Studies on the mechanism of renal transport depression caused by pretreatment with 2,4,5-trichlorophenoxyacetate. Relatively low toxicity in the adult has been reported for the organic acid herbicides 2,4-dichlorophenoxyacetate and 2,4,5-trichlorophenoxyacetate (2,4,5-T). Although small doses of these herbicides are excreted rapidly, acute impairment of renal excretion has been reported when large doses of herbicide were administered. After the administration of 2,4,5-T in vitro analysis of renal proximal tubular function showed a decrease in the activity of the organic acid transport system which handles these herbicides. In addition, the pretreated animals show an impairment in the organic base transport system. To determine the nature of 2,4,5-T renal depression, renal cortical slices from herbicide-pretreated animals were studied. Alterations in the initial influx of organic ions, steady-state accumulation, and efflux were measured. Furthermore, a specific and reversible depression of tissue oxygen consumption was demonstrated. These changes do not appear to be the result of alterations in the gross morphology, electrolyte composition, or cell water content of the renal cortex.


Cadmium levels in hair and other tissues during continuous cadmium intake. Rats that received cadmium 300 ppm in drinking water (average daily cadmium intake = 4.5 mg/rat) for 12 wk attained peak cadmium levels of 112, 34, and 19 mug/g in hair, liver, and kidney, respectively, at week 4. Rats that ingested cadmium 200 ppm (average daily cadmium intake = 3.6 mg/rat) for 13 wk attained peak cadmium levels of 29 mug/g in kidney at week 7, and 94 and 27 mug/g in hair and liver, respectively, at week 9. Despite continuous exposure to the heavy metal, tissue cadmium concentrations declined to steady-state levels of 24-33 mug/g in hair and 10-17 mug/g in liver and kidney. Histopathologic effects were not observed in liver or kidney. In contrast to cadmium in hair, blood cadmium levels, which remained consistently low (less than 0.04 mug/ml) throughout the study, did not correlate with changes in cadmium levels in liver and kidney.


Metabolic responses of rats to chronic theophylline ingestion. Studies of the metabolic responses of rats to 0.2% dietary theophylline were conducted. Young male rats were fed theophylline-containing diets or control diets for 8 wk and killed after 22 hr without food. Levels of serum lipids, glucose, and ketones were determined as were hepatic glycogen, lipid, calcium, magnesium, and zinc levels. Epididymal fat pad lipid content, as well as kidney cation levels and hepatic mitochondrial respiration, was also determined. Chronic theophylline feeding lowered blood glucose levels, serum triglyceride levels, hepatic lipid and calcium levels, and the state III respiration with succinate as the substrate. Kidney calcium and magnesium levels were elevated in theophylline-fed rats as were the serum cholesterol levels. The relationship of these metabolic responses to theophylline feeding is discussed as a function of the theophylline effect on tissue cation levels.


Effect of inhaling medication vapors from a colds preparation on murine pulmonary bacterial defense systems. The usefulness of murine pulmonary defense systems as a means for assessing potential toxicity was further confirmed. Recent investigations had indicated that the effects of a chemical agent on mucociliary transport and phagocytic function comprised a sensitive indicator. As one example of such an application, because of the wide usage of proprietary colds preparations containing volatile oils, as well as the use of such oils in various industries, it is important to reassess the potential of such preparations for toxicity when new test systems become available. Mice and rats were exposed to vapors of camphor, menthol, eucalyptol, and turpentine, as contained in a commonly used colds preparation, for 4 and 8 hr prior to challenge with aerosols of radiolabeled Staphylococcus aureus. The exposure system simulated conditions present when the colds preparation is vaporized according to directions for use. Rates of pulmonary bacterial transport and inactivation, as well as of phagocytic ingestion, were determined following exposure to the colds preparation. Each of these rates was unchanged by the treatment. Thus, in this biological system exposure to therapeutic levels of the colds preparation did not impair mucociliary or phagocytic function.


Unmatured science and government regulation. A common feature of much scientific information reflected in government regulation is its passage directly from the laboratory into government decision without benefit of review and interpretation. This pattern can be attributed to a variety of factors. One is the incentives that lead government agencies to act quickly and conservatively in the name of protection of human health. Another is the relatively lengthy process of traditional review and interpretation via professional meetings and scientific publication. Yet, the case appears very strong for preserving, if foreshortening, the stages of peer review of otherwise unmatured data used in regulation. Several schemes of this sort have been tried in the past few years-some with apparent success. These are discussed alongside the proposal for a science court-a quasi-judicial vehicle for rendering judgements about scientific findings.


Administration of aspartame in non-insulin-dependent diabetics. A study was designed to determine the effect of the consumption of the nutritive sweetener aspartame on non-insulin-dependent diabetics. Forty-three adult diabetics between the ages of 21 and 70 completed a 90-day study; all were diabetics whose conditions were managed by diet and/or hypoglycemic agents. Participants in the blind study were instructed to continue their usual diet and to take two capsules of an assigned preparation three times daily with meals, either the aspartame or the placebo. The 1.8 g of aspartame administered is approximately three times the expected daily consumption of aspartame if used as a sweetener to replace sugar. Throughout the study subjects were examined for (1) symptoms of intolerance, (2) fasting plasma phenylalanine levels exceeding 4 mg/100 ml, and (3) deterioration of diabetic control. At the conclusion of the study subjects exhibited no symptoms that could be traced to the administration of aspartame or the placebo, and diabetic control was unaffected by the chronic administration of these substances. Aspartame seems to be well tolerated by non-insulin-dependent diabetics.


Results of loading doses of aspartame by two phenylketonuric (PKU) children compared with two normal children. Separate tolerance tests with aspartame at 34 mg/kg-day and phenylalanine at 19 mg/kg-day were compared. The results reveal that slight serum elevation of phenylalanine and tyrosine occurred in the two PKU and the normal healthy adolescents. It would appear that the phenylalanine in the sweetener aspartame is small enough to be of little clinical significance.


A computerized procedure for estimating nutrient intake. A procedure was devised for computing intake in terms of calories, total protein, phenylalanine, carbohydrate, and fat. The procedure used a magnetic tape containing 3,122 numbered food items. The nutrient composition of each food was reported for 100 g of the edible portion of the food. In addition, diet diaries were prepared in which the foods eaten during the preceding 24-hr period, the code for each food corresponding to the number for the same item on the magnetic tape, and the number of units of each food eaten were recorded. A computer program then was written that calculated the amounts of intake per day for each nutrient. Application of the procedure for 42 consecutive days on the daily diet records of 43 adult carriers of the phenylalanine hydroxylase enzyme formed the data base used to determine if aspartame significantly increased levels of phenylalanine in the blood. Adaptations of the procedure permit calculations of intake for periods from 1 to 30 days and analyses of additional nutrients including calcium, phosphorous, iron, vitamin A, thiamine, riboflavin, niacin, and ascorbic acid.


Pattern of labelling of poly (A)-associated RNA in the CA3 region of rat hippocampus during training. Newly synthesized poly (A)-associated mRNA was analysed in the hippocampal CA3 pyramidal nerve cells in rats subjected to training to reverse handedness. The nerve cells of trained animals showed a smaller percentage of poly(A)-associated mRNA than did the active controls. However, a specific fraction of this poly (A) hippocampal RNA with a SE value of around 25 was reproducibly stimulated. This qualitative nerve cell mRNA change is discussed in relation to similar changes in the protein pattern as a function of training.


Behavioral evidence showing the predominance of diffuse pain stimuli over discrete stimuli in influencing perception. This experiment was directed toward determining the relative effectiveness of discrete and diffuse pain stimuli in influencing perception and behavior. Shocks to the footpads were used to activate the discrete pain pathways and shocks to the upper canine teeth to activate the diffuse pain pathways. In the first phase of this experiment, cats were trained to escape from foot shock in a shuttle box. Current applied to the feet was varied in ascending and descending sequences for each animal according to the psychophysical method of limits and each animal was trained until stable thresholds for escape responding were achieved. In the second phase of the experiment, the effect on behavior of simultaneous activation of both the discrete and diffuse pain systems was assessed. The principal finding is this experiment was that excape responding that was well established when foot shock was presented alone was routinely abolished on trials when tooth shock and foot shock were presented together. These results were interpreted as indicating that the diffuse pain system was prepotent in influencing behavior when both the discrete and diffuse pain systems were activated simultaneously.


Production of the weanling rat dorsomedial hypothalamic syndrome by cathodal electrolytic lesion current. Weanling male Sprague-Dawley rats received bilateral electrolytic lesions in the dorsomedial hypothalamic area by means of a direct cathodal current. Sham-operated rats served as controls. Ponderal and linear growth, obesity index, food intake, and several indices of intermediary metabolism of adipose tissue and muscle were measured. Cathodal lesions, as did anodal lesions reported on previously resulted in retardation of body weight, length, and food intake, while the obesity index remained in the normal range. Similarly, the metabolic data in adipose tissue and muscle are comparable to those from experiments in which dorsomedial lesions were placed by anodal current: incorporation of glucose into CO2 lipid, and glycogen of muscle tissue (diaphragm) were similar in DMN-lesioned rats and controls. The difference between anodal and cathodal lesions in this hypothalamic syndrome is a delay in the onset of hypophagia until about 30 days after the hypothalamic operation. The data support the concept that lesions in the hypothalamus, in general, exert their effect by destruction of neuronal assemblies, i.e., nerve cells and/or fiber tracts passing through the lesioned area.


Effects of hippocampal and amygdalar stimulation on uptake and binding of 3H-hydrocortisone in the hypothalamus of the cat. Stimulation of the hippocampus or amygdala of adrenalectomized cats occurred for 10 sec followed by a 50 sec period of no stimulation, beginning 30 min prior to and ending 30 min after administration of 100 muCi of 3H-hydrocortisone into a lateral ventricle. Sixty min after administration of labeled hormone, the hypothalamus was excised and homogenized. Cytosol and nuclear extract fractions were obtained and analyzed for radioactivity and protein content. Separation of bound from free hydrocortisone was achieved by charcoal and adsorption assay. Results reveal that stimulation of the hippocampus resulted in a greater concentration of 3H-hydrocortisone taken up into hypothalamic cells. Also, a greater percentage of total hormone found in the nuclear extract was assayed as bound 3H-hydrocortisone, and the concentration of bound radioactivity in the nuclear extract was increased over control values. Amygdalar stimulation, in general, yielded results similar to those obtained from control cats. However, although a lesser percentage of total hormone in the hypothalamic cytosol was assayed as bound hormone, there was a greater concentration of nuclear bound hormone than in controls, but less than that determined in the hippocampal stimulation group. These results add to the evidence that hippocampus and amygdala have a modulating influence upon the hypothalamo-hypophyseal axis. They also suggest that one manner in which these limbic structures may influence hypothalamic function is to modulate the uptake and binding of hydrocortisone in hypothalamic cells.


Management of small arterial injuries: clinical and experimental studies. Twenty-five patients with 35 severed small arteries of the wrist, calf, or ankle are presented. Included are six cases of total ischemia of the wrist or ankle. Twenty-two repairs and thirteen ligations were performed. There was only one amputation from arterial insufficiency. We recommend repair both to preserve tissue and to restore optimum flow. By use of meticulous interrupted suture technique, optical magnification, and heparin and aspirin administration, a high degree of arterial patency can be achieved.


Modern war surgery: operations in an evacuation hospital during the October 1973 Arab-Israeli war. A forward evacuation hospital functioned in the southern front in October 1973 Israeli-Arab War as an intermediate unit in the Israeli casualty management logistics. Casualties were characterized by frequent multiple-system injuries and variable combinations of penetrating wounds, blunt trauma, burns, and inhalation injury, with an increased incidence of associated blunt trauma. As the result of the systems organization, the EH was able to provide the wounded with early intensive and definitive resuscitation therapy which permitted further evacuation of the casualties to the central hospitals in a better state of physiological stability. In the most critically wounded when there was imminent threat to survival, operations were performed at the EH as an integral part of the resuscitation process. Performance of operations in a forward evacuation hospital did not increase the number or severity of postoperative complications. Morbidity and mortality were related to the nature and magnitude of injury.


Tetanus: 2,449 cases in 68 years at Charity Hospital. The 68-year Charity Hospital experience with tetanus has been reviewed with particular emphasis on the past 8 years. There were 2,449 cases treated at Charity Hospital from 1906 through 1974. The mortality rate has remained high. There were 24 cases in the past 8 years, with a 58% case fatality rate. Clues to our high mortality rate could be: 1) many cases with a short period of onset, 2) none of our 24 cases received treatment at time of injury, and 3) there were more severe cases, as judged by the high rate of need for tracheostomy. The method of management emphasizes: 1) wound care, 2) neutralization of the toxin, 3) antibiotic therapy, 4) supportive measures including good nursing care with control of convulsions and seizures, and 5) completion of active immunization. Prophylaxis is stressed, with particular emphasis on wound debridement and toxoid. The decreasing incidence of the disease is encouraging, probably related directly to proper immunization. However, the mortality rate remains high and the solution to the problem of tetanus is still prophylaxis. Epidemiologic considerations were discussed with particular emphasis on tetanus in the five Gulf States, the South in general, and the decreasing incidence in endemic areas.


Gangrene of the hand: a complication of radial artery cannulation. Radial artery cannulation for constant monitoring of arterial pressure and blood gases has become commonplace in the care of the seriously ill. The radial artery is readily accessible and is often regarded as carrying a negligible complication risk, because there is extensive collateral arterial flow in the hand. To the rarely reported cases of gangrene of the hand secondary to cannulation of the radial artery, this publication adds two, both survivors. One, a 46-year-old female with a clinical picture suggestive of mild Raynaud's disease, was treated by closed mitral commissurotomy; the second, a 44-year-old female, was treated for drug overdose complicated by cardiac arrest and renal shutdown.


Compression neuropathy following brachial arterial puncture in anticoagulated patients. 1) Seven patients were seen and treated over a 1-year span with forearm hematoma and median nerve neuropathy following brachial artery puncture. All seven were anticoagulated. 2) A careful examination established the diagnosis. Prompt operative intervention is recommended. 3) The brachial artery should be avoided as a source for arterial blood gas sampling in the anticoagulated patient.


Psychosocial support in the treatment of severely burned patients. A psychosocial team took part in the total patient care program of a burn unit. Psychometric data were gathered during the treatment phase and at one-year followup. The treatment plan included adequate analgesics, major tranquilizers when indicated, attention to sleep requirements for patients, and active participation of family members in the treatment program, with supportive psychotherapy. Standardized psychological and intelligence tests were administered to adult patients during treatment and one year after discharge, and scores compared.


The challenge of arteriovenous fistula formation following disk surgery: a collective review. Five cases of arteriovenous fistula formation are added to the 68 found in previous reports. A review of the English-language literature revealed that the L4-5 disk space was most frequently involved, the right common iliac artery injured most often, and the right and left common iliac veins and inferior vena cava injured with similar frequency.


Diagnostic peritoneal lavage in pediatric trauma. The accuracy of diagnostic peritoneal lavage is compared to that of initial clinical evaluation in 46 pediatric patients with blunt abdominal trauma. The peritoneal lavage accuracy was 97.8%; the clinical accuracy was 71%. The use of a specially prepared 14-gauge trocar has made this technique safe for even very small children. The reliability and safety of diagnostic peritoneal lavage in this as well as in other series suggests that nonoperative or expectant treatment of the patient with blunt abdominal trauma can be safely substituted when peritoneal lavage is negative.


The self-inflicted wrist slash.

The self-inflicted wrist slash. Twenty-nine patients with self-inflicted wrist slash seen in consultation from 1970 through 1974 revealed 25 nerve and 70 tendon injuries. The average age, sex distribution, and psychiatric status generally followed previously reported series of suicide attempts. A major finding was the low patient response to surgical and psychiatric followup. Intensified efforts to improve followup and primary repair of damaged structures are recommended.


Traumatic inferior vena caval obstruction. A 57-year-old male sustained an injury to the supradiaphragmatic portion of the inferior vena cava, which presented as progressive lower extremity thrombophlebitis culminating in thrombosis of his inferior vena cava. The indications for operative intervention centered around impaired renal, hepatic, and intestinal circulation. Extracorporeal circulation permitted extraction of the clot and repair of the injury.


Surgical repair of rupture of the pectoralis major muscle: a case report. Rupture of the pectoralis major muscle in a healthy male weight lifter is described. Complete avulsion of its insertion was surgically repaired by suturing followed by immobilization for 6 weeks. Two years later the patient won a national championship by lifting 455 lb in bench-press, and has recovered full function of the shoulder.


The fourth international conference on tetanus, Dakar, Sénégal, 1975. The two main conclusions drawn at the Dakar International Conference on Tetanus appeared to be: 1) Tetanus is a real problem in developing countries in both occurrence and mortality rates; and 2) Tetanus can be eliminated by the proper use of tetanus toxoid. Preventive medicine, more important nowadays than before, especially in light of broadened legal responsibilities of medical practitioners, must include tetanus immunology, prophylaxis, and therapy. Some currently listed standards for administration of tetanus antitoxin, immune globulin, and toxoid are perhaps in need for revision, at least in developed countries, and at the same time attention must be paid to the very high incidence of tetanus in developing nations, and to the alleviation and eventual eradication of tetanus everywhere in the world.


Human histoplasmosis in Egypt-a preliminary serologic survey. Thirteen (3%) of 441 patients had histoplasma antibodies in their sera when examined by the complement fixation test. The serologically histoplama positive individuals were all from a group of 266 patients complaining of chest disorders and from a sub-group of 147 such patients with positive findings on chest x-ray. There were no positives from a group of 175 patients complaining of fevers of unknown origin. The possibility of misdiagnosing lesions which may be due to histoplasmosis as being tuberculous must be considered indifferential diagnosis of pulmonary lesions.


Staphylococcal scalded skin syndrome in Nigerian children: a report of three cases. Three cases of staphylococcal scalded skin syndrome in Nigerian children are reported. The clinical features and bacteriological findings are discussed. It is suggested that the clinical condition is not as rare in our community as absence of reports on African children in the literature may suggest. A reference centre for phage typing of staphylococci from suspected cases in a developing country like our own is recommended.


The bioavailability of quinine.

The bioavailability of quinine. Plain tablets of quinine dihydrochloride, quinine bisulphate and quinine sulphate was prepared using salts of similar particle size. Proprietary sugar-coated tablets showed protracted disintegration and dissolution using dialysis method with forced convection and sink conditions was as anticipated by the solubilities. In vivo availability studies indicated release from the plain tablets in the order dihydrochloride, bisulphate, sulphate. The sugar-coated tablets showed delayed release and corresponding low availability


Levels of some serum enzymes in patients with schistosomiasis. The effect of active schistosomiasis on the activity of some serum enzymes of hepatic origin has been studied in 46 male Egyptian patients with S. mansoni infections. These enzymes included total lactic dehydrogenase and its isoenzymes, 5'nucleotidase, B-glucuronidase, ornithine carbamyl transferase and sorbitol dehydrogenase. Samples were collected on admission, a week after the end of treatment and one month later. B-glucuronidase showed no change whereas ornithine carbamyl transferase, sorbitol dehydrogenase and 5'-nucleotidase showed elevated levels throughout the study. Total LDH was not significantly different on admission but increased significantly after treatment and returned to normal at follow up. Of the five LDH isoenzymes only LDH4 showed elevated levels. The significance of these findings in relation to conventional liver function tests is discussed.


Seroepidemiologic investigations of malaria in Guyana. The results of longitudinal seroepidemiologic malaria surveys with the indirect haemagglutination test in four sectors in the interior of Guyana did not suggest recent malaria transmission. Indigenous malaria cases had not been detected in these sectors since 1968 but malaria surveillance here had been incomplete. The multi-stage cluster sampling method used proved to be efficient and permitted the survey of a large and sparsely populated area to be concentrated in relatively few localities. Observation of a group of 147 seropositive and seronegative persons after one year showed a four-fold or greater decline of antibody titres in five per cent of the cohort population and no such titre increases were seen, thus confirming the absence of recent malaria infections. Seropositivity rates were higher in persons with a history of malaria than in those without such a history. Collecting blood on filter paper facilitated obtaining material for serologic testing especially in the younger age group and no refusals were encountered. This advantage compensates for the slight loss in sensitivity when filter paper eluates are titrated instead of sera. The difference between the past infection probabilities of the age groups over and under 20 years old suggests that the disappearance of malaria from the interior was related more to the elimination of malaria transmission along the coast than to the specific malaria campaign in the interior.


Middle ear effusion in children.

Middle ear effusion in children. The middle ear function of over 100 school children has been observed for more than seven years with the aid of an electroacoustic impedance instrument. The technique readily demonstrates middle ear abnormalities. A few children may have middle ear malfunction for considerable periods without this being detected by those responsible for their health care. The presence of fluid in the middle ear is not necessarily an indication for treatment. The concept of acoustic impedance screening is advocated with suitable safeguards to prevent over-referral.


Middle ear effusions -- complications of disease and treatment. The results of treatment of secretory otitis media with commonly found disease in Finland is described. Treatment includes adenoidectomy and/or insertion of tympanostomy tubes with mastoidectomy in selected cases. Tympanostomy tube treatment results in an increased amount of visible tympanic membrane scar formation and tympanosclerosis, but these are of no major functional importance. In about 10 per cent of the glue ears a mastoid disease process complicates the disease. Here thorough mastoidectomy at an early stage is the treatment of choice. Cholesteatoma formation appears in about two per cent, but in the majority of cases this is not related to tympanostomy treatment but is due to the disease process itself.


Rational management of middle ear effusions in the cleft palate patient. Middle ear effusions are common prior to surgical repair of a congenital cleft of the secondary palate. The insertion of middle ear ventilating tubes will result in an aerated middle ear, but significant complications will also occur. A review of 57 infants suggests that these ventilating tubes rarely need to be inserted prior to palatal closure but only if there is persistence of middle ear fluid three months after such surgery.


Xeroradiography in the assessment of the pediatric larynx and trachea. Xeroradiography is a newer technique of radiologic imaging which provides both a wide recording latitude and the phenomenon of edge enhancement. It is the phenomenon of edge enhancement in particular which allows for excellent imaging of mucous membrane anatomy and abnormalities. The purpose of this presentation is to demonstrate the role of xeroradiography in the assessment of the pediatric larynx and trachea, with particular reference to the evaluation of tracheal stenosis.


Surgical correction of subglottic stenosis of the larynx. Clinical results of the Fearon-Cotton operation. Thirty-five cases of subglottic stenosis were treated by one of the authors during the 6-1/2 year period January 1970 to June 1976 inclusive. Six of these failed to respond to routine management by repeated dilatation or were considered unlikely to do so. These cases were treated by a new operation, the experimental aspects of which have been previously described. Two of the six cases have been successfully extubated and two others will be so in the near future. An analysis of the problems encountered and some possible solutions are presented, as is a brief description of the operative procedure. The carbon dioxide gas laser would appear to have an important part to play in the management of glottic and subglottic webs, but its value has yet to be proven.


Extended laryngofissure in the management of subglottic stenosis in the young child: a preliminary report. The child with subglottic stenosis and a tracheotomy is a management problem. To date, a consistent method for successful and expeditious correction of the primary lesion to permit decannulation has eluded clinicians. The child is tracheotomized and thus frequently hospitalized for a lengthy period. Personal development and family relationships are adversely affected and the mortality rate during this period of cannulation is significant. During the past eighteen months in an attempt to achieve earlier decannulation, three children with subglottic stenosis have undergone a surgical procedure in which division of the anterior and posterior aspects of the cricoid ring are the key surgical maneuvers.


Laryngeal papillomatosis in children.

Laryngeal papillomatosis in children. Thirty-one cases of juvenile papillomatosis of the larynx treated in the Department of Otolaryngology at the Hospital for Sick Children are reviewed. The incidence, pathology, and etiology of laryngeal papillomata are described. Various types of treatment reported from the literature are discussed. Favorable results have been attained by careful frequent endoscopic removal of papilloma lesions using forceps, the cryoprobe, or the carbon dioxide laser. With the use of the operating microscope, the tumor population is reduced and this may allow the circulating antibodies to be more effective on the residual tissue. Tracheotomy is avoided unless near obstruction is present. Decannulization is not advisable until the danger of obstruction from regrowth of the tumor is passed.


Hearing without hair cells? A case report. Audiograms from a five year old accident victim with a profound hearing loss are compared to temporal bone and brain stem histological findings. One temporal bone was evaluated using surface preparation and transmission electron microscope techniques. The other temporal bone was evaluated using serial section procedures. No sensory cells were present in either cochlea. This unusual finding is discussed. Evaluation of ventral cochlear nuclei showed a 50 per cent loss of neurons on both sides.


The cost of upper respiratory tract infections in Canadian children. We reviewed reports of the incidence, duration, causative organism, sequelae, and cost of upper respiratory tract infections (URI). Using these data, we projected the extent and cost of URI in Canadian children from birth to age 14. We estimated that in 1973, some 6.2 million Canadian children suffered between 23.8 and 42.3 million episodes of URI, of which 5.6 million needed medical attention; approximately 215,300 children were admitted to hospital for treatment of URI-related diseases and utilized 742,800 hospital days. Some direct costs were estimated, including physicians' fees, hospitalization, antibiotics, "cold remedies", and pharmacists' prescription fees; in 1973 these ranged from $141 million to $211 million. The common cold is as common as its name implies, and we need to intensify the search for a solution. Until this is found, both medical profession and the public should be warned of the uselessness, and possible hazards of some of the "remedies" for colds, and made aware of the vast amounts of money expended upon them.


Cervical teratoma.

Cervical teratoma. Cervical teratomas are rare tumors in an unusual location. A neck mass in a newborn was excised when it enlarged disproportionately; histologically, it was a teratoma. Teratomas may occur because of an alteration in sterol chemistry; conception in this case occurred while the mother was ingesting estrogens. Retinal tissue, an unusual finding, was present in this teratoma. Symptoms in cervical teratomas are secondary to interference with deglutition and respiration. Treatment is surgical excision.


The sternomastoid "tumor" of infancy.

The sternomastoid "tumor" of infancy. The sternomastoid "tumor" of infancy is a firm, fibrous mass, appearing at two to three weeks of age. It may or may not be associated with torticollis. Generally, the "tumor" initially grows, then stabilizes, and in about half the cases recedes spontaneously after a few months. It may leave a residual torticollis or may be associated with a facial or cranial asymmetry of a delayed torticollis. The etiology is unknown, a direct cause and effect relationship to birth trauma has been largely disproved although approximately half these children are products of breech deliveries. The treatment is controversial. Approximately half of these "tumors" will resolve spontaneously without sequelae. Progressive torticollis or development of facial asymmetry are considered indications for surgery. The purpose of this report is to acquaint the head and neck surgeon with this entity which may confront him for diagnosis and treatment.


[Secondary tumors of the kidney].

[Secondary tumors of the kidney]. Secondary tumours of the kidney are relatively common. Found at autopsy in approximately 4 per cent of patients dying of malignant disease, they are clinically latent in most instances. Thus in a total series of 295 malignant tumours of the kidney, only 8 were metastases. The primary tumour is most often a bronchial carcinoma, this being confirmed in our series (5 cases). This is followed, in order of decreasing frequency, the breast, stomach, pancreas and stomach. Two of the 8 cases were rarities: a renal metastasis from a meningoblastoma and a metastasis from one tumour to another, a carcinoma of the ovary metastasising to a hypernephroma. The pathogenesis of these secondary tumours leads to the consideration of 2 modes of spread: haematogenous and lymphatic. They present no special clinical features. Intravenous pyelogram reveals the appearances of a malignant tumour mass. Angiography is more informative, the results reflecting the histological nature of the primary tumour. The latter being most frequently a carcinoma, the arteriographic image is one of hypovascularisation, thus differing from a hypernephroma with its rich vascularisation and resembling an infiltrating pelvi-calyceal carcinoma. Histopathological examination is not always conclusive itself. Nephrectomy is effectively only justified if the primary tumour has been or can be successfully treated in the absence of other metastases.


[Left varicocoele and iliac venous stasis (author's transl)]. Idiopathic left varicocele is not always due to renospermatic reflux, as is shown by left renal phlebography. Furthermore, radiological exploration of the left iliac venous axis has shown the frequency of main iliac obstruction, compressed by the right iliac artery. The lumen of the iliac vein frequently bears traces of this compression (May and Thurner). The multiplicity of the colateral pathways draining the iliac vein in stasis, is evidence of the reigning increase in pressure. The authors propose the hypothesis that the varicocoele may be due to iliospermatic reflux. This occurs through anastomoses which are well known to anastomists and found on 2 occasions in the series presented. If this hypothesis were verified, it would incite an approach to the cord via the inguinal canal in order to ligature the spermatic veins above their anastomoses with the epigastric.


[Leydig cell testicular tumour with an endocrine syndrome. Clinical, biological, ultra-structural and histo-enzymatic study (author's transl)]. With respect to a particularly demonstrative case of Leydig cell tumour with gynaecomastia in a 40 year old man, the authors review the current data in the literature concerning the clinical and biological features and treatment of this tumour. They pay particular attention to the classical anatomo-pathological features, the ultra-structure and the ultrastructural and histo-enzymatic appearances.


[Antireflux by advancement. First results of 39 recent interventions (author's transl)]. 39 congenital malformations of the ureterovesical junction, with reflux, were treated by transvesical plastic advancement. The surgical indications, technique and results are presented. These encourage the continuation of the choice of this technique.


[The new Iglesias resectoscope with simultaneous irrigation and suction (author's transl)]. This new resectoscope is the result of over 30 years experience of T.U.R. Its principle is a double flow running through the resectoscope: inflow and outflow under succion. The advantages are: 1. T.U.R. can be performed continuously, quicker than with conventional resectoscopes and theoretically with no limit of time. 2. T.U.R. is done under intra-vesical pressure, avoiding the T.U.R. syndrome. 3. T.U.R. is done more confortably: better vision bleeding control by watching the suction bottle, no more wet surgeon.


[Impaired statics of bladder and urethra in some lower motor neurobladders and its treatment by colocystopexia (author's transl)]. In spite of sphincter paralysis, the peripheric moto-neurone lesions induces bladder retention. Secondary retention forces fail to open the bladder neck owing to detrusor flaccidity. Long-dated, abdominal straining increases this static dysfunction by inducing posterior bladder prolapsus upon a flaccid perineum. This disorder est characterized by three components: --posterior prolapsus of the bladder, --horizontal position of the proximal urethra, --deepening of Douglas peritoneum. These patients may get a micturation using a perineal compression; similarly, surgical management consists in a making-up and fastening of the bladder by means of the rectum which is used as a hammack (colocystopexia). The procedure had been used in five cases with good results.


[Experimental studies on diffusion of gentamicin into body fluids (author's transl)]. For the purpose of measuring concentrations of gentamicin (GM) into body fluids (pancreatic juice, abdominal cavity, and bile) after intramuscular injection, the authors conducted experiments using adult mongrel dogs with following results. 1) The highest concentration in pancreatic juice was observed 1 approximately 1.5 hours after single intramuscular administration of 4 mg/kg. The highest concentration was 51.3% of that in blood. 2) The highest concentration in bile was observed 30 minutes approximately 1 hour after single intramuscular administration of GM. The concentration was about 50% of that in blood. 3) The diffusion of GM into the abdominal cavity was good after single intramuscular administration. 4) The rate of urinary excretion was high as is generally known.


[Pharmacokinetics in constant drip infusion of cephaloridine-Lilly (author's transl)]. The serum and urinary levels and urinary recovery of cephaloridine during and after two-hour drip infusion of 1 or 2 grams of cephaloridine dissolved in 500 ml of physiological saline solution were determined in four healthy volunteers in cross-over fashion. Using the values of serum levels obtained from this experiment, pharmacokinetic parameters were calculated and simulation curves of serum levels for various doses and durations of cephaloridine drip infusion were drawn.


Differential diagnosis of pulmonic stenosis by means of intracardiac phonocardiography. The purpose of the present paper is to describe the origin of the systolic murmur in pulmonic stenosis and to discuss the diagnostic possibilities of intracardiac phonocardiography. Right heart catheterization was carried out with the aid of a double-lumen A.E.L. phonocatheter on 48 pulmonic stenosis patients with or without associated heart lesions. The diagnosis was confirmed by heart catheterization and angiocardiography in all cases and in 38 of them, by surgical intervention. Simultaneous phonocardiograms were recorded with intracardiac pressure tracings. In valvular pulmonic stenosis, the maximum ejection systolic murmur was localized in the pulmonary artery above the pulmonic valve and well transmitted to both right and left pulmonary arteries, the superior vena cava, and right and left atria. The maximal intensity of the ejection systolic murmur in infundibular stenosis was found in the outflow tract of right ventricle. The contractility of the infundibulum greatly contributes to the formation of the ejection systolic murmur in the outflow tract of right ventricle. In tetralogy of Fallot, the major systolic murmur is caused by the pulmonic stenosis, whereas the high ventricular septal defect is not responsible for it. In pulmonary branch stenosis, the systolic murmur was recorded distally to the site of stenosis. Intracardiac phonocardiography has proved useful for the differential diagnosis of various types of pulmonic stenosis.


Comparison of pressure in lesser circulation with left ventricular filling pressure in patients with ischemic heart disease. The left ventricle (LV) was catheterized without X-ray control by a thin teflon catheter introduced through the right brachial artery. Shaping of the catheter allowed entering LV in more than 95% of patients and its safe placements in LV cavity without causing ectopic beats or other complications. Pressures in the pulmonary circulation (PAP, PAPd, PCW) do not reflect left ventricular filling pressure (LVEDP) precisely, particularly when the LVEDP is elevated. The assessment of pathological LV filling pressure from the pulmonary arterial pressures shows, that there was high percentage of false negative results at rest, but during exercise the abnormal values of LVEDP could be predicted from the pulmonary artery pressures. However, PCW or PAPd cannot be considered as identical with LVEDP. For the rough assessment of apparent left ventricular failure it is sufficient to measure pressures in the pulmonary artery. However, for the exact study, the LV should be catheterized. The described bed-side method fulfill all requirements: it is simple, convenient and safe; the pressure is recorded accurately; the procedure can be repeated and is therefore recommended for wider use.


Tachycardia- and bradycardia-dependent left bundle branch block associated with first degree a-v block. A study using his bundle electrogram during carotid sinus compression. His bundle electrographic examination was performed during carotid sinus compression as well as atrial pacing in a patient who exhibited intermittent left bundle branch block (LBBB) and first degree A-V block. LBBB was observed at the corrected RR intervals below 920 msec and above 1600 msec. The QRS complexes showed normal intraventricular conduction between these 2 values. The critical cycle lengths could not be determined when ordinary RR intervals were used. The HQ interval remained constant at 70 msec regardless of the pattern of intraventricular condution. It was demonsrated that the patient had both tachycardia- and bradycardia-dependent LBBB with first degree A-V block due to HV block. The authors believe this to be the first case of tachycardia- and bradycardia-dependent bundle branch block studied by His bundle electrography. The important role of His bundle recordings and carotid sinus compression in the diagnosis of rate dependent intraventricular conduction disturbance was stressed and possible mechanisms underlying this rare condition were discussed.


Simplified vectorcardiographic method for assessment of pulmonary arterial pressure in children with chronic rheumatic mitral valve disease. We previously reported that pulmonary artery pressures can be assessed in children with chronic rheumatic mitral valve disease by measuring right maximum spatial vector from Frank vectorcardiogram. To simplify the calculation, pulmonary artery systolic pressure was correlated with maximum negative deflection on Frank scalar X-lead (SX), maximum negative deflection on scalar Z lead (SZ), sum total of SX and SZ (SX+SZ) and combined SX and SZ. The patient material consisted of 30 children with chronic rheumatic mitral valve disease, aged 8-14 1/2 years. Eleven were male and 19 were female. Sixteen had mitral stenosis, 8 had mitral regurgitation, and 6 had combined mitral regurgitation and stenosis, documented by cardiac catheterization and angiocardiographic study. The results showed a significant correlation between pulmonary artery systolic pressure and SX (r=0.782). As calculation of SX is considerably easier and less time consuming than that of right maximum spatial vector, this simplified method is preferable to right maximum spatial vector for prediction of the pulmonary artery systolic pressure of children with pulmonary hypertension due to chronic rheumatic mitral valve disease.


A clinicopathological study on the sick sinus syndrome. A total of 6 cases of sick sinus syndrome were presented, including 2 cases of sinoatrial (SA) block and 4 cases of bradycardia-tachycardia syndrome. There were 2 men and 4 women, and their ages ranged from 69 to 91 years. Electrophysiological studies were performed in 3 cases, showing positive overdrive suppression in 1 and normal atrioventricular (AV) conduction in 3. Syncopal attacks were found in 4 cases, and 2 cases died suddenly. Histological examination of the SA node and AV conduction system disclosed (1) marked reduction of the SA nodal muscle fibers by 70 t0 80%, (2) moderate to marked proliferation of connective tissues in the SA node, and (3) moderate fibrosis in part of the left bundle branch. The SA node artery was patent.


Coronary blood flow and lactate metabolism during isometric handgrip exercise in heart disease. Twenty-one patients with various heart diseases undergoing the coronary sinus catheterization had myocardial blood flow studies before and during isometric handgrip exercise. At 30% of the maximal voluntary contraction (MVC), handgrip increased both coronary sinus blood flow by 19.8% and myocardial O2 consumption by 21.0% on the average as compared to those at rest. At 20% of MVC, the increase of the both was slight except for 1 case. The increase in coronary sinus blood flow significantly correlated to the increase of myocardial O2 consumption. Lactate extraction ratio decreased to less than 10% during handgrip in 4 of 19 cases studied despite of normal values at rest. Lactate extraction ratio had significantly positive correlations with coronary sinus blood flow and myocardial O2 consumption during handgrip, while there were not significant ones at rest. It is suggested that isometric handgrip exercise is useful as a stress test for detection of myocardial ischemia in the heart of coronary artery disease.


Electrocardiographic changes in rats after inhalation of dichlorotetrafluoroethane, Arcton 114, C2Cl2F4. The effects of dichlorotetrafluoroethane, Arcton 114, on the heart of rats were examined in 17 white rats. The animals inhaled dichlorotetrafluoroethane for 1 or 1.5 min. Severe electrocardiographic changes including marked bardycardia, atrioventricular heart block of the second degree and complete heart block were registered. Cardiac standstill appearing 11 to 31 min after inhalation was a death cause in all rats. These results are similar to our previous results concerning the effects of dichlorodifluoromethane (Arcton 12) on the heart of rats.


The prolongation of QRS-duration resulting from delayed recovery of ventricular excitability. A new mechanism for intraventricular conduction disturbance. A preliminary note. Chlorpromazine (1, 5, and 20 mg/Kg) was injected intravenously to anesthetized and open-chest dogs under artificial respiration. Using right atrial pacing, the heart rate was increased stepwise from intrinsic sinus rate to higher rate where the A-V block first developed. ECG (II) was recorded simultaneously with arterial blood pressure, ventricular monophasic action potentials and left atrial electrogram. In the control, QRS-duration was constant (46.9 +/- 0.8 msec) irrespective of heart rate. After the drug injection, however, the duration increased significantly with increasing heart rate, the effect depending on the injected dosage (r==0.283, P less than 0.1 in 1 mg/Kg; r==0.406, P less than 0.01 in t mg/Kg; r==0.631, P less than 0.001 in 20 mg/Kg). During the drug action, QRS-duration of atrial premature beats was also longer than that of sinus beats, and the lengthening increased with shortening of preceding cycle length. The observed QRS-prolongations were due to neither incomplete ventricular repolarization nor bundle branch block. The mechanism of prolongation was attributed to delayed or time-dependent recovery of ventricular excitability, i.e., slowed removal of inactivation in rapid sodium system in the ventricular muscle fibers.


A case of diffuse endomyocardial fibrosis of the right ventricle with persistent pericardial effusion. A case of 42-year-old female with persistent pericardial effusion and recurrent congestive heart failure was presented. The clinical course, laboratory and cardiac evaluations confirmed the existence of tricuspid incompetence and restrictive condition of the right ventricle. At autopsy, the right atrium and ventricle showed moderate hypertrophy, the left ventricle being almost completely spared macroscopically. Diffuse fibrous thickening of the right atrial and ventricular endomyocardium with mural thrombi, and mild lymphocytic infiltation were noted microscopically. These findings are compatible with endomyocardial fibrosis described by Davies. The etiology and pathogenesis of the disease were discussed.


Hemopericardium, anticoagulation, and an endocardial pacemaker. A case report with description of new auscultatory and radiographic signs. A case of organizing hemopericardium and cardiac tamponade in a patient with a permanent endocardial pacemaker who was maintained on anticoagulation is presented. The hemopericardium is concluded as solely due to the anticoagulation. A new auscultatory finding attributable to an endocardial pacemaker and a helpful radiographic sign of pericardial effusion in patients with these pacemakers is described.


Successful replacement of a thrombosed Björk-Shiley mitral valve prosthesis. A case is presented in which 7 months after the first mitral valve replacement (MVR) the malfunction of a Björk-Shiley valve prosthesis was supposed and the thrombosed valve prosthesis was 2 months later successfully replaced. For the detection of the malfunction of the valve prosthesis echocardiography was especially useful.


Echocardiographic diagnosis of prolapsing right atrial myxoma. A case of right atrial myxoma with mimicking symptoms and signs of constrictive peridarditis is reported. The presence of a prolapsing right atrial tumor was easily recognized in the right ventricle during diastole by a routine echocardiography and it was confirmed by cineangiography and operation.


Properties of hepatic tissue extracts: 2. An approach to the artificial liver. In the previous paper [3], the lethal effect of normal rabbit liver extract intravenously infused into rabbits was described. By comparing to the course of destruction of the liver tissue in fulminant hepatitis, the toxicity of the liver extract was recently studied. Attempts were also made to adsorbing the liver extract by activated clay and detoxifying the liver extract with a formaldehyde solution, and the results suggested that the findings would be applicable as an approach  to the artificial liver.


Hepato- and cardiotoxicity of xanthoascin, a new metabolite of A. candidus Link, to mice. I. Blood chemistry and histological changes in mice. Aspergillus candidus Link, one of the commonest constituents of cereal mycoflora, produces two kinds of mycotoxins, terphenyllin and xanthoascin, which show different chemical and toxicological properties. The latter, xanthoascin, caused severe hepatic injury with jaundice and focal or confluent necrosis of hepatocytes, when given to mice in doses of 6 mg/kg b.w. or higher by a single subcutaneous injection. With higher doses above 15 mg/kg, myocardial degeneration and necrosis was induced after a week or two in addition to the hepatic injury. Vacuolation of the nuclei of the alveolar interstitial cells of the lung and myocardial interstitial cells was another characteristic lesion caused by this mycotoxin. Other organs including the testicles and thymus were widely involved. The unique nature of lesions in the liver and heart may necessitate further investigations in the field of mycotoxicology in relation to human diseases such as nutritional hepatitis and primary myocardial degeneration.


Stimulation by adenine of uridine uptake in cultured mammalian cells. Adenine and its related compounds stimulated the incorporation of [3H]-uridine both into acid-soluble and insoluble fractions of cultured rat liver cells. The incorporation of [3H]-thymidine or -leucine was not affected by the addition of adenine. Rate of RNA synthesis as measured by [32P]-incorporation was not increased by adenine.


Typhlohepatitis in hamsters infected perorally with the Tyzzer's organism. Tyzzer's organisms from a hamster case were administered perorally to 6- to 8-week-old APG hamsters and the growth of organisms and lesions produced in the intestine and the liver were studied. When cortisone was given after oral infection with 2 X 10(5) or more organisms, most animals died in 4 to 7 days showing severe necrotic lesions in the liver but no diarrhea was observed. Without cortisone, watery diarrhea was seen between 2 and 7 days after infection and some animals died in 7 to 13 days. Dead and surviving animals showed liver lesions to a lesser degree as compared to those with cortisone treatment. Two days after inoculation either with or without cortisone, a number of organisms were found within mucosal epithelial cells of the cecum and colon, and 1 or 2 days later when focal necrosis occurred in the liver, they were also found in the duodenum, jejunum and ileum. Inoculated into a ligated cecal sac, organisms were shown to multiply in epithelial cells and the lamina propria of the ligated sac, then producing hepatic lesions in 3 to 4 days when bacterial growth was not detected at any other parts of intestines, suggesting that organisms might gain access to the liver from the cecum via the portal circulation or lacteals.


Continuous monitoring of circulating blood hematocrit. The relationship between the hematocrit value and the absolute value of impedance of whole blood was analyzed. The results indicated that the hematocrit value was linearly proportional to the logarithm of the impedance of whole blood over the range of hematocrit values of 10 to 60% with a correlation coefficient of 0.995. The circuit used for detection of the impedance of whole blood was described. It required no adjustments during measurements and had a wide linear range. The sources of error during continuous measurements were the rate of blood flow through the sensor cell, the temperature of the blood, and the concentrations of plasma proteins and ions. Accordingly, the flow and temperature of blood were kept constant during measurements. Changes in the concentrations of plasma proteins and ions within physiological ranges caused errors of +/- 2.0%. Typical results of continuous measurements were presented, showing that the hematocrit values obtained by this method agreed well with those obtained by the conventional methods from the packed cell volume. An advantage of this method over the conventional methods was that it could follow rapid and transient changes in the hematocrit.


Temperature influence on the development of electrical activities in mammalian brain slice during incubation. Thin slices, 500 mum in thickness, prepared from the guinea pig olfactory cortex and maintained in vitro, generate presynaptic and postsynaptic potentials following electrical stimulation of the lateral olfactory tract. These responses, however, cannot be elicited immediately after slice preparation; they start to develop gradually as the incubation continues. It was found that there was a remarkable time lag for the development between the pre- and the postsynaptic potentials. The presynaptic potential appeared early and developed its maximum height within 10 to 20 min from the onset of incubation. This time course was only slightly influenced by low temperature. Development of the postsynaptic potential in incubation was delayed and the time required to obtain the maximum height was about 30 min at 37 degrees C and 70 min at 22 degrees C. Upon step-like warming from 24 degrees C to 37 degrees C, there was a rapid increase in the amplitude of the response. In the glucose-deficient solution the presynaptic potential maintained its amplitude longer than the postsynaptic potential. Frequency potentiation of the postsynaptic potential was studied by applying a train of six stimuli. The maximum augmented ratio among six responses was the highest in early incubation and reached a steady at 50 min. The ratio of the post-tetanic potentiation of olfactory neurons was the highest at 5 min incubation and reached a steady at 20 min.


Vascular and lipolytic responses to infused norepinephrine in canine subcutaneous and omental adipose tissues. Vascular and lipolytic responses to intravenously administered norepinephrine (NE, 1 mug/kg-min for 30 min) were examined in autoperfused canine subcutaneous and omental adipose tissues. In response to NE, arterial perfusion pressures increased initially and then returned gradually to the pre-infusion levels. Shortly after the onset of NE infusion, the blood flow increased greatly in both adipose tissues. The higher blood flow was maintained throughout the whole infusion period in the subcutaneous adipose tissue, whereas in the omentum the initial high flow fell gradually to the pre-infusion level. Vascular resistance started to decrease after 2-5 min from the onset of NE infusion in the subcutaneous adipose tissue and the reduction of resistance was consistent and persistent as the infusion continued. NE infusion increased the net output of FFA from the subcutaneous adipose tissue, but not in the omentum. The increased FFA output seemed to coincide with the decrease in vascular resistance. Omental adipose tissue may not be influenced by NE at the concentration tested in this experiment. A marked fall in the blood flow was observed in the hindleg of the same animals. Such fall in blood flow was not observed in the adipose tissues in this experiment. It was concluded from the present results that there was a qualitative difference in the effects of norepinephrine on adipose tissues from different locations in the same animal and lipolytic response occurred only if active vasodilatation was present in these tissues.


Oxygenation properties and intraerythrocytic constituents of human blood when stored in different media of ACD and CPD. In the blood stored in acid-citrate-dextrose solution (ACD blood), the oxygen affinity and red cell 2, 3-diphosphoglycerate (2, 3-DPG) content showed parallel exponential decays with half-lives of 3 to 4 days. In the blood stored in citrate-phosphate-dextrose solution (CPD blood), the two parameters increased during the first 4 days before showing the same decay as that seen in the ACD blood. There was no significant change in the transmembrane pH gradient of the red cells, and thus the intracellular pH at the plasma pH of 7.40 was always in the range of 7.17 +/- 0.02 throughout the period of storage in ACD medium. In both ACD and CPD blood, the Hill exponent n was always normal (approximately 2.8) while the Bohr coefficient (delta log P50/delta pH) rose along with the lapse of time for preservation. The oxygen affinity of the CPD blood was less influenced by the red cell 2, 3-DPG than was that of the ACD blood. This phenomenon was thought to derive from higher concentration of salts within the CPD-stored red cells. The efficiency of blood oxygen transport in ACD and CPD blood was compared.


Radioactive calcium influx at rest and during potassium contracture in the T-disrupted, and the urea- or manganese-treated frog sartorius muscles. 45Ca influx in the intact, the T-disrupted, and the urea-treated or Mn++-treated frog sartorius muscles was measured at rest and during potassium contracture. In the intact muscle, Ca influx increased with the increasing of potassium concentration in the bathing solution, and the time course of the Ca influx showed considerable correspondence with that of the potassium contracture. This increased Ca influx was divided into two components: early rapid Ca influx and late slow Ca influx. The amount of early rapid Ca influx at higher concentrations of potassium occupied about 60% of the total Ca influx. The early rapid Ca influx markedly decreased in the T-disrupted and in the urea-treated or Mn++-treated muscles. On the other hand, the late slow Ca influx and the resting Ca influx in these muscles changed only slightly. These results suggest that the early rapid Ca influx occurs mainly through the membrane of the T-system, particularly at the triadic junctional area of muscle fiber, while the late slow Ca influx and the resting Ca influx occur mainly through the surface membrane.


Role of the chemoreceptor in diving bradycardia in rat. Responses in heart rate and blood pressure to the dive in unanesthetized rats were studied by submersion of the head in water for 30 sec. During the dive, remarkable bradycardia developed and blood pressure was slightly elevated. Bilateral section of the carotid sinus nerves or selective destruction of the carotid body chemoreceptor by intrasinusal injection of acetic acid attenuated the bradycardic response to the dive, while section of the recurrent nerves or section of the sympathetic trunks at the cervical level together with the superior laryngeal nerves had no effect. These data indicate that the chemoreceptor plays an important role in diving bradycardia in rats.


Repetitive caffeine contractions in single crayfish muscle fibers. Crayfish muscle fiber responded to 1-4 mM caffeine with repetitive contractions. At 4 mM caffeine, two to four peaks with intervals of 2-3 sec were observed in the tension curve. At 2 mM caffeine, the intervals were prolonged so that the second contraction started after the first contraction ceased. The tension in the second contraction was slower and smaller than the first one. At 1 mM caffeine, very small tensions developed repetitively at intervals of about 1 min and lasted for more than an hour. The time courses of these caffeine contractions were not modified by the current flow in the direction of hyperpolarizing a major part of the muscle membrane. It was observed under a microscope that the contraction in caffeine solution was induced asynchronously. Moreover, repetitive contractions occurred at several sites and propagated in the longitudinal direction of the muscle fiber. The propagation velocities of contraction waves were between 330 and 40 mum/sec depending on the time after perfusion with caffeine solution.


Intracellular ion concentrations of epithelial cells in rat small intestine. Effects of external potassium ions and uphill transports of glucose and glycine. The water content (V) and the concentrations of K+, Na+, and Cl- in the epithelial cells of rat small intestine ([K]i, [Na]i, and [Cl]i) were were measured in high K+ media and in the presence of glucose or glycine (20 mM). Raised external K+ concentrations brought about increases in V. Parallel with swelling of the cell, increases in [K]i and [Cl]i and decreases in [Na]i were observed. Such a pattern of changes in [K]i, [Na]i, and [Cl]i was concordant with that expected from the K+ -induced depolarization and the permeability properties of the cell membranes. In the presence of D-glucose or glycine, remarkable increases in V were observed, which resulted in concomitant decreases in [K]i, [Na]i, and [Cl]i. Assuming the osmotic balalance between intra- and extracellular fluids, the concentrations of accumulated solutes within the cell as well as the net gain of these ions were estimated. The results demonstrated that the accumulated solute was in an osmotically active form, resulting in cell swelling with concomitant decreases in [Cl]i, while the net gain of Na+ and K+ in the cells occurred despite apparent decreases in [Na]i and [K]i.


Reflex swallowing elicited by water and chemical substances applied in the oral cavity, pharynx, and larynx of the rabbit. Water and various chemical solutions were applied to the oral cavity, pharynx, and larynx of anesthetized rabbits to study their effects on the swallowing reflex. Laryngeal stimulation: Water was an effective stimulus in eliciting reflex swallowing; NaCL depressed this reflex. The effect of salt solutions on swallowing was dependent on anion species. Weakly hydrated anions had a depressing effect while greatly hydrated anions had a facilitating effect. The order of the depressing effect of the anions was Br-greater than SCN- greater than CL- congruent to NO3 -, and the order of the facilitating effect of anions was citrate greater than SO42 - greater than HCO3-. Oral and pharyngeal stimulation: Water elicited swallowing; however, this effect was less marked than that in the larynx. NaCL in concentrations lower than 200 mM had a depressing effect while at higher concentration it had a facilitating effect. Sucrose, acetic acid, and alcohol evoked successive swallowing in the first two or three trials. It was found that water applied to the laryngeal region had the marked effect of eliciting reflex swallowing and that most gustatory substances infused into the oral and pharyngeal regions had a facilitating effect on the initation of swallowing.


Relationship between effects of procaine and Ca on spontaneous electrical and mechanical activities of the smooth muscle cells of the guinea pig urinary bladder. The relationships between the effects of procaine and those of Ca on the spontaneous electrical and mechanical activities of smooth muscle cells of the guinea pig urinary bladder were studied using both microelectrode and sucrose gap methods. Procaine(1, 7, and 15mM) depolarized the membrane and increased spontaneous spike freqency. The maximum rates of rise and fall and the after-hyperpolarization of the spike decreased. Enhanced spontaneous rhythmic contractions accompanied these membrane activities (1 mM). The tone of the preparation (resting rension) increased transiently and decreased gradually (7-15mM). These procaine effects were suppressed by the application of excess Ca (7.5 mM). The increased electrotonic potential induced by 7mM procaine was reduced by the addition of 7.5 mM Ca. Reduction of Ca concentration (0.8 and 0 mM) IN Krebs solution containing procaine further depolarized the membrane and decreased the spike amplitude. In Ca-deficient solution, the enhanced rhythmic contractions induced by procaine were slightly reduced. Compound D600 (1-3mg/1), manganese ion (Mn) (1-3 mM), and cobalt ion (CO) (1-3 MM) inhibited the effects of procaine on spike discharges and mechanical responses. From these results it is concluded that procaine action is related to that of Ca which controls the membrane permeability, since procaine depolarizes the membrane by reducing K conductance. Furthermore, action potentials observed in the Krebs solution containing procaine are considered to be Ca spikes, which seem to play an important role in excitation-contraction coupling in the guinea pig urinary bladder smooth muscle.


Inhibitory effects of procaine on the electrical and mechanical activities of the smooth muscle cells of the guinea pig urinary bladder. Modification of the effects of K, Ca, acetylcholine and rapid cooling by procaine were examined in the smooth muscle of the guinea pig urinary bladder. Contraction enhancement by procaine was observed in 5.9 mM K - and 23.6 mM K-Krebs solution but was not confirmed in 59 mM K solution. Procaine enhanced contraction in relation to membrane activities. Relationships between membrane potential and K concentration showed that procaine reduced K conductance. This effect decreased as K concentration increased. K-induced contracture was inhibited by procaine at 37 degrees and 10 degrees C. Procaine inhibited Ca- and  acetylcholine-induced contractions in isotonic K2SO4-Locke solution. Rapid cooling contracture, initiated by lowering the temperature of the solution from 36 +/- 1 degrees C to 12 +/- 2 degrees C within 30 sec, was inhibited by procaine. From these results, it is concluded that procaine has an inhibitory effect on Ca permeation through the cell membrane and on Ca release from  sequestered sites, and it is confirmed that procaine enhancement of  spontaneous contractions is related to the spike activity resulting from depolarization which is caused by reduction of K conductance (KURIHARA, 1975). The mechanism of the procaine effect is discussed in relation to excitation-contraction coupling in the guinea pig urinary bladder.


Extracellular calcium and positive inotropy of ionophore (X537-A) in cardiac muscle. The role of extracellular calcium in the positive inotropic effect of X537-A in dog's cardiac muscle was investigated. Ionophore (20 mug/ml) in the presence of external calcium increased the contractility by 67 +/- 12 percent within 2 min. In the absence of external calcium ionophore was ineffective in producing a positive inotropic effect in the muscle. Lanthanum, an inhibitor of calcium influx, in the concentrations of 2, 4, 6, and 8 mM produced a concentration dependent decrease in the contractility. Ionophore-induced increase in the contractility was inversely related to the concentration of lanthanum used. It is suggested that the release of calcium from intracellular stores under the effect of ionophore is not enough to maintain contractility. Also positive inotropic effect of ionophore appears to be mediated through the transportation of calcium across the sarcolemma. Such ionophore mediated transportation of calcium appears to be dependent upon surface binding of calcium.


Effects of prostaglandins on electrical and mechanical activities of the guinea pig stomach. Effects of prostaglandin E1, E2, and F2alpha (PGE1, PGE2, and PGF2alpha) on the electrical and mechanical properties of the smooth muscle of various areas of the guinea pig stomach were investigated. PGE1 and PGE2 (10(-9)-10(-6) g/ml) suppressed the spontaneously generated mechanical activity in circular muscle of the pylorus, but increased the activity of muscles in other areas of the stomach, while PFG2 alpha (10(-9)--10(-6) g/ml) showed excitatory action on muscles in all the areas of the stomach. These PG actions on the stomach muscle were mainly myogenic responses, and were not affected in the presence of tetrodotoxin (10(-7) g/ml). PGE1 and PGE2 (10(-8)-10(-6) g/ml) hyperpolarized the membrane and suppressed the generation of slow potential change in the circular muscle of the pylorus, thus causing the cessation of spikes which were superimposed on the slow potential change. On the other hand, these agents depolarized the membrane and increased membrane activity in the longitudinal muscle of the pylorus and both layers of the corpus. When voltage-current relationships were observed before and during application of PGs in the circular muscle of the pylorus, PGE1 and PGE2 consistently reduced membrane resistance at any given membrane potential level when compared with that in Krebs solution. In other regions of the stomach, PGE1 and PGE2 depolarized the membrane, and reduced the membrane resistance at any given membrane potential level. The differences of PG action on the various regions of stomach were compared with those observed in the other visceral smooth muscles.


Clinical and pathophysiological evaluation of esophageal and reconstruction using gastric tube and pedicled colon segment. Pathophysiological and nutritional conditions were compared after esophageal reconstruction in 15 patients with a gastric tube and in 12 patients with a pedicled colon segment for the treatment of esophageal cancer. There was no significant difference in the postoperative nutritional index, iron and vitamin B12 metabolisms. On the other hand, the long gastric tube from the greater curvature of the stomach used as an esophageal substitute retained some secretory functions of both exocrine and endocrine although the effect of truncal vagotomy may have to be taken into consideration.


Serum globulin assay of estrogen-binding ability during endocrine treatment of postmenopausal advanced breast cancer. Estrogen-binding ability of sex hormone binding globulin (SHBG) was assayed in sera of 18 postmenopausal patients with advanced breast cancer during the treatment of diethylstilbestrol by agar gel electrophoresis at low temperature. In eight cases showing high level of SHBG, seven cases (88 per cent) responded to the estrogen therapy. On the contrary, only one case (13 per cent) responded out of eight patients with low levels of SHBG. This result may indicate that the level of estrogen binding ability of SHBG (SEBA) is a useful tool in predicting response to estrogen therapy for breast cancer.


Histological appearance of small thyroid carcinoma. Histopathological characteristics of the tumor growth were studied in 59 small carcinomas detected in thyroids at autopsy and in 33 from surgically removed thyroids. Tumor size was less than 5 mm in 56 of the 59 carcinomas (95 per cent) detected in autopsy materials. Histological findings of the small carcinomas were papillary adenocarcinoma in 45 of 59 (76 per cent), and sclerosing carcinoma in 32 (54 per cent). Among these 59 small carcinomas, intrathyroid metastases were found in six (10.2 per cent). In small carcinomas measuring less than 5 mm, carcinomas in females had an average diameter of 2.19 mm and were significantly larger than those found in male, having an average diameter of 1.14 mm (p less than 0.05). In small carcinomas from the surgical specimen, incidence lymph node metastasis was high when associated with numerous intrathyroid metastases and when the distance was great between the edge of the primary tumor and the farthest satellite metastatic focus.


Surgical treatment of tricuspid insufficiency in patients undergoing mitral valve replacement. During the past eight years, 46 of the 106 patients who underwent mitral valve replacement were associated with tricuspid insufficiency. No surgical correction was performed (14 cases) in cases of slight tricuspid insufficiency. Tricuspid annuloplasty (11 cases) or valve replacement (21 cases) was employed according to the severity of insufficiency. In the non-repair group, the mortality rate was fairly low (21 per cent), but the postoperative status was the least satisfactory by the NYHA classification. Tricuspid insufficiency was significantly reduced only in two of these 14 cases after the mitral valve replacement. In the tricuspid annuloplasty group, although the technique of tricuspid annuloplasty did not always correct insufficiency completely, only one patient died of residual insufficiency. The cardiac output measured with Minnesota Impedance Cardiograph increased postoperatively in proportion to stress in this group. In the tricuspid valve replacement group, cardiac catheterization studies revealed hemodynamic improvement at rest in all, but cardiac output during exercise remained unchanged or decreased in some cases. Now we consider that tricuspid insufficiency with advanced mitral valve disease, even of a slight degree, should be surgically treated and that annuloplasty has more obvious hemodynamic benefits than valve replacement.


The effectiveness of family planning education on acceptance of contraception by postpartum mothers. A prospective controlled study on the maternity service of the American University Medical Center, Beirut, Lebanon, tested the effect of family planning education during the postpartum lying-in period on recruiting contraceptive acceptors. The study further determined how women with different socio-demographic backgrounds, life styles, and levels of readiness for the practice of family planning responded to the educational program. The results revealed that a postpartum educational effort could almost double family planning acceptance among women who returned to the postpartum clinic within the first 9 weeks after delivery and that the educational impact was evident irrespective of the respondents' socio-demographic characteristics, life styles, and levels of readiness for family planning.


Diagnosis of pulmonary hydatidosis by sputum cytology. Patients with pulmonary hydatid cysts have been noted to have lower incidence of positive serologic tests than patients with hepatic cysts. Two patients with hydatid cysts of the lung and negative serologies in whom diagnoses were made by demonstration of scoleces in sputum samples prepared for cytologic study are discussed.


The prevalence of hepatitis B surface antigen (HBsAg) among students and blood donors at the American University of Beirut (AUB). HBsAg testing by CEP was performed on 2359 students and 6153 blood donors at the American University of Beirut. No significant difference existed in the prevalanece rates among the various socioeconmic groups of the Arab Asians tested. There was, however, a definite difference among the various geographic groups. The findings suggest that socioecomic factors do not satisfactorily explain the differences in the prevalence rates among various nationals.


The myopahtology of congenital generalized lipodystrophy light and electron microscopic observations. The light and electron microscopic myopathology in five patients with congenital generalized lipodystrophy consist of variation in fiber size, ringbenden, various degrees of fiber degeneration and fragmentation, accumulation of glycogen, aggregation of mitochondria. streaming of Z line, myofilamentous inclusions and dilatation of sarcoplasmic reticulum profiles. The light microscopic myopathology in the five patients is compared with the few available observations in the literature. No reports of electron microscopy of muscle in this syndrome are available in the literature. No reports of electron microscopy of muscle in this syndrome are available in the literature. It is concluded that the myopathologic features are nonspecific in nature and may be secondary to the diencephalic disturbance which is known to occur in this syndrome.


Anemic infarction of the liver resulting from hepatic and portal vein thrombosis. True anemic infarction of the liver is a rare lesion. Most of the reported cases are due to occlusion of the hepatic artery. Whether venous occlusion can result in such anemic infarcts has been disputed although few authentic cases have been reported. A case of polycytheia vera complicated by hepatic and portal vein thrombosis with anemic infarction of a large segment of the liver is presented. The case illustrates that anemic infarcts of the liver can result from venous occlusion. The intense congestion secondary to hepatic vein occlusion may cause secondary arterial hypoperfusion unless the portal vein is available as an outflow tract.


Chronic mountain sickness.

Chronic mountain sickness. Chronic mountain sickness was first described in the Peruvian Andes. It consists of an excesive polycythemia for the altitude of residence. Its main symptoms are of cerebral congestion and occasionally of right heart insufficiency. The authors postulate that it is caused by a decay of the ventilatory rate with age with the corresponding increase in hematocrit.


[Asynchrony of atrial contractions in mitral-tricuspid heart defects and its clinical significance (according to cardiac catheterization findings)]. A temporal analysis of the pressure curves recorded in the right and left atria revealed that in mitral-tricuspid heart diseases the asynchronism of atrial contractions was 2--6 fold as compared to the normal cases [on the average, 0.05--0.06 (0.02--0.13) sec., the normal being 0.02 sec]. The delay in the left atrial contraction is due to the deceleration of interatrial conduction of the excitation. Due to the increased asynchronism different shapes of a-waves are recorded in the right and left atria, as well as presystolic gradients of pressure at the level of the left and right atrioventricular orifices and presystolic murmurs of different shapes typical of mitral (crescendo) and tricuspid (crescendo-decrescendo) stenoses.


[State of regional hemodynamics in patients with vibration disease during sanatorium treatment (reographic studies)]. The state of the regional haemodynamics was studied in 216 patients with vibration disease kept on balneologic therapy. Vibration disease was the result of "local" vibration in 104 patients, and that of combined vibration -- in 112. Rheographic studies of the peripheral blood flow demonstrated disorders of the regional haemodynamics in 76% of the patients, their severity depending on the stage of the pathological process. Rheogrammes recorded during spontaneous attacks of angiospasm or following a cold test revealed a distinct, sometimes complete levelling of the rheographic elements predetermined by the angiospastic state of the peripheral vessesl. The revealed changes in the functional state of the regional flow were of a similar angiospastic nature and reflected the severity of the pathological syndrome, as well as the site of the prevailing vibration effect. Dynamic rheographic studies conducted in patients following balneological treatment (nitrogen-thermal or bromiodine baths) revealed positive changes in the qualitative and quantative rheographic parameters indicating normalization or improvement of the peripheral circulation in vibration disease cases. A comparative assessment of the immediate therapeutic effect of the balneological treatment demonstrated more distinct positive shifts in the rheographic parameters of the regional haemodynamics following a course of nitrogen-thermal baths.


[Comparison of the contractile function of the heart in hares and rabbits under conditions of relative rest and under resistance loading]. A comparison was conducted between the contractile function of the heart of hares and rabbits at rest and under isometric contractions regimens, and under such conditions the concentration of ATP and its breakdown products was studied in the myocardium of both species. It was demonstrated that the cardiac muscle of hares adapted by the evolution to the performance of intensive work does not possess any increased ability of developing systolic tensions, or any increased power of the ATP resynthesis apparatus. The advantage of such a heart-- its ability to pump an increased blood volume -- must be ensured by some different mechanism that requires still further investigations.


[Analysis of depression of contractions of the isolated dog heart following paired stimulation]. In 30 experiments in isolated canine hearts perfused with whole donor blood disorders in myocardial contractions were studied following the termination of paired stimulation. It was concluded that the cause of depression of cardiac contractions following paired stimulation is not myocardial hypoxia and energy reserve exhaustion during enhanced mechanical activity of the heart, but a dissociation of the electric and mechanical processes in the myocardium; switching off the second (stand-by) action potential together with the termination of the paired stimulation caused disorders in the regimen of coupling processes that have established themselves under this form of electric stimulation. This suggestion is supported by the fact that repeated paired stimulation during depression is capable of producing the same stimulating effect upon the cardiac contractions as the initial one. The depression was eliminated by the administration of potassium ions and catecholamines.


[Change in hemodynamic indices in progressive hypertension]. The results of a long-term observation (for 1 to 4 1/2 years) of haemodynamic changes in 32 non-treated patients with stage II essential hypertension are presented. In 18 patients the lesion did not progress throughout the observation period (group I). At re-examination the haemodynamic parameters in this group of patients did not change significantly, although in some of them the haemodynamic mechanism of maintenance of hypertension underwent certain changes: the cardiac output decreased and the total peripheral resistance increased. In 14 patients (Group 2) their essential hypertension was progressively developing. At the same time a deceleration of the heart contractions rate, a reduction of the cardiac and stroke outputs, a decrease of the circulating blood volume, and an increase of the total peripheral resistance were noted. The reduction of the cardiac output was directly proportional to its initial value (r = +0.78, P less than 0.01) and to the elevation of the arterial pressure (r = +0.71, P less than 0.01). The most distinct changes were noted in 3 patients who developed signs of cardiac insufficiency during the period between the two examinations. The possible mechanisms of haemodynamic changes under the progression of essential hypertension are discussed.


[Use of glucose-6-phosphate dehydrogenase and transketolase for characterization of pathologic processes in the myocardium in rheumatism]. In patients with active rheumatism the activity of the key enzymes of the pentose cycle -- glucoso-6-phosphatedehydrogenase and transketolase -- increases in the erythrocytes of the peripheral blood parallel with the severity of the inflammatory lesion of the heart. In patients with distrophic changes in the myocardium without concomitant carditis the level of glucoso-6-phosphatedehydrogenase did not change significantly, while the content of transketolase decreased considerably. Antirheumatic therapy helping to reduce the inflammatory reactions in the heart results in a reduction of the level of pentose cycle enzymes. The study of the ratio between glucoso-6-phosphatedehydrogenase and transketolase may prove valuable for an approximate evaluation of the predominance of inflammatory or dystrophic processes in the cardiac muscle.


[Cortisol metabolism in hypertensive patients during the crisis period]. The examination was conducted in 67 patients with Stage II essential hypertension, aged 29 to 60 years (13 males and 54 females). Cortisol metabolism was assessed on the basis of a study of daily urine excretions of tetrahydrocortisol, tetrahydrocortisone, cortisol, cortisone, 17-oxy-11-desoxycortisol and of their ratio. It is found that in patients with Stage II essential hypertension, beyond the period of exacerbation, cortisol metabolism and the glucocorticoid function of the adrenal cortex are unchanged. During crises the gluococorticoid function of the adrenal cortex is activated, and some changes develop in cortisol metabolism. The severity of the crisis does not affect cortisol metabolism, but results in a growing total secretory activity of the adrenal cortex.


[Changes in the vectorcardiogram in rheumatism with coronary vessel lesions]. Changes in vectorcardiograms (VCG) taken in 5 projections by the I.T. Akulinichev technique were studied in 101 patients with rheumatic fever involving the coronaries. The VCG changes were found not to be specific of rheumatic coronaritis, but to reflect the degree of coronary insufficiency and myocardial hypoxia in general. In coronaritis with myocardial infarction VCG displayed asynchronism and the QRS complex deformities, their unlocked pattern, and a decrease in the T wave amplitude. When myocardial infarction of a rheumatic genesis developed, signs of focal myocardial lesion appeared on the VCG similar to those observed in cases of ischaemic heart disease. Vectorcardiography was concluded to significantly supplement the capacity of electrocardiography in revealing coronarites.


[Experience with conducting transcutaneous kidney biopsy in a cardiology clinic]. The analysis of 450 closed puncture biopsies of the kidneys permits to conclude that the employment of this method in a cardiological hospital provides rather valuable information on the state of the renal tissue in cases of various diseases entailing the arterial hypertension syndrome. The incidations for kidney biopsy include arterial hypertension, developing against the background of the nephrotic syndrome of varying genesis, clinically distinct glomerulonephritis (to precise its morphological variant), various forms of renovascular hypertension, and in some cases -- hypertensive form of pyelonephritis. Important complications such as macrohematuria and pararenal haematoma were observed in 25 cases. The employment of kidney biopsy in a cardiological clinic helped to make the diagnosis of the lesion underlying arterial hypertension, to choose the adequate method of treatment and to improve the prognosis of the disease.


[Role of microcirculation in the development of pulmonary hypertension in chronic non-specific lung diseases]. A comparison of the results of morphological studies of pulmonary and pleural microcirculation with the indices of haemodynamics in the system of the pulmonary artery in patients with chronic non-specific lesions of the lungs accompanied by suppurative processes indicates the participation of microcirculation in the development of pulmonary hypertension. A lasting course of the disease with frequent exacerbations results in profound changes in the system of micricirculation. The pathological developments in the vascular terminals, the disorders in the rheological properties of the blood, in vascular permeability- the hampered lymph drainage that are the causes of irreversible metabolic shifts not only become additional factors in the development of the underlying pathology, in the formation of bronchiectases in particular, but also provide for a further development of pulmonary hypertension.


[Morphologic basis for several myocardial metabolic disorders in the presence of respiration uncoupled from phosphorylation]. It was experimentally established that the destruction of mitochondria due to a reduction of ATP production and to their compensatory hyperfunction under energy defecit is underlying some disorders in the myocardial metabolism caused by 2,4-DNP intoxication. Energy deficit results in K+ metabolism disorders and the related acetylcholine synthesis which predisopses the changes in the cardiac function and still further increases the myocardial requirements of energy. The bio-energy disorders develop in a vicious circle manner, and when the intoxication increases, it inevitably results in energy depletion and cardiac arrest.


[Morphologic indices the influence of selenium and vitamin E on the course of experimental myocardial infarct]. Myocardial infarction was induced in rats by ligating a coronary artery. During a week they received daily injections of 50 mg/kg of vitamin E intramuscularly or 30 mug/kg of sodium selenite subcutaneously, or else a combination of these preparations. The control animals received no injections. Stereometrically a statistically significant reduction of the infarcted zone was noted under the effect of selenium, this reduction being especially distinct during the ischaemic stage; the maturation of granulation tissue with an enhancement of the fibroblast reaction therein was accelerated. The muscle cells of the myocardium beyond the infarction zone displayed an increased activity of lactate dehydrogenase and a reduced activity of succinate dehydrogenase, intactness of the ultrastructure of the cell pattern, an enhancement of the signs of ultrastructural regeneration. Vitamin E potentiated the effect of selenium and executed itself a similar, but less distinct effect.


[Morphologic festures of cardiac lesions in rheumatoid arthritis]. Morphological examinations of the heart in cases of articulo-visceral rheumatoid arthritis revealed in 20 of the 35 conducted observations certain changes attributable to the underlying disease. The following groups of changes were revealed: 1) endocarditis; 2) myocarditis; 3) pericarditis; 4) rheumatoid nodules; 5) valvular sclerosis and mural endocarditis; 6) cardiosclerosis; 7) amyloidosis; 8) coronaritis and coronary sclerosis; 9) adhesions in the pericardial cavity. The severity of cardiac leasion in rheumatoid arthritis is determined by the involvement of the serosa into the pathological process. Inflammatory and sclerotic changes in the myocardium are predimonantly of a subepicardial and subendocardial nature, usually non-accompanied by any clear clinical symptoms, or taking a latent course. Rheumatoid nodules typical of rheumatoid arthritis, and deposits of amyloid masses in the walls of the coronary arteries are noted rarely. Changes in the heart are observed mostly in "septic", subacute rheumatoid arthritis and in Still's disease. Cardiac lesions in rheumatoid arthritis are connected with microcirculatory disorders caused by immunopathological processes.


[Microspectrophotometric study of oxidative enzyme activity in experimental myocardial ischemia]. The method of comparitive microspectrophotometry was used to study the changes in the activity of oxidative enzymes in the zone of ischaemia and the juxtaischaemic region of the cardiac muscle in rabbit experiments (104 animals, including 10 controls). A certain periodicity was noted in the changes of the activity of oxidative enzymes in separate zones of the ischaemic myocardium during different periods of the infarction development and healing. The terms of maximum reduction of the enzymatic activity falling within the 4th-6th and 24th hours and 2nd day should be taken into account while developing the methods of metabolic protection and enzyme therapy of the ischaemic myocardium.


[Damage to the contractile myocardium in disorders of lymph drainage (experimental-morphologic findings)]. The role of the lymphatic system of the heart in the development of cardiosclerosis was studied in experiments in 43 adult dogs. An important influence of lymphogenic edema as an agent favouring the damaging of the myocardial parenchyma was established. Micronecroses occurring throughout the contractile myocardium stimulate a continuous substitution of the elements of the damaged parenchyma by the pre-existing or newly formed stroma. Proceeding from personal and literature data on the frequent involvement of the lymphatic system of the heart into its pathological processes it is suggested that the lymph directly participates in the development of the functional incompetence of the organ.


[Blood and lymph vessels of the heart in pericarditis of different etiology]. 56 heart specimens with pericarditis of different etiology were studied (uraemic, tuberculous, bacterial). In the majority of cases pericarditis was a complication of rheumatic heart diseases, fibrous-cavernous tuberculosis and chronic nonspecific pulmonary lesions, cardiac tumours and other pathology. Models of uraemic and purulent pericarditis were created in 5 rabbits and 30 dogs. The methods of venous injections and cardiac blood vessels injections, angioradiography, macro- and microscopy, histology, electrocardiography were employed. The function of the lymphatic system of the heart was determined by studying dynamically the resorption of Polyglukin from the pericardial cavity of the experimental animals. It was established that the disorders in cardiac activity in cases of pericarditis largely depend on the involvement of its vessels, primarily of the cardiac microcirculation bed, as well as of the veins and lymph vessels ensuring the drainage of the myocardium. Blocks of the venous and lymphatic beds of the epicardium in acute bacterial pericarditis causes disorders in blood and lymph circulation in the superficial layers of the heart muscle. Oedema and hypoxia developing in such situations favour the transit of the process into a chronic one with the formation of adhesions of the serous sheaths of the heart. The complication of any disease by bacterial pericarditis, especially with the development of pericardial obliteration, should be considered as an unfavourable factor worsening the prognosis. Aseptic pericarditis is accompanied by insignificant changes in the vascular system of the heart and cause important disorders in the blood and lymph circulation only in cases of constrictive pericarditis formation.


[Influence of aging on synthesis and breakdown of RNA and protein in the myocardium]. The rate of decomposition of RNA and proteins in the heart muscle of aged rats, as well as the effect of t-RNA on the rate of translation in the reconstructed non-cellular system of protein synthesis were studied. The rate of decomposition of sarcoplasmatic and myofibrill proteins and RNA is known to be decreased in the heart muscle of old animals. The metabolic changes. The addition of homologous t-RNA to the non-cellular system of protein synthesis was shown to stimulate the incorporation of labelled amino acids into the ribosomes of the heart of old rats.


[Disruption of erythrocyte membrane permeability for sodium and potassium ions in hypertension]. The kinetics of Na22 efflux from the erythrocytes and K42 accumulation by the erythrocytes in patients with essential hypertension and in normotensive persons was studied. Sodium efflux from the erythrocytes into a normal medium was found to be significantly accelerated in hypertensive patients, and their rate constant of Na/Na exchange in the erythrocytes has a higher value (1.61 +/- 0.39 mol.1(-1) min.-1 versus 0.56 +/- 0.08 - 10(-6) mol. 1(-1).min. -1). The difference is statistically significant only under active transport inhibition with ouabain. K42 accumulation by the erythrocytes is slower than in normotensive indifiduals. The observed changes in the transport of cations are attributed by the authors to an increased passive permeability of the erythrocytic membrane in hypertonics. The latter is interpreted as a fragment of a more general defect of the cell membrane function that may be the cause of activation of the mechanisms that maintain a high arterial pressure.