disparities as great as 5 degrees. 7. These results imply that animals without binocular cells in area 17 do not have stereoscopic vision, but do not determine if disparity-selective cells in the visual cortex are responsible for stereopsis.


Direction selectivity of simple striate cells: properties and mechanism. Most simple cells in the striate cortex of the cat are direction selective, firing to broadside movement of an optimally oriented edge or bar in one direction of motion and not the other. The smallest stimulus displacement for which a direction-selective discrimination can be made cannot be smaller than the threshold for the detection of the displacement itself. It is shown that retinal image quality is an important limiting factor in respect to the thresholds both for stimulus displacement and direction selectivity.


Direction selectivity of complex cells in a comparison with simple cells. Following our earlier study on direction selectivity in simple cells (5), the present findings on complex cells made it possible to compare the direction selectivity in the two types of striate cell. Common properties were found in the dimension of the smallest stimulus displacement giving a direction-selective response and in the role of inhibition in suppressing the response as the stimulus moved in the nonpreferred direction. However, the effectiveness of this inhibition varied in the two cell types since it suppressed both driven and spontaneous activity in the simple cell, but only driven firing in the complex cell. It is argued that direction selectivity must enter the response before the complex cell if the inhibition responsible for it's generation fails to influence the spontaneous activity of the cell. The consequences of this finding are considered in the terms of parallel or sequential processing of visual information in striate cortex.


Kinking and coiling of the internal carotid artery: Clinical-statistical observations and surgical perspectives. The incidence of kinking and coiling of the internal carotid artery in an unselected series of 1,010 angiographies is reported. The angiographies of patients with cerebrovascular insufficiency and those of patients with other brain diseases were separately reviewed. On the basis of a statistical comparison, the finding of kinks and coils appears significantly higher in "vascular" than in "non-vascular" patients. The greater difference concerns age subgroups up to 50 years. These data give support to the assumption that both kinking and coiling of the internal carotid artery may play a role in determining cerebral ischemic attacks. Surgical experience concerns a series of 19 patients operated by various corrective procedures, including resection of the internal carotid artery and end-to-end anastomosis. It is felt that surgery, performed in appropriately selected cases, can afford significant benefits to cerebrovascular patients, especially those presenting recurrent ischemic episodes.


Small arterial anastomoses: experimental models applicable to microneurosurgical practice. Four main models of vascular microsurgical anastomoses in rabbits are described with reference to revascularization procedures in man. Some technical expedients designed to improve the patency rate, are outlined. This preliminary report emphasizes the value of laboratory training to achieve successful results with microneurosurgical treatment of cerebral ischemia.


[Peripheral secretion and inactivation of catecholamines (adrenaline, noradrenaline, dopamine)]. In spite of the biochemical relationship between catecholamines (E,NE,DA), the unity of the adrenergic system is only apparent; catecholamines are present in numerous pools, which exhibit different anatomical and cellular localizations, secretory patterns, control of release, physiological functions, inactivation schemes and metabolic behaviour. The main sources of catecholamines in the periphery are the orthosympathetic nervous system, which is permanently active in maintaining homoeostasy, and the adrenal medulla, an essential element in the struggle against stress. In addition to these large pools, catecholamines are found also in extra adrenal chromaffin tissue and in sympathetic ganglions; the latter represents a potential store of amines, whilst ganglionic dopamine-rich interneurones are important links in the regulation of orthosympathetic activity. Rather than by a topographic distinction, it seems more satisfactory to classify the catecholamines spread in adrenergic fields into a small number of pools possessing their own physiological functions and inactivation patterns. Two main pools of catecholamines in the periphery may be described: The functional pool, represented by those catecholamines already released, or able to be released; in this pool are found plasma and adrenal medullary catecholamines and NE from sympathetic nerve endings. The tissue pool, consisting of the synthesis and storage compartments, which are poorly penetrated by plasma pool with respect to their high possibilities for synthesis and storage. Catecholamines from cellular bodies and axons of sympathetic neurons and a part of the adrenal medullary amines may be related to it. Two other pools of catecholamines have to be reported: a potential extrachromaffin pool, which is apparently negligible in the physiological state, but able to exhibit its synthetic and secretory capacities in particularly critical situations; an intraganglionic dopamine pool, which plays a modulator role in ganglionic synaptic transmission; its mode of secretion and inactivation are not necessarily the same as those of the above pools. To such a physiological diversity, specific regulatory processes, correspond the aim of which is, to stop physiological activity of released catecholamines, by means of physical and chemical inactivating mechanisms; to limit the amount of released product by local control of the neuromediator outflow; to minimize losses of active compound by neuronal and cellular uptake and perhaps by sulfoconjugation; to destroy the excess of synthesized or reabsorbed amines when tissue or neuronal concentration becomes too high (tissue metabolism).


[Circadian variations of the effects of ethanol and of blood ethanol values in the healthy adult man. Chronopharmacological study]. Six healthy young men (22 to 26 years) who had fasted for 12 hours volunteered for this study (subject synchronization: diurnal activity from 07(00) to midnight and nocturnal rest). A set dose of ethanol (0.67 g/kg body weight) was ingested at the fixed (and random) hours of 07(00), 11(00), 19(00) and 23(00), with a week between tests. A set of physiological variables: psychological tests (selft-rating of mood, of physical vigor and of ebriety, tempo, random number addition test); physical variables (heart rate, systolic and diastolic blood pressure, peak expiratory flow, oral temperature and grip strength); blood variables (plasma ethanol, cortisol, lactic acid, pyruvic acid, glucose and erythrocyte K+) and urinary variables (volume, epinephrine, nor-epinephrine and 5-HIAA) were documented at least at 4 hourly intervals and set times. The cosinor method was used for chronobiological statistical analyses. The parameters characterizing the ethanol pharmacokinetics (chronopharmacokinetics) demonstrated a circadian rhythm (p less than 0.05): e. g. the peak height of ethanolemia is greater when ethanol is ingested at 07(00) than at other times. Also a circadian rhythm in biosystems susceptibility can be demonstrated (p less than 0.05) (chronesthesy) with a peak time not necessarily corresponding either to that of ethanolemia or to that of other variables. The overall circadian changes in ethanol effects (chronergy) can be viewed as a combination of both ethanol chronesthesy and chronokinetics.


[Effect of 2,4 dinitrophenol and ouabain on the ability of cesium ions to substitute for intracellular potassium ions in isolated and perfused turtle heart (author's transl)]. 1. It has been shown that most of the intracellular potassium of turtle heart can be replaced by cesium. 2. The uptake of cesium is reduced by the presence of either DNP 5.10(-5) M or ouabain 10(-6) M in the external medium. The presence of 10(-5) M ouabain markedly inhibits the uptake of cesium. 3. These results lead to the conclusion that the intracellular accumulation of cesium occurs via an active inward transport system wich operates with the simultaneous efflux of sodium.


[Modulation of intestinal absorption of calcium]. 1. Absorption of ingested calcium (2 ml of a 10mM CaCl2 solution + 45Ca) by the adult rat was shown to be facilitated by the simultaneous ingestion of an active carbohydrate, L-arabinose. As the carbohydrate concentration is increased from 10 to 200 mM, the adsorption of calcium is maximized at a level corresponding to about twice the control adsorption level. 2. A similar doubling of calcium adsorption is obtained when a 100 mM concentration of any one of a number of other carbohydrates (gluconic acid, mannose, glucosamine, sorbitol, lactose, raffinose, stachyose) is ingested simultaneously with a 10 mM CaCl2 solution. 3. Conversely, the simultaneous ingestion of increasing doses (10 to 100 mM) of phosphate (NaH2PO4) with a 10 mM CaCl2 solution results in decreased 45Ca absorption and retention by the adult rat. 4. The maximum inhibition of calcium adsorption by phosphate is independent of the concentration of the ingested calcium solution (from 5 to 50 mM CaCl2). 5. The simultaneous ingestion of CaCl2 (10 mM) with lactose and sodium phosphate (50 and 10 mM, respectively) shows that the activating effect of lactose upon 45Ca adsorption may be partly dissimulated by the presence of phosphate. 6. These various observations indicate that, within a large concentration range (2 to 50 mM CaCl2), calcium adsorption appears to be a precisely modulated diffusion process. Calcium absorption varies (between minimum and maximum levels) as a function of the state of saturation by the activators (carbohydrates) and inhibitors (phosphate) of the calcium transport system.


[Effect of alcohol on the metabolic conversion of 14C erucic acid in the liver of rats receiving rapeseed or peanut oil]. The effects of addition of ethanol to diets containing rapeseed or ground nut oil on the metabolic conversions of 14 14C erucic and 9-10 3H oleic acid were studied in the rat liver. 1. Whatever the diet more 14C than 3H radioactivity was recovered in liver lipids 2 and 19 hours after injection of labelled fatty acids. Ethanol has little effect on this incorporation. 2. Only small amounts of 3H oleic acid were converted. 3. In all cases, the metabolic conversion of erucic acid was identical: the main part of 14C was not recovered as erucic acid but was present in other monounsaturated fatty acids n-9: oleic acid (18 : 1), which was the most labelled acid, 16 : 1, 20 : 1 and nervonic acid (24 : 1). 4. The amount of erucic acid converted to shorter chain fatty acids was unchanged by addition of ethanol but the alcohol increased the proportion of 14C radioactivity recovered as nervonic acid. This latter effect was opposite to the effect of rapeseed oil diet, which consisted in a decrease in the conversion of erucic to nervonic acid. 5. A high amount of 14C radioactivity was recovered in the F.F.A. fraction of the liver as an unknown compound (13 and 80% of 14C radioactivity respectively after 2 and 19 h.) Its identification is presently under investigation.


[The left superior intercostal vein (author's transl)]. Study on the LSIV has several points of value: It enters into the normal mediastinal outline, forming the aortic "nipple". It may be the site of dilatation, either congenitally or secondary to haemodynamics changes. This venous dilatation should not be confused with a mediastinal tumour. It forms, in the majority of cases, an anastomosis between the superior vena cava and the azgos vein and therefore plays a part in the collateral circulation of caval obstruction syndromes. Its transverse course explains its involvement in the anterior and posterior mediastinal syndromes. Opacification of the LSIV should be part of the study of mediastinal tumours. By virtue of its relations with the left upper lobe, its study should be part of the pre-therapeutic assessment of such lesions.


[Reversal of portal flow by obstruction of the hepatic veins by hepatic tumours (author's transl)]. Hepatic tumours may, in the course of their development, compress or invade the hepatic veins, causing in a certain way a secondary Budd-Chiari syndrome of neoplastic origin. This results in reversal of the intrahepatic portal flow in the corresponding area, easily seen at arteriography. Hepatic arteriography shows retrograde opacification of intra-hepatic portal branches (arterio-portal reflux) which is the direct sign. Return ileoportography shows the functional absence of those portal branches in which current is reversed which is the indirect sign. This haemodynamic anomaly seen at arteriography is particularly interesting when the responsible tumour is an invasive and avascular carcinoma of the liver, as was the case with our two patients, since it represents the only angiographic sign from which the diagnosis may be made, there being neither hypervascularisation nor evidence of a mass.


[Radiology of tumours of the region of the ampulla of Vater (author's transl)]. On the basis of 18 personal cases, the authors discuss the different radiological appearances of tumours of the ampulla of Vater region. After a review of the histopathological aspects, they attempt to separate the respective indications for the various endoscopic and radiological studies possible, stressing the importance of duodenoscopy. They give an illustrated classification of the different appearances seen.


[Radiological appearances of cancer of the gastric stump (author's transl)]. The authors report 35 cases of primary carcinoma of the gastric stump, describing the technique they use for radiography, noting the main diagnosis signs and discussing the importance of the various methods for their study. They emphasize the importance of periodic post-operative control in these cases.


[Topographical radiological anatomy of the extra-hepatic biliary system seen in lateral view. Tone and projecting movements of the hepatic/bile ducts (author's transl)]. This study is based essentially on lateral views of 244 examinations of the biliary tract by non-operative trans-hepato-cholecystographic radiomanometry and on some lateral views of cholecystograms. Despite the classical conception (Lutkens) of gall bladders invariably oblique, it showed that some are vertical, horizontal or even descending. Contrary to this classical conception which describes the infundibulum and cystic ducts as being oblique from the front backwards in the same direction as the long axis of an oblique gall bladder, these lateral views showed that, whilst the infundibulum may continue in the same direction as the long axis of the gall bladder, the same does not apply to the neck and cystic duct. They run from behind forwards and almost always in the direction of feet to head of the subject. Very rarely the neck is directed from head to foot. In addition, and once again contrary to Lukens description, the common bile duct is not the most posterior of the parts of the biliary tree. It is the infundibulocervical region which is the most inclined, regardless of the type of gall bladder. These lateral views also made it possible to demonstrate the pathognomic appearances of hypotonic and hypertonix hepatic/bile ducts and the antero-posterior projecting movements of the main bile duct.


[Portal venous return in cases of obstruction of the inferior vena cava. Phlebographic study of five cases (author's transl)]. Amongst 77 patients studied by phlebography for obstruction of the inferior vena cava, 5 (6%) showed evidence of a portal collateral network: 3 via the mesenteric vein, 2 via the epiploic veins. In four cases the portal flow represented the principal collateral flow. Our cases, together with those described in the literature, show that portal collateral flow occurs in at least 5% of cases of caval obstruction. They should, therefore, have been reported more frequently since it would appear that our five cases bring the total published to date to only 13.


[Reactional hyperaemia and peripheral arteriography (author's transl)]. Reactional hyperaemia is a technique for functional study of the peripheral arterial circulation which may be applied to arteriography. It represents the maximum point on the scale of modifiers of function which may be used in peripheral arteriography. It opens the way to interesting comparison between peripheral arteriography and the various functional studies which may be employed in peripheral vascular pathology.


[Diffuse gastric polyposis predominating in the antrum (author's transl)]. The authors report a case of diffuse gastric polyposis predominating in the antrum. They emphasize the interest of double contrast radiological examination of the mucosa and fiberendoscopy with biopsy, in the diagnosis.


[Double contrast barium enema in the adult, using tannin (author's transl)]. The description of a new technique of double contrast of the colon using barium, gum arabic and tannin in a low dose. The study involved more than, 1,500 adult patients without incident.


[Progress in diagnosis in osteo-articular pathology (author's transl)]. Osteo-articular diagnosis is too often considered at present to be synonymous with radiological diagnosis. This has come to be almost a sine qua non. Nevertheless a normal X-ray does not mean that the patient is free of disease. On the contrary, there exists the considerable handicap of the latent period between the onset of disease and the appearance of radiological signs. If blind faith in such a notion is allowed to persist, a profitable means of progress is closed both to our discipline and pathology in general. Over the last decade has emerged a new tendency towards the study of the initial phases of disease and an earlier diagnosis during the pre-radiological phase. This tendency, which opens new perspectives, already enjoys highly promising success and deserves wider recognition, encouragement, development and study. It results more from an attitude of mind rather than the development of a technique and for this reason should lead to the suggestion of other methods and solutions. In bringing us closer to the source of the pathological process it will aid in better understanding of its true nature and pathogenesis. In a word, it will help us to understand the starting phases of disease whilst radiology reveals only the active process. Inasmuch as early physiopathological processes are reversible, it should open the door to new therapeutic approaches.


Uptake of amino acids and thymidine during the first cell cycle of synchronized hamster cells. The net total uptake of four amino acids (valine, leucine, lysine and methionine) used at concentrations required for growth, and of thymidine at tracer concentrations, has been studied during the first cell cycle of an asparagine-dependent strain of transformed BHK cells synchronized by asparagine starvation. The rate of the total uptake of the amino acids, the free pool of the amino acids taken up, and the rate of their incorporation into protein at the end of the first cell cycle were, on the average, 12-fold that at the beginning of the cell cycle. The increase in these parameters during the cell cycle was not linear. The uptake of thymidine started before the onset of DNA synthesis and proceeded linearly beyond the peak of the S phase. The rate of accumulation of thymidine into the acid-soluble fraction also increased during the S phase, apart from a tendency to plateau off at the peak of this phase. It reached a second plateau towards the end of the cell cycle, and then declined slightly. Evidence is presented which suggests that the total quantity of protein synthesized during the cell cycle is more than the newly synthesized protein present in the cells at the end of the cell cycle; this indicated degradation and/or secretion of a substantial proportion of the newly synthesized protein. The total protein synthesized at different time points in the cell cycle appeared to contain different proportions of the amino acids used.


Sympathomimetic actions of reserpine administered during treatment with dopamine in the dog. Reserpine injected intravenously during infusion with dopamine brought about sympathomimetic effects, but a second injection of reserpine after 120 minutes did not elicit such effects. This pressor effect was eliminated by phenoxybenzamine and this positive chronotrpic effect by propranolol. Reserpine induced similar but weak sympathomimetic effects after cocaine, while it induced no changes in blood pressure and heart rate after infusion with noradrenaline. Meanwhile, pressor response to dopamine was potentiated 24 hours after reserpine and was further potentiated after additional infusion with noradrenaline. The sympathomimetic actions induced by the concurrent administration of reserpine and dopamine may be attributable to a facilitation of those indirect mechanisms, prinicpally of endogenous catecholamine release.


Drug-induced adrenaline release and blood glucose in rats: 3-phenyl-5(2-piperidinoethyl)-isoxazole citrate. The effects of 3-phenyl-5-(2-piperidinoethyl)-isoxazole citrate (31245) on blood glucose level and adrenaline release from the adrenal gland were studied in rats. Elevation of blood glucose was detected in intact and hypophysectomized rats, but not in adrenalectomized or adrenal-demedullated rats after s.c.injection of 31245. Increase of adrenaline release from the left adrenal after administration of 31245 was detected under pentobarbital anesthesia. In splanchnicotomized rats, no increase of adrenaline secretion was observed after administration of this compound. Pretreatment with 31245, 5 mg/kg i.v., prevented about 35% of the adrenaline output caused by electrical stimulation of the splanchnic nerve, though it had no inhibitory effect on adrenaline secretion caused by histamine and bradykinin. From these results, it is concluded that hyperglycemia induced by 31245 is due to hypersecretion of adrenaline from the adrenal glands through excitation of the splanchnic nerves, though its direct action on the gland is an inhibitory effect on adrenaline release.


Inhibitory effects of caffeine on developed tension and calcium movement in guinea pig taenia coli in high-K medium. Since the correlation between the K-induced contracture and the Ca movement during the contrature in guinea-pig taenia coli has been clarified, the effects of caffeine were deemed worthy of investigation. The tonic contraction induced by 40 mM K disappeared within 5 min in the presence of caffeine above 7 mM. The inhibitory effect of caffeine was reversed by a high concentration of Ca added to the external medium. High-K added to the medium increased tissue Ca, Ca uptake and the size of cellular Ca fraction that did not exchange within 4 min (tightly bound fraction TBF), and it decreased Ca efflux. An application of 7 mM caffeine to the muscle treated with high-K for 30 min restored all parameters to the control level. Further, caffeine had no effect on the developed tension of the glycerinated taenia induced by Ca, Mg and ATP. It was observed that 14C-caffeine entered the cell in the presence of high-K. From these data, it is suggested that caffeine inhibits high-K induced contracture by inhibiting Ca influx into the contractile mechanism.


Inhibition of dopamine beta-hydroxylase in blood vessels by picolinic acid derivatives in vivo and their anthypertensive effects. The effect of picolinic acid derivatives, 5-butylpicolinic (fusaric) acid (FA), 5-(3',4'-DIBROMOBUTYL)PICOLINIC ACID(BPR2FA)and 50(N'N-dimethyldithiocarbamoilmethyl)picolinic acid (YP-279) on dopamine beta-hydroxylase in blood vessels in vivo was studied. Maximum inhibition of the conversion of 14C-dopamine (14C-DA) to 14C-norepinephrine (14C-ne) in rat aorta, mesenteric artery and renal artery was detected 30 min after FA and Br2FA (75 mg/kg) and 60 min after YP-279 (75 MG/KG). NE synthesis from 14C-DA returned to near control values by 6 hr in the blood vessels. NE levels of the aorta and mesenteric artery were sigkificantly reduced by 30 to 50% at 4 hr after Br2FA or FA (75 mg/kg). Dopamine beta-hydroxylase (DBH) activity, using tyramine as substrate, in heart, aorta, mesenteric artery and renal artery was markedly reduced. The concentrations of FA, Br2FA and YP-279 in rat blood following a single i.p, injection of each drug increase rapidly, reaching highest values in 0 to 30 min and decreasing slowly to 0 after 6 hr. These compounds did not affect the uptake of 3H-NE into the rat heart. These three compounds were found to lower blood pressure effectively in normal Wistar rats (above 25 mg/kg).


Interaction of Ca, Mg and ATP in glycerinated taenia coli of guinea pig. Ca sensitivity and energy dependence in the contractile proteins of the glycerinated taenia coli of guinea pig were studied. Above 1 X 10(-7)M Ca caused contraction in muscle which had been immersed in glycerol solution for 7 days in the presence of 5 mM Mg-ATP. Muscles which had been immersed in glycerol for 30 days had a higher Ca sensitivity than ones in glycerol for 7 days. When AMP or ADP (5, 10 MM) in place of ATP was added in the presence of 1 X 10(-6) M Ca and Mg(5, 10 mM), there was no contraction. Increasing the concentration of the same molar ratio of Mg-ATP from 1 to 20 mM in the presence of 1 X 10(-6) M Ca, the tension increased according to the Mg-ATP concentration. However, increase in Mg or ATP only in the presence of 1 X 10(-6) M Ca did not increase the tension. In conclusion, the three factors of Ca, Mg and ATP are essential for the activation of the contractile elements of glycerinated taenia. It is also suggested that the tension development in glycerinated taemia is controlled by the concentration of Ca and Mg-ATP complexes in intracellular fluid.


Analytical study of acquisition on free-operant avoidance response for evaluation of psychotropic drugs in rats. Systematic research was performed on the acquisition of free-operant (Sidman-type) avoidance response, which is widely used for the study of psychotropic drugs, with the following results: When the training session was fixed at 2 hours once daily, shock-shock (S-S) interval at 5 seconds, and response-shock (R-S) interval variable-20, 30 and 60 seconds, the acquisition speed of the response was almost constant independent of the R-S interval, about 6 sessions being always required. When the S-S and R-S intervals were constantly 5 and 30 seconds, respectively and the length of one session was varying-1, 2 and 4 hours, the behavioral baseline was established after about 6 sessions independently of the length of the session. Thus the cumulative time for the acquisition was shortest when one session was 1 hour long, and longest when it was 4 hours long. There was a linear relation with negative inclination between the logarithm of mean numbers of shock delivered per sessions and the number of sessions. In rapid and exact training of animals for the evaluation of drug effects, one session of an hour per day is adequate. In the evaluation of drug effects on the acquisition process, observation of the shift in logarithmic value of shocks delivered is recommended.


Antiarrhythmic effect of aprindine on several types of ventricular arrhythmias. The antiarrhythmic effect of aprindine was compared with those of lidocaine and propranolol on several ventricular arrhythmias-epinephrine arrhythmias in cats, ouabain arrhythmias in cats and guinea pigs, ischemic ventricular arrhythmias in coronary-ligated Beagle dogs. Antiarrhythmic effects of aprindine and lidocaine were observed both in ouagain and ischemic arrhythmias, but not in epinephrine arrhythmias. While propranolol had a strong antiarrhythmic effect against epinephrine and ouabain arrhythmias, it did not increase sinus beats in ischemic arrhythmias. Marked anti-arrhythmic effects of aprindine in ischemic arrhythmias were observed in dogs using either single intravenous administration (4 mg/kg) or intravenous infusion (200 mug/kg/min, 2 mg/kg). Antiarrhythmic activity of aprindine is considered to be about twice as strong as that of lidocaine, but lidocaine is less toxic in experimental animals.


Local anesthetic activity of 1-(morpholino or piperidino)-2-propanol derivatives. The local anesthetic activities of 1-(morpholino or piperidino)-2-propanol derivatives were investigated. These activities were observed with nerve trunk anesthesia, rabbit's corneal anesthesia and intradermal injection anesthesia. Among these propanol derivatives, No. 24 and No. 25 which possess thioether-type sulfur were the most active and the effective potency was enhanced by increasing the dissociation constant (pKa) value in a series of the compounds. Effects on cat spinal reflex were also observed. These propanol derivatives revealed no selective depression of presynaptic depression or depression of the potential of monosynaptic reflex (MSR) and polysynaptic reflex (PSR). Procaine and lidocaine had similar actions. Effects on axonal membrane potential and interaction of the calcium on these derivatives were also investigated. These derivatives decreased the action potential without altering the resting membrane potential and when antagonized with calcium, sciatic nerve action potential was decreased. Procaine and idocaine also showed the same results.


Positive and negative chronotropic response of the S-A node to oxyfedrine. Direct perfusion of the sinus node artery under a constant pressure of 100 mmHg was carried out in vagotomized dogs. "Selective" injection of L-3-methoxy-omega-(1-hydroxy-1-phenylisopropylamino) propiophenone hydrochloride (oxyfedrine) into the sinus node artery induced three types of chronotropic response; a pronounced sinus tachycardia, an initial bradycardia followed by sustained tachycarcia, or a definite sinus bradcardia alone. The paradoxical sinus bradycardia induced by oxyfedrine was more pronounced at higher doses of the compound, whereas it was nver produced by the injection of isoproterenol. The oxyfedrine-induced sinus tachycardia, which occurred  even in reserpinized preparations, was not suppressed by the treatment with tetrodotoxin, hexamethonium or bretylium, but it was selectively inhibited by propranolol. Atropine, tetrodotoxin or hexamethonium did not prevent the occurrence of sinus bradycardia induced by oxyfedrine, and physostigmine failed to enhance the response. The present study indicates that the oxyfedrine-induced tachycardia is mediated mainly by a direct stimulating action on adrenergic beta-receptors, while the bradycardia appears to be induced by a direct depressant action on the S-A node.


Embryonic development and organogenesis in the snail Marisa cornuarietis (Mesogastropoda: Ampullariidae). V. Development of the nervous system. The nervous system is ectodermal in origin. All nerve ganglia arise separately by proliferation and later delamination from the ectoderm, not by invagination. They become secondarily connected to one another by commissures and connectives developing as extensions from the peripheral layer of ganglionic nerve cells. Rudiments of the cerebral, pedal, pleural and intestinal (parietal) ganglia arise almost simultaneously at a relatively early stage (Stage V). The cerebral ganglia develop from the ectoderm of the head plates. Rudiments of the pedal and pleural ganglia are separate at their inception. They later fuse (Stage VI) to form a pleuro-pedal ganglionic mass on each side. The 2 intestinal ganglia are symmetrical at the beginning, but they soon lose their symmetry as a result of torsion. The right ganglion crosses to the left over the gut and persists as the supraintestinal ganglion. The left or subintestinal ganglion shifts to the right and forward, and fuses with the right pleural ganglion (Stage VIII), thus obscuring the chiastoneury. The paired buccal and single visceral (abdominal) ganglia start differentiating in Stage VII. The former develop from the ectodermal wall of the stomodaeum, while the visceral ganglion delaminates from the right wall of the visceral sac, then shifts to the left during torsion. The statocysts develop early (Stage V) from 2 ectodermal invaginations on either side of the rudimentary foot. They later separate from the overlying ectoderm and statoconi appear in their lumina. Contrary to earlier reports on related ampullariids, the osphradium proved to be ontogenetically older than the mantle and mantle cavity. It starts differentiating as a thickened ectodermal plate in the right wall of the visceral sac (Stage V). During torsion, it becomes engulfed in the mantle cavity and shifts to the left side, then is carried forward as the mantlegrow. The eyes develop late (Stage IX) as ectodermal invaginations which rapidly separate from the ectoderm to form closed vesicles. Their cells start differentiating before hatching to form the retina, in which pigment is deposited, and the inner cornea. The lens is secreted in the lumen of the eye and grows by addition of concentric layers of secretion.


[Incidence of postoperative deep vein thrombosis in general surgical and urological patients an investigation by means of the 125I-Fibrinogen test in 95 patients withoug prophylaxis (author's transl)]. We present the results of a control group of 95 patients who were thoroughly investigated in a prospective, randomized study, where the efficacy of small doses of s.c. heparin and dextran 40 is checked. The 125I-fibrogen test was used in all patients. 1. 35.8% of the patients develop deep vein thrombosis (DVT) during the first post-operative week. More than half of them show bilateral thrombosis. 2. There is no statistically significant difference in the thrombosis incidence between males and females. 3. 47% of the patients over 60 years develop postoperative DVT. Among those younger than 60 years, only 23% have DVT (P less than 0.025). 4. The DVT incidence in surgery of the colon is 58.3%. 5. Surgery for a malignant disease means probably increased risk for DVT (P less than 0.025). 6. More than half of the patients having a previous history of varicose veins develop postoperative DVT (P less than 0.025). 7. Obese patients are statistically seen not more prone to develop DVT than those of normal body build. 8. Immediately after operation 32.4% of DVT are diagnosed, 24 hrs. later 61.8%. 94% of all DVT are diagnosed up to the third postoperative day. 9. With the exeption of one patient, all DVT develop in the calf veins, 3/4 of all abnormal values were measured in the midcalf region.


[Technique and results of hepatic resection (author's transl)]. 12 major hepatic resections are described. There were two postoperative deaths. 4 patients received more than two blood units intra- or immediately postoperatively (maximal blood loss 5000 and 4400 ml resp.). In 5 patients the operative procedure was performed in hemodilution, in these patients the maximal transfusion rate ranged to one blood unit. In nearly all patients a subphrenic collection of bile, blood and secretion was observed, but this was well treated conservatively. The various operative procedures, the possibility to avoid blood loss during hepatic resection and the concept of biliary drainage are discussed.


[Postoperative mortality and its etiology (author's transl)]. Over a ten year period of time from 1.3. 1962 to 31.12. 1972 at the Dept. of Surgery, University of Heidelberg 104927 patients were admitted to the hospital, 77950 operative procedures were carried out and 4217 patients died post operatively. The etiology of death as related to age distribution, disease and time of postop. death are discussed. The lethality causes are demonstrated by the classification of Petren. Autopsy examination reveals cardiac and/or circulatory failure to be the main cause of death (26,4%), followed by malignant tumors (12,7%), pneumonia (12,6%), cerebral causes (10,2%) and peritonitis (9,5%). Possible consequences of the distribution are being discussed.


[Contribution to the problem of shock as trigger mechanism in secondary acute cholecystitis (SACH). Fibrinoid thrombi in possible precurser state (author's transl)]. Causal connection between shock and SACH has been suggested on the basis of clinical analysis. In a case of cardiogenic shock demonstrating criteria of initial SACH, successful identification of intravascular fibrinoid thrombi is presented as valid evidence for this pathogenetic presumption.


[Surgical anatomy of the blood supply of the colon (author's transl)]. Studies in 12 cadavers about arterial supply of the appendices epiploicae. There are three kinds of appendices. All of them contain an arterial arch. This arch is derived either from the marginal artery or from the long vasa recta. The tying of appendices together with their vasa recta never interrupt the blood supply of the colon. There is always a sufficient collateral circulation. If however a marginal artery is tied the gut has to be transsected at the same level.


The rights and responsibilities of a physician in a hospital environment. Although each case must be decided on its merits, certain principles founded on case law set the pattern that may be expected to operate in resolving the problem that arises or in aiding a counselor in advising his client, be it physician or hospital. In all situations, the rights of the several parties and the relationships between them must be considered: physician's rights, patient's rights, the patient-physician relationship, the rights of the hospital and the power invested in its governing board, as well as the duties owed by the physician to his patient and to the hospital, and the duty of the hospital to serve the community in which it is situated. All of the foregoing material is a summary of the case law in the various situations that have arisen, as well as the author's expectation as to what might be anticipated in those situations not yet resolved by case law.


Malignant hyperthermia during general anesthesia: medicolegal considerations. Malignant hyperthermia is a pathophysiologic process, the occurrence of which is nearly impossible to predict, the diagnosis difficult to discover rapidly, and the treatment unsuccessful in the majority of cases as is borne by the high mortality rate. It is in almost all instances, a fortuitous event, and liability will most probably not be imposed unless the plaintiff can establish by way of expert testimony that defendant-anesthesiologist departed from acceptable methods of care. Definite departures from the present standard of care could be: (1) administering a potent general anesthetic utilizing halogenated inhalation agents and depolarizing muscle relaxants to an individual who has undergone a previous malignant hyperthermia episode, and possibly to a member of his immediate family; (2) failing to have available appropriate resuscitative equipment; and of course, (3) lack of diligence and due care in attempting to treat a case of malignant hyperthermia. It seems, at this point, that serum CPK levels and constant temperature monitoring are additional safeguards, but are not part of the standard of care imposed upon the anesthesiologist.


Malpractice aspects of medically prescribed exercise. Stress exercise testing of suspected or known cardiacs and medical recommendations to patients to undertake physical fitness conditioning exercise programs constitute medical treatment in the eyes of the law and as such render the prescribing and supervising physicians legally responsible for harmful consequences to the patient to the same degree and under the same legal principles applicable for other medically prescribed diagnostic and therapeutic procedures. The physician who employs a stress exercise test or who recommends that a patient engage in exercise as part of a prophylactic, rehabilitative, or therapeutic program must be alert to those aspects of his recommendations which possess potential malpractice hazards. In particular, he should direct his attention to recognized indications and contraindications of exercise test and exercise programs. Furthermore, he should perform an adequate preexercise screening examination and he must make sure that the exercise is properly monitored; that it is immediately terminated upon onset of signs or symptoms of impending serious reactions; that adequate advance preparations have been made for the treatment of foreseeable emergencies, particularly those requiring cardiopulmonary resuscitation and advanced life support; and that such treatment is in full accord with generally accepted and proper medical standards. Finally, the physician must make certain that he adequately informs the patient of the potential risks and hazards associated with exercise stress testing and exercise programs so that the consent to such procedures can be classified legally as valid and "informed".


The Model Postmortem Examinations Act in the State of Connecticut, 1969-1974. Five years following the 1969 passage of legislation patterned after the Model Postmortem Examinations Act, Connecticut has a central laboratory with administrative, autopsy, and toxicology facilities; 24-hour statewide reporting deaths; a records and data-processing system; and affiliation with a university health center. The state's population density, number and size of municipalities and police departments, absence of county government, and judicial appointment of coroner's were unique geographic-political features confronting implementation of the legislation. To effect a transition from the preexisting system, and because of the number of deaths reported and physicians involved, a dual system was developed for examinations and certification of deaths which differentiated autopsies performed at the central laboratory from those at community hospitals. Dissemination of procedures and forms for medicolegal autopsies conducted at community hospitals is planned in the near future. Although educational programs for graduates and law enforcement personnel have been initiated, there still exists a need for more active undergraduate and postgraduate training and a program of research and statistical reporting. Implementation of the statutes during a five-year period in which supplemental legislation and regulations were passed, changes that occurred in state administration, and budgetary restrictions mandated by economic recession has, however, resulted in the nucleus of a modern state medicolegal investigative system--a separately budgeted medical examiner's office, supervised by an independent administrative commission and located on the grounds of the University of Connecticut Health Center in Farmington.


Naturally occurring insect growth regulators. II. Screening of insect and plant extracts as insect juvenile hormone mimics. Ethereal extracts prepared from the larvae, pupae, or eggs of 10 species of insects and from various parts of 343 species of higher plants were screened for juvenilizing effects against Tenebrio molitor and Oncopeltus fasciatus. Activity in both species was shown by an extract of the larvae of the stable fly, Stomoxys calcitrans, whereas an extract of the pupae was active in O. fasiatus only. Extracts of two plant species (Echinacea angustifolia roots and Chamaecyparis lawsoniana seeds) showed high juvenilizing activity in T. MOLITOR, AND EXtracts of five plant species (Clethra alnifolia stems, leaves, and fruits, Sassafras albidum roots and root bark, Eucalyptus camaldulensis stems and bark, Pinus rigida twigs and leaves, and Iris douglasiana roots, stems, and fruits) were highly active in O. fasciatus an extract of Tsuga canadensis leaves showed lower activity in this insect. Extracts of 16 species of plants showed high insecticidal activity (mortality) in O. fasciatus but lacked juvenilizing properties in both species of test insects.


Naturally occurring insect growth regulators. III. Echinolone, a highly active juvenile hormone mimic from Echinacea angustifolia roots. A compound, C14H24O2, which induces strong juvenilizing effects in the yellow mealworm, Tenebrio molitor L., following topical application to the pupal stage, was isolated in pure form from the roots of Echinacea angustifolia DC and tentatively identified as dextrorotatory (E)-10-hydroxy-4,10-dimethyl-4,11-dodecadien-2-one. The compound has been named echinolone.