[Computer-assisted estimation of the dose distribution in intracavitary radiation therapy (author's transl)]. A new version of a computer-assisted method for determination of the dose distribution in the pelvis of female patients treated with sealed radioactive radium or caesium sources is outlined. The position of the sources in a coordinate system centered on the symphysis is determined stereoradiographically. The dose values are calculated either for singular body points or for points situated on transversal, frontal and sagittal planes through the symphysis or for planes parallel to these. In consideration of the fact that for each patient the anatomical position of the calculation planes can be reproduced with sufficient precision, it is possible to cumulate on each plane the dose values obtained from treatment performed at different times. Experimental controls show good agreement between calculated and measured dose values. Some clinical examples of dose calculation for sagittal planes and of cumulated dose values for a frontal plane 7.4 cm underneath the symphysis are presented.


Determination of total activity and its distribution in cathetron source pencils. High intensity remote-controlled afterloading devices such as Cathetron, employ tiny source elements which facilitate free movement through the curvature of the guide tubes. As the activities involved are in the curie level and a number of sources are assembled together in the form of a pencil, conventional methods cannot be employed for determining the activity of individual sources. This paper deals with the determination of the total activity of a source pencil from the measured exposure rate and an autoradiographic method used to determine the activity of individual sources.


Absorbed dose distributions for X-ray beams and beams of electrons from the Therac 20 Saturne linear accelerator. After a brief description of the Therac 20 Saturne linear accelerator a complete set of absorbed-dose distribution values is given. These values define the depths on the axis as a function of the depth dose and define the penumbra (as characterized by the positions of the intersections of the isodose curves with planes parallel to the phantom surface) for beams of X-rays and for beams of electrons. Tissue-maximum ratios are given for beams of X-rays. Analytical values for the electron depth dose curve are compared with the values obtained on the Sagittaire linear accelerator.


Investigation of gynecological cancer with nuclear magnetic relaxation methods. Nuclear magnetic relaxation times T1 and T2 of cell water protons in benign and malignant uterine cervical tissue (37 samples taken from 22 patients) were measured using a resonance frequency of 19.8 MHz. The means of relaxation times recorded for malignant tissue were (mean +/- S.E.) T1 = 0.89 +/- 0.05 s, T2 = 0.072 +/- 0.009 s, and obtained from corresponding benign tissues (mean +/- S.E.) T1 = 0.72 +/- 0.01 s T2 = 0.056 +/- 0.003 s. The differences are statistically significant (T1:p less than 0.001, and T2:p less than 0.05). The effect of dysplasia and inflammatory changes in mucosa to the relaxation times were examined and the probable sources of error in the present method are discussed.


Significance of tumor volume and blood flow in tumor control by radiation. The mean rate of blood flow in C3H/He mouse mammary carcinoma determined by the clearance of 133Xe was 0.1 ml/g/min in tumors greater than approximately 2.0 cm3, and then blood flow became increasingly greater as the tumor size decreased further. The dose required to produce lethal damage in the tumor increased with the size of the tumors. In large tumors the control rate increased with increasing doses to a maximum at a certain level; at higher doses the rate was somewhat decreased. The present experiments show that changes in blood flow could account for radiosensitivity of the tumor, and a tumor larger than a certain volume can no longer be controlled by a single dose of radiation.


Initial events in radiation-induced atheromatosis. II. Damage to intimal cells. The carotid artery of the rabbit is a suitable blood vessel to study radiation induced atheromatosis in hypercholesteremic animals, because no plaque formation occurs within two months after the start of a 0.5% cholesterol diet. Cholesterol contents as high as 2% however, do give atheromatous plaques in the carotid artery without prior irradiation. As early as five hours after local irradiation of the carotid artery activation of the plasma membrane-bound enzyme alkaline phosphatase could be observed in some intimal cells. Two to three days after irradiation the activity disappeared. This phenomenon was observed in normo-and hypercholesteremic irradiated arteries. Depending on the lipid content of the blood, infiltration of lipids was observed at one day after the irradiation or later, accompanied by activation of beta-glucuronidase in the innermost layer of medial cells. Hereafter plaque formation started and cell proliferation could be found in the subendothelial space. It is assumed that because of the irradiation, the endothelial cells of the carotid artery are damaged in such a way that they do not function properly as a barrier against lipoprotein entrance from the blood into the arterial wall. The lipid infiltration caused lysosomal activation and probably cellular proliferation.


Effect of gamma ray low doses on the system of the nonspecific defense of the organism. The author studied the response of the mechanical stage of the RES phagocytosis and the serum lysozyme level in white mice after fractionated exposures to 10 R and 100 R daily. It was observed the activation of these systems after low summed doses and, on the other hand, its significant depression after high summed doses. The causes of these changes are discussed.


The changes in pharmacokinetics and conjugation of chloramphenicol in irradiated rats. In the serum and the liver of rats levels of chloramphenicol (CAP) following its i.v. administration (200 mg/kg) in the control groups and in the rats irradiated with whole-body air exposure to 500 R were determined with spectrophotometric methods. The CAP-levels in the serum increased in the group of rats 3 days after irradiation, but only during the 1st hour. At later time intervals the values were lower than in the controls. This decrease at the 60th min is striking even in the groups 6 and 9 days after exposure. Free CAP in the liver of rats irradiated 6 and 9 days before was lower at interval 30 min after CAP-administration, but the group irradiated 9 days before was unaltered. However, 120 min after CAP-administration the values of free CAP decreased at all intervals investigated following the irradiation. The levels of conjugated CAP in the liver of the rats 3 and 6 days after exposure were lower than in controls in both intervals after drug administration; but in rats 9 days after irradiation they increased. Our results indicate that the kinetics of CAP is altered and corresponding changes in its conjugation are effected under the condition of acute radiation syndrome.


Interactions of chlorinated hydrocarbon pesticides with the 8S estrogen-binding protein in rat testes. The effect of certain DDT analogs on the binding of 3H-estradiol to the 8--9S estrogen binding protein of rat testicular cytosol was studied by sucrose sedimentation analysis. The binding of 3H-estradiol to testicular cytosol was inhibited by o,p'DDT, a DDT analog which is estrogenic in the intact female, but not by p,p'DDE which is a nonestrogen in the female. The pesticide methoxychlor, which is estrogenic in vivo in the female, failed to inhibit 3H-estradiol binding, presumably requiring metabolic activation for binding to the testicular cytosol. In fact, its di-demethylated metabolite 2,2-bis(p-hydroxyphenyl)-1,1,1-trichloroethane (HPTE), also estrogenic in vivo, caused marked suppression of 3H-estradiol binding.


Effects of cholecystectomy upon bile salt kinetics in the guinea pig. The effects of cholecystectomy upon bile salt kinetics were studied in normal guinea pigs. After cholecystectomy, bile salt pool size decreased, fractional daily turnover rate increased, and the rate of bile salt synthesis was unchanged. These data indicate that an increased frequency of bile salt enterohepatic cycling is sufficient to produce alterations in bile salt kinetics. Abnormalities of bile salt synthesis need not be present in order for a reduction in pool size to occur.


Anti-testosterone antisera produced in mice of different strains and sexes. Specific anti-testosterone antiserum was obtained from mice of the strain C57B1/6. Testosterone 3(O-carboxymethyl)oxime-keyhole limpet hemocyanin conjugate was administered to male and female mice of the strains C57B1/6 (H-2b), DBA/2 (H-2d), (C57B1/6 x DBA/2)F1, (H-2b/d), and AKR (H-2k). Antisera obtained from male and female C57B1/6 mice were more specific for testosterone than those from the other strains, and the cross-reaction with 5alpha-dihydrotestosterone was 25.0 and 29.2%, respectively. The titer of antiserum from C57B1/6 mice was the highest and that of antiserum from DBA/2 mice was the lowest. On the other hand, the titer of antiserum from the female was higher than that of antiserum from the male in each strain. These results indicate that the mouse strain and sex differences are important factors for antibody formation from challenged antigen.


Trilostane, an orally active inhibitor of steroid biosynthesis. Trilostane is a competitive inhibitor of 3beta-hydroxysteroid dehydrogenase. In vitro, the drug inhibits conversion of pregnenolone to progesterone but does not alter conversion of cholesterol to pregnenolone nor progesterone to corticoid hormones. When given orally to rats, trilostane inhibits corticosterone and aldosterone production and elevates circulating levels of pregnenolone at doses lower than those that produce adrenal hypertrophy or inhibit gonadal steroidogenesis.


Conversion, in vitro, of (7n-3H) testosterone to estrone and estradiol-17beta and their 3-sulfate conjugate by the guinea-pig placenta. Different cellular fractions of guinea-pig placenta were incubated  in the presence of (7n-3H) testosterone. Microsomal aromatization of 3H-testosterone into estrone and estradiol-17beta was demonstrated in the presence of NADPH. The predominance of estrone after incubation with 17beta-hydroxylated precursors, (7n-3H) testosterone and (6,7-3H) estradiol-17beta, indicate that there is a microsomal 17beta-hydroxysteroid dehydrogenase activity. In this report, cytosolic sulfurylation of estrogens is demonstrated. This latter activity represents a quite original characteristic of the placental metabolism of estrogens in guinea-pigs. In contrast with the human placenta where there is considerable sulfatase activity, the guinea-pig placenta can sulfurylate estrogens.


Kinetics of testosterone metabolism in normal postmenopausal women and women with breast cancer. The constant infusion and single injection techniques were utilized to study the kinetics of 3H-testosterone (T) metabolism in posmenopausal women with and without breast cancer. The metabolic clearance rates (mean +/- SEM) for normal postmenopausal women were 578 +/- 82 and 644 +/- 128 1/24 has obtained by the constant infusion and single injection techniques, respectively. The corresponding results for the women with breast cancer (patients) are 644 +/- 25 and 617 +/- 106 1/24 h. The single injection technique yielded values for rate constants (units) and volumes of distribution (1); K1 = 37.5 +/- 1.6 for the normals and 34.5 +/- 1.9 for the patients, K = 76.6 +/- 5.1 for the normals and 71.1 +/- 1.6 for the patients, V1 = 7.9 +/- 2.2 for the normals and 8.7 +/- 1.4 for the patients and V2 = 7.0 +/- 1.5 for the normals and 6.4 +/- 1.2 for the patients. The constant infusion technique yielded values for the conversion ratios for the transformation of T to several products; 4-androstene-3,17-dione/T of 0.02 +/- 0.003 for normals and 0.03 +/- 0.002 for patients, 5alpha-dihydrotestosterone/T of 0.02 +/- 0.002 for normals and 0.03 +/- 0.002 for patients, estrone/T of 0.04 +/- 0.01 for normals and 0.04 +/- 0.01 for patients, estradiol-17beta/T of 0.02 +/- 0.005 for normals and 0.03 +/- 0.005 for patients and estrone sulfate/T of 0.16 +/- 0.02 for normals and 0.24 +/- 0.06 for patients. The T plasma concentrations and production rates were similar for the two groups of subjects. Hence there were no significant differences between the normals and the patients for all the kinetic parameters. It was determined that all the estradiol being produced in postmenopausal women could be coming from circulating T.


Synthesis of biological precursors of cholic acid. This paper describes a new and convenient procedure for the synthesis of 5beta-cholestane-3alpha,7alpha,12alpha,24-tetrol (24R and 24 S) and 5beta-cholestane-3alpha,7alpha,12alpha,26-tetrol starting from 5beta-cholestane-3alpha,7alpha,12alpha,25-tetrol. Dehydration of the 25-hydroxytetrol with glacial acetic acid and acetic anhydride yielded a mixture of 5beta-cholest-24-ene-3alpha,7alpha,12alpha-triol and the corresponding delta25 compound. Hydroboration and oxidation of the mixture of delta24 and delta25 unsaturated bile alcohols resulted in the formation of 5beta-cholestane-3alpha,7alpha,12alpha,24epsilon-tetrol and 5beta-cholestane-3alpha,7alpha,12alpha,26-tetrol. In addition, smaller amounts of 5beta-cholestane-3alpha,7alpha,12alpha,23epsilon-tetrol and 5beta-cholestane-3alpha,7alpha,12alpha-triol were also obtained. The bile alcohols epimeric at C-24 were resolved by analytical and preparative TLC, characterized by gas-liquid chromatography and mass-spectrometry. Tentatively assignments of the 24R and 24S configuration was made on the basis of molecular rotation differences. These compounds will be useful for biological studies of cholic acid biosynthesis.


Steroidogenic capabilities of the early mouse embryo. Preimplantation embryos from ICR albino mice were used to determine progesterone and estradiol-17beta production during incubation in BMOC-2. Following culture of 40 embryos/culture at either the morula, early blastocyst or late blastocyst stages, progesterone and estradiol-17beta contents were 192 +/- 27 and 82 +/- 22 pg, 289 +/- 50 and 147 +/- 46 pg and 157 +/- 28 and 88 +/- 23 pg, respectively, for incubated samples and 306 +/- 68 and 89 +/- 40 pg, 404 +/- 63 and 125 +/- 44 pg, and 241 +/- 54 and 86 +/- 39 pg, respectively for control samples. Although, there were significant stage of development and treatments effects (p less than 0.05) for progesterone, production of this steroid was not evident. These data suggest that the early preimplantation mouse embryo does not produce progesterone or estradiol-17beta in a defined culture system.


The hydrolysis of bile acid conjugates.

The hydrolysis of bile acid conjugates. Studies were made of a) the relationship of bile acid structure and analytical recoveries (measured by 3-hydroxysteroid oxidoreductase) following vigorous alkaline hydrolysis of bile acid conjugates and b) the relationship of structure and hydrolysis time of taurine- and glycine bile acid conjugates in a reaction catalyzed by glycocholic acid hydrolase. Alkaline hydrolysis resulted in good recoveries of hydroxy and 7 and 12- oxo-bile acids but poor recoveries of 3-oxo-bile acids. Borohydride reduction of the 3-oxo-acids prevented these losses. Complete enzymatic hydrolysis of glycine conjugated bile acids was about five times more rapid than that of taurine conjugates. Hydrolysis of conjugates containing oxo groups was slow. Borohydride reduction of oxo-acids corrected this and did not inhibit enzymatic hydrolysis. It was concluded that both vigorous alkaline and enzymatic hydrolysis are satisfactory in bile acid assays if borohydride reduction is instituted before the hydrolytic step. However, due to the presence of possible enzyme inhibitors and solubility difficulties, strong alkaline hydrolysis is preferable to enzymatic hydrolysis in fecal bile acid determinations at this time.


Androgen metabolism in sheep.

Androgen metabolism in sheep. 3H-Testosterone (3H-T) plus 14C-androst-4-ene-3,17-dione (A-dione) and 3H-epi-testosterone (17alpha-hydroxy-4-androsten-3-one) (epiT) plus 14C-T were injected intravenously into two male sheep with bile fistulae, respectively. Urine and bile samples were collected at intervals for 4-8 hours and analyzed by the use of DEAE-Sephadex A-25 and Lipidex 5000 columns, TLC, and paper chromatography; the aglycones were identified by co-crystallization with authentic standards. Five fractions were obtained from urine and bile: unconjugated, glucosiduronates, sulfates, sulfo-glucosiduronates and disulfates. In urine, the major conjugates were glucosiduronates, while sulfates predominated in bile. About 80-90% of recovered radioactivity was found to be either glucosiduronates or sulfates. Among the metabolites identified, epi-T was the principal one, accounting for 10-15% of the administered doses. Conversion to 17alpha-hydroxysteroids thus appears to be a major route of metabolism of the androgens administered in sheep. Other metabolites in the glucosiduronate and sulfate fractions were androsterone, etiocholanolone (3alpha-hydroxy-5beta-androstan-17-one), 5beta-androstane-3alpha,17beta-diol, two unknown diols and polar metabolites. The results indicated that androgen metabolism is somewhat unusual in sheep, as compared with other animals and the human.


Continued use of contraception among Philippine family planning acceptors: a multivariate analysis. The factors that contribute to continued use of contraception are examined through a multivariate analysis of data gathered in the course of the Philippine 1974 National Acceptor Survey. Twenty-five independent variables were utilized in the analysis, of which only three were found to have an appreciable effect upon continuation: the method accepted, age, and husband's attitude regarding family planning. When the sample was divided into method subgroups, several features of the service process explained variance in pill continuation, and fecundability explained variance in rhythm continuation. The findings suggest that there is considerable potential for improving the effectiveness of the Philippine program through administrative action. Better IUD services and information, more emphasis on the needs of husbands, and improvements in the ongoing support of pill users could substantially improve the amount of contraceptive protection offered by the program.


Two determinants of fertility decline: a test of competing models. This paper compares alternative models for the process by which education and infant mortality changes may combine to reduce fertility. A linear, interactive model appears most suitable. Substantively, it indicates that those countries with a combination of low infant mortality rates and high educational enrollments experience synergistically large declines in fertility. Patterns of contraceptive use are also consistent with this model.


Fertility and family planning in rural northern Thailand. From the mid-1960s to the mid-1970s, when fertility was declining in Thailand as a whole, especially rapid declines occurred in Northern Thailand, but they did not occur uniformly in all the region's provinces. The Northern Thailand Fertility Study, initiated in 1975 to study the reported fertility changes, gathered data in two provinces: Chiang Mai, where fertility decline has been quite rapid, and Chiang Rai, which experienced relatively little decline until 1974. This preliminary report discusses fertility levels and trends in the two provinces, fertility experience and expectations of respondents, attitudes toward and knowledge of family planning, and contraceptive practice. The results suggest that most of the difference in fertility decline is related to the different level of family planning program activity in the two provinces.


An evaluation of male contraceptive acceptance in rural Ghana. To evaluate the effect of male contraceptive acceptance on fertility, the Danfa Family Planning Project in rural Ghana studied a sample of its male family planning acceptors. The findings show that half of the survey respondents accepted foam for use by their partners and half accepted the condom. The continuation rate (69 percent at 12 months) and use-effectiveness rate (80 percent at 12 months) reported by men were higher than those reported by women program acceptors. It is felt that men can play a significant role in affecting fertility through their influence on a couple's choosing to use contraception and as a result of their motivation to obtain contraception and see that it is used. It is urged that increasing emphasis be placed on providing family planning services for men in African programs.


Symbiosis, empathy, suicidal behavior, and the family. This paper discusses the theoretical concept of symbiosis, as described by Mahler and her co-workers, and its clinical applications in suicidal situations. Symbiosis is defined as both a developmental phase characterized by a lack of differentiation between self and others and a relationship which is contingent upon the family and social network. A disturbed symbiosis is a major component in a suicide attempt. The destructive aspects of symbiosis are traced together with its relationship to empathy and the efforts to both restore and resolve a symbiotic conflict through suicidal behavior. In family therapy a repetition of older symbiotic relationships is frequently observed. These are repeated from one generation to the next in order to keep the old relationship alive. Finally, the practical implications of the concept of symbiosis for assessment and treatment are discussed.


Psychiatric hospital treament of suicidal children. Three phases of psychiatric hospital treatment of children, ages 6 to 12 years, admitted to the hospital because of suicidal threats or suicidal attempts are described. Suicidal behavior in young children must always be taken seriously. Although suicidal behavior usually ceases upon hospitalization, suicidal ideas may continue to be expressed in play fantasy. In addition to individual and milieu therapy, treatment must also include concomitant assistance of the parents. The treatment procedures are illustrated by suicidal case examples of a depressed girl, an acting-out boy, and a psychotic boy.


Dimensions of black suicide: a theoretical model. This paper has two purposes: (1) to develop a theoretical model of suicide, based on the previous work of Henry and Short, and (2) to apply that model in the study of black suicides in Orleans Parish, Louisiana. In so doing, we are focusing on suicide among a traditionally low-status, low-suicide population group, one which Henry and Short cited in support of the positive relationship between status and suicide. The generality of the theory is thus examined in this and other ways. The theory of "external restraints" is only weakly sustained by this analysis. More adequate testing of the theory must await further data, with careful attention to the subjective aspects of hypothesized structural relationships.


Vehicle drivers and fatal accidents.

Vehicle drivers and fatal accidents. This study attempts an exploratory study of the question, What happens to drivers of vehicles involved in accidents in which there is a fatality, whether or not the driver was at fault? The purpose of the investigation was to attempt to determine what, if any, crisis intervention is needed for such drivers. A total of 33 drivers participated who were involved in such an accident from 6 months to 11 years prior to the interviews. Major findings are (1) the range of time for drivers to resolve their crises seemed to be from a few hours to years after the accident, (2) the crises created many psychosocial and physical problems for these drivers, (3) the support of family, friends, and significant others was the most important variable for the drivers in crisis resolution, (4) condemnation hindered them most.


Effect of the endocrine state of blastocyst donors on the time required for initiation of trophoblast outgrowth. Blastocysts from mice in a state of delayed implantation after ovariectomy were recovered on day 5, 7 or 9 (day 1 was the day a vaginal plug was found). Blastocysts were also recovered on day 7 from animals that had received an injection of oestradiol-17beta 8, 16 or 24 hours earlier. The blastocysts were incubated in a modified Brinster's medium to which serum had been added and the time of initiation of blastocyst outgrowth was recorded. Blastcysts from early delay grew out before those from late delay. A steady state of outgrowth time was achieved on day 7. It is therefore suggested that blastocysts for culture experiments in which the metabolic activity level is crucial should not be recovered before the steady state is attained. Oestrogen injections caused earlier outgrowths, at least after 16 h, which indicates that the earlier outgrowth soon after ovariectomy might also be caused by a residual effect of the oestrogen.


Prolonged serum insulin decreasing effects of two synthetic somatostatin analogues studied in vivo by a new animal method. Preliminary communication. A newly developed in vivo method, using the ob-ob strain of obese-hyperglycaemic mice with permanently very high serum insulin values, makes it possible to detect more prolonged serum insulin lowering properties than in normal animals. Two newly synthesized analogues of somatostatin, D-alanine-somatostatin and des-alanine-des glycine-des-amino-somatostatin produced a more prolonged and greater decrease in the serum insulin values of ob-ob mice than did somatostatin. Our new in vivo method makes it possible to investigate the duration of insulin suppression of new derivatives.


Health and disease at the age of sixty. Findings in a health survey of 60-year-old men in Uppsala and a comparison with men 10 years younger. A health investigation was performed among 331 men aged 60 years in Uppsala. The investigation was performed in the same way as in 50-year-old men (n = 2322) in the same community, previously described. Thus it was possible to make certain comparisons between these two populations of middle-aged men. A considerably higher morbidity, given as point prevalence, was found for diseases of the cardiovascular system and of the endocrine organs, in the older population compared with the younger. Parallel to this a higher consumption of pharmaceuticals was reported by the older men. Only 39% among the older men versus 51% of the younger men were smokers. Nearly the same number (two-thirds) of men in both age groups were without codable ECG abnormalities in their resting ECG. Among the older men, however, there were more subjects having multiple pathological ECG findings than in the younger age group. It is concluded that it is possible to reach approximately 80% of the actual population in special health investigations, in middle-aged men. Future studies, preferably in younger subjects, should aim at an early detection and primary prevention of cardiovascular and endocrine diseases.


Microsphere measurement of regional intestinal blood supply and cardiac output in the rat. The regional blood supply to consecutive segments of the small intestine in the anaesthetized rat was investigated with a radioactive microsphere technique. A blood flow gradient with the lowest flow in the distal segments (0.85--0.89 ml/min.g) and the highest in the proximal segments (1.13--1.15 ml/min.g) was observed. Very few microspheres were found in the portal vein blood, indicating negligible arteriovenous shunting in the splanchnic area. The mean cardiac outputs in two consecutive measurements were 27.9 and 28.7 ml/min . 100 g, respectively. The cardiac output and regional blood flow values were in accordance with those obtained with other techniques.


Studies on the transport of small bowel contents. An experimental study in the rat with special reference to the evaluation of non-propulsive intestinal movements. An earlier study (4) of chyme propagation through the small bowel in conscious rats has revealed that the luminal contents are transported in separate portions, which exchange material only to a limited extent. In the present study this transport pattern was confirmed also after the following changes in the standardized experimental conditions used previously: (a) replacement of the standard radioactive labels (125I-PVP and 131I-PVP) with Na2(51CrO4) and 99Tcm-sulphur colloid, (b) replacement of the test meal with saline and (c) investigation of animals without a preceding starvation period. It was also found that the small bowel propulsion was enhanced when the test substance was infused at a higher rate, and that this change did not affect the exchange of material between the portions. The small mixing was further confirmed in experiments in which shifts of label were made repeatedly at constant intervals throughout the infusion period. Distinct regions in which one of the labels predominated could be demonstrated along the entire small bowel when the time interval was diminished to 30 but not to 20 min.


Transfer of adoptive immunity by intra-arterial injection of tumor-immune pig lymph node cells: treatment of recurrent urinary bladder carcinoma after radical radiotherapy. Twenty-four patients with invasive transitional cell carcinoma of the urinary bladder, recurrent after radiotherapy, were treated by intra-arterial infusion of tumor-immune pig lymph node cells. In 11 patients there was a remission of the disease process, and 3 patients remain alive and free of disease in excess of one year after treatment.


Urinary calculous disease in childhood.

Urinary calculous disease in childhood. Reviewed are 56 cases of children suffering from urinary calculous disease between 1970 and 1977; 27 were female and 29 male. The age distribution was from one month to fourteen years. In 34 per cent of the children urodynamic disorders were responsible for stone formation, 23 per cent had identifiable metabolic disorders, and in 43 per cent the cause of stone formation was unknown. Urinary infection was present in 60 per cent of the patients. Forty-five of the 56 children (80 per cent) had to undergo surgery. After surgery 78 per cent remained stone free, while 16 per cent had recurrent stones, only half requiring a second operation. In cases of active stone disease, especially in the group with underlying metabolic disorders, specific therapeutic measures have been applied and the patients regularly investigated afterward.


Endoscopic management of urethral stricture. Experience with transurethral management of urethral stricture using conventional urethroscope and resectroscope of both infant and adult size is reported and the surgical procedure described. Because incision, dilation, and resection of the stricture are done under direct visual control, it is safe and applicable even in severe strictures hitherto untreatable with other refined closed methods.


Clinical aspects of granulomatous orchitis. Granulomatous orchitis can present in a variety of forms varying from acute to chronic. Clinically, testicular neoplasm is usually diagnosed and radical orchiectomy is performed, with the correct diagnosis being made on microscopic examination. In this article 6 cases of granulomatous orchitis are presented, with a variety of clinical presentations varying from acute to the more chronic forms.


Ether cystitis.

Ether cystitis. Two children are reported in whom chemical cystitis developed when ether was used to dissolve a Foley catheter balloon that would not deflate. The irritative effects of ether and preventive measures are discussed.


Carcinoma of prostate presenting as retroperitoneal mass. The pattern of dissemination of prostatic carcinoma varies, but skeletal metastasis is the single most common symptomatic mode of presentation. The clinical course and treatment of the 2 cases presenting with symptomatic metastases to the retroperitoneum are described in detail and pertinent literature is reviewed.


Inflatable penile prosthesis: new device for cylinder insertion. A new device for insertion of inflatable penile cylinders into the corpus cavernosum significantly simplifies the implantation of the inflatable penile prosthesis. Use of this device assures accurate positioning within the corpora, with a minimum of device manipulation and tissue trauma, thereby minimizing postoperative complications.


Leiomyosarcoma of urinary bladder in children. A case of leiomyosarcoma of the bladder is reported in a fourteen-year-old girl who is alive and without evidence of disease two years after partial cystectomy. Electron microscopy confirmed its smooth muscle nature. The data for 7 other children, including follow-up for 5, are tabulated. Partial cystectomy with adequate margin appears to be the treatment of choice when feasible. The tumor may be controlled with chemotherapy and radiation therapy in unresectable cases.


Ectopic renal cell carcinoma: pathologists problem. Renal cell carcinoma (hypernephroma) rarely develops as a primary tumor outside the normal confines of the kidney. Although many reports of so-called extrarenal hypernephroma may be found in the literature, very few cases appear to fulfill modern criteria for tumors of true renal origin. Strict criteria for the diagnosis of true extrarenal hypernephroma are proposed, and a case that partially conforms to these standards is presented.


Intravenous urography in evaluation of acute retention. The intravenous urograms of 894 patients with acute retention were assessed. The total number of lesions demonstrated was less than 1 per cent; consequently the value of routine intravenous urograms in patients with acute urinary retention is questioned.


Reduction in renal size associated with complete ureteric duplication. Ureteric duplication, whether complicated or not, is usually associated with an increased in renal length. Two cases of renal duplex with nonfunction of the upper moeity, exhibiting a reduction in renal size, are presented. The radiologic features and the cause of this reduction in size are discussed. The importance of the postmicturition radiographs in cases of urinary tract infection is stressed.


Feasibility of inducing micturition through chronic stimulation of sacral roots. Past attempts at inducing micturition in paraplegics by electric stimulation of the spinal cord micturition center have been generally unsuccessful. Failure has most often resulted from inability to separate the response of the detrusor from that of the sphincter. Because the sacral nerves provide some organizational specificity over the spinal cord and are practically suited to chronic stimulation, experiments were carried out in dogs to find out whether or not stimulation of these roots could induce micturition. Results of acute dog studies did suggest that micturition might effectively be performed by stimulation of the ventral root of the sacral nerve having the greatest detrusor representation. Specificity of bladder response was improved by dividing somatic fibers peripherally. Selected division of somatic fibers from the sacral root stimulated was compared with complete pudendal neurotomy. (The former procedure has the advantage of preserving perineal sensation.) The principles learned from the acute studies were then applied to "chronic" dogs--5 paraplegic and 1 normal. Effective voiding was achieved on a long-term basis. Over-all results were very encouraging. Further research is necessary before application of this technique to humans can be considered.


Functional electrical stimulation: method to differentiate supraspinal from segmental detrusor hyperreflexia. Functional electrical stimulation of anal mucosa permits a differential diagnosis between supraspinal and segmental detrusor hyperreflexia. The method introduces an interesting concept on pathophysiology of micturition allowing a better selection of patients for appropriate treatment.


Flow control in prolonged ventricular bypass and clinical application in 15 patients. Long-term experiments employing left ventricular or biventricular bypass with local heparinization and blood filtration for up to 48 days was conducted in 51 calves at different flow rates. The principle of flow control obtained was applied to 15 patients in critical cardiac states. An avcothanized extracorporeal circuit consisted of heparin and protamine microperfusion lines, Pall filter, and nonpulsatile pump. Bypass with flow rates at 30--40% of cardiac output was conducted between 3 and 48 days. Survival was obtained in 34 of 36 calves. Bypass with flow rates at 60--80% of cardiac output was associated with 6 deaths in the 10 calves who underwent the procedure. Bypass with flow rates over 90% of cardiac output was often technically difficult and only 2 of 5 calves survived. Hemodynamic changes correlated well with the above results. In clinical cases flow rate was adjusted up to a maximum of 100% of left ventricular blood flow initially and thereafter to 30--40% of cardiac output for chronic support. A total of 15 patients with myocardial infarction, myocarditis and failing cardiac condition post-surgically were supported for 9--172 hrs. Six of the 15 survived. Adequate flow control in ventricular bypass support is important and the regimen developed in experimental studies proved effective clinically.


Prolonged, transapical left ventricular bypass (TALVB) in sheep and man. Transapical left ventricular bypass has been demonstrated in normal sheep and one lamb. Recently, TALVB was applied in 3 clinical cases of cardiac failure, with recovery of myocardial function in one patient after 9 days of bypass (6 days total TALVB). These studies suggest that LV apical cannula-roller pump bypass with low dose heparin anticoagulation and secondary surgery to remove the cannula may salvage some patients now dying of temporary cardiac failure.


Sorbent-filled hollow fibers for hemopurification. Filled hollow fibers were prepared and evaluated for application in hemosorption. Powdered activated carbon, urease-carbon, and macroporous ion exchange resins were used as fillers in highly permeable cellulose acetate hollow fibers. The carbon-filled hollow fibers had better mass transfer properties than encapsulated carbon in solid form. Zirconium phosphate and 2 synthetic zeolites were tested for ammonium ion adsorption from buffered saline and Ringer's salt solutions. Synthetic zeolites were found to have higher specificity and capacity for ammonium ion adsorption than zirconium phosphate. Projections are that hemosorption devices utilizing urease, carbon, and zeolites could remove all nitrogenous waste metabolites currently being treated only by dialysis. Oxystarch and oxystarch derivatives were tested for direct urea adsorption and were found unsuitable for this application.


Thirst, relative hypernatremia, and excessive weight gain in maintenance peritoneal dialysis. The conventional dialysate of 2.5 gm% dextrose, and 132 mEq/L sodium may result in mild postdialysis hypernatremia, thirst and excessive interdialytic weight gain. A reduction of dialysate sodium to 118--120 mEq/L is recommended.


In vitro permeability studies of peritoneal (P), cuprophan (C), and polycarbonate (PCM) membranes. A unique dialysis device was developed to allow direct comparison of permeability characteristics of different membranes to various solutes under identical conditions. Studies with Cuprophan (CM), polycaronate (PCM), and peritoneal membrane (P) yielded the following results: 1. PCM is similar to CM in permeability to low molecular weight solutes. 2. PCM is significantly more permeable to middle molecular weight substances than CM or P. 3. P is more permeable to middle molecules than CM.


Continuous low flow hemofiltration with sorbent regeneration of ultrafiltrate. In summary, a series of experiments have culminated in the maintenance of 2 anephric sheep for 48 and 72 hrs with CLF-HF treatment. Ewe A died of hemorrhage secondary to systemic heparinization and recent surgery. Ewe B was terminated electively. The technique of CLF-HF proved satisfactory in the control of urea, creatinine and water. Sodium and hydrogen ion balance required substantial therapeutic manipulations in addition to CLF-HF to maintain satisfactory balance with the present system. Technical and functional performance of the ultrafilter was better than anticipated. Cartridge performance was sufficiently satisfactory to demonstrate that the procedure will work. The unphysiologic linking of urea, hydrogen and sodium sorption resulted in difficulty in maintaining satisfactory sodium and hydrogen balance. Coupling a disposable reprocessing system, which lacks the deficiencies mentioned above, with continuous hemofiltration can provide a truly wearable artificial kidney.


Biochemical correlates of reversal of hepatic coma coated with charcoal hemoperfusion. Ten patients in stage IV hepatic encephalopathy who had not responded to conventional therapy for at least 48 hrs were treated with one or more 4 hr periods of hemoperfusion. Nine (90%) awoke, and 4 (40%) are alive to date, the survivors having acutely toxic and infective hepatic lesions. Biochemical changes that occurred were a reduction in blood ammonia of 23%, a rise in the ratio of branched chain to aromatic amino acids in blood (1.08 +/- 0.3 to 1.3 +/- 0.4), and cerebrospinal fluid (0.26 +/- 0.02 to 0.32 to 0.03), and a rise in cerebrospinal fluid cAMP from 2.3 +/- 0.7 ng/ml to 3.4 +/- 1.29 ng/ml with hemoperfusion. Administration of platelets and fresh frozen plasma restored the reduction of platelet counts of 29% towards pretreatment values.


Comparison of the hemofiltration/molecular separation artificial kidney concept with hemodialysis: acute preclinical trials. If adequate electrolyte adjustments are made, the only problems with the present HFMS system are the need to replenish divalent cations, add buffer, and remove the evolved CO2. Even with these deficiencies the system is portable, objectively and subjectively better than HD, and capable of being wearable in the foreseeable future.


New hydrophilic copolymers for biomedical applications. New hydrophilic copolymers with controlled number of surface hydroxyl groups were prepared using gamma-irradiation. The method involved the copolymerization of 2 monomers of varying feed ratio, using gamma-irradiation from a Cobalt60 unit, followed by partial or full hydrolysis (methanolysis), which leads to linear copolymers of simple structure with surface hydroxyl groups. These surfaces were further heparinized using covalent bonds through acetal bridges between heparin and surface hydroxyl groups. In systems of VAc and NVP, the feed ratio varied between 0.1--0.5 and the irradiation dose between 1--5 megarads. The copolymers obtained by this method were analyzed for nitrogen to establish their chemical structure. The reactivity ratios (r1 and and r2) were determined as 0.322 and 3.26, respectively, and curves of copolymer composition versus feed ratio were constructed. Upon hydrolysis swelling ratios of up to 24 were determined and reported as a function of copolymer hydroxyl composition. These hydrogels of PVA copolymers were heparinized by covalent binding of heparin on the hydroxyl groups and elution of heparin in flow was studied.


Short-time hemodiafiltration using polymethylmethacrylate hemodiafilter. Three times 3 hr/wk hemodiafiltration (simultaneous hemofiltration and dialysis: HDF) using Toray HDF system has been carried out on 4 patients. Filters used were Toray Filtryzers (membrane: polymethylmethacrylate, surface area 1.15 M2) with a dialysate flow of 500 ml/min. Nine to 10 L of body fluid was removed and 7-8 L of substitution fluid was reinfused distal to the filter (postdilution). Short-time HDF was favorable accepted by the patients. Blood pressure was stable, and disequilibrium syndrome negligible. Clinical courses as well as laboratory findings of the patients were satisfactory. The reduction rate of middle to larger molecules was 20 to 100% higher compared to conventional HD as measured by chromatogram. Loss of amino acids was about 3 gm/treatment. Reduction of hormones was negligible and no depletion syndrome was observed throughout the observation period up to 10 mos. Acidosis was corrected within 3-4 hrs. Elevated blood concentration of lactate and acetate gradually decreased to a pretreatment level within 2-3 hrs after termination of the procedure. Removal of middle molecules by HDF, in addition to removal of small molecules by conventional hemodialysis, is considered to be the treatment of choice for uremic patients.


Initial clinical evaluation of the Hospal artificial kidney system. A high flux artificial kidney system, which permits control over ultrafiltration, has been developed and patients are now being treated with it at a large outpatient kidney center. The basic operating characteristics have been described and some preliminary clinical results mentioned. Characteristics of the Hospital Artificial Kidney System are: 1. Higher clearances for middle molecules than conventional systems; 2. Adequate clearances for small solutes such as urea; 3. Predictable control of ultrafiltration with discrepancies between actual weight loss and theoretical weight loss on the order of 0.7 to 1.3 ml/min, when the system is operated in the designated manner.


Fallibility of the platelet count and fibrinogen concentration in evaluating circulatory assistance technique--a plea for turnover studies. Platelet and fibrinogen kinetics were investigated in calves undergoing prolonged extracorporeal left ventricular bypass in which both platelet and fibrinogen concentrations were within or above the normal range. Sequential survival time measurements documented significant continuing destruction of both platelets and fibrinogen during the course of these perfusions, with markedly elevated turnover rates of both components. The ineffectiveness of ASA and Persantine to return these functions to normal suggests that the mechanism of destruction includes trauma from the moving parts of the system, including the rotor and bearing seal, as well as surface-induced injury from the conduits and pump housing. Kinetic studies appear to be an essential requirement in the evaluation of blood destruction and subject tolerance of prolonged circuitry assistance devices.


A technique to assess fibrinogen, platelet and red cell kinetics in calves with artificial hearts or circulatory assist devices. 1. Normal data for routine hematologic studies including fibrinogen, VIIIAHF, AT III, and circulating platelet aggregates are reported for Holstein calves. 2. Therapy with warfarin, ASA, and dipyridamole does not alter these parameters such as VIIIAHF, AT III, or circulating platelet aggregates. 3. 75SeM can be used as an in vivo label to study the fibrinogen, platelet, and red cell kinetics simultaneously in calves. 4. Decreased VIIIAHF levels and decreased platelet survival are the most sensitive parameters to estimate the activation of coagulation in the animals with circulatory assist devices. 5. The total heart animals seem to have a significant decrease in fibrinogen and VIIIAHF levels as compared to normal and left ventricular assist animals. 6. Despite the use of warfarin and antiplatelet drugs, decreased platelet survival occurred in both the total heart and the left ventricular assist animals. Fibrinogen half life with 75SeM must be interpreted with caution until corrections for pool size, reutilization, and nonpeptide binding have been considered.


Bias-cut artificial blood vessel.

Bias-cut artificial blood vessel. Bias-cut grafts tend to return to their original porosity in the process of scar contraction. It is possible to maintain biological porosity close to the original porosity, which resists scar contraction. Development of a bias-knitting machine presents a problem in clinical application.


Rotating disk membrane oxygenator based on transmembrane catalysis of hydrogen peroxide. 1) Oxygen transfer in the catalyst membrane oxygenator is not limited by diffusion through the blood-membrane boundary layer. Instead, oxygen transfer occurs at a rate independent of blood flow conditions and is evenly distributed over the membrane surface. Shear-induced mixing combined with high boundary O2 layer gradients are the mechanisms of transfer. 2) The rotating disk design provides very high level oxygen transfer. However, H2O2 concentration, blood flow rate, and disk rotation rate must be adjusted so that excess O2 supersaturation in the blood-membrane boundary does not lead to significant bubble formation. 3) The catalyst membranes used in the hemodialysis-based oxygenator have been industrially produced. 4) Effective CO2 transfer can be carried out across a hemodialysis type of membrane as previously reported. 5) The catalyst membrane oxygenator as studied in the dog performs well for 3-5 hrs, at which time inhibition of the catalyst leads to H2O2 breakthrough which  causes methemoglobin formation. The mechanisms of catalyst inhibition and ways for its prevention are under study. 6) The catalyst membrane oxygenator offers the advantages of simultaneous artificial kidney treatment. This feature may be of help in maintaining acid-base balance and treating edema states.


Development of compact thermal and electrical energy converters left heart assist systems. The thermal converter for left heart assist systems consists of an engine which converts thermal energy to a flow of pressurized helium and a helium powered actuator/controller which powers and controls a PVAD pusher plate blood pump. The 0.43 L, 0.94 kg engine requires 20 watts of thermal input. In vitro and in vivo testing have demonstrated that the system synchronizes and provides left ventricle relief from 60 to 150 beats/min. The concepts potential for long life is based on: the inert environment for all internal components; the hermetic sealing capability resulting from a linear magnetic coupling blood pump drive; fluid control; and titanium external metal surfaces. Endurance testing has demonstrated that the converter shows promise of providing a high reliability 10 yr life. Many wear and fatigue sensitive components have demonstrated the 10 yr capability during accelerated life testing.


Mechanical circulatory support: evolving perspectives. Mechanical circulatory support of the failing circulation is an emerging discipline. Prototype circulatory support services have been established in a few institutions but are spreading15. Intra-aortic balloon pumping, developmental only a decade ago, is now widespread. Pneumatically-actuated intra and extracorporeal left ventricular assist devices, federally-approved for clinical trials only 2 yrs ago, show encouraging early results. Efforts in West Germany, Austria, Switzerland, Russia and Japan are underway and a spirit of cooperation exists. There is a need to clarify and quantitate indications and timing for deployment, prior to the onset of multiple organ failure. Electrically and nuclear-activated LVAD's16--18 are being developed. Clarification of projected patient populations are needed and the role of the right heart in left ventricular assist device function requires further investigation. There is a need to define a reasonable clinical role for the much discussed and rather elusive total artificial heart. Many problems remain with actuation, energy conversion, percutaneous leads, compliance devices and biomaterials. The challenges are many and welcomed.


An implantable permanent left ventricular assist system for man. A new implantable, electrically powered LV AS suitable for long-term use in man has been designed and is under development. The system is based on the well developed high-efficiency pulsed solenoid technology and a careful a priori systems approach to integration of the energy converter with a suitable blood pump. A novel dual pusher-plate sac-type blood pump with significant advantages in hemodynamics, antithrombogenicity and durability has been designed. The complementary energy converter, a pivoted-armature dual-gap solenoid, addresses weaknesses in previous designs while retaining all the good features of its forerunners and provides for the first time a truly integrated implantable circulatory assist system for man.


[Pathogenetic justification of organ-preserving operations and their role in improving the effectiveness of the comprehensive treatment of renal tuberculosis]. Some experimental data concerning the pathogenesis of tuberculous injury to the kidneys have been obtained from a complex study of the microcirculatory blood bed on a model of tuberculosis of the kidneys in 112 rabbits. Clinical investigations and clinico-experimental correlations have provided pathogenetic grounds for a surgical method of the treatment of tuberculosis of the kidneys complicated with strictures or the ureter. The pathogenetic association of the main tuberculous focus in the renal parenchyma with the tuberculous injury to the ureter and perivascular expansion of specific infection has been pointed to. The effectiveness of pathogenetically grounded surgical intervention has been proved in 52 patients followed-up from 1.5 to 7 years.


[Postoperative treatment of abdominal injury victims]. Among other procedures of a complex intense therapy applied upon 265 abdominal trauma cases the authors have included an early peritoneal perfusion and longlasting peridural blockade. The results evidence a high prophylactic and therapeutic effectiveness of the suggested methods


[Retroperitoneal injuries of the duodenum]. 8 observations over a closed trauma of the retroperitoneal portion of the duodenum are presented; 3 patients out of them sustained combined traumas. Only in 2 cases the rupture of the peritoneal portion of the duodenum was suspected before operation. In 4 patients the diagnosis was established in time of laparotomy, in 2 cases the rupture was recognized at the repeated laparotomy. As a rule each operation terminated in a drainage of the retroperitoneal space through the lumbar region.


[Relationship of functional liver disorders in burn disease to the treatment methods]. The dynamics of liver function in 243 cases with deep burns was studied by means of a set of biochemical tests: determination of blood plasma proteins and protein fractions, residual nitrogen, bilirubin, sugar, lipides, activity of liver organospecific enzymes, sedimentation reactions and Quick-Pytel' test. The obtained findings showed disorders of all types of hepatic metabolism which was manifested through alterations of the indices of liver function tests. An intense transfusion therapy of burn shock and acute toxemia using the method of hemodilution, together with an early necrectomy and autodermoplasty were found to be effective means of preventing and treatment of liver functional disorders.


[Functional state of the cardiovascular system in bone fractures of the lower extremities in the middle-aged and elderly]. A dynamic electrocardiographic study and determination of main hemodynamic indices were carried out in 138 patients aged from 50 to 92 with fractures of various localization. In response to the trauma the hemodynamic indices changed considerably. A positive dynamics of revealed disorders was found only in a small number of patients in response to a complex therapy.


[Clinical morphological aspects of adenogenic cancer of the esophagus]. From the authors' data adenogenic cancer of the esophagus was found in 11 out of 90 patients who were subjected to intrathoracic extirpation of the esophagus in Dobromyslov-Torek method. The macroscopic pattern of glandular cancers of the esophagus characterized by a diffuse-infiltrative growth with the involvement of all the layers of the wall and ulceration of the mucous membrane is described.


[Phagocytic activity of the leukocytes in congenital heart defects before and after an operation under artificial circulation]. The authors confirm a well-known statement concerning a direct correlation between phagocytic activity of neutrophiles and the degree of oxygenation of an organism. According to their findings the percentage of phagocytic neutrophiles and absorbing activity of phagocytes is cases with a "blue type" heart disease is significantly lower than in patients with moderate hypoxemia. The development of an infectious process has been proved to occur in patients with a low immunoreactivity against the background of a further decrease of natural immune protection factors of an organism.


[Ligation of the splenic artery in the comprehensive surgical treatment of liver cirrhosis]. Data concerning an attempt to perform the ligation of the splenic artery in 46 liver cirrhosis cases are described. In 10 of them the ligation failed, which made the authors study the indications and contraindications to this procedure. These problems are considered in relation with various forms of the disease and variants of pathological changes in the spleen.


[Modified method for catheterization of the umbilical vein]. A modified method of catheterization of the umbilical vein differs from other methods, for at the dismissal of the patient from the hospital the peripheral end of the polyvinylchloride catheter filled with maiodil is sealed and inserted under the skin, which permits to keep the catheter in the umbilical vein for several years, taking out its end periodically from under the skin for introduction of necesary drugs in case of cancer and liver cirrhosis. The catheter does not cause any discomfort and prevents the umbilical vein and surrounding tissues against infection. The suggested method has been applied in 64 patients without any related complications.


[Results of treating strangulated external abdominal hernias]. The analysis of 423 case records of the patients operated upon for incarcerated external abdominal hernia within the 10 years' period (1966--1975) has been carried out. The patients are classified with the reference to the severity of the disease, duration of incarceration, diagnostic errors, clinical course, hospitalization period, type of a surgical intervention, outcome of the treatment and complications.


[Ileoscopy].

[Ileoscopy]. The analysis of 540 ileoscopy findings from the material including more than 4000 colonoscopies in various pathological conditions of the great bowel is presented. The possibilities for an examination of the small bowel by means of various types of colonoscopes are compared and the most videly and frequently used techniques are described.


[Pressing problems in the surgical treatment of gastric and duodenal peptic ulcer]. Data on late results of stomach resection carried out upon 505 patients for peptic and duodenal ulcer with the follow-up from 4 to 24 years are presented. Improvement has occurred in 96.4% of the patients, which proves that the stomach resection should be considered as an operation of choice in complicated forms of peptic ulcer.


[State of the homeostatic constants in suppurative lung diseases]. 110 cases of suppurative lung diseases were examined, 78 of them were operated upon. The studies of external respiration function, total and pulmonary hemodynamics, a number of metabolic processes and of renal function were carried out. It was demonstrated that suppurative-inflammatory processes in the lungs give rise to considerable changes in some parts of homeostasis. The main factor controlling the depth of physiological and biochemical shifts in the body is the degree of intoxication which determines the predominance of metabolic disturbances.


[Motor activity of the gastrointestinal tract in the immediate days following a gastric resection for cancer]. The author used the method of abdominal phonography to study the motor activity of the gastrointestinal tract after resection of the stomach for carcinoma and also to determine the degree of the effect of different stages of the operation and of its volume upon the motor function in 88 patients. Diagnostic laparotomy was carried out in 41 patients. The phonography findings showed postoperative depression of gastrointestinal motor function in the most of cases within the first days after operation.


[Mucoectomy in stomach surgery].

[Mucoectomy in stomach surgery]. Considering the stage character of the formation of the stomach polyps and various patterns of histomorphologic changes the authors suggest to use polypectomy together with mucousectomy. The operation was carried out upon 38 patients with stomach polyps. The technic of mucousectomy combined with bilateral trunk vagotomy for gastric and duodenal ulcer was devised in the experiments on 62 dogs. This operation was carried out upon 7 patients.


[Clinical aspects and therapy of gastrogenic tetany]. The author observed 477 patients with sub- and decompensated stenosis of the pylorus of ulcer etiology; 11 out of them developed a severe complication--chloroprivic tetany which resulted from repeated abundant vomiting in emaciated patients and was followed by an acute total dehydration of the body, decrease of chlorides, oliguria and azotemia. Some problems concerning the prevention and the treatment of this severe complication of peptic ulcer are described.


[Aanalysis of the causes of high lethality in the surgical treatment of acute cholecystitis]. A comparative analysis of postoperative lethality in acute and chronic cholecystitis, acute appendicitis and cancer of the stomach together with the results of biochemical and morphological studies of the liver are covered here. A direct correlation of postoperative lethality in cholecystitis with the presence and stage of concomitant cholangiohepatitis has been found.


[Internal biliary fistulae and acute intestinal cholelithic obstruction]. From 1945 to 1976 the authors observed 19 patients with internal biliodigestive fistulae. 2 types of the clinical picture were noted: cholangitis phenomena and acute cholelithic ileus. In one patient only internal biliodigestive fistulae were diagnosed preoperatively. All the patients were operated upon. Some technical difficulties due to an inflammatory infiltration in the right hypochondrium tissues were noted.


[Lung resection in tuberculosis in diabetics]. The results of surgical treatment of 201 cases of pulmonary tuberculosis associated with diabetes mellitus (bilateral lung resection was carried out upon 8 patients) are set forth in this work. The operations were carried out in a climatic sanatorium during the compensation phase of diabetes mellitus and the stabilization of the tuberculosis process. The method of preoperative management and postoperative cure of diabetes mellitus using B-insulin together with simple insulin is described.


[Outcomes of the treatment of acute intestinal obstruction in the middle-aged and elderly]. During 15 years (from 1959 to 1973) the author observed 753 patients operated upon for acute intestinal ileus; 161 of them aged above 60. An early diagnosis of the condition is difficult due to blurred main symptoms against the background of pronounced age changes and concomitant diseases. The most common non-blastomatous forms are the following: adhesive intestinal ileus (16.8%) and sigmoid volvulus (14.3%). Cancer of the colon with acute symptoms of intestinal ileus was noted in 23.6%. Stomach resection was carried out upon 37.9% of cases. Postoperative complications constituted 34.1% and lethality--30.4%. Elderly and senile patients usually appeal for medical aid rather late, which together with severe concomitant diseases, late surgical intervention, diagnostic and tactical errors admitted in the treatment result in a high postoperative lethality.


[Is an appendectomy indicated when a diagnosis of acute appendicitis is not confirmed during the operation?]. In 236 out of 11,150 (1.8%) patients operated upon for acute appendicitis some other acute surgical and gynecological diseases were revealed. In this group of patients the vermiform process either seemed to be unchanged or its changes were considered to be secondary ones (reaction to an inflammation in adjacent organs). Histological study of vermiform processes proved the abscence of inflammatory alterations only in 35 cases. In the rest of patients either chronic or acute inflammatory process was found. The conclusion has been drawn that in case when diagnosis of acute appendicitis is not confirmed during operation, appendectomy does not produce any unfavourable effect upon the postoperative clinical course and outcome of the main disease and should be considered as a compulsory element of a surgical intervention.


[Characteristics of the microbial flora of the abdominal cavity in acute appendicitis]. A special study of the character and sensitivity of microbic flora of the abdominal cavity exudate in acute appendicitis was carried out upon 192 patients. The predominance of infection caused by colibacillus (44%) and correlation between the severity of the inflammatory process and the presence of the agent in the exudate were proved. The identification of the sensitivity of the cultured microbes to the most widely used antibiotics allows to recommend a combined use of the preparations of neomycin sulfate group and synthetic penicillins for the treatment of complicated appendicitis.


[Surgical procedure in combined proctologic diseases]. In 301 (23%) out of 1264 surgical cases with various pathologies of the rectum, pararectal and sacrococcygeal regions some combined diseases were observed. Such combinations as chronic paraproctitis (rectal fistulae) with hemorrhoids and with anal fissure are the most common ones. 176 one-stage operations and 63 double-stage operations were carried out. The average period of hospitalization was 16 days after one-stage operation and 24 days after double-stage operation. The authors believe that timely diagnosing of combined pathology allows to prevent the development of possible complications and to choose the most helpful surgical tactics in every specific case.


[Experience in using helium laser therapy for acute anorectal thrombosis and thrombophlebitis]. Clinical observation over 61 cases of acute anorectal thrombosis and thrombophlebitis was carried out. The duration of the disease ranged from some months to 35 years. The clinical observations have proved the advantages of laserotherapy over phototherapy with monochromatic incoherent red light and its high therapeutic activity in acute anorectal thrombosis and thrombophlebitis.


[Recanalization of the thrombus as a way for secondary blood flow restoration in a prosthetic major vein]. According to the authors data a secondary restoration of the lumen of a previously obstructed prothesis approaching a half of the initial diameter of the vein is not infrequent in the plasty of the main veins of a growing organism. This restoration results from pronounced processes of the recanalization of the intraprosthetic thrombus, which are observed in the plasty of the external jugular vein and anterior vena cava. It has been found that the recanalization occurs through the formation of some longitudinal canals in the thrombus. These canals join the capillaries growing through the pores of the prothesis which transform into venous vessels with the endothelial lining, vascular apparatus and directed blood flow,


[Significance of the state of the celiac and mesenteric arteries in the treatment of occlusive lesions of the abdominal aorta and iliac vessels]. The status of the celiac and mesenteric arteries in 124 patients with occlusive injuries to the abdominal aorta and iliac arteries has been studied by means of the antero-posterior and lateral translumbar abdominal aortography. Clinical picture and symptoms of pathological conditions with the regard to the localization of occlusion are described. Some practical recommendations are given.


Canine medullary carcinoma of the thyroid. An 8-year-old male Irish Terrior dog and a male St. Bernard dog each had a thyroid medullary carcinoma. The first dog was hypocalcemic before removal and with recurrence of the neoplasm. In both dogs the neoplasms were bilateral and microscopic metastases were seen only in the regional lymph nodes. Both neoplasms were characterized by a solid alveolar pattern separated by thin vascular stroma or a linear festoon-like arrangement with thick stroma. The neoplastic cells varied little and were polygonal or round with abundant pale eosinophilic and finely granular cytoplasm. There was little mitotic activity. Both carcinomas contained amyloid. Electron microscopically, the neoplastic cells had moderate nuclear pleomorphism, well developed Golgi complexes, and characteristic membrane-bound electron-dense secretory granules. In some sections, the secretory granule membranes were fused to the cytoplasmic membrane and the granules were in the extracellular space. In one carcinoma there were linear fibrillar structures with an average width of 7.8 nanometers similar to that of amyloid fibrils.


The pathogenesis of Trypanosoma congolense infection in calves. I. Clinical observations and gross pathological changes. Holstein calves infected with Trypanosoma congolense TREU 112 had intermittent fever, debility and a poor hair coat. At postmortem examination the most significant findings were enlargement of the liver, kidneys and spleen and increased volume of hematopoietic marrow. A group of 13 calves infected for 18 weeks had marked enlargement of lymph nodes throughout the body and hemal nodes were prominent in the sublumbar area caudal to the kidneys. Another group infected for 7 weeks had no increase in the weight of lymph nodes. Studies with 51Cr labelled autologous red cells given shortly before postmortem examination showed that the liver was the most active organ with respect to sequestration of labelled red cells.


Pathology of experimental Histophilus ovis infection in sheep. I. Lambs. Inoculation of lambs either intravenously or intranasally with Histophilus ovis resulted in septicaemia. There was bacterial thrombosis and vasculitis in the liver, lung, kidneys and heart. These lesions were similar to those in natural cases of the disease. With intravenous inoculation of a less virulent isolate there were abscesses in the subcutaneous tissues, muscle fascia and joint bursae.


The goitrogenic effect of 4,4'-oxydianiline in rats and mice. Fischer 344 rats and B6C3F1 mice were fed diets that contained 0.03, 0.06, 0.1 and 0.2% 4,4'-oxydianiline for 13 weeks. The 0.1 to 0.2% diet caused 40 to 70% mortality in female rats. Although mice ate about 3.5 times more chemical than rats, no mice died. Alopecia, dyspnea and cyanosis in rats, and lethargy in both species occurred in the 0.1 to 0.2% groups. Goiter was found in rats that died as early as the 4th to 5th week of study in the groups given the 0.06 to 0.1% diet. At the end of the study, diffuse parenchymatous goiter was seen in all rats given the 0.06% and higher concentration diets and in most mice given the 0.2% diet. In rats, the thyroids also were heavily encapsulated and had interstitial fibrosis and vascular degeneration. There was concomitant hyperplasia of pituitary basophils in both species, but an increase of cells that secrete thyrotropin was seen in rats only.


Infective arthritis of the elbow joint in horses. Six horses were found to have infective arthritis of one elbow joint. The history, and presence of a small wound on the lateral aspect of the elbow suggested the condition was trauma induced. Two horses recovered following joint lavage under general anaesthesia and antibiotic therapy. The joint changes found post mortem in the others were characteristic of an infective arthritis.


Marek's disease tumour-specific antigen induced by the herpesvirus of turkeys in vaccinated chickens. The herpesvirus of turkeys, a supposedly apathogenic virus commonly used for vaccination against Marek's disease, was found to induce Marek's disease tumour-specific antigens on spleen and peripheral blood lymphocytes in vaccinated chickens. Herpesvirus of turkeys may be able to induce the neoplastic transformation of lymphocytes and the consequential stimulation of an anti-tumour immune response may be an important component of vaccinal immunity.


Treatment of experimental calf salmonellosis with amoxycillin. Treatment of experimental Salmonella dublin infection in the calf with amoxycillin is described. In most animals a rapid response occurred when the drug was administered by the parenteral route. Results were moderately good when the oral route was used in calves fed solely on a milk replacer diet. In calves consuming hay and concentrates oral administration was much less efficient.


Antibodies to Leptospira in the sera of aborted bovine fetuses. Antibodies to Leptospira serotypes were detected in sera from 15 (6.9 per cent) of 218 aborted fetuses, but were not detected in the sera from 196 non-aborted fetuses. Fourteen (6.4 per cent) sera from the aborted fetuses had antibodies to strains belonging to the Hebdomadis serogroup and 1 (0.5 per cent) had antibodies to a strain belonging to the Icterohaemorrhagiae serogroup. These antibodies were predominantly immunoglobulin M whereas in the dams, antibodies belonged to both immunoglobulin M and G classes.


Sudden death in calves associated with acute myocardial degeneration and selenium deficiency. A syndrome on four dairy farms in which calves up to two months of age died suddenly during a period of excitement usually precipitated by feeding was investigated. The description given by owners was that during, or shortly after milk feeding, the calves grunted, fell and died within one minute. Post mortem examinations revealed patchy myocardial pallor but no other lesions or evidence of infectious disease. Histopathological studies revealed peracute myocardial degeneration. Biochemical examinations have shown a selenium deficiency in in-contact calves and since this was corrected, no further cases have occurred. It is suggested that this is an additional manifestation of the selenium deficiency syndrome and that in certain circumstances, a deficiency of available selenium renders cardiac muscle vulnerable to stresses which induce severe peracute damage and leads to cardiac failure and sudden death.


Serum folate levels in horses, with particular reference to the English thoroughbred. The assay of serum folate has been used to investigate the folate status of thoroughbreds in training to race, in-foal thoroughbred mares at stud and crossbred ponies kept permanently at grass. Throughbreds in training, with no obvious haematological or clinical abnormalities, had lower serum folate levels (mean 3.3, range 1.5 to 6.1 microgram per litre) compared with thoroughbred mares at stud (mean 10.6, range 6.4 to 15.8 microgram per litre) and crossbred ponies at grass (mean 10.9, range 7.4 to 16.6 microgram per litre. Intensive exercise, over a period of six months, significantly decreased serum folate levels (P less than 0.001) and significantly increased the levels of bilirubin (P less than 0.0001) and PCV (P less than 0.0002) in a group of 30 thoroughbred racehorses. Haptoglobin levels showed no significant changes.


A complement fixation test for antibody to the contagious equine metritis organism. A complement fixation test (CFT) based on that used for brucellosis (Brinley Morgan and others 1971) has been developed for use on the sera of horses exposed to the contagious equine metritis (CEM) organism. None of 50 single samples from horses thought to be unexposed to the CEM organism was positive to the test, although five showed inconclusive reactions. Samples were examined from 41 mares either proved to be infected or from an infected stud. Of these 21 were positive, 11 were inconclusive and nine were negative. The relationship of the CFT to reactions in the other tests used in this condition is discussed--the serum agglutination test (SAT) and antiglobulin test (AGT) (Benson and others 1978). Complement fixing antibodies appear to remain for a longer period in the infected animal, and are therefore more likely to be of use in the diagnosis of the chronic carrier state.


[Messenger RNA and RNP complexes of normal mouse liver cells and of hepatomas]. The messenger RNA spectra of highly malignant ascites hepatoma 22A and hepatoma 48, belonging to the group of hepatomas with minimum deviations, examined by a sedimentation method in the sacchrose concentration gradient, are characterized by higher heterogenecity as compared with that of the normal liver. The nuclear RNA contents of these hepatomas differ but insignificantly. Whereas in cytoplasm of hepatoma 22A and, to a less extent, of hepatoma 48 some deviations were found in quantitative correlations between polyribosomes and messenger somatic cells (free cytosol particles) in favour of the latter.


[Characteristics of the cellular RNA in viral leukemia]. A description is given of the differences in the fractional content of normal cell nuclear RNA and in Rauscher leukemia, which are manifested in the appearance of an accessory fraction 35 S RNA in leukemia-changed cells. The results of examining poly(A)-RNA amounts in normal splenic cells cytoplasm and nuclei, and in Rauscher leukemia are reported. The differences in the fractional content of poly(A)-RNA of normal leukemia changed cells are described.


[Nuclear and cytoplasmic poly A-containing RNA in normal and leukemic human leukocytes]. The method of affinity chromatography on a poly(A)-cellulose column was used to study the content and radioactivity of poly(A)-rich RNAs in the nuclei and cytoplasma of lymphocytes of healthy subjects and patients suffering chronic lymphatic leukemia. It was found that in the nuclei of normal and leukemic lyphocytes the amount of polyadenylated RNAs was higher than that in cytoplasma. The content of poly(A)-rich RNAs in the normal lymphocytes nuclei was 6.7%, whereas in leukemic ones--4.3% of the total nuclear RNA, in the latter, however, the specific radioactivity of polyadenylated RNAs was 1.5 times as that in normal cells. Poly(A)-containing RNAs normally make up as much as 3.1% of the total amount of cytoplasmic RNA, while in leukemic lymphocytes--1%. The specific radioactivity of poly(A)-rich RNAs in normal and leukemic lymphocytes cytoplasma was on average 3 times higher than in other classes of RNA.


[Changes in the structure of Ehrlich tumor cell populations]. In late stages of Ehrlich tumor development there occurs a gradual increase of the portion of cells, being in the second half of the mitotic cycle, on account of cells of the initial stages of mitosis. Simultaneously, resting cells are accumulated. The data of energy metabolism may account for these changes in the population structure. Under conditions of the glucose deficiency accompanying tumor growth the ATP deficit proves to be greater in cells of the second half of the mitotic cycle than in cells of the beginning of mitosis, thus resulting in redistribution of cells with stages of the mitotic cycle. In an old tumor the rate of DNA synthesis was shown to be lower at all stages of S-phase, while RNA synthesis was mostly activated in cells of G-period. In S- and G2 cells of an old tumor the total protein content was reduced. In G0-cells nuclei of Ehrlich tumor electrophoresis in polyacrylamide gel would show protein with a molecular weight 9000 +/- 500, which was absent in proliferating cells nuclei. It was demonstrated that protein with analagous properties is contained in nuclei of 13 transplantable animal tumors.


[Specificity of the action of the RNA released by Ehrlich carcinoma cells on the transplantability and growth of a homologous tumor]. A comparative study was undertaken on the effect of different RNA preparations on the transplatability and growth of Ehrlich carcinoma. The RNA isolated from Ehrlich carcinoma ascites fluid was found to render the specific stimulating action on the transplantability and growth of a homologous tumor, while total RNA from bovine liver, tRNA from rabbit liver and synthetic polyribonucleotides show no stimulating effect. The RNA from Ehrlich carcinoma ascites fluid is formed as a result of its release from intact tumor cells, and it seems to be one of the factors responsible for the interaction between the tumor and the organism.


[Membrane phospholipids of the rat liver endoplasmic reticulum normally and in the early stage of carcinogenesis]. There were found certain changes in the total content of phospholipids as well as in the content of their separate fractions in the membranes of endoplasmic reticulum in the rat liver at early stages of carcinogenesis. In the first week under the carcinogen DENA exposure a considerable reduction of the total phospholipids content was noted in the fraction of granular endoplasmic reticulum, while in agranular reticulum during this period of embryogenesis the total content of phospholipids is not changed, but subsequently the former increases as compared with normal values. During the whole period of carcinogenesis under study changes in the phospholipid content are observed in both fractions of endoplasmic reticulum membranes, the greatest changes being noted in the fractions of lysophosphatidicholines, phosphatidilcholines, and phosphatidilinosites.


[Pancreatic enzymatic activity in the blood and urine in tumors of varying localization]. Under study was the activity of proteinases and their inhibitors, amylase and lipase of the blood serum and urine in 15 healthy subjects and 40 patients with tumors of different localization, and in 8 patients subjected to surgical interventions. There was found a reliable increase of total antitryptic activity in tumors of different localization and extensive operative procedures, while an increase of proteinase activity of blood serum in gastric cancer.


[Tumorous origin of the hexokinase in human biological fluids]. Hexokinase of the endometrium and gastric mucosa is represented by 5 isoenzymes. The "simplification" of HK isoenzyme spectrum is characteristic of cancer tissue. So, in gastric cancer there is a disappearance of the "slowest" isoenzyme, while in malignant endometrium the "fastest" one was absent. Hexokinase isoenzymes of the serum were identical to those in the tumors in question, that indicates the tumor origin of the body fluid hexokinase. The latter was not observed in normal body fluids. The isoenzymic composition of hexokinase in uterine fibromyoma did not differ from that in normal tissues. If hexokinase appeared in the serum of these patients, its isoenzymic composition was similar to that in the normal uterus. The study on the hexokinase isoenzyme composition may be a valuable adjunct in establishing the differential diagnosis between benign and malignant tumors.


[Cortisol content in the blood plasma in lung cancer]. Under examination were 25 patients with lung cancer. It was found that the cortisol level in blood plasma was significantly higher in the patients than in healthy subjects (in patients--20.99 mkg/100 ml +/- 1,36, in healthy subjects--12.73 +/- 1.12, p less than 0.001). In a favourable course of the disease the cortisol level in lung cancer patients after the combined or radiotherapy was reliably reduced. An increased cortisol level in blood plasma after the treatment was followed (3--6 months later) by the appearance of metastases and the cancer process generalization.


[Copper content and the ceruloplasmin activity in the blood in melanoma of the skin]. In comparative studies on the copper content and ceruloplasmin activity in blood of 212 patients with malignant melanoma, cancer and benign skin neoplasms, hypercupremia and an increased activity of the enzyme was revealed in 80% of patients with melanoma. Serum copper uptake in patients with non-pigmented melanoma was manifest to a greater extent. Some redistribution mechanisms are likely to underlie hypercupremia, that is especially indicated by the migration of copper from blood erythrocytes. Hypercupremia in patients with melanoma may be of a certain clinical interest as an accessory criterion for the differential diagnosis between malignant melanomas and benign skin neoplasms.


[Antioxidative activity of breast tissue in fibroadenoma, fibrocystic mastopathy and cancer]. The data obtained indicate that AOA of a tumor and adjacent normal tissues is reasonably changed as the tumor grows. The character of these changes is analogous to the AOA changes, observed while inducing experimental tumors in animals, which evidence some common physico-chemical mechanisms of tumors occurrence and growth in animals and man. This concept may be supported by a resemblance of the response (by AOA changes) to the irradiation effect on tumor and tumor-bearer tissues, obtained both on experimental and clinical materials. The fact, that in each separate case a correlation between tumor AOA values and those of normal tissues is strictly individual (in the presence of a general tendency for the average tumor growth for each stage), seems to offer the opportunity to use the AOA test in prognosticating the radiotherapy effect for each particular case.


[Phenotypic changes in acetylation in tumor patients]. The authors have determined the activity of N-acetyltransferase and the type of acetylation in patients with cancer of the lung (38) and gastrointestinal tract (39), and in 72 control individuals. It was found that there is a changed distribution of patients in relation to the activity of acetylation in maintaining the normal correlation of "slow" and "fast" acetylators. There was noted an increase in N-acetyltransferase activity with greater spread of the tumor process, whereas the activity decreased in radical operations and increased in palliative surgical procedures and in the presence of recurrences or metastases.


[Nucleic acid and protein metabolism in vitamin D and dietary protein deficiency]. Protein deficiency and D-hypovitaminosis lead to marked disturbances of the RNA and protein metabolism in different organs, tissues and subcellular fractions. With a complex action of the food protein and vitamin D deficiency, changes in most organs and tissues became more intensive. The nature of the discovered shifts is largely determined by the kind of the tissue, and the degree of its metabolic activity.


[Lipid makeup of erythrocyte membranes of varying age in body thiamine deficit in rats]. The influence of different methods of simulating B1 avitaminosis on the lipids of the erythrocytes membranes was studied. The greatest changes were found to occur in alimentary B1 avitaminosis. Then, in all the age populations of erythrocytes the cholesterol content decreases, in membranes of old and young erythrocytes the amount of cardiolipine rises, while in the mature ones the sphingomyelin level goes up. In a dose of 40 mg/100 g body weight oxythiamine forces down the cholesterol content in the "shadows" of old and mature erythrocytes and brings down the amount of lecithin in young cells. In a dose of 10 mg/100 g oxythiamine lowers the cholesterol level only in the membranes of mature erythrocytes. In these conditions the total phospholipids in the red blood cells remains unchanged.


[Effect of prolonged fasting on cathepsin and lipolytic enzymatic activities of the rat liver]. In the liver of rats fasting for 2,5,8 and 11 days the activity of kathepsins A, B1, C, D, phospholipases A1, A2 and of the cholinesterase was determined. Reciprocal relations in the change of the kathepsins A and D activity was revealed, whereas the kathepsins B1 and C showed a substantial fall. Of the phospholipases A1 and A2 was characteristic a progressive decline of the activity up to the 8th day of fasting. At the terminal stage a brusque activation of phospholipases, largely of the A1 phospholipase was observed, the activity of the latter reaching 205 per cent of the control level. The cholinesterase activity was consecutively declining throughout the whole of the experiment. The data obtained bear evidence to an important role of the kathepsins A and D in the adaptation of the organism to conditions of the endogenous nutrition.


[Effect of thiamine deficiency in hydrochloric acid secretion in the stomach]. The effect of the thiamine deficiency on the H+ secretion in an isolated gastric mucosa and also on the functional properties of the mitochondria was investigated. The thiamine deficiency was called forth through introduction of oxythiamine or by exclusion of thiamine from the ration. It is shown that the thiamine deficiency in an isolated gastric mucosa of the frog produced inhibition of the H+ secretion and in the gastric mitochondria of rats--a higher activity of succinate-dehydrogenase and a diminution of the exogenous cytochrome oxidation rate.


[Characteristics of milk protein digestion in the early postnatal period of development]. It is found that in the period of the 1st to the 20th day of life there takes place shifting of the cavitary digestion of milk proteins toward the distal part of the small intestine. The change-over from the milk to the definite alimentation is accompanied by a shift of the process of the milk proteins digestion to the proximal part of the small intestine. The jejunum chyme of the 3, 12 and 20-day old rats contains roughly equal amounts of free amino acids, whereas in the jejunum chyme of the 30-day old animals their concentration is twice as high. The results of determining the speed of the amino acids release in tests with incubation in vitro of the jejunum chyme in 3, 12 and 20-day old rats bear proof to the existence at the young age of two types of digestion, viz. of the cavitary and intracellular (and/or membranous).


[Retinylpalmitate and retinylacetate hydrolases in the intestinal juice of dogs secreted on an empty stomach and on the intravenous administration of protein hydrolysates]. Intravenous injection of caseine hydrolysate, hydrolysin or amino-peptide to dogs was not attended by any substantial changes in the activity of retinylpalmitate- and retinyl-acetate-hydrolase in the intestinal juice, as compared to the juice secreted on an empty stomach. The mutual relation of these enzymes activity in the intestinal juice and jejunal wall was dissimilar, which testifies to their different localization in the intestinal tissues.


[Experimental study of the aftereffects of feeding rats certain types of canned fish]. For 3 years fish canned goods were added to the ration of rats. These additions included atlantic herring in tomato gravy ("Stavrida"), dressed sprat in tomato gravy (sprats-small-sized) or sprat in vegetable oil ("Sprat"). Rats receiving canned "small-sized sprats" or "sprats developed much more often malignant tumors of different localization than did the animals fed on "Stavrida" or control rats. Feeding of rats on the vegetable oil from "stavrida" and "sprat" cans did not have any material effect on the development of tumours. Introduction of these samples of oil together with the food or parenterally to mice did not have any substantial influence on the development in them of skin tumors, induced with benzpyrene. The canned goods under investigation, especially of the "sprat" kinds, demonstrated small amounts of benzpyrene and carcinogenic nitroso-compounds.


[Activity of the indicator enzymes of liver subcellular structures with the prolonged administration of Valexon]. The free and unprecipitated activity of succindehydrogenase and glucose-6-phosphatase, as well as of that of glucose-6-phosphate-dehydrogenase in the rats liver was determined. The animals received for a long time (1--3 and 6 months) a new organophosphorus pesticide valexon (0.0-diethyl thiophosphoryl-oxyiminophenylnitryle acetate) by mouth in doses of 31 mg/kg and 3.1 mg/kg which corresponds to 1/20 and 1/200 LD50. The earliest changes (after 1 month) include: falling activity of hexokinase and a rise in that of glucose-6-phosphatase and succindehydrogenase, pointing to the damage of microsomes and mitochondria supervenes in 1 and 6 months time after introduction, respectively. The role of an early injury of microsomes and of disturbed first stages of glucose metabolism in the mechanism of the valexon action is suggested.


[Method of isolating, identifying and quantitatively determining alkanes, cycloalkanes, monocyclic arenes and squalene in animal organs and tissues]. A method for analyzing hydrocarbons in animal organs and tissues has been developed. This is made up of the following stages: decomposition of the biological material through alkaline hydrolysis; extraction of non-saponifiable lipids fraction; separation by using preparative thin-layer chromatography of the alkanes and cycloalkanes, monocylic arenes and squalene from the non-saponifiable lipids fractions; determining the content of the alkanes and cycloakanes fraction and also ascertaining the alkanes of normal and isoprenoid structure, by means of gas-liquid chromatography, and, finally, quantification of monocyclic arenes, based on the UV spectra findings. The statistical characteristics obtained through a mathematical processing of the analyses results bear evidence to a sufficient accuracy and good reproducibility of the method stages.


[Diagnosis of extrahepatic biliary tract obstruction and constriction via direct cholangiography]. The diagnostic potentialities in cholestasis and cholangitis could be considerably improved by endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatal cholangiography (PTC) with a thin needle (0.7 mm). First ERCP was performed, enabling us to establish pathological findings in 62 per cent of the 233 examinations in the period 1975--1977. Gallstones were most often found-in 65 cases (28%). Second to be found was the suptapapillary stenosis of the bile ducts and obstruction of the bile ducts--42 cases (18% of the examined), caused by surgical interventions, tumours of the bile ducts and processes in the region of the head of the pancreas. When ERCP fails to provide sufficient data or is ineffective - PTC is performed. Correct diagnosis was made in 15 cases out of 23 examinations, in six - partial data were obtained and in two - the examination failed.


[Echocardiographic (EchoC) dimensions of the right cavities of the heart in right ventricular insufficiency]. Seven dimensions of the right ventricle at different levels and one dimension of the right auricle at the tricuspidal valve level were determined in 414 patients with cardiac ailments without volume loading. The data obtained are confronted with the hemodynamics of the right ventricle determined via clinical investigations, right cardiac catheterization and the method of dye dilution. A considerable correlation exists between the size of the EchoC-dimensions of the right ventricle and right auricle and the values of the final diastolic pressure in the right ventricle and the mean pressure in the right auricle, being a precondition for the determination of the right ventricle function via echocardiography. Enlargement of all EchoC-dimensions of the right ventricle and right auricle is present in right ventricle insufficiency. The echocardiography dimensions of the right ventricle and right auricle show a high sensitivity (91%) in the determination of initial right-ventricle insufficiency, presenting a relatively low false positive results (13%).


[Electrophysiological methods of assessing myocardial hypoxia]. The potentialitis of the standard electrocardiogram, precordial cartogram and spatial analysis are confronted in 38 patients with extensive anterior or anteroseptal myocardial infarction, acute phase, in order to determine the extent and propagation of the myocardial hypoxia. The determination is performed on the base of the correlation dependence as regards the creatinine-phosphokinase level in blood. The best degree of correlation dependence has the spatial analysis of the changes in the segment ST - Vmax ST sp. r=0.69, as well as the changes in the segment ST reflected in the precordial electrocardiography - nST-0.1 mv. r=0.67. Close is the degree of correlation dependence in the standard electrocardiogram - STv r=0.59. The difference in the correlation coefficients are not statistically significant, allowing their application in the routine work of the three methods.


[Assessment of left ventricular function in hypertension by means of phase analysis]. Polygraphic records of ECG, PCG, carotissphygmogram and apexcardiogram were performed and 16 systolic and diastolic intervals were taken in 86 patients with hypertonic disease, distributed according to the stage of the disease according to Mjassnikov classification as well as in 62 subjects with intact hearts. A lengthening of asynchronous contraction was established as well as of the isovolumetric contraction, pre-blood driven period, isovolumetric relaxation and shortening of the left-ventricle time of blood driving, the ratio pre-blood driven peroid/left ventricle time of blood driving showing the most pronounced changes. Regression and correlation analysis in the comparison of those changes in the intervals with a means blood pressure in patients from the three stages of hypertonic disease, show that the best correlation is obtained in the patients from the III stage. The results obtained are discussed and a conclusion is drawn that the ratio pre-blood driven period/left ventricle time of blood driving is with the highest practical importance from the systolic and diastolic intervals in the assessment of the adequacy of the left-ventricle compensation.


[Proteinuria in the nephropathy of pregnancy and posttoxicosis renal lesion]. Proteinuria was studied in 110 females - 28 pregnant with nephropathy of pregnancy with primary late toxicosis and 82 with past history of the disease with a residual proteinuria after childbirth. Selective type proteinuria was more often found both in pregnant women and in those with a past history of nephropathy. The relative share of the pregnant with non-selective proteinuria is considerably greater. After childbirth, in parallel with the decrease of proteinuria quantity, the non-selective one turns to selective in the majority of the cases. The quantity of the excreted proteins, in the urine, of patients with confirmed glomerular lesions, shows no tendency to decrease. The absence of dynamics in proteinuria quantity and its non-selectivity provides grounds to suspect a deeper lesion of the renal filter, retaining the involution of the morbid process and a tendency to its chronification.