[Haemoperfusion on coated activited charcoal. Experience in French anti-poison centres based upon 60 cases (author's transl)]. Sixty three sessions of haemoperfusion on coated activated charcoal were carried out in 60 cases of poisoning. The indications concerned 2 clinical situations: - massive poisoning with coma (by hypnotics or chlorine-containing solvents) with high extracellular concentrations of the toxic agent, with the aim of reducing the duration of the coma; - intoxications with a high mortality rate, such as those due to paraquat, colchicine, digitoxine, tricyclic antidepressants, and heavy metals, even when plasma levels were low in relation to the dose ingested. Such discordance may be related not only to predominantly intracellular fixation, but also to low intestinal absorption. The effectiveness of haemoperfusion was estimated in terms of the amount of toxic substance extracted, measured either indirectly by repeated calculation of the arteriovenous difference multiplied by the flow rate through the column, or directly by elution of the column. This method for the removal of toxic substances would not appear to be life-saving, is too costly for the extraction obtained and is not free from specific complications. Thrombocytopaenia remains an epiphenomenon, but the frequency of infection is significantly higher than with haemodialysis. An effective and safe method for the vascular extraction of poisons, particularly one favourising removal of toxic substances from intracellular localisation, remains to be found.


[Malabsorption syndrome during the initial phase of a case of severe rheumatoid purpura]. We report a case of severe Henoch syndrome in which the first manifestation was digestive with a prolonged and important intestinal malabsorption syndrome. The clinical, radiological and histological data allow to consider a malabsorption due to lesions of the chorion and submucosa probably secondary to the allergic vasculitis. The malabsorption syndrome, confirmed by the intestinal absorption tests, the study of which must be more systematic, seems to belong to the severe and polyvisceral forms of the Schönlein-Henoch syndrome.


[Total iliectomy with preservation of the lower limb (author's transl)]. We treated a chondro-sarcoma of the ilium by total resection of the hemipelvis preserving the lower limb. We describe our technique and give the fonctionnel result of this operation which we believe could in certain cases replace a hemipelvectomy.


Regulation of hemopoiesis.

Regulation of hemopoiesis. The development of in vitro cloning systems for populations of hemopoietic and lymphoid cells has enabled a family of specific regulatory macromolecules to be detected and characterized. These macromolecules control proliferation and differentiation in hemopoietic cell populations. Studies have demonstrated the complexity of the spectrum of molecules which are involved in the regulation of each group of hemopoietic cells. Heterogeneous subpopulations of molecules exist for each regulatory function and more than one molecular form exists for the various regulator molecules. While the cellular origin of many of these regulators has not been clearly demonstrated, it is apparent that hemopoietic populations themselves can be significant sources of both stimulatory and inhibitory regulators. In particular, there are now clear examples of regulatory interactions which occur in both directions between hemopoietic and lymphoid populations. While in no case a complete analysis of the control systems has been achieved, maintenance of homeostasis in hemopoietic systems is now better understood than for most other cell populations in the body. Further, with existing techniques, and in particular, the exploitation of the full potential of the semi-solid cloning systems, it is realistic to expect that a complete analysis of hemopoietic regulation can now be accomplished.


[Repeated sampling of rat polymorphonuclear leucocytes from the pleural cavity. Application for the study of leucocyte chemotaxis (author's transl)]. A method is described for allowing the sampling of a homogeneous population of polymorphonuclear cells (PMN) from the rat pleural cavity a well as a technique involving the use of a phase-contrast microscope and video-recording system to study the necrotaxis of rat PMN towards a single erythrocyte lysed by ruby-laser irradiation. This allows both the speed of the leucocytes and the degree of their chemotactic response to be determined. The advantages and disadvantages of the experimental technique are discussed along with its application to the study of in vitro and in vivo actions of various drugs on rat PMN chemotaxis.


Proliferation of human lymphocytes in culutre: determination by measurement of nuclear volume and cell number. Proliferation of stimulated human lymphocytes was studied in cultures by determining cell counts and nuclear volume enlargement. DNA content and the nuclear volume increase before the cell divides. Volume-frequency curves were obtained of unstimulated and phytohemagglutinin (PHA) stimulated lymphocytes on 0, 3, 6 and 9 days of cultures with the Coulter Counter H4 system. As the number of lymphocytes in the cultures transformed and enlarged in volume, the area under the volume-frequency curve increased proportionately. The fraction of transforming cells was determined by comparing the area under the curve of the unstimulated and the stimulated lymphocytes. This method provides both the fraction of cells transformed and the increment of the number of cells in the culture and is therefore a better indicator of cell proliferation than the commonly used isotope-labeled thymidine uptake method which monitors the fraction of the cells in DNA synthesis phase only.


[Study of the electrophoretic and kinetic properties of erythrocyte glucose-6-phosphate dehydrogenase in hereditary enzyme deficiencies. Description of a new variant of glucose-6-phosphate dehydrogenase: the Gd Kremenchug]. A study of the activity of human erythrocyte G-6-PD has been completed on a great number of normal controls, coming from different regions of the USSR. This study has led to the discovery of a new variant of erythrocytic Gd, which was named "Kremenchug" from the origin of the patient. This new Gd, has a very low Km for G-6-P, and has a greater affinity for 2-deoxyglucose-6-phosphate. The maximal activity versus the pH of the medium is also characteristic of this new Gd.


[In vitro study of erythroblast precursors in Vasquez disease (polycythemia vera). Arguments in favor of a double population of erythroblastic stem cells in the bone marrow]. In vitro studies using the plasma clot culture system have been performed in order to compare the red cell pregenitors able to rise to erythrocytic colonies in 7 days (CFUE) in the bone marrow of polycythemia vera (PV), secondary polycythemias and normal subjects. In PV but never in normal individuals or secondary polycythemias, the bone marrow cells producing  erythroid colonies without addition of erythropoietin were found. The erythropoietin dode response curves in PV is biphasic with a plateau up to a concentration of erythropoietin of 0.02-0.05 i.U./ml followed by a near normal response to erythropoietin at higher doses. Thus our results demonstrate that two populations of erythroid stem cells coexist in PV, one being abnormally sensitive to (or independant of) erythropoietin, the other normally responding to erythropoietin. After remission induced by P32 treatment, the abnormal population can disappear but the prognostic significance of this disappearance is uncertain. On the whole these results are in agreement with those of others laboratories using the plasma clot culture system. The reasons of the disagreement with the data published using the methylcellulose technic of culture are discussed.


[Distribution of HLA antigens among the population of Finistère (France) (author's transl)]. We have studied by using HLA system, 200 people, without filiation but having the same geographic origine (Finistère). The results have been compared with those measured for Parisian and Basque population. A significantly decrease of antigen A29, B18 and BW16 frequency have been observed in the population from Finistere. But, antigen B8 and B27 seems to be more frequent than in population from Paris. A linkage desequilibrium is described for A1-B8 and A3-B7 haplotypes as in population from Paris; but the desequilibrium for A11-B5 seens to be characteristic of population from Finistere.


[Materno-foetal transfer of anti-HLA antibodies. Study by using LDA test (author's transl)]. The LDA test was used to study the materno-foetal transfer of anti-HLA antibodies. The results were compared with those obtained earlier by the complement dependent lymphocytotoxicity test (CdL). Although more sensitive than CdL, the LDA test did not demonstrate more maternal antibodies in cord blood when these antibodies corresponded to the child's paternal antigens. Nevertheless LDA demonstrated antibodies did not always behave similarly to those seen by CdL.


Hydergine and vincamine derivative LD 4298 exhibit no anti-sickling properties in vitro. Amongst the treatments proposed for Sickle Cell disease Ergot derivatives and extracts from Pervinca have been proposed. We have studied in vitro the effect of Hydergine and LD 4298 on Sickle Cells and Sickle Hemoglobin according to the following four parameters: percentage of sickling, potassium leak, minimum gelation concentration and speed of gelation. In these studies no anti-sickling effect was detected. Moreover Hydergine at 50 microgram/ml increased spontaneous potassium loss without any anti-sickling effect. One can conclude that these two drugs have no effect on sickling.


The mechanism of action of tRNA methylases studied with immobilized tRNAs. Each of the individual tRNAs immobilized on aminohydroxybutyl-cellulose (ABC) through their oxidized 3'-terminal binds affinitively all methylases present in the enzyme extract irrespective of whether this tRNA will be involved in the following step of methylation or not. These data allow to suggest that (a) the formation of a methylase-tRNA complex and the catalytic act of methylation are indeed autonomous processes and (b) the first step of interaction between tRNAs and tRNA methylases is rather unspecific and consists in the recognition of the whole class of tRNA molecules.


The DNA polymerases associated with the adenovirus type 2 replication complex: effect of 2'-3'-dideoxythymidine-5'-triphosphate on viral DNA synthesis. An adenovirus (Ad) DNA replication complex extracted from infected HeLa nuclei could be purified free of the bulk of intracellular DNA polymerase activity by sedimetation in neutral sucrose gradients. However, the replication complex still retained some alpha and gamma DNA-polymerase activity. Since this complex is inhibited by 2', 3' dideoxythymidine-5'-triphosphate (ddTTP), an inhibitor of DNA polymerase gamma, a functional role for this enzyme in Ad DNA replication is suggested. Similar inhibition by ddTTP in intact Ad infected nuclei and comparable inhibition of Ad DNA synthesis in whole cells by dideoxythymidine (ddThy) are consistent with a role for DNA polymerase gamma. Uninfected HeLa nuclei or whole cells are not similarly inhibited by ddTTP or DDThy respectively. Such data does not rule out an additional functional role for other DNA polymerases, and recent experiments from this laboratory (1) suggest that DNA polymerase alpha is also involved in Ad DNA synthesis.


Raman spectral studies of poly(1-methylinosinic acid). The synthesis and characterization of poly(1-methylinosinic acid) are described. Laser Raman spectra of poly (mII) were obtained as a function of temperature in D2O solution. Thermal melting profiles derived from the intensity variations of the 712, 795, 814, 986, 1333, 1509, 1550 and 1680 cm-1 bands indicate a cooperative melting temperature of 9 +/- 1 degree C. The low temperature form of poly(mII) exhibits a carbonyl frequency at 1710 cm-I which is decreased to 1680 cm-I upon melting. The Raman hypochromism in the bands reported are equal to or much larger than any reported for other nucleic acids. The data are consistent with the low temperature form of poly(mII) being an ordered single stranded unit with a high degree of basestacking. The melting profiles obtained from the uv and cd spectra are consistent with and support the Raman data. This single stranded RNA exhibits an uncharacteristic behavior in that it melts cooperatively.


Model studies of interactions between nucleic acids and proteins: hydrogen bonding of amides with nucleic acid bases. The formation of hydrogen bonded complexes between nucleic acid bases and acetamide has been studied by nuclear magnetic resonance in CDC13 at different temperatures. Pairs of hydrogen bonds are formed when acetamide binds to nucleic acid bases. Thermodynamic parameters have been computed and compared to those obtained for the association of carboxylic acids with nucleic acid bases. The role of hydrogen bonded complexes in the association of proteins with nucleic acids is discussed.


Anisotropic flexibility of DNA and the nucleosomal structure. Potential energy calculations of the DNA duplex dimeric subunit show that the double helix may be bent in the direction of minor and major grooves much more easily than in other directions. It is found that the total winding angle of DNA decreases upon such bending. A new model for DNA folding in the nucleosome is proposed on the basis of these findings according to which the DNA molecule is kinked each fifth base pair to the side of the minor and major grooves alternatively. The model explains the known contradiction between a C-like circular dichroism for the nucleosomal DNA and the nuclease digestion data, which testify to the B-form of DNA.


Properties of a small transcribed poly A sequence in heterogeneous nuclear RNA of HeLa cells. A class of heterogeneous nuclear RNA (hnRNA) molecules contain an internal transcribed poly A sequence of close to 25 uninterrupted AMP residues. HnRNA molecules containing this sequence are separable from those containing the large 3' terminal poly A sequence on the basis of their differential affinity for oligo dT cellulose. The fact that the transcribed small poly A and the 3' terminal poly A are not found in the same hnRNA molecules even though both are present in similar size classes and that the small poly A is absent from cytoplasmic messenger RNA (mRNA) has led us to propose a scheme for mRNA processing in which the 3' end of the small poly A in hnRNA becomes a priming size for the post-transcriptional addiction of the large poly A.


A conformational study of nucleic acid phosphate ester bonds using phosphorus-31 nuclear magnetic resonance. A systematic phosphorus-31 nuclear magnetic resonance study of some nucleic acid constituents (6-N-(dimethyl)adenylyl-(3',5')-uridine and some nucleotide methyl esters) is presented. The temperature dependent phosphorus-31 chemical shifts were analyzed by standard thermodynamic procedures. It is shown that gt conformations about the P-O ester bonds have a lower free energy content relative to gg conformers.


Cytoplasmic location of undermethylated messenger RNA in Novikoff cells. Novikoff cells in culture were labeled with L-[methyl-3H]methionine and [U-14C]uridine in the presence of (a) TubHcy2, (b) AdoHcy, (c) homocysteine, (d) tubercidin, or (e) without any additions. Only in cultures labeled in the presence of TubHcy were undermethylated cap structures observed to represent a significant portion of [3H]methyl radioactivity. Novikoff cells in culture were then simultaneously labeled with L-[methyl-3H]methionine and [32P]orthophosphate in the presence or absence of TubHcy. Total cytoplasmic, polysomal and monosomal poly(A)-containing RNAs were analyzed. Both monosomal and polysomal mRNA fractions from TubHcy-treated cells contain partially methylated cap structures, suggesting that 2'-O-methylation of the nucleoside adjacent to the pyrophosphate linkage in caps is not required for transport, ribosomal binding or translation. Comparison of nuclear and cytoplasmic cap structures from normal and inhibited cultures indicate that an altered mRNA population is generated in the presence of TubHcy.


The use of exonuclease III for preparing single stranded DNA for use as a template in the chain terminator sequencing method. Exonuclease III, which degrades DNA 3' leads to 5' and is specific for duplex DNA, can be used to prepare single stranded DNA from linear duplexes. This is shown to be suitable as a template for use with the chain terminator DNA sequencing method of Sanger et al. [1]. Strategies are discussed for preparing single stranded DNA templates by this method and, in particular, its application to the sequence analysis of DNA cloned in plasmid vectors.


The mode of Mg++ binding to oligonucleotides. Inner sphere complexes as markers for recognition? Large changes of UV absorbance and CD spectra as well as specific relaxation processes with time constrants around 50 mus are found for the association of Mg++ with A(pa)n. The Mg++ binding constants strongly increase with increasing n. The relaxation data demonstrate that a large fraction of Mg++ bound to short A(pA)n forms inner sphere complexes (ISC), with H2O molecules from the inner hydration sphere of Mg++ exchanged against some site (s) of the oligomer. This fraction decreases from about 85% for A(pA)4 to less than 10% for A(pA)17. A parallel decrease is observed in the relative change of CD spectrum upon Mg++ binding from 77.5% for A(pA)4 to 13.4% for (pA)17. The rate of ISC formation decreases with increasing n suggesting some (probably sterical) hindrance effect at high n. The data support the conclusion that Mg++ favours the formation of outer sphere complexes with linear polynucleotides and require a special chain folding for ISC. Measurements of Mg++ binding to C(pC)5, U(pU)5, I(pI)5 and d[A(pA)5] did not give evidence for the formation of ISC, indicating that both specific base and sugar residues are required for ISC. These results suggest the possibility that Mg++ISC ARE USED FOR SPECific recognition of nucleic acid sequences.


Comparison of non histone proteins selectively associated with nucleosomes with proteins released during limited DNase digestions. Cultured mammary cells from GR mouse were used to analyse proteins associated with the mononucleosomes and released by a short micrococcal DNase treatment of nuclei. On metrizamide density gradients, mononucleosomes appear to be heterogeneous according to their content of associated non-histone proteins. Proteins associated with the denser fraction (1.22 - 1.24 g/ml) were analysed by two dimensional electrophoresis and compared to the proteins released by DNase I treatment. All the proteins associated with mononucleosomes were also released by DNase I treatment. It could then be assumed that these proteins are associated with the active part of the genome. Additional proteins were released by micrococcal DNase treatment of the nuclei. They could be involved in a higher order organization of chromatin.


Isolation of hydroxy-Y base from rat liver tRNAPhe. A Y-base derivative was isolated from rat liver tRNAPhe and its structure was assigned to be alpha-(carboxyamino)-beta-hydroxy-4,9-dihydro-4,6-dimethyl-9-oxo-1H-imidazol[1,2-a]purine-7-butyric acid dimethyl ester (hydroxy-Y), based on the results of mass spectrometry and chemical degradation. This modified base seems to be the major fluorescent component of rat liver tRNAPhe; the peroxy-Y base previously isolated from rat liver tRNAPhe and characterized by Nakanishi and his coworkers (1,2) was not present in our preparation.


Isolation and partial characterization of plasma membranes from rat lung alveoli. Plasma membranes from rat lung alveoli were isolated under hypotonic conditions (1 mM NaHCO3, 5 mM dithiothreitol, pH 7.5) using differential centrifugation and nonlinear sucrose gradient centrifugation techniques. Plasma membranes possessed densities of 1.13 and 1.16 g/cm3. The low density (1.13 g/cm3) fraction represented 2.2 and 2.0% of the total initial homogenate 5'-nucleotidase, EC 3.1.3.5 (a plasma membrane marker enzyme for rat lung, B.L. Riemer and C.C. Widnell, Arch. Biochem. Biophys. 171, 343-347, 1975) and adenylate cyclase, EC 4.6.1.1, respectively. The purification of 5'-nucleotidase and adenylate cyclase in the low density fraction relative to their specific activities in the homogenate was 11.2 and 5.7, respectively. The cholesterol to phospholipid ratio of this fraction was 0.73. The electron microscopic study of this fraction revealed the presence of small vesicles exhibiting a typical unit membrane structure. Plasma membrane vesicles isolated by this procedure could provide a source of material to study this adenylate cyclase system.


A rapid procedure for the large scale purification of elastase and cathepsin G from human sputum. A procedure is described which permits the rapid isolation of large amounts of elastase and cathepsin G from purulent sputum. This procedure involves: (1) digestion of sputum with DNase, (2) extraction of the insoluble residue that remains with 1 M NaCl, pH 8, (3) affinity chromatography on Sepharose-bound Trasylol, and (4) separation of the two enzymes by chromatogrphy on CM-Sephadex. Starting with 500 g of sputum it was possible to isolate 175 mg of each of these two enzymes within 7 to 10 days. Active site titration indicated both enzymes to be at least 97% pure. Disc gel electrophoresis in the presence and absence of SDS and amino acid sequence of the N-terminal region support the conclusion that the elastase and cathepsin G isolated from sputum are identical to the same enzymes isolated directly from the leukocytes of human blood.


On preparative separation of brain mitochondrial monoamine oxidases. A method was developed for solubilization from bovine brain stem mitochondrial fraction of monoamine oxidases deminating biogenic amines. Preparative separation of the monoamine oxidases, possessing different substrate specificities, was achieved by column chromatography on a biospecific adsorbent AH-Sepharose 4 B. The enzyme preparations thus obtained did not contain any detectable by disc-electrophoresis of isoelectrofocusing in polyacrylamide gels proteins which were devoid of the monoamine oxidase activity.


Interaction of brain noradrenaline and the pituitary-adrenal axis in learning and extinction. The effect of 6-hydroxydopamine-induced degeneration of the dorsal tegmental noradrenergic (NA) projection alone or in combination with the removal of the adrenal glands was examined on several behavioral tasks. No impairment of acquisition on a continuously reinforced lever pressing response for food reward was seen as a result of the combined treatment. However, resistance to extinction was observed after depletion of forebrain noradrenaline on its own and this effect was prevented by the adrenalectomy. Adrenalectomy on its own failed to affect extinction. Acquisition of a passive avoidance task was slightly impaired after forebrain noradrenaline depletion but only the group with combined noradrenaline  loss and adrenalectomy showed a 24 hour retention deficit. No alteration in shock thresholds was found in any group although both adrenalectomized groups consumed less food and were slightly less active in locomotor cages. It is suggested that previous reports of acquisition and retention deficits in avoidance tasks after combined dorsal NA bundle lesions and adrenalectomy are due to alterations in fear motivation rather than to a general learning impairment.


Effects of chronic intraventricular administration of angiotensin II on drinking behavior and blood pressure. Angiotensin II was continuously infused into the lateral cerebral ventricle of rats, and the effects on daily food and water consumption, urine volume, and aortic blood pressure were studied. All was infused at a rate of 10 ng/hr for seven days, using subcutaneously implanted osmotic minipumps. An intraventricular (IVT) control group was infused with only the saline vehicle, while a third group received AII subcutaneously. IVT AII rats showed a four-fold increase in water consumption, to a mean of 171 ml/day during Days 2-4 of infusion, whereas water intake of the other groups did not change from preinfusion levels. Urine volume showed a similar pattern to water intake, increasing five-fold in the IVT AII group during Days 2-4. These measures declined during the final three days of AII infusion, but significant tolerance was not observed. Food intake decreased markedly in both saline and IVT AII groups after implantation of the pumps, but the latter resumed normal food intake more slowly than the former, and body weight remained below preinfusion levels throughout the AII period. Aortic blood pressure of the IVT AII rats showed a slight, but progressive, rise during the infusion period, but it did not significantly exceed that of the saline rats. These results indicate that continuous, low-level, intraventricular infusion of AII may markedly increase water intake without significantly increasing fluid retention or blood pressure.


Free-operant and auto-titration brain self-stimulation procedures in the rat: a comparison of drug effects. Rats were implanted with bipolar stimulating electrodes aimed at the medial forebrain bundle of the lateral hypothalamus, and trained to press a lever in one of two different procedures in order to receive electrical stimulation through the electrodes. In a free-operant procedure, each response produced a 200 msec train of electric pulses at a suprathreshold current, the intensity of which remained constant throughout the session. In an auto-titration procedure, each response produced an electrical stimulus which was initially set at a suprathreshold intensity. Every 15th response reduced the stimulation current by 3 muA. The animal could reset the current to its initial intensity at any time by pressing a second lever in the test chamber. The average current at which the animal pressed the reset lever was defined as the reinforcement threshold. Dose-response functions were determined for d- and l-amphetamine, alpha-methyltyrosine, and haloperidol. The reinforcement threshold was decreased by both d- and l-amphetamine, increased by haloperidol, and not changed by alpha-methyltyrosine. These effects on reinforcement threshold were not consistently related to the drug-induced changes in response rate in either procedure. The auto-titration procedure may be useful for distinguishing between drugs which cause nonspecific changes in the rate of ongoing behavior and those which specifically modify the reinforcement efficacy of brain stimulation.


Avoidance, operant and locomotor behavior in rats with neostriatal injections of kainic acid. Compared with saline injected controls, rats with bilateral injections of kainic acid (KA) in the dorsal neostriatum showed increased locomotor response to d-amphetamine, increased resistance to extinction and impaired acquisition and retention of passive avoidance. The KA injection resulted in loss of local neurons in the dorsal neostriatum, with no appreciable damage either to dopaminergic terminals or to extrinsic myelinated axons, thus supporting both the selective neurotoxic action of KA on neuronal perikarya and the proposed similarity of KA-induced neostriatal lesions with those found in the caudate-putamen of patients with Huntington's disease. Although loss of hippocampal neurons was occasionally observed, the behavioral results could not be wholly attributed to hippocampal damage, since rats with no demonstrable extrastriatal lesions were not less impaired than those with hippocampal damage. An altered arousal reaction to stressful situations might account for the learning and memory impairments of the KA neostriatal rats.


Disruption of taste aversion learning by pretreatment with diazepam and morphine. Laboratory rats were pretreated with either morphine (9 mg/kg IP), diazepam (4 mg/kg 1P) or Ringer's solution 2, 3 1/2, and 2 hr, respectively, prior to ingestion of a novel tasting saccharin solution followed immediately by a single injection of one of these agents. Animals pretreated with Ringer's solution followed by an injection of either morphine or diazepam showed a conditioned taste aversion (CTA) as determined by a significant reduction in the mean saccharin intake on a subsequent test trial. Although the drug pretreatments alone produced no conditioned avoidance behavior, the diazepam pretreatment completely blocked the development of both diazepam and morphine-evoked CTAs while the morphine pretreatment prevented a CTA induced by itself but not by diazepam. The results were discussed in terms of the attenuating effects of the pretreatments on the relative saliency of the subsequent conditioning drug injection.


Reversal of ethanol induced body dehydration with prolonged consumption in rats. Ethanol induced negative water balance has been previously inferred from fluid turnover rates upon initial exposure followed by restored normal fluid balance with prolonged exposure. The first two experiments of the present investigation noted hypovolemia and carcass dehydration during the initial few days of forced choice maintenance on 10% ethanol with recovery to near normal levels of intravascular volume and carcass water after 2 months of forced consumption. A third experiment attempted to test whether the alcohol induced dehydration could be corrected with the administration of exogenous ADH.


Cross-tolerance between delta9-tetrahydrocannabinol and ethanol: the role of drug disposition. Acute challenge doses of delta9-tetrahydrocannabinol (THC), 10.1 mg/kg, administered intragastrically by gavage (IG), or ethanol, 1.24 g/kg, IP, reduced the rotarod performance of female rats by 50%. Daily treatment of the animals with THC, 10.1 mg/kg, IG, or ethanol, 4 g/kg, IG, resulted in tolerance development to the impairing effects of the challenge doses of each drug on rotarod performance. THC-tolerant animals were cross-tolerant to the challenge dose of ethanol, but ethanol-tolerant rats did not show complete cross-tolerance to the challenge dose of THC. THC-tolerant animals initially had higher blood levels of 14C-THC than controls after IG drug administration. Following IV injection, the rates of 14C-THC disappearance were equivalent in the latter groups. 14C-THC disappearance was not altered in ethanol-tolerant animals. The rates of ethanol disappearance were not significantly modified in THC- or ethanol-tolerant animals. In conclusion, THC-tolerant female rats demonstrated cross-tolerance to ethanol as shown previously for males. Furthermore, the development of tolerance and cross-tolerance was not a function of changes in drug disappearance.


Effects of clozapine on the activity of central dopaminergic and noradrenergic neurons. The effects of clozapine on the spontaneous firing rate of noradrenergic (NE, locus coeruleus), dopaminergic (DA, zona compacta, ventral tegmental area) and non-dopaminergic (zona reticulata) neurons was studied in chloral hydrate anesthetized rats. Clozapine administered intraperitoneally significantly increased the spontaneous activity of NE and DA neurons. After a cumulative dose of 8 mg/kg clozapine, the increase of mean firing rate per min of zona compacta and ventral tegmental area neurons attained almost similar values. Amphetamine reversed the clozapine-induced stimulation of NE and DA neurons. Zona reticulata neurons were depressed by clozapine. Neither amphetamine nor physostigmine were effective in antagonizing the inhibition. Our results suggest that clozapine blocks central NE and DA receptors. Furthermore, they fail to reveal a smaller sensitivity of the striatum as compared to the limbic system to the effects of clozapine.


Possible involvement of brainstem norepinephrine in pentylenetetrazol convulsions in rats. The thresholds of twitch and clonic convulsion induced by intravenous infusion of pentylenetetrazol (PTZ) were measured in rats treated with 6-hydroxydopamine (6-OHDA). In adult rats, intraventricularly applied 6-OHDA increased susceptibility to PTZ convulsions and decreased norepinephrine (NE) contents of the cortex, hypothalamus and brainstem. When 6-OHDA was applied intraventricularly at 8 days after birth, PTZ convulsion susceptibility was slightly decreased and brainstem NE content was significantly increased. However, the effects of 6-OHDA given at 20 days after birth were similar to those observed in adults. Significant decrease of cortical and hypothalamic NE contents, but no change in PTZ convulsion susceptibility, occurred following 6-OHDA injections into the dorsal and ventral NE bundles. These results suggest that the brainstem NE neurons play an inhibitory role on the development of PTZ convulsions.


Opiate modification of intracranial self-stimulation in the rat. Studies were conducted to confirm the involvement of central opiate receptors in the expression of opiate modulation of intracranial self-stimulation (ICSS). Biphasic, dose-related changes in ICSS responding are described following IP administration of morphine sulfate (1-25 mg/kg) and levorphanol tartrate (LEV, 0.5-5 mg/kg). Similar patterns of response modification are reported following intraventricular (IVt) administration of LEV (0.01-0.2 muMoles) LEV's enantiomorph, dextrorphan, was not found to elicit comparable effects after either IP or IVt administration. Both the facilitatory and the depressant phases of LEV's action were antagonized by naltrexone (10 microgram, IVt), which had no apparent effect on ICSS by itself. Complete tolerance developed to the suppression of responding by 2.5 mg/kg LEV (IP) but not to the facilitatory effect of 0.5 mg/kg (IP), during a 5-day course of administration. The implications of these results for opiate reinforcement theory are discussed and possible mechanisms are advanced.


Cholecystokinin, amphetamine and diazepam and feeding in lean and obese Zucker rats. The hyperphagia characteristic of some types of obesity may result from a deficiency in one or more components of the systems controlling satiety which in rats may include the gastrointestinal hormone cholecystokinin (CCK). Obesity may also influence responsivity to often used central nervous system (CNS)-acting drugs and combination of drugs. In these experiments it was shown that: (1) Zucker fatty rats were less sensitive than lean to intraperitoneal injections of 20 U/kg CCK after a 6-hr fast and when reduced were less sensitive than lean and less sensitive than when obese to injections of 5 U/kg CCK; (2) Although fatties were equally sensitive as leans to injections of 0.5 and 1.0 mg/kg d-amphetamine sulfate, when reduced, they were less sensitive; (3) Injections of 1.25 and 2.5 mg/kg diazepam produced smaller increases in food intake after a 6-hr fast in fatty and reduced fatty than lean rats; (4) Combination of diazepam with cholecystokinin in both fatty and lean rats produced feeding similar to that following injection of carrier; and (5) A similar additive effect was obtained in both fatty and lean rats when diazepam was combined with amphetamine; however, the fatty appeared to be more sensitive to the amphetamine than the diazepam effect. Thus the Zucker fatty rat appears to be less sensitive to these chemicals which affect food intake, which supports the contention that their CNS is generally less responsive.


Drug induced activity in lead-exposed mice. Three interrelated studies were conducted to examine the locomotor activity of lead-exposed mice. The effects of lead were examined as a function of the dose and duration of exposure. Exposure during the first three weeks occurred via the maternal milk supply. Exposure following weaning was achieved via the water supply. Mice received challenges with various pharmaceutical agents, including d-amphetamine, methylphenidate, apomorphine and phenobarbital. The spontaneous activity prior to injection and the drug-induced activity were monitored. Lead-exposed mice usually displayed spontaneous activity which was indistinguishable from that of the control animals. In only one set of observations did lead exposure result in a modest increase in spontaneous activity. The drug-induced activity varied in a complex manner as a function of the magnitude and duration of the lead exposure. Depressed body weight, which was concurrent with high lead exposure (0.5% Pb(Ac)2) was also a significant parameter affecting both the spontaneous and drug-induced activity.


[Identification of an antimicrobially active constituent isolated from propolis (author's transl)]. On isolating and identifying antimicrobially active propolis constituents, the authors detected a substance that must be regarded as a mixture of caffeic acid esters. The caffeic acid moiety was unequivocally identified by various chemical and spectroscopic methods. The results obtained from the gas chromatographic study of the alcohol fraction after hydrolysis of the isolated compound identify benzyl alcohol, phenyl ethyl alcohol and cinnamic alcohol as ester components. Furthermore, the mass spectroscopic findings are indicative of the presence of a caffeic acid pentenyl ester in the mixture. Attempts to separate this ester mixture by recrystallization and thin-layer chromatography failed.


[On the importance of the steam trap to the efficient sterilization of solutions in stored blood bottles by saturated steam under pressure (author's transl)]. Biological tests with soil samples were performed to fix the sterilization time for a new steam sterilizer. These tests yielded repeatedly positive spore findings despite modifications of the conditions of sterilization. Having excluded a series of possible sources of trouble, the authors stated that the quality of the steam was the assignable cause. After restoration of the functionality of the steam traps, the biological tests yielded negative results also under normal conditions of sterilization.


Synthesis of some substituted aminophenazones of possible therapeutic interest. Synthesis of four different series of compounds having the phenazone moitety was accomplished, in the hope that one or more of the prepared compounds might possess pharmacological activity. These compounds may contain a hydrazone, an acid hydrazide, certain basic residues, or disubstituted urea structure.


[Contribution to the stability of papaverine. Part 2: Quantitative determination of papaverine in the presence of degradation products (author's transl)]. With resort to the coralyne reaction the authors present a fluorometric method permitting to determine papaverine directly in the presence of papaverinol and papaveraldine. The standard deviation of the method is +/- 1.63.


Effect of certain additives on the dissolution rate of chloramphenicol. A study was conducted on the effect of certain additives on the dissolution rate of chloramphenicol. The effect of adsorbents, natural and synthetic surface active agents, diluents and lubricants was studied. Many of these additives increased the dissolution rate of chloramphenicol from capsules.


Effect of chronic exposure to tobacco smoke on some blood lipids and coagulation parameters in the rat. Adult male rats were exposed to tobacco smoke from filter-tipped cigarettes twice daily for a period of four months. Some blood lipids and coagulation parameters were studied. This treatment did not change the serum cholesterol, whereas it significantly increased serum triglycerides and plasma free fatty acids; these were possibly secondary to nicotine-induced catecholamine release. Blood thromboplastic activity as well as platelet aggregation were significantly increased. On the other hand blood fibrinolytic and prothrombin activities were unaffected. These results were discussed.


Assessing exercise tolerance: a review.

Assessing exercise tolerance: a review. The purpose of this article is to provide guidelines for monitoring and assessing exercise tolerance. Monitoring and interpreting pulse rate, blood pressure, respiration, skin characteristics, fatigue, pain, coordination, and electrocardiography are discussed. The basis for applying these principles to graded-exercise-tolerance testing is also discussed.


Energy cost of walking of below-knee amputees having no vascular disease. Fifteen unilateral below-knee amputees with no preexisting vascular disease were studied during free velocity walking to determine energy expenditure with and without a prosthesis. Expired air was collected, and heart rate and respiratory rate data were telemetered. Mean velocity for the unrestrained walking was 71 m/min, both during ambulation with a prosthesis and during crutch walking (without a prosthesis). Heart rates were within normal ranges during prosthetic walking (106 beats/min), but rose significantly to 135 beats/min for crutch walking. Energy cost also rose significantly from a mean of 15.5 ml O2/kg/min with a prosthesis of 22.3 ml O2/kg/min with crutches. The oxygen uptake measured in units of ml O2/kg/m increased when the subjects walked faster or slower than their free cadence. We concluded that the use of the prosthesis should be encouraged and that the amputee should be allowed to choose his natural velocity of walking.


The right to health care. Ideal or imperative? The purpose of this presentation is to increase the physcial therapist's understanding of the current concept of a "right to health care" and to explore the moral implications for physical therapy arising out of the various interpretations currently being advanced. The term "right" is used in two ways: 1) "freedom right," providing freedoms from certain types of interferences and 2) "entitlement rights," calling for positive action on the part of others. The right to health care is viewed as an entitlement right. As such, it has been variously interpreted as a praiseworthy ideal or an imperative upon society. The moral implications associated with accepting either position are briefly examined, giving special attention to the dilemmas and promises posed for physical therapists in both positions.


The asymmetrical tonic neck reflex in normal full-term infants. The purpose of this study was to determine whether the asymmetrical tonic neck reflex was present in normal 1- to 12-week-old infants. Twelve infants were observed seven times within the first 12 weeks: at the first and second week and every other week thereafter. Spontaneous behavior was videotaped while the infant lay supine. Infants maintained a head-turned posture during every visit. The asymmetrical tonic neck reflex was present: 1) in the infants' arms during every visit, at a maximum at the sixth week; 2) in their legs, with the longest duration of the response at the first week's visit; and 3) in both arms and legs, with no change throughout seven visits. There were more movements of the face arm than of the skull arm during the seven visits, and the additional movements were in the extension range. The face leg moved more than the skull leg, but only at the 6th, 8th, and 10th weeks. The study confirms that the asymmetrical tonic neck reflex can be observed in the posture and movement of normal infants and that the pattern of appearance of the reflex differs in arms and legs.


Establishing activity and training levels for patients with ischemic heart disease. The paper presents guidelines for determining ideal training heart rates and recreational and occupational energy-cost levels for individual patients with ischemic heart disease. These guidelines were established by Karvonen, are based on results of progressive exercise testing, and have been applied to a broad spectrum of subjects in outpatient conditioning programs. How to apply these guidelines to establish beneficial and safe activity levels is illustrated with a fictional patient's medical history, progressive exercise test results, and recreational and occupational history and preferences.


The effect of an exercise program on change in curve in adolescents with minimal idiopathic scoliosis. A preliminary study. Forty-two adolescents with minimal idiopathic scoliosis, who had been on an exercise program for 9 to 15 months, were evaluated to determine the influence of exercise on change in their curvatures. A difference of 4 degrees or greater between initial and final curve measurements was considered to be a change. Five percent of the curves increased, 74% remained the same, and 21% decreased. Change in curvature for these patients was also compared with that of a matched retrospective group of adolescents with scoliosis who had not had the exercise program. No significant difference in change in curve between the two groups was found. For patients who had been on the exercise program, there was no significant relationship between change in curve and extent of physical activity or between change in curve and exercise recall, correct performance, or frequency. Limitations in the study design and possible explanations for the results are discussed.


Is there a reduction mammaplasty for "all seasons?". No technique will serve the needs of all patients requiring a reduction mammaplasty and mastopexy. However, the modified, inferiorly-based dermal flap technique appears to us to offer the most advantages and the greatest latitude for a predictable breast reduction in most of these patients.


Prevention of muscle necrosis in an experimental neurovascular island muscle flap by a vasodilator drug--isoxsuprine. We report an experiment that demonstrates one means to prevent necrosis in an experimental island muscle flap. The results imply that necrosis of skeletal muscle in a clinical flap could be prevented by treatment with isoxsuprine.


Five-year history of the American Society of Plastic and Reconstructive Surgeons, 1974--1978. This report was intended to summarize the significant happenings in the American Society of Plastic and Reconstructive Surgeons, and its affiliates, from the end of the annual meeting in 1973 to the end of the 1978 annual meeting. It was decided to not include our sister organizations--the American Association of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, the American Society of Maxillofacial Surgeons--because their historians publish periodic reports about their activities. I am sure that the future reports of historians will record with pride the continued growth and development of plastic surgery, because the future of our specialty has never seemed brighter.


The fate of breast implants with infections around them. In a retrospective study of 41 infected breasts following the insertion of implants, a high incidence of postoperative hematoma was noted. When infection occurred, cultures usually demonstrated the causative organism to be Staphylococcus aureus. Treatment by conservative drainage and vigorous antibiotics was generally successful in salvaging those implants which had been inserted through an areolar incision for simple augmentation, or under the pectoralis muscle (or a dermal pedicle) after a subcutaneous mastectomy. Those patients whose augmentations had been done through an inframammary incision, or whose implant after a subcutaneous mastectomy was under the skin flap, had a statistically higher incidence of implant loss. Most breasts will salvaged implants became firm.


Successful lymph node transplantation in rats, with restoration of lymphatic function. After doing a popliteal lymphadenectomy in rats, we were able to transfer a mass of inguinal nodes to the area, either on an island pedicle of the superficial epigastric vessels, or as a free flap by microvascular anastomoses. The transplants survived and at 7 days were able to entrap india ink particles, or particles of radioactive gold, injected in the distal part of the extremity.


Aneurysms after microvascular anastomoses. Incidence and pathogenesis in experimental animals. This study has demonstrated that aneurysms occur in about 50 percent of the rat femoral arteries subjected to microvascular anastomosis. These aneurysms are consistent histologically--being characterized by medial necrosis, loss of elastic lamellae, and subintimal hyperplasia. Mechanical trauma is implicated as a factor in their pathogenesis, though further study in necessary to define the exact etiology.


Easy removal of a partially embedded ring from a finger. An unusual case of a wedding band embedded under the skin of the ring finger is presented. A technique for removal of an embedded ring is described, which avoids additional trauma to the finger.


Blowout fracture of the medial orbital wall, with entrapment of the medial rectus muscle. A case of fracture of the orbital wall, with entrapment of the medial rectus muscle and paresis of the 6th nerve in association with a large fracture of the orbital floor, is presented. The diagnosis was made primarily by the forced duction test.


[Serum creatine kinase activity in psychoses]. This is a report of the initial results of determinations of the creatine kinase activity in the serum of forty psychiatric and twenty-five neurological patients. A determination of the creatine kinase activity made in the first days of an acute endogenous psychosis invariably showed an increase in creatine kinase which returned to normal values after eight to fourteen days. Patients with residual schizophrenia, conditions of acute excitation accompanying psychopathy, and abnormal personality or circumscribed paranoid development showed creatine activity in the range of normal values. Alcoholics with incipient or strongly marked delirium tremens showed normal creatine kinase activity in those cases where the situation was not complicated by additional traumata or other accompanying diseases.


[Medical prerequisites for the rehabilitation of adult epileptics]. The rehabilitation of adult epileptics may be substantially improved by (1) having all patients suffering from attacks carefully examined by specialists; (2) perfecting methods of diagnosis with the goal of drastically reducing the number of inexplainable cases of epilepsy; (3) making further progress in therapy and improving the present methods of checking the results of treatment; (4) and removing prejudices against both epilepsy and epileptics.


[Diagnostic problems of chronic misuse of barbiturate-free sedatives]. Atypical neuropsychiatric disease pictures resulting from chronic abuse of barbiturate-free soporifics are often misinterpreted diagnostically. The problems of diagnosis are discussed on the basis of experience gathered by the authors and with due consideration of results reported in the literature.


[Oral automatism in acute coma].

[Oral automatism in acute coma]. Of 98 patients in ai acute state of coma different etiology, 18 (or 18.4 percent) showed series of rhythmic oral motions ("chewing automatisms"). Only one of these patients was observed to develop an apallic syndrome. The characteristic features of chewing automatisms and their concomitant symptoms are described, and the need for delimiting them from more differentiated oral-motor patterns is emphasized. Both forms are of different importance to an assessment of the respective course of disease. The observation of chewing automatisms in acute states of coma does not allow the incipient development of an apallic syndrome to be inferred.


Depressive affect, anxiety, and psychic conflict in the phallic-oedipal phase. The author's recent contributions to affect theory and its relation to psychic conflict are applied to the understanding of the nature, genesis, and consequences of psychic conflict in the phallic-oedipal phase. These contributions lead to a better understanding of 1) the importance of depressive affect in phallic-oedipal conflicts, 2) similarities and differences between such conflicts in boys and girls, 3) depression as a symptom in adult life, and 4) some aspects of narcissism.


An approach to the study of analyzability and analyses: the course of forty consecutive cases selected for supervised analysis. The cases of 40 consecutive patients, accepted for supervised psychoanalysis at the Treatment Center of The New York Psychoanalytic Institute, are reviewed. The process of the initial evaluation is examined as well as the nature of the patient group, the characteristics of the treatment, outcome, and follow-up data. A survey of a group of 42 patients from the private practice of a group of graduate analysts during the same period of time is also reported. Both studies are discussed in relation to methodological issues, and an approach is suggested for the study of assessment of analyzability and analyses through a systematic prospective study of analytic treatments conducted by experienced analysts.


Form creation in rat: an ego-psychological approach to creativity. The recent ego-psychological approach to form in art is utilized to understand the significance of form creation to artistic creativity in general. Two kinds of form in art are discussed--"good form"  and "perfect form". The first is explained as the means used by the artist's ego to facilitate the expression and communication of latent meanings; the second, as the means used by the artist's ego to order disparate mental elements and to reconcile those opposite wishes, ideas, and emotions, whose opposite valences may endanger the integrity and cohesion of the self. In line with the assumptions presented in the paper, creativity and neurosis are described as two different methods used by the ego to solve the same underlying problems.


Imaginary companions in childhood and adult creativity. Case material is presented to illustrate the thesis that the ability to create an imaginary companion during childhood is an early expression of the special ego aptitudes found in creative individuals in adult life. Such "companions" allow these children to attempt to master creatively a variety of narcissistic mortifications suffered in reality and to displace unacceptable affects. In creative adults who had imaginary companions in childhood, the early fantasies serve as an organizing schema in memory for the childhood traumata. Stimuli in adult life which evoke the earlier traumata may revive the original imaginary companion fantasies. These then serve as nodal bases for the creation of specific adult works of art.


A signal detection analysis of the effects of transcutaneous stimulation on pain. Transcutaneous nerve stimulation (TNS) applied both ipsilaterally and contralaterally with a tonic pain stimulus was compared to a control condition to determine its effect on pain reports. The ipsilateral TNS condition significantly reduced ratings and increased pain thresholds relative to the contralateral and control conditions which did not significantly differ from each other. A Signal Detection Theory analysis of the data was employed to assess the sensitivity and response bias effects of the treatment conditions. Ipsilateral TNS significantly reduced pain sensitivity and response bias in the direction of showing a lesser tendency to report pain. The effects of ipsilateral TNS were most pronounced at the higher levels of stimulation. The results are consistent with Gate Control Theory which holds that ipsilateral TNS attenuates painful sensation. Most importantly, these results support the efficacy of TNS for the treatment of clinical pain.


Medical outcome in asthmatic patients: effects of airways hyperreactivity and symptom-focused anxiety. Hypotheses about medical outcome in asthma, indexed by rates of rehospitalization within 6 months after discharge from long-term intensive care, were evaluated. Predictions for rehospitalization were based on the levels of airways hyperreactivity, indexed by inhalation challenges with histamine or methacholine, and levels of anxiety focused upon and concurrent with periods of asthmatic distress, indexed by Panic-Fear symptomatology. Results indicated that, although some prediction could be made on the basis of levels of anxiety and airways hyperreactivity alone, the best predictions resulted from the combined effects of these factors. Almost half of the patients who had highly hyperreactive airways and a tendency to disregard symptoms of breathing difficulty were rehospitalized. By comparison, none of the patients who had less hyperreactive airways and a tendency to be vigilant about their symptoms were rehospitalized. The hypotheses and results are discussed with respect to symptom-focused and general, illness-dependent types of anxiety which have different effects upon medical outcome in chronic asthma. The results have implications for the application of anxiety-reducing forms of intervention in asthma.


Adjustment in diabetic adolescent Girls: I. Development of the Diabetic Adjustment Scale. A 37-item scale was designed to assess life adjustment in 105 adolescent girls with juvenile diabetes. The scale elicited information on peer relationships, family relationships, body image concerns, dependence-independence conflicts, school adjustment, and attitudes toward diabetes. Results of this initial attempt at measuring diabetic adjustment suggest that this group of girls was relatively well adjusted and that their attitudes toward diabetes correlate positively with many adjustment factors. The importance of self-report scales which address the realities of life with diabetes is emphasized.


Adjustment in diabetic adolescent girls: II. Adjustment, self-esteem, and depression in diabetic adolescent girls. The Rosenberg Self-Esteem Scale, Beck Depression Inventory, and Sullivan Diabetic Adjustment Scale were administered to 105 adolescent girls with diabetes. Results indicate that levels of self-esteem and depression highly correlate with the level of adjustment as assessed on the Diabetic Adjustment Scale (DAS). That is, the adjustment of adolescent diabetic girls in peer and family relationships, dependence-independence conflicts, and attitudes toward diabetes is significantly related to self-esteem; and the level of depression is significantly related to all these adjustment factors as well as body image. The results point to the usefulness of the DAS as a potential screening device for low self-esteem and depression in adolescent girls who have diabetes. The importance of diabetes as a scapegoat for normal adolescent concerns is discussed. It was also hypothesized that depression in adolescents may be expressed through concerns about diabetes. The importance of exploring relationships with peers and fathers is emphasized.


Learned control of coronary blood flow.

Learned control of coronary blood flow. Mongrel dogs with chronically implanted electromagnetic flow probes on the left coronary artery were curarized and trained to decrease coronary blood flow in order to avoid and escape from stress. Each of four animals learned to consistently decrease coronary flow with increasing independence from changes in other cardiovascular dynamics. One animal achieved dramatic decreases suggestive of profound coronary vasoconstriction. The results may have important implications for the understanding of ischemic heart disease.


Computed tomography of the pancreas: a new roentgenographic examination. Lesions of the pancreas are considered to be among the most difficult lesions to visualize roentgenographically. The capability of computed tomography to record accurately the attenuation coefficients of human body tissue in cross section has enabled detailed images of the pancreas to be obtained for the first time. Computed tomography is proving to be one of the most reliable imaging modalities for demonstrating some of the many complex lesions of the pancreas.


Systematic approach to inservice education. To insure the success of an inservice education program in radiology, it is necessary for persons with the responsibility for it to base all programs on the needs of the patients, department, technologists, and other workers. In determining these needs and applying solutions to meet these needs, a systematic approach such as the one presented here should be used. It should guide those persons involved from a realization that needs exist to the implementation and evaluation of workable solutions.


Integration of clinical physics in radiation therapy education. The need and importance of training in clinical physics for the radiation student cannot be overemphasized. Through the approach described--the integration of clinical physics tutorial sessions with radiation therapy educational programs--there is no doubt that the student should be well versed in clinical physics before the completion of the program. It will enhance the technologists's position among his colleagues and he will be able to communicate intelligently with the three-member team--the radiation oncologist, the clinical physicist, and the radiation therapy technologist. The time and effort that the physics section extends to the student in radiation therapy technology will only enhance the professional status of the radiation therapy technological community.


["Polycystic disease": evaluation of the value of nuclear medicine. A case report (author's transl)]. The value of examining "polycystic disease" by means of nuclear medicine is being demonstrated -- using one case as an example. Nuclear medicine studies, because of their inherent capability of evaluating both morphology and function at the same time, seem to place this method ahead of others, including ultrasound and C.T.


[The anterior chorioidal artery and the posterior communicating artery in traumatic lesions of the middle cranial fossa (author's transl)]. The anterior chorioidal artery and the posterior communicating artery are for the angiographic evaluation of space occupying lesions in the middle cranial fossa very important. Dislocation of the temporal lobe can be differentiated in 5 types by angiographic demonstration of these arteries.


X-ray tube failures and prevention: a preliminary report. In a busy radiology department, the failure of a radiographic or fluoroscopic x-ray tube is costly in respect to the replacement of the tube and the amount of time that the radiographic or fluoroscopic suite is down. Several examples of tube failures are given, many methods of how tube failures can be prevented are discussed, and illustrative cases are shown.


Student preceptorships--a factor in alleviating maldistribution of health professionals? The maldistribution of health professionals between metropolitan and rural areas is a well-documented fact. The preceptorship has been hypothesized as a means of alleviating this problem. Upon completion of a preceptorship in radiologic technology, the students completed a questionnaire concerning values and interpretations derived from the preceptorship. This paper describes the results of the preceptorship and questionnaire.


[Extension of thoracic roentgen diagnosis by computer tomography (author's transl)]. In 400 examinations of the thorax results of computer tomography were compared with respective pa chest films and conbentional tomograms. In the peripheral areas of the lung, interstitial parenchymal alterations and metastases were better visualized by CT. The size of central bronchial carcinomas and space-occupying lesions of the thoracic wall can be determined with greater accuracy by CT. Primary tumors, lymphnode enlargement and vascular alterations can be differentiated and localized more precisely by CT. The size of the heart chambers, intracavitary tumors as well as septal and myocardial wall thickness can be determined non invasively.


[Pharmacokinetics of intravascular contrast agents in computerized tomography (author's transl)]. The pharmacokinetic behaviour of intravascular renal and biliary contrast agents is being evaluated with help of CT-densitometry. Contrast enhancement is best with high-dose bolus injection and rapid sequence CT-scanning of at least 4 cuts per minute.


[The use of a new renotropic contrast-medium in infants with special reference to magnesium metabolism (author's transl)]. Rayvist is the meglumine ioglicinate. This contrast medium is compared with Urovist in two groups of 15 infants. Electrolyte and osmolality changes in both groups are equal. In infants receiving Rayvist there were less gastro-intestinal distrubances than in those receiving Urovist. The drop of magnesium level in both groups is similar to the drop of calcium level following contrast medium injection. It is recommended to add calcium to the contrast medium in infants (1 ccm Calcium gluconicum 10% for 10 ccm contrast medium).


[Diagnosis and differential diagnosis of acute hematogenous osteomyelitis in infants (author's transl)]. Clinical and laboratory data are frequently unspecific in acute hematogenous osteomyelitis of infants. As prognosis is dependent on early treatment, a timely radiologic diagnosis is mandatory. Because of specialties in the vascular supply, the roentgenmorphologic alterations of acute hematogenous osteomyelitis in infants differ from the appearance of the disease in other age groups. The acute osteomyelitis in infants frequently leads to destruction of the epiphysis and purulent joint effusion. A subtle analysis of soft tissue lesions will already rise suspicion for acute hematogenous osteomyelitis before destructive or reactive osseous alterations prove the diagnosis by roentgenology. Nuclear medicine examinations of the bone have contributed significantly to radiologic diagnosis of acute hematogenous osteomyelitis in infants despite of few negative results. Osseous trauma and other diseases should be included in differential diagnosis. Especially in neonatals and premature infants, variations in the typical course and appearance of the disease may occur.


[Soft tissue changes of fingers in rheumatoid arthritis. Results of low k.v. radiographs in three views (author's transl)]. Based upon a large series of low k.v. radiographs of fingers in three views, the X-ray anatomy of the soft tissue of fingers is presented and soft tissue changes in joints, tendons and tendon sheaths due to rheumatoid arthritis as well as perifocal effects of the inflammatory process upon the subcutaneous tissue and the skin are described. Because of the resolution of even minute soft tissue changes it is possible to recognize the incipient stage of rheumatoid arthritis and of relapses devoid of clinical symptoms.


[Neuroradiological findings in epilepsies without consideration of cranial computerized tomography and radioactive brain scanning (author's transl)]. This paper gives a detailed summary of neuroradiological findings (X-rays of the skull, pneumoencephalograms and angiograms) in epilepsies and epileptic seizures, that is based on 902 patients, which have been treated in the Neuro-Psychiatric university hospital of Mainz during 1960 and 1975. First the different pathological findings and their frequency in relation to the single types of epilepsy are described. Then it is tried to draw conclusions from the neuroradiological findings to the etiology of the particular seizure-classes. In further passages important etiologies are chosen and the appearing different seizures with their neuroradiological findings are presented. Epilepsies due to unknown causes, due to brain damage in early childhood, post-traumatically, alcohologenic and caused by brain-tumors are considered. As no similar classification was found in the literature, our data could only be compared with those of different papers, each dealing with some aspects. In the absence of recent publications with statistical data we also had to refer to older papers. Differences between our results and those of the literature are discussed.


[Right vertebral artery originating from the right common carotid (author's transl)]. In the study of 273 aortic arch angiograms, one case of right vertebral artery arising from the right common carotid artery was encountered. The embryology of this anomaly and its clinical significance are discussed.


[Soft tissue hemorrhage in acute pelvic vein thrombosis. A rare phlebographic diagnosis (author's transl)]. Clinically suspected deep leg--and/or pelvic vein thrombosis nowadays is usually evaluated by ascending phlebography. This paper demonstrates the unusual additional finding of soft tissue hemorrhage--shown by Phlebography--in a 53 year old female suffering from acute pelvic vein thrombosis. A possible pathophysiologic mechanism for this hemorrhage is being discussed briefly.


Radiographic patterns of drug-induced lung diseases. Drugs which induce lung disease are categorized according to the radiographic pattern of the disease. The five categories are: (a) diffuse interstitial (reticulo-nodular) findings, (b) diffuse air-space consolidation, (c) pleural effusion of fibrosis, (d) hilar or mediastinal widening, and (e) localized areas of consolidation. Information regarding onset, reversibility, fever, eosinophilia, and findings associated with each drug is presented. An extensive list of references is included.


Pulmonary lesions due to Dirofilaria immitis (dog heartworm). Report of four cases with radiologic findings. Chest radiographs of 4 patients with Dirofilaria immitis (dog heartworm) revealed solitary, small, peripheral, noncalcified nodular lesions. The pulmonary lesions were apparently produced secondary to lodging of the parasite in peripheral pulmonary vessels. None of the patients had symptoms referable to the heartworm lesions. Needle aspiration in 2 patients revealed a nonspecific inflammatory lesion.


The lateral radiograph for early diagnosis of lung cancer. The authors reviewed lateral radiographs to analyze the first findings in lung cancer in three groups of patients: those with proved lung cancer (78 patients); those with lung cancer initially undetected (27  patients); and those who had chest radiographs for any reason (10,597 patients). In no instance was a lesion detected on the lateral view only.


Pulmonary pseudonodule.

Pulmonary pseudonodule. A nodular density seen at the posterior lung base on lateral chest radiographs proved to be normal bone in the spine. This nodule results from slight thickening of the bone at the superior aspect of the area where the two laminae join to form the spinous process.


The coracoclavicular joint.

The coracoclavicular joint. The coracoclavicular joints are genetically determined anatomic variants. There are problems in determining their presence by dissection examination of osteologic material as well as by radiography. Based on a survey of published material and a prospective radiological survey carried out in Malaysia, it is clear that the anomaly is more frequent in Asia than in Europe and Africa. There is a high incidence in people from Southern China. The joints are subject to osteophytic marginal lipping without development of symptoms or disability.


Augmentation enterocystoplasty.

Augmentation enterocystoplasty. The anatomy and radiographic appearance of five types of augmentation enterocystoplasty (ileocystoplasty, cecocystoplasty, ileocecocystoplasty, sigmoidocystoplasty, and enterourethroplasty) are described. Retrograde cystrography is the procedure of choice for optimal visualization of an augmented bladder and most complications. Excretory urography is useful for following concurrent upper tract disease and ureteral stenosis. Critical factors in a optimal examination are maximal filling of the bladder and radiographs in multiple projections.


Renal duplication with a diminutive lower pole: the Nubbin sign. Eight patients with a duplex kidney demonstrated severe attenuation of parenchyma in the lower pole. The radiographic appearance of a diminutive lower collecting system indicated the proper diagnosis when there was sufficient parenchyma for visualization. Parenchymal attenuation may represent either hypoplasia or inflammatory atrophy. Whichever the cause, it is important that the diminutive lower pole not be mistaken for a renal mass, extrinsic tumor, renal infarction, or a postoperative change.


Arthrotomography of the glenoid labrum.

Arthrotomography of the glenoid labrum. Arthrotomography was used to study the glenoid labrum in 8 patients with problems of shoulder instability. In 4 patients, an anterior lesion of the labrum was noted radiographically. The abnormality was confirmed at surgery in 3 of the 4. In 1 of the 3, anterior capsular detachment was also demonstrated radiographically and confirmed surgically. One patient had voluntary posterior subluxation: radiographically, the labrum was normal, and at surgery no abnormalities could be found. The technique, which is simple to perform is described and radiographic anatomy discussed.


Differential diagnosis of brown tumor vs. cystic osteitis by arteriography and computed tomography. An expansile lytic lesion of bone can be either a brown tumor or a cyst when the patient has hyperparathyroidism. If weight-bearing bones are involved, the diagnosis must be made prior to parathyroidectomy in order to avert a possible pathological fracture. In the authors' patient, arteriography and computed tomography both demonstrated that the lesion in question was a brown tumor, which is hypervascular and clearly separable from a fluid-filled cyst; however, CT has the advantage of being a noninvasive procedure.


Thermographic diagnosis of deep venous thrombosis. Two hundred patients with suspected deep venous thrombosis had thermography performed prior to ascending phlebography. Diagnostic agreement was obtained in 79%. Published diagnostic thermographic criteria were used; it was not possible to diagnose consistently limited or early thrombosis, especially in the calf muscle veins. Venous insufficiency produced the majority of false positives.


The radiographic signs of fatty liver.

The radiographic signs of fatty liver. Ninteen cases of radiographically visible fatty liver are presented. The four radiographic signs are muscle-fat interface, fat-water interface, a visible hollow viscus wall, and blurring of the medial margin of the right properitoneal fat stripe. The last sign, the authors believe, is the earliest radiographic change in developing fatty liver. In one case, isolated glycogen synthetase deficiency was the cause of fatty liver; this finding, to the authors' knowledge, has not previously been described. The value of the chest radiograph in diagnosing fatty liver is stressed.


Simple serous cysts of the kidney in children. Simple renal cysts and reported in 9 children. Two children presented with hematuria following trauma and the cyst was demonstrated on the initial excretory urogram. The other 7 had cysts found on excretory urograms in be course of evaluation of various urologic complaints. The diagnostic approach used was identical to that advocated for adults, namely, percutaneous needle puncture once a solid renal mass has been excluded by an appropriate screening procedure such as ultrasonography. These cysts are benign lesions similar to cysts in adults and are probably more common than the few reported cases would suggest.


Mastocytosis with skeletal and gastrointestinal involvement in infancy. Two case reports and a review of the literature. Two cases of mastocytosis with skeletal involvement in children three and six months old are reported. Bone lesions, either sclerotic or lytic, were encountered in their skeletal surveys. Gastrointestinal lesions in children with mastocytosis are exceedingly rare; in addition to skeletal lesions, one of our patients had a large duodenal ulcer. The diagnosis of mastocytosis was established by skin biopsy in both patients. A review of the literature is also presented.


Exaggerated anterior vertebral notching. Three children with marrow-packing disorders demonstrated exaggerated anterior vertebral notches with poorly defined cortical margins. One child had thalassemia major, another had Gaucher disease, and a third had metastatic neuroblastoma. A discussion of each case and the etiology of the notches is presented.


Pseudohyperphalangism in fetal Dilantin syndrome. Apparent distal hyperphalangism was observed in three siblings with fetal Dilantin syndrome. Other stigmata of this syndrome were also present. The anomaly in these patients was cuased by division of an otherwise normal phalanx, as opposed to the case in true hyperphalangism.


Expanded high iodine dose in computed cranial tomography: a preliminary report. Fifty patients undergoing cranial CT had expanded-high-iodine-dose (EHID) scans. The EHID was given either as an additional bolus dose (37--40 g iodine) after a routine infusion contrast scan (42.3 g), or as a continuous infusion (total 74--80 g). Diseases presented include primary and metastatic neoplasm, pituitary neoplasm, and demyelinating disease. The results suggest that the primary usefulness of the EHID is in (a) detecting multiple rather than solitary brain lesions, (b) the definitive demonstration of an equivocal area of abnormal enhancement, and (c) differentiating solid histologically microcystic from frankly macrocystic neoplasms.


Rapid-high-dose contrast computed tomography of isodense subdural hematoma and cerebral swelling. Ten patients were studied in whom precontrast computed tomography (CT) revealed an isodense mass which obliterated cerebral sulci and deformed the ventricle(s). Upon rapid-high-dose (RHD) contrast enhancement, the cerebral hemispheric surface was so well demonstrated, that in 4 patients the possibility of an isodense subdural hematoma was exluded, while in the other 6 it was correctly diagnosed. Preoperative angiography was not necessary.


Computed tomography of the enlarged cisterna magna. The unusual appearance of the large cisterna magna on computed tomography is presented and the radiographic signs are reviewed and correlated. This entity may be confused with a variety of other lesions. Awareness of such developmental anomalies may obviate the need for angiography and pneumoencephalography in selected cases.


Sensitivity of computed tomography and serial scintigraphy in cerebrovascular disease. Computed tomography and serial scintigraphy with 99mTc-pertechnetate (radionuclide angiography and early and late static imaging) were compared in 214 patients with cerebrovascular disease. CT correctly identified 151 (95.0%) of 159 patients with completed ischemic stroke but was positive in only 11 (25%) of 44 patients with asymptomatic stenosis, transient ischemic attacks (TIA), or prolonged reversible ischemic neurological deficit (PRIND). Scintigraphy was positive in 93.1% of patients with completed stroke. CT detected 175 territories of vascular supply involved, scintigraphy 164. In patients with asymptomatic stenosis, TIA, or PRIND, scintigraphy was correct in 77.3% of cases. The combined evaluation offered a sensitivity of 97.5% in patients with completed stroke and 86.4% in those with asymptomatic stenosis, TIA, or PRIND. The rate of true-positive scintigraphic findings in patients with completed stroke did not change as the interval between ictus and study increased. In patients with intracerebral hematoma, CT was far more specific than scintigraphy. If cerebrovascular disease is suspected, radionuclide angiography should be performed first.


The value of routine cranial computed tomography in neurologically intact patients with primary carcinoma of the lung. The most common cerebral metastatic lesion is from carcinoma of the lung. Preoperative cranial computed tomography (CCT) with contrast enhancement was performed in 55 neurologically intact patients with a diagnosis of bronchogenic carcinoma; 3 patients (5%) demonstrated cerebral metastasis. CCT could spare a significant number of such patients from unnecessary surgery, with a net saving substantially greater than its cost.


Computed tomography in Behçet disease.

Computed tomography in Behçet disease. In Behçet disease, CT may demonstrate low attenuation mass lesions with or without contrast enhancement. Since neurologic involvement may precede the typical dermatologic manifestations, Behçet disease should be included in the differential diagnosis of intracranial mass lesions. A case is presented with central nervous system involvement.


Computed tomographic metrizamide myelography in syringohydromyelia. Four patients with surgically verified syringohydromyelia, including 2 with and 2 without a collapsing cord, were examined with computed tomographic metrizamide myelography (CTMM). When the cord is collapsed, or a contrast-containing cyst is observed on the scan, no further examination is necessary. If the cord is not collapsed, it is difficult to differentiate an intramedullary cyst from a tumor. Flattening of the ventral border of the cord in the supine position, coupled with an increased transverse diameter and alteration of the normally smooth, oval shape are suggestive of syringohydromyelia.


Symmetrical extracranial fenestrations of the vertebral artery. Two cases revealed by angiography. Extracranial duplication of the vertebral artery was demonstrated angiographically on both sides in a patient with postmeningitis hydrocephalus and in another with hemangioblastoma. Forty-six cases of this anomaly are reviewed.


Lumbar epidural venography. Review of 1,200 cases. A review of 1,200 lumbar epidural venograms demonstrated venography to be accurate in 98.5% of 595 patients operated on for lumbar disc herniations. Venography is particularly valuable in two situations: first, in extreme lateral disc herniations, which frequently cannot be demonstrated by myelography, and second, if the caudal sac ends more cephalad than usual or tapers sharply, a centrally herniated L5-S1 disc can be missed by myelography. The examination is done on an outpatient basis, causes negligible discomfort, and is essentially free of complications. The authors feel that venography is the examination of choice in the investigation of suspected disc herniation. If there is clinical suspicion of an intradural lesion, myelography should be performed first.


Epidural venography in the diagnosis of lumbar spinal stenosis. Epidural venography is valuable in diagnosing lumbar spinal stenosis. It shows anterior displacement of the posterior medial longitudinal intervertebral veins at the level of the lamina and the superior and inferior articular facets. This results in decreased distance between and sometimes overlapping of the posterior and anterior medial longitudinal intervertebral veins. Three cases of spinal stenosis diagnosed by epidural venography are presented.


Computed tomography of focal hepatic lesions: a blind clinical evaluation of the effect of contrast enhancement. Hepatic CT scans in 61 consecutive patients with proved liver metastasis performed both before and after administration of contrast medium were subjected to blind analysis by two observers. In 10 patients (16%) hepatic lesions were better defined before CE and focal hepatic lesions were diagnostically visible only before CE in 8 patients (13%). Lesions were better defined following CE in 16 patients (26%) but in only 2 cases (3%) were lesions diagnostically visible only after CE. The majority of lesions [35 (58%)] were equally well visualized before and after CE.


Comparison of computed tomography and other imaging modalities in the evaluation of musculoskeletal tumors. An algorithmic approach for the evaluation of musculoskeletal tumors is proposed on the basis of a prospective comparison of different imaging techniques in 50 unselected patients. Conventional radiography was superior to other techniques in predicting the nature of primary bone tumors. Computed tomography proved the most effective method for assessing the extent of musculoskeletal tumors and therefore had a significant influence on management in 66% of patients studied. CT was more informative than angiography and also provided more anatomical detail than ultrasound. Radionuclide scanning was mainly of value in detecting unsuspected skeletal metastases in patients with apparently solitary skeletal lesions.


The sonographic diagnosis of neonatal adrenal hemorrhage. Neonatal adrenal hemorrhage can be diagnosed with a combination of ultrasound and excretory urography without resorting to surgical exploration or invasive diagnostic procedures. The radiologic findings of adrenal hemorrhage on excretory urography include downward displacement of the kidney on the affected side and a radiolucent suprarenal mass on the body nephrogram phase. Ultrasound studies reveal a sonolucent suprarenal mass. Four cases of varying degrees of adrenal hemorrhage are presented together with the radiographic and sonographic findings.


Lack of an acoustic shadow on scans of gallstones: a possible artifact. The high attenuation of gallstones results in the formation of an acoustic shadow on the ultrasound scan. Such shadows are best seen when the stone lies within the focal zone of the transducer and is large in comparison to the beam width or wavelength employed. Inadequecies in the dynamic range of available TV display units necessitate the use of compression-amplification signal processing which may preclude perception of such a shadow and seriously interfere with diagnostic accuracy.


Placenta praevia: significance in the second trimester. A prospective study was performed on 98 patients to determine the risk of a second trimester placenta praevia remaining until term. The presence and degree of anterior or posterior praevia were scored for each patient. Follow-up data were obtained at delivery on 58 patients. A greater fraction (63.8%) of second trimester praevia was implanted posteriorly. The overall incidence of a second trimester praevia persisting until term was 8.8%.


The clinical impact of ultrasonic beam focusing patterns. Previous clinical ultrasound investigations have been adversely affected by inadequate knowledge of the focusing characteristics of the transducer. Precise knowledge of the beam width profile has substantial impact on routine diagnostic procedures and is essential for proper display of the anechoic nature of small cysts, tissue textures, and particularly the distal shadow which characterizes gallstones. In vitro and in vivo tests using transducers with various beam focusing profiles clearly demonstrate that optimal imaging performance occurs within a very narrow range at a critical distance from the transducer face.


R-wave synchronized blood-pool imaging.

R-wave synchronized blood-pool imaging. Three methods for determining the left ventricular ejection fraction (EF) from R-wave synchronized blood-pool images were compared to contrast angiography; the reproducibility of these methods was established in 51 patients. The EF was systematically underestimated by the fixed region-of-interest (ROI) method compared to the two methods that used varying ROI's which track the left ventricular boundary. All methods correlated reasonably well with angiography and were highly reproducible. Use of varying ROI's resulted in EF values that were essentially identical to those determined by angiography. Resolution-recovery image processing appeared to improve reproducibility when varying ROI's were used.


Demonstration of gastroesophageal reflux in children by radionuclide gastroesophagography. Twenty-five infants and children with proved gastroesophageal reflux were studied by radionuclide gastroesophagography to determine its sensitivity in detecting reflux. Patients swallowed an inert radiotracer (Tc-99m sulfur colloid) and gamma camera images of the stomach and esophagus were made with and without abdominal pressure. The test was easy to perform and was well tolerated. Reflux was demonstrated in 20 patients (80%); this compared favorably with barium gastroesophagography.


Radionuclide skeletal survey in neuroblastoma. Of 63 99mTc-phosphate bone images in 49 patients with neuroblastoma, 41 were abnormal, 17 showed tracer uptake within the primary tumor, 29 showed evidence of skeletal metastatic disease, and 17 demonstrated renal/urinary tract involvement. The metastases were asymmetric in 24 patients and symmetrical in 9, in whom they involved the metaphyses and epiphyses of the long bones. Except for one patient with multiple "cold" areas, all metastases were seen as focal hyperactive regions. Eleven of 42 skeletal radiographic surveys were abnormal. The radionuclide study appears to be more accurate than skeletal radiography in estimating bone involvement in neuroblastoma. Primary tumor concentration of the tracer is almost pathognomonic of neural crest neoplasms in childhood.


Comparison of dosimetry and image quality in computed and conventional tomography. Comparison was made of tomograms of a phantom head and a normal adult cadaver head on GE CT/T, Delta 50, EMI 5005, and CGR Stratomatic units. Image quality was ranked as follows: First, GE CT/T 8800 system; second, EMI; third, GE CT/T 7800 and Delta. The GE CT/T 7800 imaged 3.7 line pairs at high contrast with an exposure to the head phantom of 2.5 R (6.5 X 10(-4) C kg-1). The EMI exposure level was 5 R (13 X 10(-4) C kg-1) in the fast mode and 12 R (31 X 10(-4) C kg-1) in the slow mode, while the Delta 50 exposure level was fixed at 2 R (5.2 X 10(-4) C kg-1). The GE CT/T 8800 could image 6.1 line pairs/cm in a high-contrast phantom with exposures as low as 100 mR (25.8 muC/kg) but a typical operating exposure would be about 1--2 R (2.58 -5.2 X 10 (-4) C kg-1). Dosimetry ranged from 1.1 to 5.5 R/scan section (2.8--14.2 x 10(-4) C kg-1) in the CT units but never increased by a factor of more than 2, irrespective of the number of sections scanned. In conventional tomography, however, exposure increased almost arithmetically with the number of contiguous sections scanned.


Differential effect of procaine on irradiated mammalian cells in culture. HeLa and V-79 Chinese hamster cells temporarily stored in ampoules were treated with the local anesthetic procaine. Postirradiation treatment increased lethality in HeLa cells depending on drug concentration, duration of treatment and cell density, as measured by colony-forming ability upon plating. If present during irradiation only, procaine protected from irradiation. In V-79 cells procaine potentiated radiation lethality only in freshly trypsinized cells. Procaine effect was thus cell type specific and most likely involved the cell membrane.


Tissue signatures with dual-energy computed tomography. By providing information on two parameters, dual-energy computed tomography can offer clinically useful tissue signatures for metallic deposits (Ca) or injected iodine, as well as for different normal and abnormal types of brain parenchymal tissues and CSF. Cerebral CT was performed on 36 patients and tissue differences analyzed using Hounsfield notation.


After-loading transperineal iridium-192 wire implantation of the prostate. Aided by suprapubic surgical access, after-loading transperineal iridium-192 wire implantations have been done for prostatic cancer in 16 patients, with major complications in 3. Personnel exposure is reduced, and, more especially, precision and flexibility of dose control and source geometry are improved. The technique is thought to render permanent implantation with grains or seeds obsolete.


A semi-upright portable venographic table. A 45 degrees semi-upright venographic table which incorporates superimposed variable-ratio water grids and variable speed screens in long cassettes for leg phlebographic recording is described. It is constructed from used x-ray table top material placed on a standard equipment moving truck, for convenient use and easy upright storage.


The use of a CT scan computer for non-CT applications: teaching file program. The utility of CT scanners may be further increased by using the computer contained in such scanners for non-CT purposes-the creation of a teaching file in this case. No knowledge of computer programming is assumed on the part of the operator. Directions are given in accessing the computer as well as in programming.


An electronic digital display system to record contrast medium injection rates on angiographic film. The authors describe an electronic numerical digital display system which utilizes light emitting diodes to record contrast medium injection rates on serial angiographic film. The display system is conveniently mounted within the film changer. It was developed to record injection rates during an increasing rate of injection employed in the radiographic "spillover" technique or estimating blood flow.


A new needle for pre-operative localization of nonpalpable breast lesions. A new needle for pre-operative localization of nonpalpable breast lesions is described. Its major advantage is that it can be sutured to the skin to prevent dislodgement.


A simplified method for intracavitary radiation for recurrent nasopharyngeal carcinoma. A simplified method for constructing a custom-made mold to hold radium for intracavitary radiation therapy of recurrent nasopharyngeal carcinoma was developed. The technique for fabrication and insertion of the mold in a single operative procedure is described. Computer dose distributions were obtained and the applications were well tolerated by the patients.


A nomogram for time-dose-fractionation factors. Time-Dose-Fractionation (TDF) factors have been defined mathematically and listed in table form. A rapid reference, single-page nomogram representation of these factors is presented here.


A modified technique for percutaneous insertion of biliary T-tube. Following percutaneous removal of retained biliary calculi through a t-tube tract, a tube should be reinserted over a guide wire. Reinsertion usually is easy; however, if buckling occurs, a coaxial system consisting of a t-tube over a teflon dilator will give added stiffness, and the t-tube will advance easily into the common bile duct.


Hysterosalpingography using a Foley catheter. The authors describe a simple method of hysterosalpingography using a Foley catheter to inject contrast media. The technique allows the patient to assume a more comfortable position during the study. The radiologist can perform the examination without the need of a second physician to assist during spot filming and with no chance of metal artifacts obscuring anatomy.


Foley catheter hysterosalpingography: a simplified technique for investigating infertility. A simplified technique for hysterosalpingography, based on over 5,000 studies, is described. This method is quickly and easily performed. Patient acceptance is high.


Lymphography following leg amputation.

Lymphography following leg amputation. Bilateral lower-extremity lymphangiograms were obtained on 2 patients who previously had one leg amputated for unrelated indications. In both cases an underlying malignant tumor was present, and opacification of the lymph nodes draining the amputated limb was clinically important.


Contrast-induced renal failure: a radiological problem and radiological diagnosis. Renal failure induced by intravenous iodinated contrast media is a frequent medical problem. While such cases are generally reported first by the clinician, the phenomenon can be seen even earlier by the radiologist. An abnormally persistent nephrogram is a sign of abnormal clearance, which in turn should alert the physician to the likelihood of renal failure.


Risk of breast cancer following low-dose radiation exposure. Risk of breast cancer following radiation exposure was studied, based on surveys of tuberculosis patients who had multiple fluoroscopic examinations of the chest, mastitis patients given radiotherapy, and atomic bomb survivors. Analysis suggests that the risk is greatest for persons exposed as adolescents, although exposure at all ages carries some risk. The dose-response relationship was consistent with linearity in all studies. Direct evidence of radiation risk at doses under 0.5 Gy (50 rad) is apparent among A-bomb survivors. Fractionation does not appear to diminish risk, nor does time since exposure (even after 45 years of observation). The interval between exposure and the clinical appearance of radiogenic breast cancer may be mediated by hormonal or other age-related factors but is unrelated to dose. Age-specific absolute risk estimates for all studies are remarkably similar. The best estimate of risk among American women exposed after age 20 is 6.6 excess cancers/10(4) WY-G-Y (10(6) WY-rad).


Microfocal spot magnification mammography using xeroradiographic and screen-film recording systems. Direct radiographic magnification (1.5X) of the breast, using a microfocal spot x-ray tube and either a xeroradiographic or screen-film recording system, produces images superior in quality (improved resolution, reduced noise) to conventional contact mammograms. Six hundred twenty-one patients had a single magnification mammogram in addition to conventional mammography; 216 subsequently underwent biopsy within one month of study. The additional magnification mammogram increased the diagnostic accuracy of the conventional examination in 40% of the pathologically proved cases, particularly among those for which conventional mammograms were interpreted as equivocal for malignancy. The superior image quality of magnification mammograms appears useful in distinguishing malignant from benign breast disease.


The angiographic appearance of the coronary arteries in constrictive pericarditis. Coronary artery motion was evaluated in normal subjects and patients with constrictive pericarditis (CP), congestive cardiomyopathy, restrictive cardiomyopathy, and coronary artery disease. Seven of the 8 patients with CP had lack of motion of the major coronary arteries. Nine of the 10 patients with congestive cardiomyopathy and a markedly reduced ejection fraction showed normal motion, as did all 4 with restrictive cardiomyopathy and 9 of the 10 with segmental dysfunction due to coronary disease. Pericardial stripping in 5 patients with CP revealed epicardial involvement corresponding to regions of absent motion; one CP patient with normal motion had no epicardial involvement. Lack of motion may suggest CP when the diagnosis is unsuspected, right heart pressures are not obtained, or hemodynamics are atypical. This sign may also help to distinguish CP from restrictive cardiomyopathy, which produces similar hemodynamics.


Embolotherapy with detachable silicone balloons: technique and clinical results. Catheter techniques and early clinical results of therapeutic embolization with detachable silicone rubber balloons are described in 13 patients. Effective control of post-traumatic or spontaneously occurring hemorrhage or preoperative devascularization of neoplasms was achieved in 10 patients. Three additional patients, one each with pelvic arteriovenous malformation. pulmonary arteriovenous malformation, and hemangioendothelioma of the liver, were partially treated by balloon occulsion. Therapeutic embolization with detachable silicone balloons provides a method of long-term, extremely selective arterial occlusion with reduced risks from inadvertent embolization of neighboring circulations.