Itch in liver disease: facts and speculations. Pruritus in hepatobiliary disease is commonly believed to be caused by retention of bile acids with their sequestration in the skin. HOwever, we have recently demonstrated that skin levels of bile acids in patients with cholestasis correlate poorly with pruritus. In this report, we present additional data concerning the relationship of pruritus to bile acid retention: (1) the urinary excretion of sulfated and nonsulfated bile acids was not significantly different in patients with cholestasis who itched compared to those who did not; (2) one patient with itch associated with a liver abscess had normal levels of bile acids in serum, skin, and urine; (3) patients with primary biliary cirrhosis who itched had lower serum bile acid levels than patients with mechanical biliary obstruction who did not itch.These studies support our premise that pruritus in hepatobiliary diseases is not directly related to bile acid retention. They suggest that the type of cholestatic disorder, and not simply the magnitude of the cholestasis, as estimated by the elevation of serum bile acids, is important. We propose that the agent responsible for pruritus is produced in response to cholestasis, possibly through activation of the alternate pathway of bile acid synthesis. Properties of the hypothetical pruritogen are discussed.


Hepatic copper accumulation in primary biliary cirrhosis. Hepatic copper accumulation is a regular feature of primary biliary cirrhosis (PBC). The levels are directly related to the clinical stage of the disease. Since the copper values in PBC are comparable to Wilson's disease, there is the potential for copper toxicity, although this is speculative since the two diseases differ in the binding, distribution, and intracellular localization of the copper. The involvement of copper toxicity in the progression of PBC is supported by the observation that the highest values occur in association with the hepatic failure that occurs in the advanced stage.Corticosteroid therapy appears to decrease hepatic copper levels in PBC. Although this therapy does not invariably lower the hepatic Cu content in patients with PBC, it does so in many individuals. Therapeutic trials with d-penicillamine are in progress. When results are available they will guide us in the management of individual patients with PBC. In the meantime, dietary copper should be restricted as is done in management of Wilson's disease.


Familial intrahepatic cholestasis: an update. Familial intrahepatic cholestasis is a confusing group of syndromes. Four forms are defined and discussed in detail ("arteriohepatic dysplasia," the Byler syndrome, the THCA syndrome, and Norwegian cholestasis). A comparison of the distinguishing characteristics of these syndromes demonstrates that they share many features, including areflexia, retinal degeneration, and paucity of the intrahepatic bile ducts on biopsy. Alternatively, some traits appear to be specific for a single syndrome: posterior embryotoxon and bony anomalies for arteriohepatic dysplasia, the presence of an abnormal bile acid for the THCA syndrome, and giant cell transformation for Norwegian cholestasis. These syndromes, although rare, merit complete evaluation because, as nature's experiments in bile formation, they represent models of cholestasis and may provide clues to the understanding both of other forms of cholestasis of unknown etiology and of the normal mechanisms of bile formation.


The three syndromes of fat embolism: pulmonary manifestations. The clinical course and radiographs of 30 patients with fat embolism syndrome were reviewed. In all cases the classic triad of neurologic dysfunction, respiratory insufficiency, and petechiae were present. Three responses to embolized fat were noted. The hyperacute response was seen in two patients with paradoxical embolization of fat to the systemic circulation. A "classic response" was noted in 18 patients with transient respiratory compromise and variable radiographic findings. The two deaths in the group responding in the classical manner were attributed to massive pulmonary emboli. The third response, noted in ten patients, consisted of a chest radiograph compatible with pulmonary edema in the clinical setting of the adult respiratory distress syndrome. In this group the degree of respiratory dysfunction and pulmonary damage correlated with the development of disseminated intravascular coagulation. Pathologic correlations are presented and the mechanisms by which embolic fat produces tissue damage are discussed.


Feminization of chronic alcoholic men: a formulation. A review of the factors historically thought to contribute to the feminization of men with Laennec's cirrhosis is presented. Objective scientific data is presented both in support of and in rejection of such factors when available. Recent hypotheses about the significance of an altered estrogen to androgen (E/T) ratio as being important in the pathogenesis of feminization also are discussed. Finally, a hypothesis which incorporates the findings of hypogonadism and cirrhosis with portal-systemic shunting is presented as a pathogenic mechanism for the feminization of men with alcohol-induced Laennec's cirrhosis.


[Studies on sleep quality in old age].

[Studies on sleep quality in old age]. A survey of 480 randomly chosen men and women over 65 years of age observed complaints concerning the quality of sleep in 26%, the use of sleeping drugs in 33%; complaints and/or drugs were found in 45% of cases. On the average complaints were more often made by women. The percentage of men complaining increased from 65 to 90+ years. In the group over 90 years of age both sexes showed the same frequency. The quality of sleep was correlated with self-rated health-status, mobility and impairment especially of the cardiovascular system. No correlations were found with contentment, place of residence, noise, outdoor exercise and socioeconome status. Sleeping drugs were most effective in subjects with cerebral impairment and of least effect when subjects suffered from cardiovascular trouble.


[Differential diagnosis of sleep disorders in old age]. Somnipathy represents neither an independent disease nor a nosological entity. The simple formulated complaint: "I can't sleep" requires a very detailed investigation of the surrounding conditions, habits and the physiological situation of the patient. Further one has to consider, resp. to rule out a great number of causes of diseases, i.e. those of the internal organs, the central nerve system and the psyche. The majority of cases of somnipathy in elderly patients reveals a treatable cause, of the prescription of hypnotics becomes unnecessary.


[Fine-structure changes in Toxoplasma gondii trophozoites after deep-freezing with dimethyl sulphoxide (author's transl)]. The changes observed in trophozoites of Toxoplasma gondii after deep-freeze preservation were examined by electron microscopy. Toxoplasmas (strain BK) from peritoneal exudate of infected NMRI mice were supended in Ringer's solution, deep-frozen in liquid nitrogen with 5% dimethylsulphoxide (DMSO), and compared after thawing with control samples with and without the addition of DMSO. Slight structural changes such as widening of endoplasmic reticulum, formation of fissures in the cytoplasm, and loosening of chromatin were only observed in some of the free toxoplasmas of the DMSO control. Among the deep-frozen parasites, about 1/5 of the free stages showed no or only slight morphological changes. In contrast to this, almost all intracellular forms found in macrophages showed lesions. The most remarkable change was a partial destruction of the inner cell membrane complex. The outflow of ribosome-containing protoplasm with ballon-like swelling of the outer elementary membrane was observed as a consequence of this frequent lesion. The outflow of protoplasm induced a drastic decrease in the electronic density of the whole cytoplasm. Other characteristic degenerative signs were vacuolation of cytoplasm up to formation of great optically empty spaces, widening of the perinuclear space, swelling of mitochondria, disintegration of rhoptria, micronemata, and Golgi zone, coarse-plaque loosening, and displacement of electron-dense areas of the nucleus up to disintegration with maintenance of the karyoplasm. In some almost completely disintegrated trophozoites, enlarged mitochondria with remarkable electronic density were observed. Apart from the cell membrane, the conoid was the longest-persisting organelle. The alterations observed after deep-freezing permit the conclusion that the free cells, which were only slightly impaired or not at all, remained infective.


[Sleep disorders in a isolation situation. Hyposomnia in older convicts]. Modern world is hostile to sleep and by its achievements it disturbs our hereditary biological rhythm. About 80% of all the cases of hyposomny are caused by emotional disturbances in the broadest sense. Somnipathy in a prison shows of course considerable characteristics, although here, too, we can find the same problems a normal doctor working outside a prison has to cope with. 54% of all the inmates of the prison in Straubing (= JVA Straubling) complain about somnipathy; from the prisoners more than 50 years old only 43%. Physical diseases cause somnipathy within 19% of the older prisoners where we find predominantly heart-diseases and circulatory diseases. 5% of somnipathy are due to an abuse of coffee or nicotine and the rest is due to emotional disturbances in the broadest sense. The normal medical treatment for simple somnipathy is of no success in a prison and the prisoners abuse the normally used medicaments to get into a state of ectasy. Therefore medicaments on a vegetable basis are used, also neuroleptica and medicaments against depression, where there is practically no danger for addiction.


[Management of sleep disorders from the geriatric psychiatry aspect]. Sleep disorders are a common phenomenon in patients of all age groups and often are not easy to influence. In geriatric patients sleep disorders are even more common and often are the main complaint. In addition to pharmacotherapeutic approach with a number of different psychotropic drugs non-drug procedures should also be used in the treatment of geriatric and psychogeriatric patients and combinations of different therapeutic approaches can be indicated. With every patient complaining of disturbed sleep a careful exploration of the origin of the sleep disorder is imperative prior to treatment.


Changes in worm burden, haematological and serological response in rats after single and multiple Angiostrongylus cantonensis infections. Thirteen groups of rats were first sensitized with single or double doses of 5--30 third-stage larvae of Angiostrongylus cantonensis, followed by a challenge infection with 100 larvae at various periods after the primary infection. Seven other groups of rats receiving only the sensitizing infection served as the controls. In all the sensitized rats, a significantly (p less than 0.05) smaller mean number of adult worms was found established in the challenge infection as compared to the control. The frequency of the sensitizing dose and timing of the challenge infection appeared to influence the intensity of the host's response. There was no conclusive evidence to indicate that the immune response could retard the growth, development, or sex ratios of the worms established in subsequent infections. A positive haemagglutinating antibody response was first observed in some rats as early as four weeks post-infection with 100 larvae when the worms began migrating from the brain to the lungs. The antibody response and eosinophilia were most pronounced during the oviposition of the female worms and hatching of first-stage-larvae. Changes in white blood cell, lymphocyte, and neutrophil counts were also followed in some groups.


Discussion of the relationships between Schistosoma and their intermediate hosts, assessment of the degree of host-parasite compatibility and evaluation of schistosome taxonomy. Studies of the spectrum of the intermediate hosts of schistosomes and the relationships between parasites and intermediate host snails have been carried out with each researcher using different methods. A comparison between compatibility studies has therefore been impossible. The following three basic problems in these kind of studies are discussed in this paper: (1) the standardization of experimental materials such as schistosomes, intermediate and final hosts, (2) the methods involved in the experiments, and (3) the sort of data which must be collected. Standardized methods and materials are described in this paper. The relationships between the genus Schistosoma and the intermediate host snails belonging to the two genera Biomphalaria and Bulinus, and the mechanisms behind the process resulting in various degrees of compatibility between the two involved organisms are reviewed and discussed. Why certain combinations of schistosomes and snails result in the production of cercariae and others do not is still unknown, but there is now some indication of a camouflage behaviour during the intramolluscan stages, e.g., the larvae in the snails cover themselves with snail material and are not recognized as foreign objects. The same mechanism has already been found in the schistosomules in the final host. Much of the confusion in the discussion of the relationships between schistosomes and intermediate hosts is the result of a lack of an objective way to describe and assess the compatibility between the two. Based on a series of experiments with S. haematobium, S. intercalatum, S. bovis, S. mansoni, and several species of possible intermediate hosts, the following index for estimating the degree of compatibility is proposed: the total cercarial production from 100 exposed snails (TCP/100 exposed snails). Seven classes have been suggested: the first one (Class 0) with a TCP/100 exposed snails of zero, is called 'refractory'; the next one (Class I) called 'not very compatible' has a TCP /100 exposed snails between 1 and 10,000; the last group (Class IV) called 'extremely compatible' produced more than 500,001 per 100 exposed snails during the entire lifespan. The ability to use a spectrum of intermediate hosts and the compatibility in the taxonomy of schistosomes is discussed. The results for the different species of schistosomes indicated that each species consists of strains with 'hybrid populations' in between.


[Reflection of the phases of conditioned reflex placing of the paw on a support in the activity of motor cortex neurons in cats]. In four cats trained to respond with the placing of a fore-leg on a support to both tactile stimulation of the leg and to electrostimulation of the primary motor and sensory cortical areas, of the ventral posterolateral nucleus of the thalamus and of cerebral peduncles, the activity of 77 cortical neurones in the area of motor representation of anterior contralateral extremity was studied before the conditioned movements and during them. The pattern of activity in approximately 83.9% of the studied neurones 200 s before the instrumental placing movement was constant for this movement and did not depend on the type of its trigger (p = 0.01). The activity of such neurones probably reflects the formation of the program of the forthcoming movement at the motor cortex level.


[Autonomic reactions during mental activity in 4--7-year-old children]. The paper deals with formation of the complex of effector vegetative components of mental activity (on the model of sum doing) in the children under school age (4-5 and 6-7 years old) with different correlation of direct and verbal stimuli. It is found that the perception and processing of direct signals (kinesthetic, visual) creates optimal conditions for voluntary activity and its vegetative provision. Processing of the information with second signal significance worsens the performance of mental operations and of their vegetative provision particularly in 4-5 years old children (as compared to 6-7 years old ones).


[Interhemispheric EEG-asymmetry in 5--7-year-old children]. Interhemispheric asymmetry (IHA) of the theta-rhythm in the frontal, central, parietal, occipital and temporal cortical areas was studied in 5-7 years old children. The children performed visual-spatial (drawing mosaic) and verbal (reciting, associative experiment) tasks. IHA was also estimated in the state of rest, when a child doesn't move with his eyes open. It is found that in the state of rest the theta-activity is predominant in the right hemisphere in all cortical areas. During performance of visual spatial tasks this correlation does not change significantly. During verbal activity IHA values shift towards the left hemisphere. These changes are mostly pronounced in the frontal and temporal cortical areas where the left-side asymmetry of the theta-activity is revealed. In the central areas no significant IHA is recorded; in the parietal and occipital areas the theta-rhythm is predominant in the right hemisphere. The data obtained suggest a functional specialization of the hemispheres in 5-7 years old children. The left hemisphere is more active during verbal activity whereas the right one plays the leading role both during visual-spatial activity and in the organization of the rest state.


[Effect of long-term electric stimulation of the head of the caudate nucleus on alimentary secretory reflexes in dogs]. In chronic experiments on dogs with implanted electrodes prolonged (30 min) subthreshold (20-30 mca) low-frequency (1 imp/sec) stimulation of the dorsal part of the caudate nucleus head inhibited the achievement of conditioned secretory alimentary reflexes. High frequency (100 imp/sec) stimulation under the same experimental conditions facilitated conditioned and unconditioned alimentary secretory reflexes. Under the influence of stimulation--high-frequency stimulation in particular--of the dorsal part of the caudate nucleus head differentiation inhibition tends to disinhibition.


[Changes in the excitability of command neurons during the initial period of conditioned reflex formation in grape snails]. The procedure of elaboration of conditioned defensive pneumostomum closure was reproduced in neurophysiological experiments on half-intact preparation of the snail. Activity of identified command neurones involved in the reinforcing unconditioned reflex, was recorded intracellularly. Conditioned and unconditioned stimuli converged on these neurones. Excitability of the explored command neurones increased during the first stages of conditioning. Appearance and consequent intensification of the initially absent spike response to the conditioned stimulus was essentially due to this excitability change. Command neurones action potentials evoked by the conditioned stimulus elicited some effector reactions which were the first signs of conditioning. The conclusion is made that the excitability changes in certain nerve cells are essential for determining the initial phase of conditioning.


[Frequency of self stimulation in cats when two parameters are changed simultaneously]. In cats, with electrodes implanted in the lateral hypothalamus a dependence was obtained of self-stimulation frequency (SSF) on paired changes of current strength and each of other stimulation parameters-duration, pulse duration and frequency. In some cases these parameters may independently affect SSF but generally they are in interaction. For stimulation with electrodes located at the level of the hypothalamic ventromedial nucleus, two-peak dependences of SSF on the current strength and the duration of stimulation pulses were obtained. An attempt to describe empirical response surfaces with a regression equation with members of not higher than 4-th order led to an insufficient accuracy of approximation as compared to the results obtained previously on rats. The cause of this insufficiency as well as two-peacked SSF dependencies are discussed in terms of morphofunctional heterogeneity of activated brain structures.


[Evoked potentials in the auditory cortex with systematic use of standard series of stimuli on the internal geniculate body]. Standard series of short electrical stimuli of the medial geniculate body were systematically applied to dogs with chronically implanted electrodes. Gradual formation was observed of a dependence of amplitudes of averaged EPs in the auditory cortex on the consecutive place of the stimulus in the series. This points to the existence in the dog's central nervous system of an elementary form of counting not only adequate signals, as has been previously shown, but also electrical stimuli of the thalamic nucleus. In contrast to what was observed in response to clicks, the EPs amplitude of MGB electrical stimulations increases by the middle of the series and diminishes by its end. It has been assumed that the cortical level of the analyser to which the stimulation was applied, suffices for the formation of the above phenomenon.


[Possible model of interaction between areas of the cat cerebral cortex]. The effect of neuronal activity of one area in the cerebral cortex on the activity of another area was studied on adult alert cats with algorhythm of estimation of dependence and backward connection. On this basis a structural-functional model was developed of interaction between the visual and somatosensory cortical areas in the periods of aftereffect of repeated photic stimulations. This algorhythm permits to determine quantitatively the weight and direction of the mutual influences of these areas as well as to calculate approximately the volumes of the cellular masses which may participate in the formation of connections between these areas. It is assumed that the model may be used as one of the numerous means of studying the complex pattern of brain structures interactions.


[Reactions of visual cortex neurons to painful stimulation]. Responses of 18 neurones of the first cortical projection visual area to photic and nociceptive stimulation (plunging of a paw into hot water) were studied in immobilized cats. The increase in blood pressure recorded in the femoral artery served as index of pain response. During plunging the paw into hot water 14 neurones showed an increase in the frequency of spike activity by 3 times as compared to the background. The changes in spike activity preceded the increase in the arterial pressure by 1-2 sec. 12 out of 14 neurones also responded to a photic stimulus. After administration of chlorpromazin the neuronal response to the nociceptive stimulus was blocked, but the response to the photic stimulus persisted. A conclusion is made that pain excitation reaches cortical visual neurones through functional connections, which are different from those functioning during activation of the same neurones with specific photic stimulus.


[Cerebral evoked potential recovery cycles following exposure to a constant magnetic field in rats]. The recovery cycles of somatosensory evoked potentials (EP) in the cerebral cortex, hypothalamus and cerebellar cortex were studied in experiments on rats. During the action of constant magnetic field (CMF) with an intensity, subthreshold for the changes in biopotentials, as well as after intensive magnetic influence, the recovery of the response to test stimulation of the nerve was more rapid and more complete, the duration of areactivity and subnormality periods was reduced and phenomenon of facilitation was observed. The obtained data testify to a rise in the level of excitability of the studied brain structures under the effect of CMF. Paired stimulation of sciatic nerve with definite interstimuli intervals may also lead to the intensification or provocation of the "magnetic effect"--the appearance in the EP structure of additional phases under the effect of the subthreshold field.


[Effect of damage to the serotonin- and noradrenergic systems of the brain on alimentary and defensive conditioned reflexes in rats]. A study was made on 79 Wistar male rats of the influence of destruction of single nuclei in the brain serotonin- and noradrenergic systems on their learning with alimentary and pain reinforcements. Electrolytic lesion of the raphe dorsal and medial nuclei hindered the formation of alimentary conditioned reflexes, while facilitating the elaboration of a conditioned active avoidance reaction. Destruction of the locus coeruleus was attended with improved alimentary learning, while the elaboration of conditioned active avoidance reaction proved to be more difficult as compared with that in the control animals. A conclusion is drawn that the nature of the influence of local ablation of individual nuclei in the brain serotonin- and noradrenergic systems on animals' learning is determined by the emotional sign of the reinforcing stimulus.


[Analysis of hippocampal RNA in rats with genetically determined differences in their ability to learn]. Selection for twelve generations, by the speed of elaboration of a food-procuring motor conditioned reflex, produced an increased intensity of the synthesis of n and c fractions of the hippocampal RNA in rapidly learning animals as compared with those slowly learning. Electrophoretic analysis of the two fractions revealed similar series of RNA classes in the initial and the learning animals' groups. With high molecular RNA classes, insertion of the radioactive precursor was higher in the rapidly learning animals than in the slow learning ones. The learning process was attended with an increased insertion of the radioactive precursor in the area of high molecular n-RNA classes and in the area of 18S-4S RNA c-RNA. The percentage of radioactivity inserted in the poly-A RNA, as well as a change due to learning were significantly higher in the rapidly learning animals.


[Evaluation of research findings of potassium metabolism through biological modeling]. The cybernetic modelling of the water balance and the electrolyte balance has a heuristic value for the physiology and pathophysiology, by clearing up connections and open problems. This concerns problems of regulation size and regulation extension, but also the validity of reference values. Under this aspect is referred to the significance of steady state, input- and output inbalances and of the static and dynamic characteristics in the examination of the functional performance of the regulation circle. The static and dynamic compartment modelling is discussed at the instance of the potassium balance and exemplarily confirmed by findings of examinations. Here is referred to the special information value of the dynamic compartment analyse, as apart from the pool sizes (capacities) also intracorporal turnover rates (effects) are established.


[The effect of training on the physical fitness of patients with chronic kidney failure]. Apart from the specifically uraemically conditioned decreasing in vitality factors a physically inactivity which originates from the want of the patient or is iatrogenically induced, respectively is one of the causes for the decrease in physical vitality in patients with chronic renal insufficiency. 10 patients with chronic renal disease (serum creatinine 9.2 mg%) after an ergometric test were trained regularly twice a week for 30 minutes with a training intensity which corresponded to 80% of the load intensity. After a training duration of 15 weeks 9 of the 10 patients yielded a better result, in one female patient the bicycle-ergometric effect remained constant. The physical load capacity of the successfully trained 9 patients increased by 22.2 W from 80,5 W to 102.7 W. This corresponds to a 27.6% increase in vitality. After the end of the training the patients achieved a result which is higher than that of untrained patients with renal insufficiency in the same region of insufficiency. In comparison to healthy persons of the same age before the training the patients were to be loaded with 71% and after the training with 92% of the normal. The result of the training can also be read at a decrease of the heart rate and at a shortening of the recreation phase after constant load. The significant decrease of the systolic blood pressure on the 50 W-step indicates to a favourable influence of the RR-behaviour.


[Ophthalmologic studies of chronic hemodialysis patients]. The authors have examined 27 patients who participate in the chronic haemodialysis programme. It was established that the hyperphosphataemia, the hypocalcaemia and the later hypercalcaemia which developed in consequence of the chronic renal insufficiency are the cause of the calcification of the cornea and of the conjunctiva. In order to pursue this process the slit-lamp examination is recommended as necessary and useful method. The authors consider frequent neither the existence of the "red eye" symptom nor the development of a cataract.


[The significance of social factors in the genesis of psychic substructures. Suggestion on the schematic description of internalization in psychoanalytic theory]. In the conceptformation concerning the genesis of mental substructures, classic Psychoanalysis has much more stressed instinctual conflict conditions than psychosocial ones. The authors present a schematizing attempt which permits a description of the structure forming part of psychological processes following the internalization of social offers. A distinct disproportion of the modes of internalization is presumed for the social low and lower middle class. A normative, a final, a cognitive, a selfimage related, and an operational mode of psychosocial internalization are proposed.


[Work addiction].

[Work addiction]. The symptomatology of workaholism (work addiction) was presented in the form of a questionnaire and compared with other forms of addiction, especially alcoholism. Then a case was used as example to illustrate the development of the illness and its psychodynamics. The therapy procedure was also briefly explained. Moreover the psychodynamics of workaholism (work addiction) are described, once again in comparison to other addictions. Finally the author gives general guidelines for therapy.


[Serum complement and protein metabolism in chronic dialysis patients]. 1. When a so-called free diet is granted there is the danger of a protein deficit, which can be proved in a significant decrease of the serum transferrin and of the complement factor E3c, in patients in the chronic haemodialysis programme. 2. Within the group undergoing dialysis a correlation analysis did not result in a statistically ascertained connection between the complement factor C3c and the total haemolytic activity and the transferrin, respectively. 3. On the basis of a diet analysis a connection between the protein supply and the serum transferrin level could be established, which was not to be proved for the complement factor C3c and the total haemolytic activity, respectively. 4. Low transferrin values in the serum seem to be followed by a deterioration of the anaemia situation of the patient undergoing haemodialysis. 5. Compared with the total haemolytic activity and the complement factor C3c the determination of the serum transferrin allows an essentially exacter information about the protein metabolism of the patient undergoing a chronic haemodialysis.


[Kidney cyst puncture for diagnosis and therapy]. It is reported on 38 punctures of avascular space occupying lesions of the kidney. The method is little stressing and poor of risk. It is recommended above all for older patients for the exclusion of an avascular tumour or a tumour within a cyst. The demonstration of the cyst in the double contrast may be performed following the angiography. The simultaneous therapeutic effect of the obliteration of a benign cyst be instillation of Propyliodon and Vistarin is desirable. A positive effect (complete obliteration including essential shrinking) was observed in 91%. Roentgenograms without contrast medium are not sufficient for course control. When the results of the demonstration of the hollow space, the cytology and the arteriography are unclear, operation is recommended.


[Study of two psychosomatic disorders of the gastrointestinal system (ulcer, colitis) using the Frustration Test]. By means of the frustration test (PFT) authors studied two psychosomatic diseases (ulcer and colitis) of the gastrointestinal tract. According to pertinent literature and pertinent literature and personal experiences the test will be helpful in revealing elaboration modalities of stress which are of decisive importance in the pathogenesis of the diseases. The study has been carried out on altogether 281 persons divided into following groups: psychosomatic patients in the "organic" and the "functional" stage, neurotics, and sine morbo controls, respectively. Statistical analysis and the paired t-test was used for the evaluation of results. It has been established that the particular psychosomatic type of reaction, the PFT-profile corresponding the "acting in", having been assessed by authors did exist. Nevertheless it permits no differentiation between patients in the "organic" and "functional" stage, as well as the neurotics with psychosomatic complaints, respectively. Some specific signs have been found however being characteristic for psychosomatic patients in the "organic" stage. According to authors disturbances of personality development lead in both, the neurotic and, they psychosomatic patients to disorders of adaptation, the ego integration, and inadequacy of mechanisms of stress elaboration. PFT is suitable to clear severity of the psychic anomaly.


[Empirical research and the psychoanalytic situation]. The possibilities of applying empirical research methods to the psychoanalytical treatment situation are discussed. Until now, the application of such methods has been too closely bound to the fixing of aims in standard quantitative scientific terms. Frequently "reasons" in psychological areas have been compared to "causes" in scientific terms. As a result, a displacement has occured in the understanding of the reciprocality and circular nature of communication processes. In order to achieve a differentiation between scientific approaches it has proved useful to contrast concepts of linear-causal determination with those of interaction. The consequences of placing varying emphasis on such concepts within the therapeutic situation are described. The important differentiation between a level of working alliance and one of transference and countertransference processes in psychoanalytical treatment technique may perhaps be pursued according to basic logical concepts. On the level of the working alliance, the therapeutic relationship is understood to be mainly linear-causal: working alliance does, of course, mean working together, however, the analyst is seen to evoke a specific effect in the patient, a specific way in which attitudes and fantasies are questioned. When processes of transference and countertransference have reached a specific intensity, the constellations of the relationship can be more precisely comprehended in terms of parameters based on interactional concepts: specific unconscious processes in a given therapeutic situation can most be easily be discerned in the reciprocality of feelings, associations and reactions, and not in terms of a theory which persits in conceptions of linear-causal determination. Hitherto, it has hardly been possible to comprehend those processes where interactional determination predominates, in quantative terms.


[Malignant hyperthermia: clinical aspects and treatment (author's transl)]. The essential epidemiologic, pathophysiologic and clinical data of malignant hyperthermia are presented. Prophylactic measures, early recognition and an effective therapy schedule may reduce the appallingly high lethality of this rare complication during general anaesthesia.


[Simultaneous operations; analysis of 516 cases (author's transl)]. We performed from 1965 to 1977 516 accidental operations. In 38% and appendectomy, in 50% an operation at the biliary system and in 9% herniotomy was simultaneously performed.


[Contraindications of combined surgical procedures in abdominal surgery (author's transl)]. Combined surgical procedures can often increase the entire trauma of operation. A comparative study of our patients showed, that small additional procedures did not influence the operative stress and had only few contraindications. On the other hand medium sized and greater simultaneous operations caused an increased number of postoperative complications, which to some extent resulted from additional surgery. Among other risk factors the increased rate of postoperative complications should be considered concerning the performance of combined surgical procedures.


[Bile-duct-stenosis after operation of the common bile-duct with T-tubes (author's transl)]. 3 stenosis of the bile duct were observed in a postoperative study out of 25 patients, who underwent operations of the bile-duct-system and had T-tubes. These patients had no complaints. One patient had a reanastomosis of the bile duct, the stenosis was in the area of the anastomosis. The T-tubes of 2 patients were postoperatively under traction, which might have favoured the stenosis. The possibilities of intravenous cholangiography and endoscopic-retrograde cholangiography are discussed.


[Reoperations on the extrahepatic bile ducts (author's transl)]. Out of 725 operative procedures at the gallbladder and bile duct there were 33 multiple interventions. The mortality rate of reoperations came up to 3 per cent. If feasible long-time T-drainage or ring-drainage is preferred. Biliodigestive anastomoses should be avoided.


[Topography of the vagus nerves in the oesophageal hiatus (author's transl)]. Topographic variations of the vagus nerves are important to know for modern surgery of the stomach (SPV). That is why vagus nerves were prepared in 53 human cadavers. Based on these findings the perioesophageal plexus and the vagal truncs in the hiatus oesophageus are precisely described including the situs of a diaphragmatic hernia and an intrathoracic aortic aneurysm.


[Prognostic indices in acute pancreatitis (author's transl)]. In a retrospective study 55 patients with acute pancreatitis were reviewed in order to establish the prognostic value of 11 indices which can be determined either at admission of 48 hours after the onset of the disease. The results show: 1. the 5 indices determined at admission (age, white blood cell count, blood glucose, SGOT, LDH) do not permit a clear identification of the variable courses of acute pancreatitis, 2. a high risk group can be selected; in this group an early intensive care is recommended, i.e. a vigorous fluid replacement, endotracheal intubation and assisted ventilation with PEEP, and, if necessary, peritoneal dialysis. Furthermore these indices are helpful to decide very early whether a patient has to be transmitted to a medical centre for intensive care and/or surgical treatment.


[The relationship between haptoglobin type and serum agglutination titers against group G streptococci with the T4-antigen in pregnant women and newborn infants]. The relationship between haptoglobin type and titer of agglutination against streptococci carrying the T4-antigen was examined in 100 pairs of sera (mother/child). In healthy pregnant women high titers were predominant in individuals of haptoglobin type 2--2. Lower titers were found in sera of women with diseases during pregnancy. In 4% of the newborns only the haptoglobin type could be recognized. In comparison of maternal and neonate titers of agglutination pointed out the antibody-like activity of haptoglobins.


[Intrauterine infections in pregnancy. The significance of premature rupture of the membranes and early lung complications]. The course of intrauterine infections are illustrated and 5 maternal deaths reported. Early lung complications were predominant, described as shock lung or septic pneumonia. Renal complications or disseminated intravascular coagulation were absent or developed late. In contrast to gram negative sepsis there was a frequent association with premature rupture of the membranes, which indicates the danger of this event. On microbiology gram positive rods were found more frequently than a mixed flora. The morphology of intrauterine infection is similar to those of puerperal sepsis although the clinical course is quite different. This indicates a change in infectious pattern during the last centuries.


[Priming with intracervically administered prostaglandin F2 alpha before abortion]. 75 Patients were treated with Prostaglandin-F2 alpha-gel intracervical to ripe the cervix prior to first trimester abortion. In all patients we get the wanted effect with Prostaglandin-gel. Priming of the cervix seemed to be especially needed with PG-gel in young patients with first pregnancy.


[External cardiotocography utilizing the US-Doppler principle developed by VEB Ultraschalltechnik Halle]. Clinical report about an ultrasonic cardiotocograph developed by VEB Ultraschalltechnik Halle/GDR. The ultrasonic-option was combined with variable modules of the Biomonitor system (VEB Kombinat Messgerätewerk Zwönitz).--Efficiency and clinical results registered with this new equipment are demonstrated by means of numerous FHF-patterns.--The cardiotocographic method is very important in connection with a further decrease of perinatal mortality and morbidity. A shortly beginning of industrial production is recommended.


[Experience with nuclear medical placenta perfusion diagnosis]. Report about evaluation of placenta perfusion studies in 105 females with pregnancies in risk. They were aged between 17 and 48 years and examined during the 27. to 42. week of gestation. Placenta was located after preinjection of 0.1 mCi 113mIn chloride. Examination was performed with a gamma camera, Type NC-HP, and a computing system PDP 11/10 (Gamma 11) on line. Sequential scintigraphy after slow injection of 1.5 mCi 113mIn chloride with 2-seconds-frames over a period of 3 minutes. Performance of histogramm after ROI-contouring of placenta. Half time of the ascending limb of placenta curve is the criterion of perfusion. The mathematical formalism was developed assuming an one-compartment model by Lorenz and Ostertag. Analyzing on the screen by hand we received normal values of half time: 19 +/- 3.4 seconds; using automatical analysis for suitable e-functions developed by Potschwadek we received normal values of half time: 11 less than 1.8 sec.


[Inversion of the uterus in the postpartal period]. A case of inversion of the uterus in the postpartale period is reported on, which was treated by a modified operation of Küstner.


[Serological integration of all known Arizona-species into the Kauffmann-White-scheme (author's transl)]. This paper reports on the integration of the Arizona group as sub-genus III into the K. W.-Schema. For many years comparative serological analyses of all serotypes belonging to sub-genus III have been carried out and detailed antigenic formulae have been established which now, for the first time, are published in full. These detailed antigenic formulae are not only of the utmost significance for the precise definition of serotypes but are also of immense importance to reference laboratories, in particular for the production of specific diagnostic sera, their correct absorption and specificity control.


Preparation and properties of a standardized lipopolysaccharide from salmonella abortus equi (Novo-Pyrexal). The paper describes the preparation of the lipopolysaccharide from Salmonella abortus equi as obtained by standardized methods. The include the extraction with pehnol/water followed by phenol/chloroform/petroleum ether extraction, ultra-centrifugation, electrodialysis and conversion to the uniform sodium salt form. Chemical composition and physico chemical properties are described. The preparation, which is free from contaminants, was tested for local Shwartzman reactivity, pyrogenicity, lethal toxicity, mitogenicity, reactivity towards complement and tumoricidal action.


[Nosology, epidemiology and bacteriological taxonomy: salmonella infections as an example (author's transl)]. Salmonella infections are discussed as an example of the interdependence of the classification of infectious diseases on the one hand and the taxonomy of bacteria on the other. The term paratyphoid was first created as a name for a disease but was later turned into a common name for the cause and then refined into a specific epitheton of a species of bacteria. It was difficult to create terms for pathology as long as a reliable differentiation of related species of bacteria was not possible, so both a typhoid and an enteric form of paratyphoid fever were referred to, superimposing the clinical differentiation of typhoid fevers and food poisoning (enteritis infectiosa). Epidemiology and bacteriology cannot expect their classifications to determine the classification of bacteria on the level of genus and subgenus, but systematic bacteriology should not conserve or create species and subspecies that are unnecessary for applied medical bacteriology. The needs of epidemiology usually require identification and determination of serovar, biovar and phagovar of the individual strain, but for pathology it is important to classify series of strains on the basis of certain combinations of serovars, biovars, and phagovars as special forms.


[On the frequency of occurrence of salmonella species. An analysis of 1.5 millions trains of salmonellae isolated in 109 countries during the period 1934-1975 (author's transl)]. 1 542 257 strains of Salmonellae isolated in 109 countries during the period 1934-75 were analysed to determine the relative frequency of the 1864 species currently recognized. In addition to the absolute numbers of strains isolated, the "age" of the species and the numbers of reports were used to compute a frequency quotient (QF). It is proposed, on the basis of occurrence, that species be classified as most frequent, frequent, uncommon, rare and very rare. The Salmonella species most frequently isolated from man, food animals, other animals, foods, feeding stuffs, and water including sewage are listed in tables.


[Tetrathionate reductase, beta-glucuronidase, and ONPG-test in the genus Salmonella (author's transl)]. Tetrathionate reduction can be detected simply by acid production. Some commonly occuring Salmonella serotypes can be subdivided into biotypes by the tetrathionate reductase test. The enzyme beta-glucuronidase can be detected using p-nitro-phenyl-beta-D-glucuronide as substrate. The enzyme was found in 30% of Salmonella strains. Each Salmonella serotype was found homogeneous with respect to presence of (or lack of) beta-glucuronidase. This test can then be useful for the identification of monophasic or non-motile variants of normally diphasic serotypes. A positive ONPG-test does not always indicate the presence of a true beta-galactosidase. In the genus Salmonella, ONPG-positive strains of sub-genus III and strains harboring a lactose-plasmid have a true beta-galactosidase. A late positive ONPG-test - as commonly shown by subgenus II strains - is not due to a true beta-galactosidase. The distinction between beta-galactosidase positive and beta-galactosidase negative strains among ONPG-positive strains may be taxonomically significant.


[Short-term oral chemoprophylaxis before intestine surgery. Quantitative determination of bacteria and fungi in stool specimens (author's transl)]. The methods of quantitative analysis of aerobe and anaerobe microbes and fungi stool specimens are described. The results of the studies in health people are compared to the results in patients undergoing surgical treatment of intestinal tract. A group of these patients received Neomycin and Bacitracin orally as short-time chemoprophylaxis to diminish possible woundinfection and/or sepsis. After oral medication germs as Bifidobacterium, Bacteroides and Clostridium (not Cl. perfringens) are reduced or lost, Veillonella, Eubacterium, Fusiformis, Peptostreptococcus and Lactobacillus were suppressed. Resistant strains of E. coli and Enterococci increased to high concentration/g faeces. After treatment the rate of gram-negative bacteria resistant to Neomycin increased. This might be of epidemiologically importance for the distribution of microbes resistant to Neomycin and other aminoglycosides as Klebsiella, Candida spec. and Torulopsis.


Genetic determination of lipopolysaccharide: locus of O-specific unit polymerase in group E of salmonella. By genetic analysis of a semirough mutant of Salmonella muenster we show that a gene determining the polymerization of the repeating units of the O-3, 10-type lipopolysaccharide side chain in Salmonella of group E resides in the his-linked rfb cluster.


[Search for the presence of salmonella in the channels of Bruges (author's transl)]. Salmonella, as indicators of faecal pollution, were monitored for four years in the water of Bruges' channels. Sanitary engineering works resulted in the cleansing of most of the channels which were open sewers; these works successfully transformed the heart of the city.


Enterobacteriaceae infections in man and animals and detection of their natural reservoirs in India. The study presents a summary of the results regarding the presence of Enterobacteriaceae in domestic animals and birds, endeavouring to explain the origin of the infections. Wild reptiles, amphibians, mammalia, rodents and birds were examined into the demonstration of Enterobacteriaceae, whereby particular attention was paid to the following species: Arizona, Edwardsiella, Citrobacter, Enterobacter, Serratia, Yersinia and Erwinia.


[Salmonella in free living snakes of Northern Germany (author's transl)]. Fourty-nine adders (Vipera berus L.) and thirty-one grass-snakes (Nitrix natrix L.) from northern Germany were investigated by cloacal swabs. The samples were usually taken in the field and preenriched in peptone water and further-on processed in three steps of tetrathionate. After each step of enrichment the material was transfered to salmonella shigella agar and fuchsine lactose agar (acc. to Endo). Salmonella screening was done by inoculation of lactose positive and lactose negative colonies into lysine iron agar (acc. to Edwards and Fife). Salmonella excretion was found in 59% of the adders and in 68% of the grass-snakes. Some specimens excreted several Salmonella species. 22 different species resp. variants were detected, of which 19 species belonged to subgenus III (Arizona). Subgenus I occured infrequently and was represented by S. duesseldorf, S. heidelberg and S. sunnycove. Three new triphasic variants S. III 17:Z10: e, n, x, z15: z56, S. III 38: (k): z35:z56 and S. III 50:z10:z:z56 of species already known and four so far unknown species S. III (6), 14: 1,v:z (Ar. 7a, 7c:23-31), S. III 21:1,v:z57 (Ar. 22:23-40a,40c), S. III 43:1,v:z56 (Ar. 21:23-38) and S. III 28:z10:z57 (Ar. 35:27-40a,40c) were discovered. The present results suggest that adders and grass-snakes in northern Germany represent autonomous reservoirs of salmonellae. There exist only few relations between the Salmonella species in these kinds of snakes and other European snakes.


[Action of laser radiation on the properties of staphylococci]. The action of laser irradiation on some properties of three staphylococcus strains (Wood-46, 8325 PIIde and 8325-I) was investigated. In case of the action of LG-23 and LGI-21 there was a loss of hemolytic, lecitovitelase and coagulase activity in 0.2--0.6% of the cells. The loss frequency depended on the irradiation intensity. LG-75 energy caused no loss of the mentioned signs.


[Possibility of purifying cholera toxin (choleragen) and its antibodies by an immunosorption method]. A study was made to establish the possibility of using an immune adsorbent based on polyacrylamide gel with the concentration of T = 10% and C = 25% for the purification of cholerogen and antibodies to it. For the isolation of cholera toxin the gamma globulin fraction of antitoxic serum was incorporated into the adsorbent; for obtaining antibodies an adsorbent with partially purified cholerogen was used. Desorption was made with 3 M sodium rhodanide solution. The yield of cholerogen was 41%, and the yield of antibodies was 4.5%. The non-specific sorption of the immune adsorbents was insignificant.


[Immunological diagnosis of Mycoplasma pneumonias]. A complex of immunological cell tests with M. pneumoniae antigen (the lymphocyte blast-cell transformation test, the allergic neutrophil alteration test) was carried out in order to establish the correlation between the results of positive seroconversion and the sepcific immunological reactivity of lymphoid cells in pneumonia patients. Mycoplasmic cutireactive allergen, when used for the accelerated diagnosis of mycoplasmic pneumonia in humans, was shown to be specific and safe. Cuti-allergic tests with mycoplasmic allergen allowed to diagnose mycoplasmic pneumonia at early stages (beginning from days 5--7), which ensures the possibility of indicating etiotropic treatment to patients in due time.


[Dynamics of Leptospira colony formation on solid nutrient media]. The formation of Leptospira colonies on solid culture media varying in composition were studied. In all species of Leptospira 3 main periods of colony development were revealed, each of them having its characteristic morphological changes connected with the growth of the colony deeply into agar.


[Syndromology of a vascular lesion of the oral regions of the brain stem]. Nineteen patients with a history of circulatory brain disorders in the oral areas of the brain stem showed, along with known neurological syndromes, psychopathological conditions (peduncular hallucinosis, oneiroid and deliriously changed consciousness) and other more rare syndromes (hypersomnia, akinetical states with mutism and intellectual and memory impairment). Apart from describing the clinical picture of these conditions, the pathogenetical mechanisms underlying the syndromes are suggested.


[Spontaneous spinal subarachnoidal hemorrhages]. Spontaneous spinal subarachnoidal hemorrhages were diagnosed in 15 patients. Of these in 12 cases the diagnosis of the underlying disease was established. The main symptom of spontaneous subarachnoidal hemorrhages (SSH) is shown by the appearance of acute spinal pain, followed by meningeal and mild general cerebral disorders. Eventually most of the patients develop focal spinal symptoms. Depending upon the combinations and succession of these symptoms 4 clinical variants of SSH were distinguished. Appropriate evaluation of the anamnestic and clinical data, with the use of lumbar punctures, allows a correct diagnosis, although in an atypical development it may cause certain difficulties.


[Characteristics of the restoration of motor functions in patients who have had a cerebral stroke depending on a lesion of the right and left hemispheres]. A group of 227 patients was observed, who following brain strokes underwent rehabilitative and residual phases. The lesion focus was localized in the right and left hemispheres in 116 and 111 patients, respectively. The results of clinical and clinical-neuropsychological studies showed a worse rehabilitation of motor functions in patients with right hemispheric lesions. It was conditioned by components of an apractognostical syndrome and particularly of anozognosia. Therefore, rehabilitation specialists should treat patients who had brain strokes, taking into consideration the localization of the lesion focus and promote the use of techniques directed toward a correction of specific right hemispheric defects.


[Clinical electroencephalographic characteristics of the phasic nature of the course of severe cerebrocranial injury]. In order to early recognize intracranial hematomas and contusions, differential diagnostic criteria for analysis of neurological symptomatology and EEG signs are considered from the standpoint of a phasic clinical progress of traumatic pathological conditions of the brain. The EEG syndromes of initial, pronounced and gross synchronization correlated with the clinical phases of subcompensation, mild and deep decompensation. The study demonstrates a contrary trend in the dynamics of the clinical and EEG data in compression and contusion of the brain.


[Evaluation of the state of the parasympathetic branch of the autonomic nervous system by cholinergic blood activity]. On the basis of the data obtained during a determination of the cholinergic blood activity in different physiological and pathological conditions of the organism it was possible to evaluate the state (tone and reactivity) of the parasympathetic part of the vegetative nervous system. The conducted studies demonstrate that the cholinergic blood activity depends upon the quantitative relationships between the separate components of the "acetylcholine system" which consists of the free acetylcholine content, bound erythrocytes, the activity of the acetylcholine esterase and the capability of blood in vitro to fixate the added acetylcholine. The pathogenetic therapy in the different forms of disturbed cholinergic blood activity (conditions of parasympathicotonia and parasympathicoatonia) should be directed to a restitution of normal relationships within the acetylcholine complex.


[Verografin epidurography in the diagnosis of spinal and spondylogenic diseases]. In order to elaborate an epidurographic technique, the water-soluble contrast substance (verografin), oil solution of iodine, iodolipol and air were used in experimental studies on animals and in cadavers. The studies demonstrated that oil and gaslike contrast substances penetrate into the vein and create a threat of embolia formation. For epidurography the most acceptable are water-soluble contrast substances. The method of an ascending verografin epidurography was elaborated and used in clinical practice. Some indications and contraindications for epidurography are outlined. A group of 396 patients with osteochondrosis of the lumbar part of the spine was examined. The method allowed a topic diagnosis of the disc hernia not only along the spine, but in the cross-section of the motor segments (median, paramedian and lateral hernias). The studies make it possible to exclude a disc prolapse in a nonhernial form of osteochondrosis. In 32 patients with spinal tumors epidurography permitted to determine the initial growth of the tumor, its size and relation to the dura mater.


[Thermography in the diagnosis of spinal cord tumors]. Clinical studies of 22 patients with pathological processes in the spinal cord and vertebral column allowed a new method of diagnosing spinal tumors with the aid thermography on a Soviet thermovision "Rubin" set. According to the preliminary data this method facilitates the diagnosis and differentiation between tumors of the spinal cord. The paper contains thermograms of the back in normals and patients with extramedullar tumors of the spinal cord at the vertebral level D5--D6 and thermograms of the lower extremities in this pathological condition.


[Clinical diagnosis of neurinomas of Gasser's ganglion]. The first symptoms of the disease encountered in 30 patients were paresthesia, constant dull headaches and a feeling of numbness of the face or its half. Eventually weakness, atrophia of the masticatory muscles, a drop or absence of the corneal reflexes and cerebral and focal symptoms super vened (the symptoms depended upon the direction of the neurinoma growth). Signs of hypertension were seen in 17 cases. There was also a protein-cell dissociation: 0.5--7% of protein in pleocytosis 6/3--68/3. The craniograms showed a destruction of the ground of the middle cranial cavity in 24 cases, while in 23 cases there was a destruction of the pyramidal apex. Antiographic studies demonstrated a displacement of the carotid siphon medially (18 cases), forward (8 cases) or behind (5 cases). The tumor vascular network was detected in 5 patients. The diagnosis of neurinomas of Gasser's node requires a comprehensive summarization of the clinical and x-ray findings.


[Development of experimental peripheral nerve tumors in hormonal imbalance]. According to the data obtained by the authors, some modifying factors, and in particular artificial disorders of hormonal balance in rats, influence the realization of the blastomogenic effect of methylnitrosourea. The results of these studies indicate that the manifestation and the development of tumors in the peripheral nerves occurs more rapidly and easier in experimental hypothyrosis due to a daily administration of anti-thyroid drugs (merkazolyl) and an estrogenation of the organism of animals by a monthly subcutaneous suturation of sinestrol pills. In castration and administration of thyroid hormones (thyroidin) the amount of experimental neurogenic newgrowths decreases with an extension of the latent period of their development.


[Kinin system components and immune complexes in schizophrenia]. The sera of schizophrenic patients showed existence of immune complexes and an increased activity of kallikrein, as well as relationship between these indices and the phase of the process. Their totality may be recommended for evaluating the activity of the process and efficacy of the treatment.


[EEG characteristics of the parents in relation to the form of the course of schizophrenia in the children]. The study is concerned with the traits of brain electroactivity in 35 parents (19 mothers and 16 fathers) whose children had attack-like schizophrenia and in 65 parents (36 mothers and 29 fathers) where the process in the children had a continuous course. The results of the study demonstrated certain differences in both groups according to the frequency in the cortical rhythms of some encephalographical signs and their interconnected combinations. The traits of the EEG, indicating the existence of a tendency to some changes in the functional state of the brain in parents correlated with the indices of their clinical state.


[Possible systems approach to the study of circulatory system regulation in schizophrenia]. From the point of view of a systemic approach the model of schizophrenia is considered as a system of 2 substructures: clinico-psychopathological and vegetative-regulatory. Changes in the latter are shown by disturbances in the circulation control in orthostasis. Factor analysis of the respective indices in 70 cases of schizophrenia established a correlation between the factor of progression and the quality of palpitation frequency regulation. The character of correlations of these indices with the indices of regulation permits one to distinguish the forms of development in schizophrenia. Conclusions about a relationship between clinical and regulatory substructures in the model of schizophrenia are confirmed by a discriminant analysis of the respective data on 122 mental patients.


[Families of late delusional schizophrenia patients]. Families of 44 schizophrenic probands with an onset over 45 years of age, were studied. Among the secondary psychoses, typical schizophrenical psychoses, with an onset in young and middle age were prevalent, no affective psychoses being revealed. The risk for schizophrenia in the parents and sibs was lower than in the families of schizophrenic patients with an onset in young age. However, the risk of morbidity in the relatives of first degree was higher than the incidence of schizophrenia in the population. The general familial background corresponded to the familial background of schizophrenic patients described in the literature. The question of genetical bonds with late delusional schizophrenia and schizophrenia in general is discussed.


[Characteristics of the development of juvenile schizophrenia in view of the late catamnesis]. By means of a clinico-follow-up method the author studied 751 schizophrenic patients with the onset of the disease in adolescence and a catamnesis more than 10 years. It was established that in 96.5% of the cases the diagnostic evaluation made in inpatient conditions was correct. A comparison of the assessment of forms in the development of schizophrenia during the first examination and during follow-up study demonstrated that in most of the cases the first determination of the form of the development on the initial stages of the disease in adolescence was justified, but the frequency of correct initial assessment of the forms of development was different in various clinical states. Despite the formed opinion concerning the prevalent unfavourable outcome of schizophrenia with the onset in adolescence, on the remote stages there was a high percentage of patients under outpatient observation (80.7%), and those working at an ordinary production (40%). In many cases (49.6%) there was a frequent alleviation of the process activity on remote stages and formation of remission.


[Role of sex and age in the occurrence and course of attack-like schizophrenia (based on epidemiological study data)]. On the basis of an over-all investigation of 2 districts of Moscow (1548 patients) the authors studied correlations between clinical traits of attack-like schizophrenia and factors of sex and age. It was demonstrated that the disease most frequently (irrespective of the sex and duration) manifests itself by affective-delusional attacks, then go depressive states, acute-delusional oneiroid and manic attacks. The statistical processing of these results demonstrates the existence of a common regularity in the development of clinical traits of attack-like schizophrenia. Factors of sex and age contribute only to conditions of a predilectiveness in an occurrence of different syndromes.


Plasma clearance of cortisol as a function of plasma cortisol levels in normal and obese persons and in patients with uraemia or cirrhosis of the liver. Plasma cortisol levels in 2 normal persons, 2 obese persons, 2 uraemic patients, and 2 patients with cirrhosis of the liver were raised in 4 steps by a combination of iv priming doses and continuous infusions of cortisol. Plasma cortisol levels and transcortin binding were measured as well as plasma clearance rates of labelled and unlabelled cortisol during each of the 5 experimental periods. Plasma cortisol levels increased less and plasma clearance rates of labelled and unlabelled cortisol increased more in obese persons than in normal persons; in patients with disturbed metabolism of cortisol (uraemia, cirrhosis of the liver) the reverse is true. Plasma clearance rates of free cortisol were calculated and differed from an estimated hepatic plasma flow of 0.7 1/min under certain conditions. Since free cortisol is metabolized faster than transcortin-bound cortisol, increasing plasma clearance rates of cortisol are probably due to increasing ratios free/bound cortisol when total plasma cortisol levels are raised. Low plasma clearance rates of cortisol in uraemia and cirrhosis of the liver are thought to be due to endproduct inhibition, respectively reduced liver cell mass.


Metabolic and endocrine responses to a standard mixed meal. A physiologic study. In order to study endocrine and metabolic responses to normal food ingestion, 8 'healthy' subjects received a standard mixed meal which reflected the composition of Western diet (CHO  47%, protein 23%, fat 26%, alcohol 4%), in 20 min. Before and after the meal, in each subject glucose, lactate, FFA, insulin, C-peptide, glucagon and HGH were determined. The results showed that glycemic and insulinemic responses were not very different from those observed after the classical oral glucose tolerance test. Plasma FFA and blood lactate decreased progressively after the meal. Plasma glucagon and HGH showed opposite changes: pancreatic glucagon rose and HGH slightly declined after composite food ingestion.


Circadian rhythms of plasma corticosterone binding activity in the rat and the mouse. Corticosterone binding activity (CBA) and corticosteroids were measured by competitive protein binding techniques in plasma samples drawn from rats and mice at different times of day. Circacian rhythms of plasma CBA were found in both rats (onset of 14-h daily photoperiod: 0600) and mice (onset of 14-h daily photoperiod: 0700). The plasma CBA rhythm was bimodal in rats with peaks at 1000 and 1800 and unimodal in mice with peak level from 0100 to 0500. Circadian rhythms of plasma corticosteroid concentration with peaks during the late afternoon were confirmed in both rats and mice. The plasma CBA rhythms appear to be related to the circadian rhythms of both locomotor activity and plasma corticosteroid concentration.


Radioimmunoassay for 2-methoxyoestrone in human plasma. A bovine serum albumin conjugate of 2-methoxyoestrone was used for the preparation of highly specific antibodies in rabbits. Cross-reactivity for catecholoestrogens and monophenolic steroids was below 0.3%. Only 2-methoxyoestradiol cross-reacted with 44%. An assay procedure for the determination of unconjugated and conjugated 2-methoxyoestrone in human plasma is described. The following mean plasma concentrations (pg/ml) were found (unconjugated/conjugated): children 61/1130, young men 74/1320, elderly men 109/1260, cycling women 131/1040, post-menopausal women 102/1420, and pregnant women 3980/5850.


Transducer probe for the measurement of oestradiol-induced changes in the vagina of ovariectomized ewes. A modified non-invasive vaginal probe, using electronic transducers to monitor six physical variables reflecting vaginal changes, was tested in oophorectomized ewes according to a Latin-Square design allocating six treatments to six animals in a balanced time sequence. The transducers measured thermal conductance, temperature near the cervix and near the vulva, and light reflectance at 900, 660, and 565 nm. The treatments included four iv doses of oestradiol-17 beta (0.5, 5.0, 50, and 500 microgram per 50 kg body weight) and two controls (injection vehicle, and no injection). Despite large residual variation, the results (1) show that the higher oestradiol doses produced responses of all six variables; (2) suggest improvements in future probe design; and (3) raise interesting questions on dose-response relationships deserving further study.


Relationship between body fat mass, carbohydrate tolerance and IRI response during glucose infusion in subjects with early diabetes. We have studied the interrelationship of total body fat mass, carbohydrate tolerance and IRI response in 17 non-obese and obese subjects, who were suspected of having early diabetes. We carried out an i.v. glucose infusion test consisting of a priming injection of 0.33 g/kg followed by constant glucose infusion of 12 mg/kg/min in all persons. Total body fat mass was estimated by the tritium dilution method. There was a positive correlation of body fat mass, fasting glucose concentration and blood glucose concentration at 150 min as well as a strong correlation between body fat mass and BG area 60--120 min as parameters of carbohydrate tolerance in all subjects, i.e. the degree of carbohyrate intolerance was directly related to the quantity of total body fat mass. A similar correlation was found when the non-obese and obese groups were analyzed separately. In neither group did total body fat mass correlate with parameters of IRI response. In obese subjects with pathological carbohydrate tolerance, however, a positive correlation of basal IRI concentration and total body fat mass was found. Furthermore, a close relation between basal IRI level and parameters of carbohydrate tolerance could be demonstrated in obese subjects. The present study failed to demonstrate any correlation of parameters of carbohydrate tolerance and glucose-induced IRI response in either group. Thus, the significant relationship between body fat mass and degree of carbohydrate intolerance indicates that body fat mass plays an important role in the disturbance of blood glucose homeostasis in early diabetes with and without obesity.


Investigation of bone and mineral metabolism in hyperthyroidism before and after treatment using calcitonin, 47Ca and balance studies. Seventeen normocalcaemic patients with severe hyperthyroidism were examined before therapy was initiated; 9 were re-examined about 1 year later. Studies with 47Ca under balance conditions and with calcitonin demonstrated a high rate of bone resorption in untreated patients. As a result of the increased bone turnover, the reaction to 6 MRC units of porcine calcitonin iv was more marked in the untreated than in the treated patients or the control group. In contrast to the normal diurnal pattern for PO4, it was found that during fasting the plasma PO4 level increases in the morning in patients with hyperthyroidism. This increase which was not suppressed by the administered dose of calcitonin developed in spite of an elevated urinary PO4 excretion. After treatment, the serum Ca concentration as well as the urinary and faecal Ca excretion was decreased. The Ca balance improved; the rapidly-exchangeable Ca pool returned to normal. The slowly-exchangeable and the total Ca pools, however, remained enlarged. The rate of bone resorption normalized. The accretion rate on the other hand remained elevated. This is atributed to continued enhancement of bone formation to compensate for the previous loss of bony tissue.


A comparative study of metabolic and hormonal responses to somatostatin and propranolol in man. The aim of this study was to compare the metabolic and hormonal effects of somatostatin to those of propranolol, a beta-adrenergic blocking agent known to reduce basal insulin secretion. For this purpose, 6 normal subjects received somatostatin (4 microgram/min) per 60 min and 6 subjects were infused with propranolol (0.08 mg/min). Somatostatin resulted in a significant decrease of basal insulin (p less than 0.05) and glucagon (p less than 0.01) and raised plasma FFA levels from a mean basal value of 417 +/- 24 muEq/1 (x +/- SEM) to 600 +/- 46 muEq/1 at 60 min (p less than 0.01). Propranolol significantly decreased basal insulin (p less than 0.05) and glucagon (p less than 0.05); FFA levels rose slightly at the end of propranolol administration (p less than 0.05). The levels of FFA which were significantly higher (p less than 0.025) during somatostatin as compared to those observed during propranolol, seem to suggest a role for this tetradecapeptide in lipid metabolism independent of its inhibiting action on islet hormone release.


Diabetic changes of the extra-ocular muscles in man. Axonal and myelin changes of the degenerative type were found in the extra-ocular muscles of 21 out of 23 diabetics of all ages (30--74 years). In all these 21 cases both axonal and myelin changes were observed; they did not correlate with the duration, degree of severity or treatment of diabetes. In 19 of the 23 cases (82.6%) nervous changes were accompanied by vascular changes. In 10 controls (50--80 years) nervous and vascular changes were of a slight degree. The findings of the alteration of peripheral nerve endings in the extra-ocular muscle corroborate and complete the description of the central nervous changes in diabetics with ophthalmoplegia given by several authors. We agree with Domínguez et al. that ophthalmoplegia may appear in the preclinical stage of diabetes and may be the first manifestation of the disease.


Metabolic and hormonal changes during exercise in healthy, diabetic and obese subjects. The metabolic and hormonal changes during a standard physical exercise were studied in healthy subjects and in insulin-dependent diabetics well matched for body weight, and therefore submitted to a similar work load in a physiologic range, and in obese subjects that, owing to their weight, faced a significant heavier work in the same environmental conditions. Moderate work load did not lead to significant changes in metabolic and hormonal blood parameters (blood glucose, FFA and glycerol; insulin, glucagon, growth hormone and cortisol) in healthy subjects. A similar substrate homeostatis was seen in insulin-dependent diabetics, that however showed marked hormonal alterations. In these subjects, indeed, higher levels of plasma glucagon and GH were reached during work and in the recovery phase. Obese subjects, submitted to a heavier work load, presented a marked increase in blood glucose and glycerol which agrees with high GH and cortisol levels, and a subsequent increment of IRI which corresponds to a normalization of blood glucose and glycerol. Obese subjects, therefore, show a normal sensitivity to work load. Considerations about the work load in everyday life are discussed.


Effects of food restriction on mice with the hereditary obese-hyperglycemic syndrome. The purpose of this study was to compare the organ weights of obese-hyperglycemic (ob/ob) mice with the organ weights of their normal litter-mates. The absolute weights of the epididymal fat pads (white fat), interscapular fat pads (brown fat) and liver were greater in ob/ob mice than in normal mice. The weights of the kidneys and heart were similar in the 2 groups. The weights of the brain and testes were decreased in ob/ob mice when compared with normal mice. The weight gain of a second group of ob/ob mice was decreased by chronic food restriction resulting in a 26% reduction in weight when compared with ob/ob mice having unrestricted access to food. This substantially reduced the weight of the liver, but resulted in a minimal reduction in the weight of the epididymal fat pad. Food restriction did not alter the weight of the interscapular fat pads. It caused a relative reduction in kidney weight and a further absolute and relative reduction in testis weight.


Arterial thrombosis of the arm in infant of diabetic mother. A case of multiple arterial thromboses of the arm in the infant of a diabetic mother is reported. A hemocoagulative pattern of intravascular disseminated coagulation was present. Conservative thrombolytic treatment with Urokinase and Calciparin proved successful.


Tuberculous meningitis.

Tuberculous meningitis. Ten patients with confirmed tuberculous meningitis were seen at Meilahti Hospital, University of Helsinki, in 1966--1977. Six of the patients had a positive CSF culture for M. tuberculosis, and a positive CSF smear for acid-fast bacilli was found in one case. On admission, seven patients had an altered state of consciousness, five complained of headache, and nuchal rigidity was noted in two. Five patients recovered completely, three had persistent late sequelae, and two of the patients died. The most important fact influencing the prognosis was an early institution of adequate antituberculous chemotherapy.


Pancreatic encephalopathy.

Pancreatic encephalopathy. A prospective study was conducted on 17 cases of acute pancreatitis; encephalopathy was discovered in six patients (35%). The following parameters were studied: the usual ones in pancreatitis conditions (amylasemia, lipasemia, amylasuria, ions, glucose, pO2, pCO2, pH, etc.), and electroencephalographic changes and determinations in CSF of cells, proteins, lipase, amylase, lipides and cholesterol. A direct relationship was found to exist between the pancreatic encephalopahy condition and an increase in CSF-lipase. The electroencephalographic changes were nonspecific. The encephalopathy did not affect the course of the pancreatitis condition, and showed no relationship to type of treatment involved. The severity of the pancreatitis was not related to the presence or absence of encephalopathy.


Possible increased tendency to thrombosis after cerebral angiography. Two patients are presented in whom cerebral angiography was complicated by bioccipital infarcts resulting in cortical blindness with persisting severe restriction of the visual field (case 1) and persisting cortical blindness (case 2). One patient (case 1) demonstrated a compensated, protracted disseminated intravascular coagulation (Table 1), which disappeared after treatment with phenprocoumon (Marcoumar). The other patient (case 2) demonstrated increasee spontaneous platelet aggregability (Table 2), which was treated sucessfully with acetylsalicylic acid (Magnyl) and dipyridamole (Persantine). We presume that the coagulation disturbances demonstrated after the angiography may be pathogenetic to the complications. We propose that patients with transient cerebral ischemia and apoplexy who are undergoing cerebral angiography should be studied with regard to coagulation before and after the cerebral angiography so that coagulation disturbances demonstrated may be treated before, or corrected after the angiography.


No elevated sister chromatid exchange in Alzheimer's disease. Chromosomal abnormalities have been reported earlier in Alzheimer-type dementia. Sister chromatid exchange (SCE) was studied in four patients with Alzheimer's disease and five control subjects. The sensitive method to detect chromosomal damage showed no elevated number of SCEs in Alzheimer's disease.


The enhancing effect of multiple sclerosis brain homogenates on the active E-rosette forming lymphocytes in neurological disorders. Peripheral blood lymphocytes from 23 out of 27 (85%) patients with multiple sclerosis responded to MS brain homogenates by increased formation of active E-rosettes. Lymphocytes from only six out of 78 (8%) patients with other neurological diseases responded to MS brain homogenates. The possible value of the test in the diagnosis of MS is discussed.


Serum phenytoin, phenobarbital, carbamazepine, albumin; and plasma estradiol, progesterone concentrations during the menstrual cycle in women with epilepsy. Six menstrual cycles and three 1-month periods were studied in seven patients with epilepsy. The patients all had had anti-epileptic treatment for a long time. In each case, the dosages had been costant for at least 1 month prior to the start of the investigation. Blood samples were taken every second day. Phenytoin, phenobarbital, carbamazepine, estradiol and pregesterone were analyzed. The serum levels of the anti-epileptic drugs were correlated to the plasma hormone concentrations. No correlations were obtained between the plasma hormone concentrations and the serum levels of the anti-epileptic drugs. There is, therefore, no evidence that the relationship between the seizure frequency and plasma hormone concentrations, shown in a previous study (Bäckström 1976)) was related to a change in serum levels of the anti-epileptic drugs.


Differences of latencies and amplitudes of brain stem evoked potentials in subgroups of a normal material. Brain stem auditory evoked potentials have been recorded in 40 normal subjects aged 13--48 years, by stimulating monaurally with random stimulus interval. The male subjects have latencies of the waves III-VII, which are significantly longer than female subjects (P less than 0.0005), the elongation increasing from 0.09 to 0.44 msec from wave III to VII. The female subjects have amplitudes significantly higher than male subjects, although the variations are very wide. No difference in latencies from tall versus short subjects is found, as well as no significant difference in latencies between subgroups of older and younger subjects of the material. It is found necessary to have different normal values for the two sexes.


Changing epidemiology of Parkinson's disease: predicted effects of levodopa treatment. Recent studies suggest that levodopa treatment reduces the excess mortality due to Parkinson's disease, found to be three times that expected in the general population. This will affect the equilibrium state of the epidemiology of Parkinson's disease. The predicted increase in prevalence of Parkinson's disease was calculated according to two mortality patterns, one the same as expected in the general population and the other 1.5 times that expected; the proportional increase in prevalence is 1.8 and 1.4, respectively. The predicted increase in the duration of the disease if 6.3 or 3.2 years. As a consequence, there will be an increase of patients with long-term levodopa treatment difficulties, and with Parkinson's disease symptoms not treatable with levodopa, e.g. dementia. This seriously warrants the research of new approaches in the treatment of Parkinson's disease.


Auditory double click evoked potentials in multiple sclerosis. Brain stem electric responses (BSER), evoked by acoustic stimuli, were investigated in 29 patients with multiple sclerosis and compared with the responses in a control group of 26 young adults without neurological disease or hearing defect. The procedure included monaural and binaural stimulus presentation of single clicks and pairs of clicks. In the evaluations the vertex-positive Jewett I, III and V response components, and the vertex-negative "FFP7" peak were considered. In the assessment of the BSER components, the FFP7 (the vertex-negative 7 ms far field potential following the JewettV wave) proved to be the best single component with respect to reproducibility in normal subjects. In addition the FFP7 was the single most consistently abnormal component in the patient group. Determination of the latency of the Jewett components and the interpeak conduction times, however, contributed further to the disclosure of the abnormal cases. Five of the patients whose hearing was impaired were considered separately. Of the remaining 24 patients, 20 (83%) had BSER abnormalities. Further analysis did not reveal a clear correlation between BSER abnormalities and clinical signs of brain stem dysfunction.


Assessment of pituitary function.

Assessment of pituitary function. Sellar and parasellar tumours comprise 10-15% of all intracranial neoplasms. Neurologists will this often be faced with the problem of assessing pituitary function. A thorough clinical examination is of the foremost importance. In addition a small number of simple and rapid tests is required. Knowledge of the physiological variation in pituitary function is, however, necessary to allow a safe interpretation of the results. A simple routine procedure for assessing pituitary function is proposed.


Calcification in a pineal tumour studied by transmission electron microscopy, electron diffraction and x-ray microanalysis. The calcification in a totally calcified pineal tumour was studied. Transmission electron microscopy indicated that the tumour was a pinealoma. The type of calcification was investigated by bright-field and dark-field transmission electron microscopy in addition to electron diffraction and electron-induced x-ray fluorescence. The calcified material consisted predominantly of amorphous calcium phosphate. The type of calcification differs from the normal calcification present in pineal acervuli which consists of crystalline hydroxypatite.


Effect of prostaglandin E2 and of indomethacin upon cerebral and pulmonary consequences of exposure to hyperbaric oxygen in rats. There are few data in the literature suggesting that endogenous prostaglandins (PGs) might be involved in the pathomechanism of seizures. Since the mechanism of seizures inducted by exposure to oxygen high pressure (OHP) is not fully elucidated, this study was designed to investigate the effect of exogenous PG s and of indomethacin (a Pg synthesis inhibitor) upon the development and consequences of seizures in rats exposed to OHP (5 ata). In the animals pretreated with PGE2 (1 ng/kg s.c.) pre-seizure time was shortened, lung weight : body weight index increased and symptoms of respiratory failure potentiated, as compared with the control group. Indomethacin (5 mg/kg i.p) prevented the development of seizures and of pulmonary consequences of OHP exposure. Biochemical examination of brains has shown that velocity of free radical oxidation of lipids (reactions manifested by the breakdown of phospholipid fatty acids, mainly unsaturated ones) enhanced by OHP exposure, is further potentiated in rats pretreated with PGE2. Electron microscopic study has shown the alterations similar to those seen in brain ischemia and/or hypoxia, and the magnitude of changes was related to the intensity of symptoms evoked by OHP. The results show that cerebral and pulmonary consequences of OHP exposure are potentiated by exogenous PGE2 and prevented by inhibition of endogenous PG synthesis. This suggests that PGs and/or their active metabolites might be involved in the mechanism of oxygen toxicity during exposure to hyperbaric oxygen.


Muscle involvement in association with filarial chyluria. Twenty unselected consecutive patients of filarial chyluria were evaluated clinically, electromyographically, and histopathologically for neuromuscular dysfunction. None of the patients showed clinical evidence of muscle wasting or weakness suggesting myopathy, although generalized muscle weakness was complained by all of them particularly while climbing the stairs or on getting up or during lifting heavy weights. Electromyographic abnormalities were found in nine patients and slight histopathological abnormalities in two. The average duration of motor unit potentials and the mean amplitude were reduced, compatible with myopathy. There were no fibrillation potentials. Histological  abnormalities consisted of a marked variation in muscle fibre size, sarcolemmal nuclear proliferation, and mild interstitial fatty infiltration. None of the patients showed evidence of clinical neuropathy, abnormalities in conduction velocity along the nerves or signs of segmental demyelination in the biopsy of the nerve. Our data suggest that muscle weakness in these patients is myopathic in nature without peripheral nerve involvement, and is possible due to hypoproteinaemia and hypolipidaemia, as these patients lose excessive amounts of protein and fat in their urine.


On the physiological and clinical significance of a trapezius reflex evoked by tapping the spine. On routine clinical examination it was observed that precussion over the thoracic spine occasionally produced reflex contraction of the intermediate  and caudal parts of the trapezius muscle. The observation was made in one case of spondylitis and one case of inflammatory connective tissue disorder. Both patients had pain in the thoracolumbar regions. The neurophysiological features of this reflex have been analyzed. The incidence of the phenomenon in a randomly selected normal material was 3%. Electromyographic recording from the trapezius muscle demonstrated that the reflex is present at a subthreshold level in subjects not exhibiting the clinical reflex. The latter is established by pain and/or tension in the thoracolumbar paravertebral region.


Acute measles infection in a case of multiple sclerosis. A young woman with firm evidence of early multiple sclerosis (MS), who had never had measles, developed a clinically and serologically evident measles infection. Follow-up 1 year later confirmed the MS diagnosis. Thus, if measles can have a causal role in MS, it is probably not the only agent with this ability.


Early events in canine distemper demyelinating encephalomyelitis. The early neuropathological development of demyelinating Canine Distemper Encephalomyelitis (CDE) was studied in SPF dogs. Neural tissues were examined up to 30 days post infection (PI). Three phases of activity were observed. The primary event (first observed 8 days PI) was a nonsuppurative encephalomyelitis associated with the initiation of central nervous system (CNS) infection by virus-laden lymphocytes. At 24 days PI noninflammatory demyelination occurred in well defined, subependymal foci. Cell fusion and syncytia formation accompanied this early demyelination. The third phase, found at day 30 PI in one dog showing signs of recovery, was a second wave of nonsuppurative inflammation. The initial encephalomyelitis was widely disseminated throughout the CNS but subsequent demyelination appeared to be initiated from within the ventricular system. Myelin was phagocytosed by endogeneous CNS macrophages often infected with Canine Distemper Virus (CDV). The possible importance of viral induced cell fusion as well as immune factors in the mechanism of demyelination are discussed.


Quantitative estimate of pinocytosis in experimental acute hypertension. Cerebral cortical arterioles in focal neocortical areas develop increased permeability to plasma proteins and protein tracers in experimental hypertensive encephalopathy. The mechanism underlying this increased permeability has been the subject of several studies. In our previous studies of angiotensin-induced acute hypertension, pinocytosis appeared to be the principal mechanism for the increased blood-brain barrier (BBB) permeability observed. In the present study pinocytotic activity was assessed quantitatively to determine whether enhanced pinocytosis was confined to the permeable arteriolar segments of hypertensive animals. In addition, the effect of horseradish peroxidase (HRP) itself on the pinocytotic activity of normal cerebral cortical arteriolar endothelium was determined. In 12 rats following administration of HRP, hypertension was induced by an infusion of angiotensin. The animals were perfusion-fixed 90 s after the onset of the infusion. Control animals received saline only or HRP only. The area of arteriolar endothelium in cross section was determined by a planimeter from overlapping electron micrographs taken at a constant magnification around the circumference of the vessel wall. Results indicate a significant (P less than 0.001) increase in the number of pinocytotic vesicles in the permeable arteriolar segments of hypertensive animals as compared with nonpermeable arteriolar segments of the same animals and comparable segments of normotensive rats. In addition, eight times as many vesicles appear to be transporting tracer in the permeable arteriolar segments of hypertensive animals as compared to the nonpermeable segments of the same animals and normotensive animals. HRP alone did not affect the pinocytotic index, there being no difference (P greater than 0.05) in the number of vesicles in normotensive animals receiving saline only and those receiving HRP only. Our previous observation that disruption of endothelial cells or their tight junctions did not occur was confirmed.


Histochemical investigation of the Mongolian gerbil's brain during unilateral ischemia. The ischemic effect on cerebral enzymes and glycogen content was histochemically evaluated in mongolian gerbils subjected to unilateral common carotid artery occlusion for various periods of time from 1/2 to 9 h. In early stages (up to 2 h), the only enzyme affected was the phosphorylase which revealed a decreased activity. Thereafter, the observed changes inclusive of glycogen and other enzymes such as the dehydrogenase, nonspecific acid and alkaline phosphatases, leucine aminopeptidase and thiamine pyrophosphatase progressed proportionally to the duration of ischemia. There was an overall inverse appearance of histochemically demonstrated enzymatic disturbances between the severely damaged ischemic regions and its marginal zones; the former revealing a conspicuous decrease and/or loss of enzymatic activities while the latter showing an increase of the same enzymes. Correlating the various ischemic responses of the intracellular organelles it appears that the changes in the lysosomes and Golgi apparatus occurred slower than those of mitochondria.


A study of the perineurial diffusion barrier of a peripheral ganglion. The perineurial diffusion barrier to horseradish peroxidase (HRP) and ferritin was investigated in superior cervical ganglia of rats and mice. The ganglion was surrounded by a delicate epineurium and 2-5 perineurial lamellae joined by zonulae occludentes and desmosomes. Following local application of tracers the animals were killed after 5, 30, and 60 min and the distribution of HRP and ferritin was studied by light and electron microscopy. The inner layers of the ganglionic perineurium prevented diffusion of both HRP and ferritin perineurial lamellae investing the ganglion. HRP had often extended to the innermost lamella 60 min after application. HRP and ferritin were present in vesicles of ganglionic perineurial cells. There was no passage of tracers via intercellular junctions.


Chlorpromazine treatment of blood-brain barrier dysfunction. A quantitative and fluorescence microscopical study on small cerebral stab wounds in the rat. The extravasation of albumin around small cerebral stab wounds in the rat frontal cortex was studied by fluorescence microscopy after i.v. injection of Evans blue-labeled albumin and by quantitative immunoelectrophoresis after i.v. injection of bovine albumin, in both nonintoxicated and ethanol-intoxicated rats. The extravasion of albumin was enhanced in ethanol-intoxicated compared to nonintoxicated rats, as studied both by immunoelectrophoresis and by fluorescence microscopy. Administration of chloropromazine (2 mg/kg body weight i.v.) 16 h after inflicting cerebral stab wounds decreased the area around the wound showing extravasation of Evans blue-labeled albumin as studied by fluorescence microscopy both in nonintoxicated and in ethanol-intoxicated rats. Quantitative studies showed a significanct decrease in the amount of extravasated albumin around cerebral stab wounds in ehtnaol-entoxicated rats, while the extravasation in nonintoxicated rats was not significantly changed by chlorpromizine treatment.


Neuroaxonal dystrophy in the neonate. A case report. The nervous system of a female infant who was hypotonic from birth and survived for 8 days was examined. Neuropathological and electron microscopic study revealed numerous neuroaxonal swellings, so-called spheroids, in the brainstem and extensive necrosis in the cerebral hemispheres and cerebellum.


Spongiform alterations in brain biopsies of presenile dementia. Spongiform lesions were observed in close association with typical presenile alterations in three of six frontal lobe biopsies taken in presenile demented patients without any familial relationship. These findings are discussed in relation with recent investigations indicating the production of spongiform lesions after inoculation of nervous tissue from an Alzheimer patient to animals and the effects of saline extract of such material on cultured nerve cells.


Fine structure of prolactin pituitary adenoma with special reference to annulate lamellae. A case report. Electron microscopy revealed the presence of annulate lamellae in the cytoplasm of a heavily granulated prolactin cell adenoma that had been removed from a 34-year-old male patient presenting impotence. To our knowledge this is the third case of pituitary adenomas where annulate lamellae are reported.


Influence of 2,4 dichlorophenoxyacetate and of dantrolene sodium on the target phenomenon in tenotomized rat gastrocnemius muscle. The effect of 2,4 dichlorophenoxyacetate and of dantrolene sodium on the occurrence of target fibers in tenotomized rat gastrocnemius muscle was studied. Neither of the drugs influenced the appearance of target fibers or its inhibition by simultaneous neurotomy.