[Delayed onset of postoperative deterioration in clivus chordoma and clivus meningioma]. The starting-point of the presented retrospective, clinical study is the observation, that in some cases a delayed postoperative neurological deterioration develops after removal of great, extraparenchymal, infratentorial brain tumors. Therefore, we evaluated the postoperative clinical course of 50 clivuschordomas and clivusmeningiomas of the Neurosurgical University Clinic in Mainz (Germany). The results obtained show, that 1 of 3 patients develops a delayed, postoperative deterioration. Important factors, which cause that deterioration, are the age of patients and the size of tumors. Mostly, we found a perifocal edema concomitant to the delayed deterioration within the decompressed brain tissue. We call that phenomenon "decompression edema" as a "hypothesis a posteriori", which has to be proven experimentally.


[Effects of nimodipine in experimental permanent focal cerebral ischemia]. In a controlled double blind experiment the influence of a continuous i.v. infusion of Nimodipine (1 microgram kg-1 min-1) upon infarct size, histopathology and neurological outcome in rats with permanent middle cerebral artery (MCA) occlusion was examined. The infusion was started 20 min. before the induction of ischemia and continued 4 hours thereafter. The nimodipine treated animals were subdivided into hypotensive (MABP lower than 85 mmHG for more than 5 minutes after arterial occlusion) and normotensive groups. Infarction size, documented by TTC, H&E and Nissl staining was significantly smaller (p less than 0.001) in nimodipine normtonic rats than the lesions in placebo and saline treated rats, as well as compared with hypotonic nimodipine animals (largest infarction). These differences were found to be entirely at the expense of the cortical (frontoparietal) component of the lesion, suggesting "penumbra" action of the drug. Moreover, nimodipine normotonic rats displayed lower cortical neuronal injury in the periinfarct zone. These findings were corroborated by corresponding better neurological scores. Our results indicate that nimodipine is effective in reducing focal cerebral ischemia, provided the MABP is maintained higher than 85 mmHg.


[Linear relations of brain pulse amplitude to mean intracranial pressure]. A catheter for intracranial pressure monitoring was introduced into the right lateral ventricle in 71 neurosurgical patients. In 63 patients (88.7%) a significant linear relationship was found between the cerebral pulse amplitude (PA) and the mean intracranial pressure (Pm). In 8 patients (11.3%) no linear relationship was established between PA and Pm. PA- and Pm-analyses performed subsequent to these compliance tests are discussed on the basis of the pathophysiology of the intracranial space.


[Remission of schizophreniform psychosis after brain tumor surgery]. A 19-year-old female was admitted to hospital due to a schizophrenia-like psychosis of the paranoid type including delusions and various hallucinations. Neurologically she only showed tics of the eyebrows with increased eye blinking. 30 months before an astrocytoma located on the left basal temporal lobe had been resected after the patient suffered from several psychomotor and two grand mal seizures. Following post-operative anticonvulsant therapy seizures had completely disappeared and the patient had been free of symptoms of any kind. After the acute onset of the psychosis another follow-up MRI of the brain using coronary sections revealed a small relapse-tumor. Symptoms disappeared after high-dose neuroleptic therapy. Finally another surgical intervention led to a lasting remission of the psychotic symptomatology (so far 18 months). Postoperatively neuroleptics could be discontinued. Clinical picture and MRI findings will be discussed with a focus on possible etiological factors in schizophrenia.


Influence of duration of simulated transport on plasma stress markers in the calf. The effects of simulated transport of calves for 150 min on plasma cortisol, NEFA, glucose, and calcium were evaluated. Both cortisol and NEFA reached maximal values within 30-60 min, with no further increases during the transportation. Changes in glucose and calcium were not significant. The results indicate that in simulated transport, the duration per se is not a crucial factor in transport stress.


[Diagnostic potential of biochemical and cytological parameters in bronchoalveolar lavage fluid in healthy calves and calves with pneumonia]. Bronchoalveolar lavage fluid (LF) was obtained from cranial as well as from caudal regions of the bovine lung in healthy and pneumonic calves. LF was investigated biochemically, cytologically, and bacteriologically. In healthy lungs free of pneumonic lesions, no differences due to the different parts of the lung were established. An increase in both protein content and number of cells and a marked influx of neutrophils were found to be the most important alterations caused by pneumonic lesions. The diagnostic potential of lactate dehydrogenase, alkaline phosphatase and the size of alveolar macrophages in LF was validated.


Electrocardiographic findings in calves with experimentally induced right ventricular hypertrophy. Surface electrocardiograms (ECG) from 20 clinically healthy calves and 3 calves with experimentally induced right ventricular hypertrophy (RVH) were studied to assess the influence of RVH on the configuration of the bovine ECG. In the calves with RVH decreased cardiac axes and increased voltages of QRS complexes in leads I and aVL (extremity leads) and in bv1 and bv5 (precordial leads) were found. Using generally accepted human electrocardiographic theories, these findings could be explained from geometrical differences between the hearts of normal calves and the hearts of calves with RVH.


Relationship between lactation-associated body weight loss, levels of metabolic and reproductive hormones and weaning-to-oestrous interval in primiparous sows. Twelve conventionally fed primiparous sows with a similar number of piglets were divided into 3 groups (n = 4) according to their body weight loss after a 5-week lactation as follows: H-gr (loss greater than 25 kg), M-gr (loss 11-25 kg) and L-gr (loss less than or equal to 10 kg). Blood samples were collected at 9, 12, 15, 18 and 21 h, from 4 days before weaning until 3 days afterwards, and every 15 min for 6 h on the day before and the day after weaning. The group of sows with higher weight loss during lactation tended to have a higher farrowing weight and higher pre-weaning plasma prolactin levels. At weaning, the L-gr sows had higher plasma insulin and lower plasma cortisol concentrations, especially when compared with H-gr sows. Among the ten sows that showed oestrus within 10 days of weaning, no between-group differences were found in the length of the interval from weaning to oestrus. No significant differences between groups were observed in levels of oestradiol-17 beta and LH. The higher level of insulin in L-gr sows might relate to the higher number of corpora lutea observed in this group.


Farrowing disorders in the sow: a field study. A prospective study was carried out in three intensive farms. 150 sows were individually followed from 20 days prior to farrowing to 5 days after farrowing. During the five post farrowing days, the prevalences of fever (rectal temperature greater than or equal to 39.8 degrees C), anorexia, vulval discharges and mammary gland disorders were 15.3%, 20%, 64.5% and 3.3% respectively. Parturition duration (piglet delivery) was 197 minutes on average. Farrowing lasted over 300 minutes for 10% of the sows. The 5 parameters were combined to build a score on farrowing disorders. The sows getting the highest rate of disorders tended to show specific physical features prior to farrowing. The oldest sows, the heaviest, those showing urinary infections or locomotor disorders were more predisposed to problems. Moreover affected sows gave birth to larger litters for a given parity.


Opioid inhibitory control of the ruminant stomach motility: functional importance of the hypothalamus. In conscious sheep, Leu-enkephalin (10 and 20 micrograms.kg-1) administered into the third cerebral ventricle caused a psychosedative action and a significant inhibition of the frequency of rumen contractions. The amplitude of the first rumen contractions, following immediately after the end of the Leu-enkephalin's infusion (at a dose of 20 micrograms) and the average amplitude of primary rumen contractions were also significantly inhibited. The hypothalamic isolation prevented both the inhibitory effect of Leu-enkephalin on the rumen motility and the drug induced psychosedative action. In contrast, Leu-enkephalin (20 micrograms.kg-1), significantly enhanced phasic contractions of the rumen after hypothalamic isolation. However the hypothalamic isolation did not prevent Leu-enkephalin induced inhibition of the mean amplitude of rumen contractions, but this inhibition was not significant (NS). The character of the histopathological changes induced by the isolation of the hypothalamus showed descending degenerative changes of the neuronal pathways connecting the hypothalamus to the pons and lower to the medulla. These results do suggest that the isolation of the hypothalamus causes the degeneration of the descending inhibitory opioid pathways connecting the hypothalamus to the gastric centers of the medulla and point act out the functional importance of descending tonic opioid inhibitory control of ruminant forestomach motility.


Bovine vectocardiography: a comparative study relative to the validity of four tridimensional lead systems. For spatial vectocardiography to become applicable for cardiac investigation in cattle, it was necessary to develop a reliable standardized electrocardiographic lead system in this species. In this study, four tridimensional lead systems, initially developed in horses, were compared when applied in calves. Fifty seven electrocardiograms were collected. The between-subject variability of the magnitude and angles of the tridimensional P, QRS and T modal vectors obtained by use of each lead system was compared. Reproducibility of vectrocardiographic measurements was analyzed by comparing results obtained in 10 calves within a one day interval. The Holmes semi-orthogonal lead system, giving the lowest between-subject variability and the highest between-day reproducibility, appeared to be the most reliable lead system in order to apply vectocardiography in the bovine species.


Ectopic mammary tissue in the vulva of goats. Ectopic mammary tissue was described in ten goats belonging to the Nubian and Syrian breeds. This consisted of multiple cavitations containing white milky fluid, which greatly resembled milk in colour, odour and composition. Histologically, the tissue was composed of alveoli lined by cuboidal epithelium and contained pinkish staining secretion. Surgical removal of the tissue was achieved without complications.


Immunocytochemical identification of a bovine peritoneal mesothelioma. Peritoneal mesotheliomas are uncommon among cows although there has been an increase in the frequency of diagnosis of this neoplasia in the past few years. The case of a 2 year old cow is described. On post-mortem examination, several nodules of variable size were found in the peritoneal cavity. These nodules fused together, but they did not go deep into the organs. Histologically, such nodules were formed by a population of fusiform cells of malignant morphological character and sarcomatous appearance. Immunocytochemical study, using P.A.P. techniques, showed a highly positive reaction towards vimentin and a negative reaction towards wide-spectrum cytokeratins, hence suggesting a mesenchymal origin of the neoplasia. According to the histopathological study, a multifocal peritoneal mesothelioma of sarcomatous appearance was identified.


Distribution of ASFV antigens in pig tissues experimentally infected with two different Spanish virus isolates. Lymph nodes, spleen, liver, lung and kidney obtained from pigs experimentally infected with two African Swine Fever Virus (ASFV) isolates of differing virulence were fixed by perfusion with glutaraldehyde and embedded in paraffin. An immunoperoxidase technique using a polyclonal anti-ASFV serum was performed on tissue sections in order to detect ASFV antigen. The distribution of ASFV antigen in such infected organs is shown and the differences between both infections compared and discussed. Monocytes, macrophages, hepatocytes, endothelial cells, neutrophils and epithelial cells were found to contain ASFV antigens.


An outbreak of enterotoxaemia in cats.

An outbreak of enterotoxaemia in cats. Eighteen local breed cats suffered from enterotoxaemia after scavenging on chicken-remnants. They suffered from vomitus and diarrhoea and collapsed dead after a few hours. An untypable strain of Clostridium perfringens was isolated in pure form and was suspected to be the cause of the outbreak.


[The diagnosis of Listeria encephalitis in ruminants using cultural and immunohistological techniques. I. Comparison of different selective media and culture techniques for the detection of Listeria from ruminant brains]. The selective L-PALCAMY differential enrichment broth, the Listeria enrichment broth of the International Dairy Federation, Oxford Listeria selective agar, and PALCAM Listeria selective agar were comparatively examined in the cultural isolation of Listeria spp. from ten ruminant brains. The L-PALCAMY medium proved to be superior to the IDF broth in both selectivity and productivity for Listeria spp. in the brain samples, which were also contaminated with other bacteria. The Oxford and PALCAM agars corresponded in their productivity for Listeria spp. The latter, however, was more selective than the Oxford agar. Bacterial counts of up to 1.2 x 10(9) CFU/g of brain stem sample were made from Listeria monocytogenes (L.m.), and up to 6.2 x 10(4) CFU/g from Listeria innocua. A total of 164 brains from ruminants showing CNS disturbances and/or pathoanatomical CNS alterations were examined using L-PALCAMY medium, and Oxford and PALCAM agar. L.m. could be isolated from 29 of the brains, and Listeria innocua from five. Cultural isolation of both Listeria spp. occurred in one brain. Of 27 brains containing L.m., which were also examined using cold enrichment, L.m. was isolated in 59.3% of the cases with direct culture, in 81.5% of the cases using selective warm enrichment, and in 77.8% of the cases by means of selective cold enrichment. Five cases each were identified solely by cold or warm enrichment, respectively. In investigations of further 69 ruminant brains the number of brains shown to contain L.m. could be increased from seven to 13 by means of selective cold enrichment for three months.


Detection of Mycobacterium paratuberculosis antigen with colloidal immunogold in naturally infected sheep. The anti-Mycobacterium paratuberculosis polyclonal serum is proved useful for labelling Mycobacterium paratuberculosis in glutaraldehyde-osmium-fixed and epon-embedded intestinal samples from sheep with clinical symptoms of paratuberculosis. M. paratuberculosis marked with antibody-coated colloidal gold stain was seen in macrophages, epithelioid cells, giant cells and neutrophils throughout intestinal mucosa. In large macrophages with a low lysosomal content, a great number of intact mycobacteria was seen within phagosomes. In macrophages with average lysosomal content, very few intact mycobacteria or mycobacterial debris were present and lysosome-phagosome fusions were observed. Mycobacteria within neutrophils were scanty. These results show the usefulness of colloidal immunogold techniques for studies of the pathogenesis of paratuberculosis.


Immuno-gold labelling of turkey rhinotracheitis virus. The morphology and morphogenesis of five viruses isolated in Great Britain, France and South Africa from turkeys with rhinotracheitis were examined. The five isolates were antigenically related by immunofluorescence and were indistinguishable by negative contrast and thin section electron microscopy. Negative contrast electron microscopy of infected Vero cell cultures revealed ortho- or paramyxovirus-like particles and helical nucleocapsids 14 nm in diameter with a pitch of 6 nm. The viral nature of these structures was confirmed by immuno-gold labelling, using a hyperimmune rabbit antiserum to TRT virus and 15 nm gold-labelled goat anti-rabbit IgG. Ultrastructural changes characteristics of paramyxovirus infection were observed in Vero cell cultures infected with each of the five TRT virus isolates. These alterations, which included areas of localised thickening of plasma membrane, associated cytoplasmic inclusions of nucleocapsids and budding virus particles also labelled specifically following immunogold staining. These observations are in accord with the suggestion that TRT virus is an avian pneumovirus.


[The fatty acid composition of the total lipids in Vibrio cholerae]. The fatty acid composition of total cell lipids of V. albensis typing strains, serovars 01-012, isolated from patients and environmental objects, as well as V. eltor and NAG vibrios, has been studied. Fatty acids contain 14-18 carbon atoms and are mainly represented by unsaturated monoacids. Palmitoleic and oleic acids constitute the greater part of unsaturated acids (their total content is 55.2-71.0%). The level of saturated fatty acids in considerably lower (27.0-43.1%), and these acids are mainly represented by palmitic acid, its maximum level being 28.4%. The similarity of the fatty acid profiles of the lipids common to the strains under study may indicate that these strains are phylogenetically related.


[The pathogenicity factors of bacteria in the genus Acinetobacter]. Eighty Acinetobacter strains, isolated in Togliatti from patients with purulent inflammatory diseases, were studied to determine their pathogenicity factors. Out of these 80 strains, 32.5% were found to have enterotoxigenic activity and 46.2%, adhesive activity. They were related to adhesins of the human type and to adhesins of the sheep, rabbit, swine and guinea pig types. But the most important phenomenon established in this study was the combination of different pathogenicity factors detected in Acinetobacter bacteria. Analysis of the combination of pathogenicity factors revealed that 7.5% of Acinetobacter strains had adhesive and enterotoxigenic activity, 15.3% of these strains combined adhesive and hemolytic activity and 1.2% of them were found to be enterotoxigenic and hemolytic. Only 5.0% of Acinetobacter strains were found to carry all there pathogenicity factors simultaneously.


[The temperature-induced early and late development of resistance to the bactericidal action of blood serum in Yersinia pseudotuberculosis]. Y. pseudotuberculosis strains were grown at 6 degrees-8 degrees C and then incubated at 37 degrees C. 3-6 hours later serum resistance appeared in the strains having plasmid virulence and producing outer membrane polypeptide with a molecular weight of 120 kD, known as P1. 10-12 hours later serum resistance appeared in the strain having the virulence plasmid, but not producing P1, as well as in strains in which the plasmid was eliminated.


[Hospital infections: the problems and ways to resolve them]. The authors present the critical analysis of the existing situation in the spread of purulent septic infections in surgical hospitals of the USSR and the state of epidemiological surveillance. Considering this situation to be highly unfavorable, the authors propose a number of urgent organizational measures (the inclusion of hospital epidemiologists into the medical staff of large clinics, the system of training in this problem). The article deals with the specific features of the epidemiological process in purulent septic infections and the main principles of the organization of the epidemiological surveillance system for this group of infections.


[The protective activity of preparations made from the tick-borne encephalitis virus grown using different cell cultures]. The preparations of tick-borne encephalitis (TBE) virus grown in swine embryo kidney cell culture have been shown to possess pronounced protective activity per unit of virion protein E in comparison with TBE virus preparations derived from cell culture 4647 and chick embryo cell culture. The antigenic activity of all virus preparations under study has proved to be practically the same. The role of post-translation modifications of TBE virus protein E in the manifestation of some of its biological properties is discussed.


[Improvement in the laboratory methods of assessing the safety of the of the pertussis component of DPT vaccine adsorbed]. The mouse paw edema test and the tests for the determination of leukocytosis-stimulating and histamine-sensitizing activity are reproducible if standard samples are used and the properties under test are evaluated with reference to the characteristics of standard samples. The standard character of the weight gain test on mice is also enhanced if all conditions of the test are standardized. The most accurate information on the toxicity of the pertussis component of adsorbed DPT vaccine can be obtained if a single human dose (0.5 ml) is injected to mice and the toxicity of the vaccine is estimated from the weight gain registered in the test mice and the control animals. The use of standard samples in each test makes it possible to observe the conditions for controlling the toxicity of the tested preparations.


[The antibacterial immunity of people under dynamic observation in an altered radiation situation]. The comparative study of the isolation rate, level, antigenic and class specificity of serum antibodies to the causative agents of purulent septic infections (Staphylococcus aureus, Pseudomonas aeruginosa, Proteus mirabilis) and acute enteric infections in healthy adults with different ABO blood groups before (836 persons) and after (1,429 persons) the catastrophe at the Chernobyl nuclear power station was made. The study revealed the fact that the genesis of antibodies directed against different microorganisms can be stimulated without additional antigenic challenge in the form of disease or immunization, which was definitely indicative of the influence of small radiation doses in Kiev on the humoral immunity of the population. The multifactor character of the dependence of antibacterial antibody formation under altered radiation conditions on the specific features of the infective agent and the intensity of its circulation among the population, individual immune responsiveness of the body and concrete radiation conditions was established.


[A comparative study of the expediency of using different chemical methods for determining protein in allergen preparations]. Parallel use of some known chemical procedures for measurements of protein in commercial forms of allergens revealed considerable variations in the results, which was due to the nature of the methods used and to admixtures of different substances in the preparations under study. The conclusion on the necessity of using at least two methods of protein determination for the standardization of allergens was made. Preference was given to Bradford's method. As the standardization of allergens manufactured in the USSR is carried out on the basis of the quantitative determination of protein (in PNU), this problem is of not only theoretical, but also practical importance.


[The syndromal approach to the diagnosis of toxic food poisonings]. The authors criticize the nosological principle of the diagnosis of toxic infections and believe that in a vast majority of cases such diagnosis must be based on syndromes. The only exceptions are cases of mass outbreaks and hospital infections. The definition of alimentary toxic infection is given, the difficulties of their clinical diagnosis and the ways to overcome these difficulties are indicated.


[The adhesive properties of S and R mutants of Salmonella minnesota during batch cultivation]. The study of the adhesive, surface-electrical and hydrophobic properties of S. minnesota S- and R-mutants in the process batch cultivation has revealed that the maximum values of the above parameters are characteristic of the stationary phase of culture growth and their minimum values, of the end of the lag phase. Electrophoretic mobility and adhesiveness increase from S- to Re-chemotype. The surface of Salmonella S-form is more hydrophilic, than in R-mutants which are indistinguishable in the degree of their hydrophobic properties. The heterogeneity of the populations under study with respect to the electrophoretic mobility and adhesiveness of cells has been detected.


[Sterol transformation by Escherichia].

[Sterol transformation by Escherichia]. The use of the Liebermann-Burhard reaction and the thin-layer chromatography of nonsaponifiable lipids of culture medium (donor blood serum) permitted the isolation of three biological variants of Escherichia in the process of their 48-hour cultivation in this medium. The cholesterol-destroying variant of Escherichia is characterized by a decrease in the content of total, free, esterified cholesterol and a decrease in the occurrence of fractions corresponding to cholesterol, delta 4-cholestenone-3, delta 5-cholestenone-3), as well as nonsaponifiable lipid, where Rf was equal to 0.36; two fractions of labeled nonsaponifiable lipids, not corresponding to cholesterol, appeared on plasma with sodium acetate-1-14C. Cholesterol-transforming biovars produced insignificant changes in the content of chemically determined cholesterol in the medium, but in plasma nonsaponifiable lipid with Rf = 0.26 and other less polar lipids were found. Escherichia strains increasing the amount of chemically determined cholesterol in the process of their growth more frequently transformed or used nonsaponifiable lipids with Rf = 0.26 and 0.42. As a rule, the occurrence of cholesterol and less polar lipids increased. The sodium acetate-1-14C was incorporated into 3-4 fractions of nonsaponifiable lipids, one of them being identified as cholesterol.


Distribution of cortical neurons projecting to dorsal column nuclear complex and spinal cord in the hedgehog tenrec, Echinops telfairi. Using retrograde axonal flow and wheatgerm agglutinin conjugated to horseradish peroxidase, we studied the distribution of cortical neurons giving rise to spinal and dorsal column nuclear projections, and correlated the regions involved in the projections with the cytoarchitectonic areas recently identified in the lesser hedgehog tenrec, Echinops telfairi (Insectivora). Labeled cortical neurons were most numerous following injections of tracer into higher cervical segments, whereas almost none were found following thoracic injections. The cortical labeling appeared more prominent ipsilaterally than contralaterally after spinal injections, although it was more prominent on the contralateral side after injection into the dorsal column nuclear complex. The majority of labeled neurons found in lamina V occupied the neocortex adjacent to the interhemispheric fissure along the rostrocaudal extent of the small corpus callosum. This location corresponded to an intermediate rostrocaudal portion of the hemisphere, and particularly to area 2 of Rehkämper. In some cases, adjacent portions of areas 1 and 3 were also involved, as well as neocortical regions of the lateral hemisphere. The present data did not suggest a somatotopic organization of the projections; likewise, evidence for the presence of more than one somatosensorimotor representation was sparse.


The ganglionic origins and central projections of primary sensory neurons innervating the upper and lower lips in the rat. Retrograde and transganglionic transport of horseradish peroxidase (HRP) was used to investigate the neurons innervating the upper and the lower lips and their central projections in the rat. Both the upper and the lower lips were observed to be innervated by a very large number of trigeminal sensory neurons, with their cell bodies located in the maxillary and the mandibular parts of the trigeminal ganglion, respectively. The central projections of neurons innervating the upper lip formed a long continuous column starting rostrally at midlevels of the trigeminal main sensory nucleus (5P) and extending caudally through the C1 dorsal horn, with occasional fibers reaching the C3 segment. The heaviest projections appeared in the middle portions of 5P and nucleus interpolaris (5I), as well as in the rostral part of nucleus caudalis (5C). A small but consistent projection to the solitary tract nucleus, originating from cells in the inferior vagal ganglion, was observed in the upper-lip experiments. The central projections from neurons innervating the lower lip also appeared as a long column located dorsally or dorsomedially to the projections from the upper lip. The most prominent projections from the lower lip were located in the caudal part of 5P, the middle part of 5I, and the caudal two-thirds of 5C. Sparse projections could be traced as far caudally as C4. At 5C and cervical levels, some labeling appeared contralaterally in the same location as on the ipsilateral side.


Retrograde labeling of lumbosacral interneurons following injections of red and green fluorescent microspheres into hindlimb motor nuclei of the cat. In order to map the laminar and segmental positions of lumbosacral interneurons that project to L7 motor nuclei, red and green fluorescent latex microspheres ("beads") were pressure-injected through micropipettes into the deep peroneal or posterior biceps-semitendinosus motoneuron pools of cats. Micropipette tips were positioned by recording the antidromic field potentials evoked by electrical stimulation of the muscle nerves. Projecting interneurons were identified by the presence of retrogradely transported beads. Small bead injections labeled large numbers of neurons. These were observed in all the spinal segments examined, L1-S2, and were most densely concentrated within laminae VI and VII ipsilateral to the injections and lamina VIII contralaterally. In addition, significant numbers of labeled cells were observed in lateral lamina V ipsilaterally and in lamina X. A few cells with bilateral projections were double-labeled following injections of red and green beads on opposite sides of the cord. These were most often observed in midlumbar segments (L3-L5) in medial regions of the gray matter. The results suggest that the intermediate zone (laminae V-VIII and X) of the lumbosacral spinal cord is a major source of interneuronal projections to the L7 ventral horn. This is true for both lateral and medial areas of the intermediate zone, as the fluorescent microspheres labeled neurons in medial regions of the cord largely undetected in previous studies in which other methodologies were employed.


The sensory effects of l-menthol on human skin. Psychophysical measurements were made of the sensory effects of l-menthol applied topically to the forearm under controlled thermal conditions. In the first experiment, subjects judged the intensity and quality of sensations produced by warming or cooling the skin in the presence of menthol or the vehicle. During cooling, menthol intensified cutaneous sensations and increased reports of burning. During warming, menthol intensified sensations transiently at low temperatures and weakened them lastingly at higher temperatures; the frequency of reports of burning varied with intensity. A second experiment tested the hypothesis that menthol would lower the threshold for warmth and raise the threshold for heat pain. No change in either threshold was observed. The primary sensory effects of l-menthol on hairy skin are therefore to heighten the perception of cooling and to attenuate the perception of moderate warming. In contrast with other common chemical irritants, menthol's pungent qualities appear to be enhanced by cooling and suppressed by warming; this suggests that its sensory irritancy may be attributable to the stimulation of a population of high-threshold cold fibers or cold-sensitive nociceptors.


Further evidence for the involvement of SmI cortical neurons in nociception: modifications of their responsiveness over the early stage of a carrageenin-induced inflammation in the rat. In this electrophysiological study, changes in the responsiveness of neurons in the primary somatosensory (SmI) cortex in rats were analyzed during the development of carrageenin (CRG)-induced inflammation, an animal model of acute inflammatory hyperalgesia. SmI neurons were characterized as responding to non-noxious light touch, non-noxious articular movement, or noxious pinch. A total of 23 neurons so characterized in three groups were recorded for 60 min (17 of these neurons were recorded for up to 150 min) after an intraplantar injection of CRG. The possible modifications in their background and evoked activities were analyzed over this period of time. After CRG administration, cells responding to noxious pinch stimuli (n = 8) showed a nonsignificant increase in spontaneous activity, but a significant increase in their evoked response to pinch. These results were quite similar to past observations in the ventrobasal nucleus of the thalamus (VB). Cells responding to non-noxious articular stimulation (n = 6) showed variable modifications and no significant increase in the mean evoked response for up to 60 min. These results for articular cells were also quite comparable to results seen for VB responses for similar cells. However, mean spontaneous activity, which showed a highly variable increase, was significantly increased after 60 min. The depressive effect of a local anesthetic, Xylocaine, was tested on the activities of four cells (one pinch, three light touch units) 60 min after CRG administration over a 20-min interval. Xylocaine was found to depress both spontaneous activity and responses to the effective somatic stimulus, thereby implying that the observed central modifications in neuronal discharge are linked to the peripheral inflammation. Modifications observed for each group of cells are compared with past observations in peripheral fibers, in spinal dorsal horn neurons, and especially in the VB under similar inflammatory conditions. These data confirm that the SmI cortex is involved in the nociceptive process. Furthermore, the contrast between some modifications observed at this level and past observations under similar inflammatory conditions suggests a unique role of some cortical neurons, which might partially account for mechanical allodynia.


[The expression of TGF beta-related mRNAs in the early development of Xenopus]. Using porcine TGF beta 1-cDNA probe, we found that three TGF beta-related mRNAs (4.2 kb, 3.2 kb and 2.3 kb) were detected in blastula (Stg. 7/8). The 4.2 kb and 3.2 kb mRNAs were very highly expressed in the blastula (Fig. 3). However, we could hardly detect them in embryos of cleavage, gestrula and neurula stages. On the other hand, the 2.3 kb mRNA could be identified in embryos of cleavage stages, blastula, gastrula and neurula and the quantity was rather stable. Comparing the quantities of TGF beta-related mRNAs in different parts of blastula, that is, animal half or vegetal half and dorsal or ventral half, we found that the transcripts were enriched in the vegetal hemisphere (Fig. 6). But no obvious difference between dorsal and ventral halves could be detected (Fig. 7).


[Immunohistochemical studies on the TGF beta-related protein in the early development of Xenopus laevis]. By the method of immunocytochemistry, using the polyclonal antibodies raised against the 1-29 N-terminal residues of TGF beta-1, we found that the protein could bind to the antibodies was present in the early embryos of Xenopus. The protein was named TGF beta-related protein. It was distributed mainly in the endoderm from blastula (stg. 7) to late neurula. In the blastula (stg. 8), the protein was localized in the vegetal hemisphere near the floor of the blastocoel [Plate I, Fig. 1]. In the early gastrula (stg. 10.5) [Plate I, Fig. 2], it was localized in the central part of the vegetal hemisphere. In late gastrula (stg. 12), it was mainly distributed around the gastrocoel [Plate I, Fig. 3], but the fluorescence in endoderm cells (ventral part beneath the gastrocoel) was stronger than in the mesoderm cells (dorsal part of the gastrocoel). In the early neurula (stg. 14), the whole endoderm displayed strong fluorescence and the part of dorsal mesoderm (presumptive somite & notochord) close to endoderm was also found to be positively stained [Plate I, Fig. 4,5], but the part close to neural plate was negative. In The late neurula (stg. 20) [Plate I, Fig. 6], it was found in the central area of yolk mass (endoderm cells). No positive stain was detected in the unfertilized egg, embryos earlier than stage and later than stage 20/21.2+ protein in early development.


[The effect of microinjection of anti-TGF beta-1 antibodies on the early development of Xenopus laevis]. In order to testify the function of the TGF beta related protein, we microinjected the antibodies against the TGF beta-1 to one blastomere of two-cell stage embryos. Dosages of antibodies injected were 24-36 ng, 12 -18 ng, 6-9 ng and 1.5-2.25 ng. Malformed embryos with exposed yolk mass were produced. They were designated as YE-1, YE-2 and YE-3 according to the degree of malformation which was found to be related to the dosage of antibodies injected to the blastomere. These malformed embryos could normally develop to blastula, but the yolk mass was exposed on the injection half during gastrulation. In the group with the highest dosage, the most seriously affected embryos belong to the YE-1. For most of them, no muscle tissue could be found from head to tail in the injection half, the development of mesoderm seemed to be thoroughly inhibited. YE-2 was the group with decreased dosage, small block of muscle tissue was usually observed in the injection half. YE-3 was the least affected group with the injection half containing blocks of muscle tissue similar to that of the non-injection half. The different groups of malformations seemed to be related to the degree and range of interference on gastrulation. In the group with highest dosage, the gastrulation of the entire injection half seemed to be prohibited, and YE-1 was produced. In the groups with lower dosages, only part of injection half was interfered, and YE-3 v and YE-3 d were resulted. From the results mentioned above, we concluded that TGF beta-related protein are not only present in the early embryos of Xenopus laevis, but also may be concerned with mesoderm induction.


[A comparative study on the metabolism of nucleic acids during the subculture and differentiation of tobacco callus]. Changes in the contents of DNA and RNA, RNA species, the synthesis rates of DNA and RNA, and the activity of DNase and RNase were investigated in the callus of tobacco (Nicotiana tabacum L. cv. Willow Leaf) during subculture and differentiation. The contents of DNA and RNA were higher in differentiating callus than that in subcultured callus. After day 12, the contents of DNA and RNA in differentiating callus rose continuously while the contents of DNA and RNA in subcultured callus remained constant. Changes in RNA species and its relationship to total RNA level were also analyzed. At the stage of shoot primordium formation in differentiating callus, the activity of RNase increased markedly and the synthesis rate of RNA increased continuously; while the RNase activity and the synthesis rate of RNA in subcultured callus were much lower during the same period. During the period of shoot growth, the synthesis rate of DNA in differentiating callus was elevated compared to that in subcultured callus. The results above suggested that the metabolism of nucleic acids in differentiating callus was more active than that in subcultured callus.


[Studies on genetic engineering of human insulin-purification and characterization of human proinsulin and insulin]. E. coli DH 5 alpha cells harboring a plasmid pWR 590-BCA 4 for fused human proinsulin production were cultured. The fused human proinsulin was isolated from the fermented cells and then subjected it to cleavage with BrCN. The cleaved product was then converted to crude proinsulin-S-sulfonate using oxidative sulfitolysis. The isolation of human proinsulin-S-sulfonate was accomplished by ion exchange chromatography on QAE-sephadex A-25, followed by gel filtration on sephadex G-50. The purified human proinsulin-S-sulfonate was folded using a disulfide interchange method. The folding mixture was then chromatographed on sephadex G-50 and purified proinsulin was obtained. The proinsulin was then converted to human insulin and C-peptide by a combination cleavage with trypsin and carboxypeptidase B. The total yield of human insulin was about 5 mg/L The Zinc insulin crystals were obtained with amorphous human insulin using citrate method. The amino acid composition N-terminal sequences as well as C-terminal amino acid residues are in agreement with expected results. The hypoglycemic activity of purified human insulin is 26-27 U/mg, as judged by mouse convulsion assay, and the RIA activity is about 99% of that of porcine insulin.


Molecular and functional properties of EF-Tu from Calderobacterium hydrogenophilum. Protein synthesis elongation factor Tu (EF-Tu) was purified from an extreme thermophilic hydrogen-oxidizing bacterium Calderobacterium hydrogenophilum. The relative molecular mass of EF-Tu. GDP was 51,000. The factor was heat stable and lost only 50% of its activity after heating at 80 degrees C for 5 min. Native and reduced EF-Tu or EF-Tu. GDP contained one SH-reactive group. The elongation factors from C. hydrogenophilum and E. coli were shown to be immunologically identical. From the Southern hybridization analysis seems to suggest that chromosome DNA of C. hydrogenophilum has two tuf genes.


[Association of chromosomal telomere DNA with nuclear matrix in HeLa cells]. Nuclear matrix from HeLa cells was gently extracted with a high salt solution and treated with DNase I. DNA that remained associated with the nuclear matrix (N. M. DNA) and DNA fragments released into the supernatant (SN.DNA) were isolated respectively and dot hybridized to human telomere sequence (AGGGTT/TCCCAA)40 probe. As the time of DNase I treatment was extended, the amount of N. M. DNA decreased while the concentration of telomere sequence in N.M. DNA proportionally increased. These preliminary results suggest that the telomere sequence is tightly bound to nuclear matrix in HeLa cells.


[The dynamics of two types of tyrosine protein kinases in the proliferation of cultivated vascular smooth muscle cells]. We have studied the membrane-bound tyrosine protein kinases (TPK) in cultivated aortic smooth muscle cells (ASMC) from the rabbit, and found that the cytosolic (membranous)TPK and the nuclear (membranous)TPK are two distinctive types of isozymes as judged by criteria on dynamics: (1) using synthetic poly(Glu. Ala. Tyr)n(6:3:1) as a substrate, the relative extents of stimulation by Mn2+ (450%) was more effective than that by Mg2+ (100%) on cytosolic TPK, but Mn2+ was less effective (100%) than Mg2+ (130%) on nuclear TPK: (2) the concentrations of Mn2+ and Mg2+ giving maximal stimulation on cytosolic TPK were 15 mmol/L and 50 mmol/L, whereas on nuclear TPK were 1 mmol/L and 5 mmol/L, respectively. These results indicate that the attitudes toward Mn2+ and Mg2+ can distinguish the cytosolic TPK from the nuclear one. In nucleus, with the entry of ASMC from G0 to G1 stage, TPK activity increased rapidly and reached the peak (12 times G0 activity) at the early G1 stage (3 hrs from G0), then decreased dramatically to basic line, and remained at a lower level thereafter. In cytosol, the TPK activity decreased with the entry of ASMC from G0 to G1 stage and reached its lowest point at the middle of G1 stage (6 hrs from G0), and then increased with a transient peak at the late G1 stage (9 hrs). It went down to G0 level before DNA synthesis.


[Occupational transmission by HIV and by hepatitis B virus. Attitude of Belgian surgeons and anesthetists. An opinion survey]. Risk of professional transmission of hepatitis B is known since the seventies. Recently the possibility of HIV transmission during surgical practice was demonstrated. It was interesting to assess Belgian surgeons and anesthetists opinion about this risk and about the precautions taken. An opinion survey was performed with a representative sample of Belgian surgeons and orthopedists (340) as well as anesthetists (100). Risks of transmission of HIV and possible elementary precautions are not well known. The rate of vaccination against hepatitis B is low, specially in smaller hospitals. However the frequency of injuries during practice is high in surgeons as well as in anesthetists. This study shows that important information efforts about the risks of HIV infection and the possible precautions to be taken are still necessary. Information about the need for vaccination against hepatitis B should also be done, considering the high incidence of operative injuries.


[Primary inguinal hernia: Lichtenstein's ambulatory hernioplasty: early clinical results and economic implications. Study of the initial 130 surgical cases]. The authors report their preliminary experience of 130 ambulatory treatment under local anesthesia of primary inguinal hernia. This method of treatment is very well accepted by the patients. There are few early recurrences. This method of treatment is very cost-effective.


[Delayed perforation of the sigmoid colon following closed abdominal trauma. Apropos of a case report]. Blunt abdominal trauma and delayed colon perforations are not common and usually occur in patients sustaining other injuries, but also as isolated event. We report a case of delayed perforation of sigmoid colon, three days after a blunt abdominal trauma in a male adult. It was caused by disinsertion of sigmoid colon mesentery for about ten centimeters. This condition is discussed with literature review.


[Small intestinal ulceration and stenosis induced by non-steroidal anti-inflammatory agents]. We report a case who developed a small bowel ulceration in a long segment of distal duodenum and proximal jejunum, a few days after he had taken high doses of diclofenac. After a month, it was complicated by a stenosis of the same segment. Nonsteroidal antiinflammatory drugs have recently been recognised as a possible etiologic factor of small bowel ulcerations. Clinical findings are aspecific. Complications of small bowel ulcerations are: obstruction, perforation or bleeding. Those have to be treated by surgery. We proposed a physiopathologic model and correlated it with histological findings. careful prescription of those drugs has to be pursued and one should think about a small bowel ulceration in a patient with an abdominal syndrome, who takes non-steroidal antiinflammatory drugs.


[Malignant retroperitoneal paraganglioma. Case report and literature review]. The authors report a case with a retroperitoneal recurrent malignant non-secretory neuroendocrine tumor. The diagnosis of this rare pathology is based on immunohistochemical and electron microscopic techniques. Due to radio- and chemotherapeutic resistance of the tumor, the therapy has to be surgical. The locoregional recurrent nature of the disease asks for a close clinical and radiological follow-up.


Simulation of appendicitis by tumor-like lesion of cecum. Four cases are presented in which an initial diagnosis of appendicitis was made. At laparotomy, a cecal lesion simulating a tumour was found. Pathological examination showed inflammatory granulomatous tumour against foreign body, non specific ulcer, diverticulitis and acute solitary diverticulitis. When malignancy is excluded, hemicolectomy is not necessarily the best treatment and we propose conservative management for these patients.


Massive intestinal haemorrhage due to a solitary jejunal metastasis of a primary bronchogenic tumour. A case is presented of a 72-year old male patient presenting with a massive intestinal blood loss due to a solitary jejunal metastasis of a poorly differentiated adenocarcinoma of the right lung resected two years earlier. After diagnostic workup and stabilization a small bowel resection with end to end anastomosis was performed. Patient is alive and well 5 months after operation. Solitary bleeding intestinal metastasis of a primary bronchogenic tumour are extremely rare but should be included in the differential diagnosis of gastrointestinal blood loss in a patient with a known bronchogenic tumour. Resection with end to end anastomosis is the treatment of choice.


Corticotropin-releasing hormone in health and disease: an update. Corticotropin-releasing hormone (CRH) was initially sequenced and identified in 1981, and has since become established as the principal organizer of the stress response. It causes activation of the pituitary-adrenal axis, behavioural arousal, sympathetic stimulation and a decrease in appetite. In vitro studies have shown regulation of hypothalamic CRH by a variety of neuro-transmitters, including the cytokines interleukin-1 and interleukin-6. However, circulating CRH is mainly derived from extra-hypothalamic sites, and levels may be elevated in patients with tumours secreting ectopic CRH. The placenta is a further source of CRH, which may be specifically raised in patients with pre-eclampsia, and could be a factor in the initiation of parturition. The recently identified CRH binding protein may play a vital role in this process. Clinically, CRH testing has become extremely useful in the diagnosis and differential diagnosis of Cushing's syndrome, and particularly for the localization of ACTH following inferior petrosal sinus catheterization. There is considerable evidence that many patients with depressive illness may have a disturbance of the central control of CRH, and this may be become of increasing importance in the therapy of this common condition. There are also intriguing new data suggesting that abnormalities in CRH regulation may be involved in the pathogenesis of inflammatory arthritis.


[Neonatal ovarian cyst. Case report and literature review]. The authors report a case of antenatal ultrasound diagnosis of a large fetal ovarian cyst; surgical extirpation in the neonatal period due to locoregional complications. Review of the literature; diagnosis, treatment, complications.


Late results in replanted digits. Is replantation of a single digit worthwhile? During the period 1980-1989 35 patients with successfully replanted digits could be selected. Only 17 patients with 32 long fingers and 2 thumbs replanted were prepared to cooperate for this retrospective study, looking for the late functional results. Mobility of the replanted digits was measured by the TAM-value. Power was indicated by grip strength and tip pinch. Weber two-point discrimination test and Von Frey test were used to investigate sensibility. Most patients show cold-intolerance. Mobility was worse for the more proximal replantations. Replantations distal to PIP do functionally very well. Therefore single digit amputations should be considered as an indication for replantation, especially amputations distal to the pip. Ring and little finger replantations have a better mobility than index and middle fingers. Mobility in younger patients is also better. Grip strength and tip pinch are respectively 66% and 73% of the normal values. All patients (except 2) could return to their work in a reasonably short time (average 5 months).


Effects of corticotropin-releasing hormone on the postoperative course of elderly patients under long-term artificial respiration. In both human and animal studies a stimulatory effect of corticotropin-releasing hormone (CRH) on respiration and on cognitive parameters has been demonstrated. Our own studies employing human CRH (hCRH) iv in healthy volunteers and different groups of patients have shown hCRH to be a safe drug. We prospectively studied the clinical effects of a standardized dose of 100 micrograms hCRH iv in 12 elderly patients following major abdominal surgery who remained comatose and were under prolonged respirator therapy over a mean period of 37 days. Cardio-respiratory parameters, blood gas values, plasma cortisol and catecholamines were evaluated before and 30 min following hCRH injection. Furthermore, vigilance was tested using a score system. Ventilation was markedly enhanced following hCRH injection while the cardiovascular parameters were only moderately affected. Vigilance was augmented in all subjects and improved impressively in five patients. The changes were of great benefit for the patients treated and supported their respirator weaning procedures and mobilization training.


Traumatic false aneurysm of the superficial temporal artery. Traumatic false aneurysms of the superficial temporal artery are very infrequent. They usually do not reveal themselves clinically until 1 to 6 weeks after the initial trauma. Diagnostic techniques are echo-doppler, CT-scan and arteriography; treatment is surgical.


Degloving injuries. A retrospective study at the University Hospital Rotterdam. Degloving injuries are severe and frequently underestimated lesions. In a retrospective study, 65 patients treated between 1985 and 1991 were reviewed. Therapy consisted of surgical exploration as soon after injury as possible, with defatting of the avulsed skin and its replacement on the most functionally important sites. The remaining raw areas were covered with split skin grafts (SSG). This technique reduced morbidity, hospital stay and work incapacity, as compared with patients treated by other methods.


The effect of a met-enkephalin analogue on growth hormone, prolactin, gonadotropins, cortisol and thyroid stimulating hormone in healthy elderly men. The aim of the study was to evaluate the effect of the guanyl derivative of the opioid analogue D-ala2,MePhe4-Met-enkephalin-(o)-ol (G-DAMME) on pituitary secretion in healthy elderly men. Nine healthy elderly men (65-88 years) and 10 young adults (20-30 years) were studied. GH, PRL, gonadotropins, cortisol (to evaluate the effect on ACTH) and TSH were measured after G-DAMME (0.25 mg iv) or placebo administration. In elderly men, the GH response to G-DAMME was reduced or absent, while prompt GH release was found in all young men. G-DAMME lowered LH levels in young men but not in elderly men. No significant variations in FSH levels after G-DAMME and placebo were noted in either group of subjects. A similar and significant rise in PRL and TSH, and a fall in cortisol, after G-DAMME was observed in both elderly and young adults. We have demonstrated that the sensitivity to opioid modulation by G-DAMME on PRL, TSH and cortisol secretion is unchanged with aging. On the other hand, the data indicate that LH and GH responsiveness to G-DAMME change with age.


Effect of digoxin on the in vitro secretion of renin and angiotensin II/III immunoreactivity by the human adrenal gland. Cardiac glycosides in man inhibit renin secretion, probably through a direct effect at the renal level (i.e. inhibition of juxtaglomerular cell Na/K ATPase). Since there is evidence that the human adrenal possesses an intrinsic renin-angiotensin system, we investigated the effect of digoxin on the in vitro generation of renin and angiotensin II/III, as well as of aldosterone, by the human adrenal gland. Minced normal adrenal tissues were studied in a superfusion system, measuring in the 15-min superfusate fractions active renin by immunoradiometric assay and angiotensin II/III and aldosterone by radioimmunoassay, respectively. In a first set of four experiments using different concentrations of digoxin in sequence for 45 min periods, digoxin 10(-5), but not 10(-8) and 10(-6) mol/l, significantly reduced renin and angiotensin II/III output from adrenals, while no change in aldosterone was observed. In a second set of three experiments, the addition of digoxin 10(-5) mol/l for 120 min caused a sustained reduction of renin and angiotensin II/III, but not of aldosterone. In the final experiment, the decrease of renin and angiotensin II/III during superfusion with digoxin 10(-5) mol/l was significantly greater than that observed during superfusion with digoxin in the presence of antidigoxin antibodies. Our data indicate that digoxin at high doses reduces renin and angiotensin II/III but not aldosterone secretion by the human adrenal gland. This suggests two different effects of digoxin, probably both mediated by inhibition of the Na/K ATPase activity, on the adrenal renin-angiotensin- and aldosterone-secreting cells.


[The treatment of giant lipomas].

[The treatment of giant lipomas]. Lipomas are the most frequent benign tumours. Usually they are removed for cosmetic reasons only. For the treatment of giant lipomas, liposuction was proposed to reduce the size of the skin incision. The reliability of this technique was compared to surgical resection in a series of 30 patients presenting with a giant lipoma. One year follow-up of these patients showed a high percentage of recurrences after liposuction but only one after excision.


A monthly cycle in the plasma concentration of GnRH and the glomerular filtered load of GnRH during second trimester pregnancy. Six healthy women were examined three times a week during the second trimester. The aim of the study was to test the existence of a monthly cycle in plasma GnRH. Because the kidney plays a dominant part in the elimination of small peptides from the circulation by filtration, the filtered load (P-GnRH x GFR) of GnRH was estimated and tested for a cycle. A mathematical model (parabolas overlaid with a cosine curve and containing parameters for cycle length, cycle amplitude and phase) was used in a multivariate analysis of changes in plasma GnRH, creatinine clearance and GnRH filtered load. We found significant monthly cycles in plasma GnRH (p = 0.003) and in GnRH filtered load (p = 0.004), but no significance for a cycle in creatinine clearance. As an intermediate result we demonstrated that the tubular reabsorption of GnRH was unsaturated for all values of plasma GnRH and GnRH filtered load in question. The increased pregnancy level of plasma GnRH originates in part in the placenta, but we assume that the cycle generator is contained in the maternal neuroendocrine system.


Body weight and/or endogenous estradiol as determinants of cortical bone mass and bone loss in healthy early postmenopausal women. The objective was to study the independent relationships of body mass index and endogenous estradiol to cortical bone mineral density and the rate of cortical bone loss at the radius in healthy early postmenopausal women. Fifty-one healthy early postmenopausal women (aged 58-66 years) participated. The women were a subset of a population participating in a 10-year longitudinal study to elucidate the influence of dietary calcium on the rate of cortical bone loss. Cortical bone mineral density at the radius, body weight and body height were measured annually (1979-89). Concentrations of sex steroids were measured in serum samples collected during the last year of follow-up (1989). Endogenous estradiol levels, although significantly positively correlated with body mass index, were not independently related to bone mass indices of the radius. Body mass index, on the other hand, was found to be positively related to cortical bone mineral density and negatively to the rate of bone loss, even after adjustments had been made for confounding factors. Our results suggest that the level of total estradiol is not an important determinant of cortical bone mass indices in healthy early postmenopausal women. Other factors of overweight such as mechanical loading may be important.


The hypothalamo-pituitary regulation of androgen secretion in young men after prolonged physical stress combined with energy and sleep deprivation. During a five days' military training course for male cadets with hard physical activity day and night and almost no sleep or food, a decrease was found in LH, FSH, PRL and TSH. A decrease was also found in testosterone, dihydrotestosterone (DHT), androstenedione, dehydroepiandrosterone and 17 alpha-OH progesterone, whereas dehydroepiandrosterone-sulfate increased twofold. The LH and FSH responses to GnRH intravenously were increased at the end of the course. This demonstrates enhanced pituitary reserves of gonadotropin, or, alternatively, increased sensitivity to GnRH stimulation and may be due to decreased hypothalamic secretion of GnRH during the course. The decreased DHT and testosterone levels were almost normalized after HCG stimulation, indicating a gonadotropin regulated decrease in testosterone secretion during the course. In spite of fairly weak correlation between the alteration in gonadotropins and androgens it is concluded that there is a major regulation of testicular androgen secretion during prolonged stress by the hypothalamo-pituitary axis.


Acute beta-interferon or thymopentin administration increases plasma growth hormone and cortisol levels in children. The interaction between the immune and endocrine systems has recently been investigated. Hodgkin's disease represents a model of immune disturbance frequently associated with endocrine impairment. The present study evaluated the effect of the acute administration of beta-interferon or thymopentin on plasma growth hormone, prolactin and cortisol levels in children with Hodgkin's disease (N = 8) and age- and sex-matched healthy controls (N = 8). beta-interferon (1,000,000 IU), thymopentin (50 mg) or placebo (saline) were injected after two basal blood samples (-15 and 0) and further samples were drawn at 15, 30, 45, 60, 90 and 120 min. Plasma growth hormone, prolactin and cortisol levels were measured by specific RIAs. Plasma prolactin levels did not show significant change following beta-interferon or thymopentin injection in either the controls or the patients. In the patients with Hodgkin's disease, beta-interferon injection induced a significant increase in both plasma growth hormone and cortisol levels, while thymopentin was not effective. In controls both thymopentin and beta-interferon administration increased plasma growth hormone and cortisol levels. These results indicate that beta-interferon and thymopentin are immune substances active on the release of growth hormone and cortisol in healthy children. The lack of effect of thymopentin in children with Hodgkin's disease suggests an impairment of the immune-endocrine interaction in these patients.


Interrelationships between urinary sodium, calcium, hydroxyproline and serum PTH in healthy subjects. The effect of sodium intake on the excretion of calcium, hydroxyproline (OHP) and serum parathyroid hormone (PTH) was examined. When seven healthy males increased their sodium intake by 200 mmol/day, excretion of calcium increased by 1.70 mmol/day and that of OHP by 27%. Serum PTH, however, did not increase significantly. In a cross-sectional study of 334 healthy female subjects there were strong positive correlations between fasting urinary sodium/creatinine (Na/Cr) and calcium/creatinine (Ca/Cr) ratios (r = 0.573) and between Na/Cr and urinary OHP/Cr ratios (r = 0.246). Serum PTH was negatively correlated with Na/Cr ratio (r = -0.161). We conclude that an increase in dietary sodium causes calciuria and an increase in hydroxyproline excretion. The results do not support the hypothesis that this is mediated by PTH.


Glucose metabolism in embryos of normal and diabetic rats during organogenesis. To investigate whether malformations in the offspring of diabetic rats are related to a disturbed embryonic glucose metabolism, lactate production, lactate content and glucose oxidation in embryos of normal and manifestly diabetic rats were measured in vitro during the period of organogenesis. The embryonic production and content of lactate decreased by 90% between gestational days 10 and 11. On both gestational days the embryos of diabetic rats showed increased lactate production and content compared to the embryos of normal rats. The embryonic oxidation of glucose decreased slightly from gestational day 10 to day 11, and the embryos of diabetic rats exhibited a lower glucose oxidation rate than those of normal rats on both days. The lactate production and content in the embryos increased with increasing concentrations of glucose in the incubation medium, whereas the oxidation of glucose was unaffected by the glucose concentration. The results suggest that the embryonic metabolism of glucose is only marginally affected by changes in the availability of glucose. The lactate production rate was higher and the glucose oxidation rate lower in the embryos of diabetic than in those of normal rats, even when the values for these metabolic variables were normalized to the embryonic DNA content. Thus, a causative role for a disturbance of the glucose metabolism in diabetes-induced embryonic dysmorphogenesis could be envisaged.


Role of the antiglucocorticoid RU 486 in the prevention of steroid-induced hypertension. In the present study, we determined the effect of RU 486 on two experimental models of hypertension in the rat, deoxycorticosterone acetate (DOCA)-salt in nephrectomized rats and spontaneously hypertensive rats. Uni-nephrectomized saline-drinking male Sprague-Dawley rats were divided into three groups and each animal was given either 0.2 ml olive oil (control), 1 mg DOCA, or 1 mg DOCA + 10 mg RU 486 dissolved in 0.2 ml olive oil every third day for a period of three weeks. Within a week of steroid administration, there was a significant increase in the systolic blood pressure (SBP) in the DOCA-salt (157 +/- 3.8 mmHg) and DOCA + RU 486 (155 +/- 2.1 mmHg) treated rats over the control (116 +/- 2.6 mmHg) rats, which remained elevated throughout the experimental period. There was significant increase in the water intake and urine output in DOCA or DOCA + RU 486 treated rats as compared to the control untreated rats. In the experiment involving the spontaneously hypertensive rats, the rats were divided into three groups and each animal given 0.2 ml olive oil (control), 1 mg RU 486, or 5 mg RU 486 dissolved in 0.2 ml olive oil for six weeks. Instead of the expected decrease in the blood pressure, RU 486 significantly elevated blood pressure during the six weeks of drug administration. Water intake, urine output, and weights remained comparable in both groups. We conclude that RU 486 has no effect on the DOCA-salt model of hypertension but, surprisingly, elevates hypertension in the spontaneously hypertensive rats.


Multihormonal response to corticotropin-releasing hormone in inferior petrosal sinus blood of one patient with Cushing's disease: comparison with in vitro secretion of the tumoral corticotropes. A multihormonal response to CRH during inferior petrosal sinus sampling in patients with Cushing's disease has recently been described. Whether it reflects multihormonal secretion by the corticotropic adenoma, or secretion by non-tumorous adjacent cells via paracrine mechanisms remains debatable. We have compared the effect of CRH on ACTH, GH, PRL and TSH secretion during inferior petrosal sinus sampling with its effect on the in vitro secretion of the corticotropic adenoma after excision in one case of Cushing's disease. Before CRH injection in vivo results show significant central-peripheral gradients for all hormones but only ACTH lateralized to the side of the tumor. After CRH administration, the petrosal concentrations of all hormones increased preferentially on the side of the adenoma resulting in significant intersinus gradients: 8.1 for ACTH, 2.0 for GH, 1.8 for PRL and 1.5 for TSH. In vitro results: the adenoma cells were immunostainable for ACTH only. In culture, they secreted ACTH only. Addition of CRH to the culture induced a mean increase of 160% in ACTH secretion but GH, PRL and TSH remained undetectable. Our results favor the hypothesis that the multihormonal response to CRH seen during inferior petrosal sinus sampling in Cushing's disease reflects a paracrine stimulation of the adjacent non-tumorous pituitary cells by the corticotropic adenoma.


HbH disease in Sardinia: molecular, hematological and clinical aspects. In this study we have defined the molecular basis and correlated the clinical phenotype with the alpha-globin genotype in a large series of patients of Sardinian descent with HbH disease. The most prevalent molecular defect was the deletion of 3 alpha-globin structural genes most commonly the (--/-alpha 3.7) genotype (83.6%) and rarely the (--/-alpha 4.2) genotype (1.4%), followed in decreasing order of incidence by the combination of deletion alpha zero-thalassemia and initiation codon mutation of the alpha 2-gene (--/alpha NcoI alpha = 9.8%), deletion alpha zero-thalassemia and pentanucleotide deletion of IVS-I of the alpha 2-globin gene, (--/alpha HphI alpha = 3.3%) deletion alpha zero-thalassemia and initiation codon mutation of the alpha 1-gene (--/alpha alpha NcoI = 1.3%), a homozygous state for initiation codon mutation of the alpha 2-gene (alpha Nco alpha/alpha NcoI alpha = 0.7%). Patients with the (--/alpha thal alpha) genotypes showed severer clinical and hematological features as compared to those with the (--/-alpha) or those with the (--/alpha alpha thal) genotypes. The single patient with the (alpha Nco alpha/alpha Nco alpha) genotype had a clinical phenotype intermediate between HbH disease and the alpha-thalassemia carrier status. This heterogeneity depends on the fact that the alpha 2-globin gene produces 2-3 times alpha-globin chains than the alpha 1-gene and the single remaining alpha 1-like globin gene in the -alpha 3.7 chromosome has a compensatory increase in the alpha-globin chain output. alpha-Globin gene mapping of HbH disease patients may be useful for predicting the clinical outcome and to improve genetic counseling.


Rare inherited bleeding disorders secondary to coagulation factors in Jordan: a nine-year study. This work reports on rare inherited coagulation factors defects which were seen in a developing country over a 9-year period. There were a total of 30 cases which fulfilled this diagnosis. Fibrinogen abnormalities were the most frequently encountered. There were 10 patients with afibrinogenemia, 2 with hypofibrinogenemia and 1 case with dysfibrinogenemia. Factor XI deficiency was found in 7 patients, factor V and VII deficiencies accounted for 3 cases each. Factor X and XIII deficiencies were found in 2 patients each. All these rare deficiencies accounted for 10% of all inherited bleeding disorders in the population studied over 9 years.


A randomized placebo-controlled double-blind study of danazol in hemophilia A. A randomized double-blind placebo-controlled crossover trial of danazol was carried out in 19 cases of hemophilia A. Danazol was given for 3 months at a dose of 150 mg/day to patients under 15 years of age, and 300 mg/day to older patients. The basal factor VIII:C level was 8.3 +/- 5.6% (mean +/- SD), and after 3 months of danazol treatment was 15.3 +/- 11.0% (p = 0.02). Six patients (basal factor VIII:C 2-22%) showed a 1.36- to 2.87-fold elevation of factor VIII:C levels after danazol. 0/2, 1/4 and 5/13 cases of severe, moderate and mild disease, respectively, responded. Decreases in the number of bleeding episodes and cryoprecipitate requirement were seen in the responders. No adverse reactions to danazol were encountered. Danazol appears to raise the factor VIII:C levels in selected cases of hemophilia A.


Comparison of the proliferative activity and sensitivity to cytosine arabinoside of leukemic blast progenitors in acute myeloblastic leukemia at diagnosis and in relapse. To determine whether the biological characteristics of leukemic cells change after repeated chemotherapy, we compared the proliferative activity and drug sensitivity of leukemic blast progenitors in 7 patients with acute myeloblastic leukemia at diagnosis and in relapse. The proliferative activity of leukemic blast progenitors was assessed based on primary (PE1) and secondary (PE2) colony formation in methylcellulose culture and on the recovery of clonogenic cells in suspension culture. The effect of cytosine arabinoside (Ara-C) on leukemic blast progenitors was studied both in methylcellulose and in suspension cultures. PE1 and PE2 values varied among the patients. PE2 of 4 patients out of 7 patients became significantly higher in relapse than at diagnosis. The sensitivity to Ara-C of leukemic blast progenitors deteriorated in 5 patients in relapse. The results suggest that the biological nature in terms of proliferative activity and Ara-C sensitivity of leukemic blast progenitors may change in the clinical course after chemotherapy.


In vitro effect of 1,25-dihydroxyvitamin D3 on proliferation and collagen synthesis by bone marrow fibroblasts. 1,25-Dihydroxyvitamin D3 [1,25(OH)2D3] has been used in the treatment of myelofibrosis and beneficial effects have been observed. The mechanism of this effect still remains unclear. The present study examined whether 1,25(OH)2D3 directly affects bone marrow fibroblast proliferation and collagen synthesis. Third to sixth subcultures of rabbit bone marrow fibroblasts were used. 1,25(OH)2D3 exerts dose-related response-inhibitory effects on collagen synthesis. 1,25(OH)2D3 significantly inhibited collagen synthesis at 10(-9) to 10(-7) M, while 25(OH)D3 was not different from controls. Furthermore, 1,25(OH)2D3 exerted its effect on collagen synthesis without affecting cellular proliferation. Both the cellular protein content and tritium-labeled thymidine incorporation after treatment with either 1,25(OH)2D3 or 25(OH)2D3 were not different from controls.


Myelofibrosis and systemic lupus erythematosus: reversal of fibrosis with high-dose corticosteroid therapy. A case of myelofibrosis in association with systemic lupus erythematosus (SLE) is reported. Acute thrombocytopenia and a bleeding tendency developed in a 24-year-old woman with SLE. Bone marrow aspiration was unsuccessful due to myelofibrosis. Pulse therapy with methylprednisolone reversed both thrombocytopenia and myelofibrosis. A review of the literature revealed that the coexistence of SLE and myelofibrosis is a rare occurrence. Only 7 cases, to our knowledge, have ever been reported in detail. The present case is the 3rd in which myelofibrosis was reversed by corticosteroids.


Central nervous system expression of a monoclonal paraprotein in a chronic lymphocytic leukemia patient. An unusual complication of chronic lymphocytic leukemia (CLL) is reported. The patient, a 79-year-old man, had a long standing history of CLL, that had been complicated by the development of a Guillain-Barré-like syndrome and a peripheral biclonal gammopathy. The biclonal immunoglobulins identified in the serum were IgM lambda and IgG lambda. The patient's condition progressed and he eventually developed ophthalmologic complications. Cerebrospinal fluid (CSF) obtained during evaluation of his visual dysfunction contained numerous small, mature lymphocytes consistent with the presence of CLL cells in the central nervous system (CNS); immunoperoxidase staining of these cells revealed a monoclonal population. Protein electrophoretic evaluation of the patient's CSF showed a single monoclonal band and immunofixation electrophoresis of the CSF revealed that the immunoglobulin present was IgG lambda. No evidence for the monoclonal IgM paraprotein identified in serum could be appreciated in the CSF by immunofixation. Taken together, these findings strongly implied that there was CNS involvement by the leukemia and this process caused the patient's neurologic symptoms. Furthermore, this study demonstrates that chronic lymphocytic leukemia should also be considered as one of the hematopoietic malignancies associated with monoclonal gammopathies involving the CNS.


An unclassified case of congenital dyserythropoietic anaemia with a severe neonatal onset. The case of a 13-year-old child with a congenital dyserythropoietic anaemia (CDA) is reported. A severe anaemia associated with a slight increase in reticulocytes, erythroblastosis, hyperbilirubinaemia, hepatosplenomegaly, generalized oedema and hypoproteinaemia was present at birth. Three exsanguino-transfusions were needed in the first 4 days of life. In the following years a continuous transfusional regimen was maintained in association with a chelating treatment. Bone marrow aspirates showed a striking hyperplasia of the erythroid lineage with ineffective erythropoiesis and changes of erythroblastic nuclei which were double but incompletely separated. Numerous histio-erythroblastic islands were also present. Electron microscopy studies did not show specific alterations of the erythropoietic cells. By a long-term evaluation of the clinical signs and of the haematological data, we came to the conclusion that the case does not fit into any of the three classical categories of CDA.


Autoimmune hemolytic anemia presenting in Sézary syndrome. Report of a case and review of the literature. A 52-year-old man, who presented with Sézary syndrome with autoimmune hemolytic anemia (AIHA) and was successfully treated with corticosteroids is reported. Helper function assay determining immunoglobulin confirmed inducer capability of this clonal population. This patient brings to 4 the number of cases of T cell cutaneous lymphoma and AIHA now reported in the English literature, and is the first case of Sézary syndrome and AIHA thus far.


A familial case of hyper-IgM immunodeficiency. A 22-year-old male was diagnosed as having immunodeficiency with hyper-IgM based upon recurrent pneumonia, marked elevation of serum IgM and markedly decreased level of IgG. IgG-or IgA-bearing B cells were not detected in peripheral blood while a number and a proportion of peripheral blood T lymphocytes were normal. Peripheral blood lymphocytes from this patient proliferated normally in response to T-independent and T-dependent B cell mitogens, and to T cell mitogens. Furthermore, the same type of dysgammaglobulinemia with increased IgM was found in the patient's father and brother. From these observations, it is suggested that it is a rare case of autosomal dominant or polygenal inheritance of hyper-IgM immunodeficiency.


High plasma urokinase-type plasminogen activator levels are present in patients with acute nonlymphoblastic leukemia. An exaggerated hemorrhagic syndrome is a characteristic in acute non-lymphoblastic leukemia (ANLL) and it determines the patient's outcome. Disseminated intravascular coagulation as a result of a procoagulant factor release and primary hyperfibrinolysis due to plasminogen activators also released by leukemic cells have been implicated in the development of this syndrome. The aim of this work was to evaluate urokinase-type plasminogen activator (u-PA) and related parameters of the fibrinolytic system in 14 ANLL patients. Our results showed an increased u-PA concentration in ANLL patients compared to controls [2.63 (1.61-4.62) vs. 0.95 (0.77-1.48) ng/ml, p < 0.01]. u-PA levels correlated positively with tissue-type plasminogen activator. The relevance of the enhancement of u-PA in this clinical setting was supported by the fact that it was the only analytical parameter positively correlated with patient mortality (p < 0.05). Though u-PA levels do not seem to be the determining factor in the development of the hemorrhagic syndrome of ANLL patients, a contributory role of this plasminogen activator is suggested from our results.


[Is it necessary to treat silent myocardial ischemia?]. Since the mid eighties of our century the clinical importance of silent myocardial ischemia, concerning definition, prevalence and pathophysiology is well established. The implication of silent myocardial ischemia, or its combination with other parameters of coronary heart disease on the outcome of ischemic heart disease concerning the endpoints myocardial infarction, myocardial insufficiency or death is still not clear. In consequence therapeutic guidelines at the moment can not be given for the entire spectrum of silent ischemia, whereas some details are becoming more and more evident.


[Is it necessary to treat silent myocardial ischemia?]. At the present time there is no firm evidence that silent myocardial ischemia (on exercise or Holter ECG) should be treated with anti-ischemic drugs. Silent ischemic episodes obviously are a marker for ischemic activity of coronary artery disease and therefore a bad prognostic sign. However, antianginal drugs (nitrates, calcium-blockers, beta-blockers) have not been shown to improve prognosis. Patients with ischemic episodes should be further evaluated by thallium scintigraphy and coronary angiography. If a significant coronary disease is present, the established therapy with risk factor reduction, lipid lowering drugs and aspirin should be administered. In some instances PTCA or CABG may be indicated.


[Early therapeutic intervention in heart failure]. During the past years, several large trials (Consensus, VHEFT I and II, SOLVD) have shown a significant reduction of mortality in patients with moderate and severe heart failure. However, despite effective treatment with vasodilators, digitalis and diuretics mortality in these patients remains unacceptable high. It seems logic, to state treatment at an earlier stage of the disease to achieve more benefit. The main early pathophysiological disturbance is left ventricular hypertrophy, resulting from hypertension, coronary artery disease, increasing age and obesity. On the long run, LVH may lead to diastolic and systolic heart failure, myocardial ischemia, arrhythmias and sudden death. With ACE-inhibitors LVH can be reduced within 1 month of treatment. The large SAVE- and SOLVD-prevention trials will show, whether this early intervention will improve proposis in patients with asymptomatic heart failure.


[Effects of treatment of arrhythmias requiring therapy in dilated cardiomyopathy with amiodarone on alpha human atrial natriuretic peptide]. In a longitudinal study comprising a total of 18 patients, the paradoxical time course of hANP plasma levels, i.e. the reproducibility of the low levels previously reported in cases of extreme cardiac insufficiency after administration of amiodarone, was investigated over a period of 9 months. At the same time, the effect of the degree of cardiac insufficiency and arrhythmia on the secretion of hANP was observed. The patients had been admitted to hospital because of the diagnoses "cardiac insufficiency secondary to cardiomyopathy" or "Grade IVb arrhythmia according to Lown's classification". During in-patient treatment, antiarrhythmic therapy was commenced in all patients. Clinical examinations and determinations of humoral parameters during therapy showed a substantial number of patients, who exhibited no increase in hANP levels despite massive cardiac decompensation. As far as drug therapy of patients with severe arrhythmias secondary to congestive (dilated) cardiomyopathy is concerned, amiodarone has proved to be the drug of choice in combination with digitalis, ACE inhibitors and diuretics. There is a close correlation between the degree of cardiac insufficiency and plasma hANP levels.


[Abnormal origin of the ramus circumflexus sinister from the left atrium in a 30-year-old patient with aortic isthmus stenosis and atrial septal defect]. In this case report a 30-year-old woman suffering from progressive angina pectoris and dyspnea, having been operated on previously for atrial septum defect at the age of 19 and later aged 24 for coarctation of the aorta, is described. Upon observation, patient showed cardiac symptoms already under mild stress and remained resistant to nitroglycerin. Rest-ECG and serum cardiac enzymes were repeatedly without findings, while stress-ECG at a level of 100 W showed a ST-segment depression of 0.15 mV, at the same time complaining of angina pectoris symptoms. Coronary angiography revealed a left circumflex coronary artery arising from the left atrium being fully supplied by the left anterior descendent artery and the right coronary artery via pronounced collaterals, both originating from the ascending aorta. Despite such severe symptoms patient refused surgery suturing the abnormally arising artery. One year following coronary angiography patient is suffering from stabile angina pectoris without occurrence of myocardial infarction or another cardiovascular event.


Carbon dioxide embolism during laparoscopy: a case report. A 28-year-old female with a diagnosis of multiparity was scheduled for laparoscopic tubal ligation. The patient had an unremarkable medical history, except that she had been a pack-a-day smoker for the past 10 years and had experienced a recent upper respiratory infection. General anesthesia was accomplished without incident, and insufflation of the abdomen with carbon dioxide (CO2) gas was begun. During insufflation the end tidal carbon dioxide (ETCO2) level dropped dramatically, ECG changes were noted, and vital signs deteriorated with the subsequent development of cardiac arrest. The patient was successfully resuscitated, fully awake, and extubated approximately 1 hour after the incident. A CO2 embolus caused by CO2 insufflation was suspected. In laparoscopic procedures, the use of CO2 gas is an efficient and inexpensive means of improving visualization of the abdominal cavity. The effect of CO2 insufflation on the patient should be given special consideration in these cases. Although serious complications associated with the use of CO2 gas are rare, such procedures must not be viewed with complacency. A protocol for the management of emergency situations should be developed and reviewed.


AANA journal course: update for nurse anesthetists--managing human immunodeficiency virus and acquired immune deficiency syndrome during anesthesia care. The human immunodeficiency virus (HIV) and its advanced progression to acquired immune deficiency syndrome (AIDS) has had a greater impact on our society than any other disease entity during this century. Throughout the past decade the prevalence of HIV disease has grown to pandemic proportions throughout many regions of the world. The infectious and often fatal nature of HIV has made AIDS the most threatening epidemic currently facing modern medicine. A myriad of fears concerns, challenges, and frustration face all healthcare providers whose awareness and impact on practice is continuously challenged. Every nurse anesthetist is responsible for maintaining the ability to both prevent HIV disease transmission and appropriately care for HIV-infected patients during anesthesia care. Experience throughout the past decade of a continuously increasing prevalence of both HIV and AIDS has provided a wealth of information and knowledge that continues to enhance patient care. The following AANA Journal Course will present a current overview of HIV disease and considerations for providing quality anesthesia care while preventing disease transmission.


Attitudes of certified registered nurse anesthetists toward AIDS and AIDS patients. This study was intended to examine and identify the nature of CRNAs' attitudes concerning acquired immune deficiency syndrome (AIDS) and patients with homosexual lifestyles. This research question has been previously addressed using sample populations of registered nurses, physicians, and medical students. This inquiry was conducted using a sample population of nurse anesthetists. The target population was 500 CRNAs who reside in areas of high AIDS incidence--New York City, San Francisco, and Houston. The participants were equally divided among the three cities using a randomized list provided by the AANA. The design for this study was an experimental 2 x 2 factorial with two independent variables: disease of the individual, either leukemia or AIDS, and the sexual preference of the individual, either heterosexual or homosexual. The randomly distributed questionnaire consisted of three scales: the interpersonal attraction inventory, the prejudicial evaluation scale, and the social interaction scale. Multivariate analyses of variance (MANOVA) were conducted not only on the main effects, disease and sexual preference, but also on the interaction effects of disease and sexual preference. The significant findings of the MANOVAs were subjected to factorial analysis for each scale, and then the MANOVAs were conducted again. The statistical analysis indicated that CRNAs possess a negative attitude toward AIDS patients but not toward leukemia patients. Their attitudes are based on their perception that AIDS patients are responsible for their illness. Potential behavioral consequences were also reported by CRNAs, based on these attitudes.(ABSTRACT TRUNCATED AT 250 WORDS)


The effect of pH-adjusted 2-chloroprocaine on the duration and quality of pain relief with a subsequent continuous epidural bupivacaine infusion. A randomized, double-blind true experimental design with a post-test only was chosen to determine if the addition of sodium bicarbonate to 2-chloroprocaine would result in a longer duration of epidural analgesia, as well as increase the quality of pain relief in stage I parturients receiving a continuous bupivacaine epidural infusion. The experimental group (number (N) = 16) received sodium bicarbonate and 2-chloroprocaine followed by a continuous bupivacaine epidural infusion. The control group (N = 15) received normal saline and 2-chloroprocaine followed by a continuous bupivacaine epidural infusion. Only ASA I or II patients in stage I labor were included in this study. Measures of pain perception were made using a self-report, visual analog scale. Measures also were made of the quality and duration of block over time, the intensity of motor block over time, and the blood pressure over time. The cephalad dermatome level of analgesia was determined by pinprick. A record of the need for a supplemental bolus of local anesthetic to maintain a sensory level of T-10 was also recorded. The mean self-perceived level of pain was significantly different for the two groups (P = .024). Moreover, the pattern of self-perceived level of pain over time differs for the two groups in a significant way (P = .023). Additional bolus injections occurred nine times in the control group and six times in the experimental group. The differences were not found to be significant (P > .106). The differences in time and amount of local anesthetic delivered were also found to be trivial (P > .80).(ABSTRACT TRUNCATED AT 250 WORDS)


Iron overload of the bone marrow by trimethylhexanoyl-ferrocene in rats. Iron-deficient female Wistar rats were fed a diet which contained 0.5% 3,5,5-trimethylhexanoyl (TMH)-ferrocene over a 57-week period. The state of iron deficiency was characterized by means of the absence of stainable iron in the bone marrow. After the first days on the iron-enriched diet, ferritin-containing siderosomes were found, in numerous erythroblasts up to orthochromatic normoblasts and in reticulocytes, i.e. the dispensed iron was used for haemoglobin synthesis. After 1 week the first macrophages showed a positive Perls' Prussian blue reaction. In the cytoplasm they stored the iron in the form of free ferritin molecules and lysosomally as aggregated ferritin and/or haemosiderin. The iron loading of the macrophages increased in both of the storage qualities proportionally with duration of the feeding period and reached a maximum after 38 weeks. Final stages showed extremely iron-loaded macrophages with high concentrations of free ferritin molecules and large siderosomes, partially flowing together to still greater units. Iron deposits within endothelial cells of bone marrow sinusoids can be observed for the first time after 4 weeks. In these cells the iron is stored as ferritin in siderosomes of relatively small and uniform size; free ferritin molecules in the cytosol were of only slight concentration. The TMH-ferrocene model of iron overload shows in the bone marrow: (1) an unimpeded utilization of the iron component for erythropoiesis, (2) development of excessive iron overload of the bone marrow in macrophages and endothelial cells of sinusoids and (3) a pattern of distribution of iron as seen in secondary haemochromatosis.


An increase in thymocyte proliferation during pseudopregnancy in two inbred strains of rat. Coitus is a unique physiological event which may result in internal fertilization, whereby active allogeneic spermatozoa are presented to the female host which can invade her tissues. Sterile coitus on the other hand, stimulates the uterine cervix in the rat and induces a physiological state of pseudopregnancy which interrupts the normal pattern of the oestrous cycle and establishes a persistent dioestrous state. This state is hormonally controlled and in its early stages is not dissimilar from that of true pregnancy. Pregnancy hormones are known to influence the immunological status of the female. Thymic observations during early pseudopregnancy showed interstrain differences in weight, cell content and thymocyte proliferation. Pooled data indicated increased cell density on days 3, 4 and 5 of pseudopregnancy associated with a peak of mitotic activity on day 3 in both strains. The timing of this proliferative activity seems to reflect the needs of the immune system in its putative response to mating and implantation.


The innervation of the lymphoid tissue at the ileocolonic transition: an enzyme and immunohistochemical study. Using enzyme and immunohistochemical methods on whole-mount preparations and cryostat sections, a morphologic and semiquantitative study was performed of the nervous tissue in the appendix and the ileum (areas with and without Peyer's patches) of the rabbit. The plexus submucous externus (Meissner) consists of a network of small ganglia, vaguely associated with the vascular submucosal plexus. From the nerve cell bodies, cell processes occasionally penetrate the lymphoid follicles at the junction between the mucosa and the submucosa while other extensions form a dense plexus in the lamina propria of the mucosa. No nerve fibers are present in the dome of the follicles. The plexus submucous internus (Henle), consisting of large cell bodies and large processes, closely follows the blood vessels. The numeration of the nerve fibers of the submucosal plexus endorses the histological finding that the appendix is a richly innervated lymphoid organ. In addition, the plexus myentericus (Auerbach) of the appendix is a network of small meshes, while in the ileum, in the area of Peyer's patches, the same plexus is composed of a network with large meshes. These differences point to a higher density of innervation in the appendix. Yet a specialized anatomic distribution of the innervation of lymphoepithelial structures cannot be demonstrated.


Weaning and the histology of the mandibular condyle in the rat. Eighty-eight Long Evans/Turku rats were used in the study. The effect of the articulatory function on the mandibular condyle was observed histologically during normal growth, when the rat is changing its diet from milk to whole pellets as a part of weaning. Six animals each were killed at the age of 10, 15, 20, 25, 30, 35, 40 and 50 days for histological tissue processing. For further information, 30 animals were fed a soft diet (6 animals each were killed at the age of 25, 30, 35, 40 and 50 days), and 10 animals were fed hardened pellets (2 animals each were killed at the ages of 25, 30, 35, 40 and 50 days). An even and regular transition from mesenchymal cells via immature chondroblasts into mature chondroblasts and hypertrophied chondrocytes was found at 10, 15 and 20 days during normal growth and also at 25, 30, 35, 40 and 50 days when animals were fed a soft diet. This maturing process appeared to be disturbed at the age of 25, 30, 35 and 40 days in the superior aspect of the condyle in animals fed ordinary pellets. The density of the mesenchymal cell layer was decreased, and the amount of intercellular matrix seemed to be evaluated in mesenchymal and intermediate cell layers. These features were later manifest deeper in the cartilage as acellular regions and as cell clusters. The changes were similar but more severe when the animals were fed hardened pellets.(ABSTRACT TRUNCATED AT 250 WORDS)


Immunohistochemical study of carbonic anhydrase III in the extraocular muscles of human embryos. The differentiation of extraocular muscles was studied immunohistochemically in externally normal human embryos (Carnegie stages 13-23), using antibodies to carbonic anhydrase (CA) III and beta-enolase as the markers of type 1 and type 2 muscle fibers, respectively. At stage 18, some myoblasts were immunoreactive to beta-enolase antibodies, however, CA-III immunoreactivity was not observed around the optic vesicle. At stage 20, CA-III immunoreactivity appeared in some muscle fibers of extraocular muscles. From stage 21 to stage 23, CA-III-immunoreactive fibers increased and almost equalled the number of beta-enolase-immunoreactive fibers. These findings suggest that CA-III-immunoreactive type 1 fibers appear in the late stage of myogenesis compared with beta-enolase-immunoreactive type 2 fibers.


[The origin and distribution of cartilage canals in the chick embryo]. 113 femurs and 111 tibias originating from chick embryos 8-21 days after incubation were injected with Indian ink and made transparent. The origin and distribution of cartilage canals are described. The existence of a pattern of segmental distribution, atypical canals and anastomosis between epiphysial canals and diaphysial marrow processes is reported.


Measurements of cross-sectional areas in selected human wrist-joint ligaments. The cross-sectional area of a particular ligament is an important characteristic in order to establish the biomechanical properties of this ligament. Calculations of the cross-sectional areas of the ligaments of the wrist joint are made from two three-dimensional models. It is discussed that differences between the presented and the scarcely published data on cross-sectional areas are the result of different divisions of the wrist-joint ligamentous complex into separate ligaments.