[Scientific-methodological foundations of the study and assessment of vaccine side-effects]. It is emphasized that against the background of significant changes in the epidemic situation and technical possibilities of mass vaccinations the injurious action of a number of traditionally used vaccines served as the cause of revision of the strategy and tactics of their use. The conept according to which the character of the changes in the organism of individuals inoculated with the liver vaccines should display a principal difference from such in the individuals vaccinated with the preparations of the antigenic level (which also points to the differences in the methodical principles of the study and the assessment of the indices of their damaging action) is discussed. The author believes that the study of the side-effects of the "candidates for the position" of the live vaccine should be realized at the pathogenetic level under the motto of the high similarity to the processes developing after their administration or natural infection with wild strains, with consideration to the special organization of investigations for the detection of the frequency and the spectrum of the possible remote sequelae of the immunization (encephalitogenicity, etc.). For the study of the injurious action of the vaccine preparations of the antigenic level the authors recommend a complex of methods giving information on the quantitative characteristics of their pharmacological, pharmacodynamic and toxicological action, and also of the biological tolerance of their different doses on the experimental and clinical levels. It is emphasized that the information collected traditionally on the vaccine reactogenicity parameters is primarily necessary for the elaboration of a system of methods of their production control for the purpose of timely rejection of non-standard batches.


[A study of the avidity of Vi antibodies in typhoid fever patients and chronic carriers]. Avidity of Vi-antibodies was studied in the patients suffering from typhoid fever and chronic carriers in the indirect hemagglutination test (IHAT) by means of titration with erythrocytic diagnostic agents sensitized with various doses of the Vi-antigen. The minimal sensitizing dose still adequate for detection of the antibodies in the titre of 1 : 20 was accepted as the avidity index. By the avidity sign the antibody heterogeneity index was calculated as the ratio of the optimal sensitizing dose to the minimal sensitizing one. In comparison with the patients suffering from typhoid fever of at the acute period of the disease in chronic carriers Vi-antibodies were more avid, this being conditioned chiefly by the highly avid IgG-antibodies. During the acute period of the disease the avidity of Vi-antibodies elevated only against the antibodies of the IgG-class. An increase of heterogeneity by the same sign was noted with increase of the degree of the serum antibody avidity.


[Phage types of typhoid cultures of the Orel region in 1964-1973]. A total of 810 cultures of the causative agents of typhoid fever were isolated at the territory of the Orel region in 1964-1973 in 655 foci; the phage type was established in 63.5% of the cases, 30.2% of the cultures could not be typed by the available phages, and the rest were polylysable or devoid of Vi-antigen (W-form). A total of 16 phage types were revealed; among them there prevailed phage types A (18%), E (15.1%), F1 (7.3%), and N (5.2%); phage types 28, 46, and 40 were less frequent; phage types C1, T and D6 were revealed in individual cases only. There occurred no significant changes in the phage pattern for the observation period.


[The protective and immunodepressive activity of cell fractions of a cholera-like vibrio]. A study was made of the protective and immunodepressive activity of the sytoplasmic fractions of a cholera-like vibrio. Ribosomal fraction proved to possess more marked protective and immunodepressive properties than the soluble cytoplasmic fraction.


[A study of immunological efficacy of the oral chemical cholera vaccine on experimental animals]. Three fractions isolated from the culture fluid of the 569B cholera vibrio strain were studied. The fractions differed by the extent of purification, and the content of the toxid and the O-antigen. In intraintestinal application to rabbits all of them caused formation of antitoxins and vibriocidal antibodies in the blood serum. The immunizing dose of the preparations in intraintestinal administration exceeded the dose required for subcutaneous application. Fraction I should be used for Producing tablet form of cholera vaccine because it was least toxic and provided the greatest yield.


[Immunostimulating action of thiamine when using purine base analogs]. Experiments were conducted on albino rats; a study was made of the effect of the antigenic stimulation and of the purine base analogues (6-mercaptopurine and azathioprine) on the thiamine content in the spleen, and also of the influence of thiamine load on the antibody biosynthesis induced with the antigen under normal conditions and in administration of immunodepressors. Immunization and administration of the analogues of purine bases caused a reduction of thiamine content in the spleen. An excessive vitamin load compensated this deficiency. Thiamine load stimulated the formation of antibodies and weakened the immunodepressor effect of the purine base analogues significantly.


[Immunological indices in the digestive tract secretions in subcutaneous and oral vaccination against typhoid fever]. Volunteers were vaccinated subcutaneously and orally against typhoid fever; a determination was made of immunological reactions in the digestive tract secretions. Oral vaccination caused a much greater production of the secretory IgA than the subcutaneous one. Immunoglobulins of classes G and M were revealed in the intestinal contents only in a few volunteers. In studying the coprofiltrates obtained before the vaccination there was shown for the first time the presence of normal coproantibodies to typhoid fever, dysentery, tetanus, diphteria, botulism and gas gangrene; in the majority of the cases there was found a correlation between the presence of normal serum and secretory antibodies. Subcutaneous and oral vaccination caused an increase of coproantibodies specific for the vaccines used. Besides, the same vaccines stimulated the nonspecific response expressed in a rise of the level of other species of antibodies. Specificity of coproantibodies in the inhibitary passive hemagglutination reaction was demonstrated in the majority of the coprofiltrates examined.


[Use of computers and mathematical methods in epidemiological work. V. Assessment of infection morbidity using standardized indices]. The paper treats of the method of obtaining special and generalized indices on the computer M-222 to be used for the analysis of infectious morbidity under the automatic control system conditions. Assessment of significance of the differences between the actual number of diseases and the "usual" morbidity level characteristic of the given territory and the time of the year lies at the basis of the calculation of the standardized indices. Complex evaluation of the epidemiological condition of the controlled district was carried out according to the data of the official monthly and annual sanitary-epidemiological report forms No. 85.


[Analysis of patenting vaccine-serum preparations in the Soviet Union]. Patenting practice of vaccine-serum preparations in the Soviet Union is not uniform. A compelx maintenance of the object, i.e. patenting of the preparation proper and the method of its production is of interest.


[Role played by the parenteral infection transmission mechanism in the spread of viral hepatitis]. The authors present the results of observations carried out for the purpose of ascertaining the role played by the parenteral mechanism of transmission in the growth of viral hepatitis incidence. A number of measures for prevention of parenteral viral hepatitis infection were carried out in the mental hospital; the incidence of viral hepatitis decreased 16.4 times (from 13.1 to 0,8 per 1000 patients) for a period of three years (1966--1969).


[Leptospirosis in rodents in the old natural focus of Eastern Slovakia]. A total of 770 rodents (40 rats, 100 hamsters and 630 rodents) were serologicall examined in the old natural foci in some of the Eastern Slovakia regions; there were 10.6% of positive reactions to Leptospirosis in dilutions ranging from 1 : 100 to 1 : 1600. In rats 17 sers (40%) proved to be positive to leptospira, mostly reacting with the L. icterohaemorrhagiae. A positive reaction with the leptospira antigen was found in 13 sera (15%) of hamsters; the sera reacted with the Leptospira grypposa more frequently than with the L. serjoe. In the group of small rodents the greatest number of positive reactions to leptospirosis was obtained in microtus arvalis (10.7%); the sera reacted most frequently with L. grippotyphosa and L. serjoe. As many as 9 serological types were revealed in the group examined.


[A comparative study of ultrastructural organization of the nonagglutinating vibrios and the causative agents of cholera]. A common plan of ultrastructural organization was revealed in a comparative study of the ultrastructure of the nonagglutinating El Tor and cholera vibrios: the presence of a three-layer cell wall and cytoplasmic membrane, the presence of vesicles on the external layer of the cell wall or between the cell wall and the cytoplasmic membrane; identity of the intracytoplasmic membranous structures; the presence of intracytoplasmic inclusions in the form of granules of various size and electron density; cell division by means of a band with the formation of two cells of equal size or of many bands in one cell, and also by the joining of the cytoplasmic membrane with the formation of rings at the sites of cell division. Identify of the ultrastructure of the vibrios under study can serve as confirmation of the views of the investigators who consider that nonagglutinating vibrios should be referred to a single V. cholerae species.


[Electron microscopic study of dry live plague vaccine EB by the scanning method]. Dry live plague vaccine EB was examined under microscope; it appeared that in the mentioned preparation the bacterial cells were enclosed in the artificial sucrose-gelatin capsule of the stabilizer which apparently maintained the vital activity of the microorganisms in the state of anabiosis by forming a stable bond with the bacterial body.


[Taxonomic subdivision of salmonellae].

[Taxonomic subdivision of salmonellae]. Elaboration of an objective approach to the classification of salmonellae by the biochemical characteristics is of great theoretical and practical interest. The authors carried out a taxonomic analysis of 966 salmonellae and 241 arizonae by 26 biochemical signs. Similarity between all the couples was estimated on the computer M-220; group analysis was carried out by 3 methods with the successive reduction of the group level by 2%. The grouping results are presented on a dendrogram. Analysis of the dendrogram demonstrated that 4 taxons were distinctly traced at the level of 94%, which were united with one another at the level of 93%. The whole group formed at the level of S = 76%, which served as the genus level of the salmonella union. Arizona group was connected with the bond between the II and IV subgenera. A method of numerical taxonomy provied arizona and salmonella to be undoubtfully affiliated, this permitting to regard arizona as the subgenus II of the Salmonella genus.


[Identification of conditionally pathogenic enterobacteria in laboratory practice in the diagnosis of acute intestinal diseases]. Identification of 361 cultures isolated from patients suffering from various acute intestinal diseasesand from persons who had sustained them, as well as from contacts and persons examined prophylactically with the use of various biochemical tests showed that ty their taxonomic properties the cultures were referred to conditionally-pathogenic representatives of Enterobacteriaceae of the corresponding genera:Citrobacter, Hafnia, Klebsiella, Proteus, Providencia. Serological typing of the strains of bacteria of the Citrobacter pointed to the most frequent circulation of the strains of the serological groups 04, 01, 03, 013, 05, 022, 08; among these groups 04, encountered among all the categories under study, prevailed. At the current stage of identification of conditionally pathogenic enterobacteria in practical laboratories it is of expedience to use in the diagnosis of intestinal diseases the serological typing along with a complex from several additional biochemical tests.


[Experimentally induced cholera in guinea pigs. I. Elaboration of the method of infection]. The method of intrapulmonary infection of guinea pigs was suggested for the assessment of the virulent properties of cholera vibrios. Addition into the diluent of 10% peptone, 10% gelatine and 0.05% agar-agar led to the reduction of LD50 by over 1000 times. A specific infectious process coursing in an acute generalized form with bacteriemia and affection of the small intestine developed in the infected animals. The majority of the animals perished in 1 to 2 days.


[The effect of Staphylococcus toxin on the electrophoretic mobility and the value of zeta-potential of erythrocytes of the BALB strain mice]. In experiments in vitro staphylococcus toxin caused a reduction of the electrophoretic mobility and of the zeta potential of the erythrocytes of the BALB line mice; the extent of this reduction depended on the duration of incubation of the erythrocytes with the toxin. The washing of erythrocytes from the toxin after the incubation led to the restoration of the zeta potential and the electrophoretic mobility to 95% of the initial value, this pointing to the sorption interaction of the toxin with the erythrocyte membranes.


[The mechanism of immune alteration of leukocytes]. The effect of properdin, lysozyme and complementary activity of the blood serum on the degree of immune alteration of leukocytes was revealed on the clinico-experimental material. In the leukocytolysis a neutrophil apparently serves as a mechanical substrate. It is likely that the cytophilic organic antibodies conditioned the indirect variety of leukocytolysis.


[Experimental study of susceptibility and infectious sensitivity to tularemia of the lemming (Dicrostonyx torquatus Pall]. Complex study demonstrated high susceptibility and infectious sensitivity of Dicrostonyx torquatus Pall. to the causative agent of tularemia, and its reference to the 1-st group of mammals (according to Olsufiev).


[Capsule formation in Staphylococcus aureus of hospital origin]. The authors elaborated suitable conditions for cultivation of freshly isolated Staph. aureus, which offered a possibility of detection among them of a high percentage (75.2) of capsular cultures. It was shown that when grown in serum semifluid agar capsular staphylococci formed diffuse colonies of three different types. No correlation between the presence of the capsule, on the one hand, and the absence of the flocculus-forming factor and resistance to the type bacteriophage, on the other hand, was revealed in the Staph. aureus strains.


[Clinical cases of food poisoning caused by NAG-vibrios]. On the basis of bacteriological and serological studies carried out during two outbreaks of food poisoning it was found that the disease was caused by NAG-vibrios of the I Heiberg group, serotypes 5 and 34 after Sakazaki. The disease was accompanied by isolation of NAG-vibrios from feces and the washings from the stomach, it was characterized by symptoms of acute gastroenteritis and enteritis of mild and moderate severity. The incubation period lasted from 3 to 30 hours. There was an increase in the agglutinin titres to homologous strains of NAG-vibrios. Of the 6 strains tested 4 proved to be enteropathogenic in intraintestinal infection of rabbits in doses of 10(5) microbial cells.


[Various aspects of the seventh cholera pandemic]. Problems on epidemiological surveillance over cholera are elucidated; recommendations elaborated at the meeting in Madrid in 1975 are given. Data on cholera morbidity on different continent in 1961-1975, with indication of the number of countries which sent their reports to the WHO, are presented.


[Peculiarities of immunological response to the administration of Vi-antigen in patients suffering from typhoid fever and in experimental animals]. Vi-antigen parenterally administered into the organism could be revealed on erythrocytes with the aid of inhibition of erythrocyte sedimentation reaction with immune Vi-serum. Patients with typhoid fever displayed positive results in 53.8% of cases. There were differences in the incidence of detection of the Vi-antigen in August and Wistar rats conditioned by theigenotype and due to the different capacity of their erythrocytes to sorb this antigen. Peculiarities of immunological response to the Vi-antigen administration depended on its sorption by erythrocytes in the organism and were the same in patients with typhoid fever and in the linear animals. A decreased capacity of erythrocyte to sorb Vi-antigen induced its more rapid elimination from the organism and caused a weak production of specific antibodies; this should be taken into consideration in immunotherapy of typhoid fever.


[Morphological and histochemical characteristics of the organism's reaction to administration of Cl botulinum toxin. IV. Cytochemical changes in the cells of the mesencephalic nucleus of trigeminal nerve following administration of Cl. botulinum type B toxin]. After the administration to guinea pigs per os of 1 Dlm of botulin toxin, type B, a change of the RNA synthesis in the nucleoli and DNA depolymerization in the nuclei was observed in some of the cells of the mesencephalic nucleus of the trigeminal nerve. An increase in the activity of succinic dehydrogenase and of acid phosphatase coursed without any necrotic processes in the cells. Basing upon the changes in the activity of succinic dehydrogenase in the neurons of the mesencephalic nucleus a conclusion was drawn that hypoxia began to develop at the period of appearance of paralyses of the limbs and reached its maximum in myasthenia.


[Histological and histochemical changes in the kidneys of rabbits immunized with Cl. botulinum toxoid type B in combination with blood loss]. Immunization of rabbits with increasing doses of Cl. botulinum toxoid, type B, led to the development in the kidneys of a focal intracapillary productive glomerulonephritis, and also of productive endo- and perivasculites. Blood letting (in the amount of 1% of body weight) aggravated the morphological picture of the affection on account of supervention of the alternative and exudative components. At the same time blood letting led to reduction of the NAD-diaphorase, succinic dehydrogenase and glucose-6-phosphatase activity in the epithelium of the proximal portions of the nephrons.


[The spread of parahemolytic vibrios in humans in the Burgass Region (Bulgaria)]. The presence of parahemolytic vibrios in the water of the Black sea and also in other water bodies, in the hydrobionts, and later in the secondarily contaminated meat products was demonstrated in 1968. In 1973 gastroenteritis caused by parahemolytic vibrios became widespread; 126 cases were confirmed bacteriologically, and 3 cases were found to be carriers. The infected food products were eliminated, and no more cases of the disease were revealed in 1974.


[Bacteria of the citrobacter genus as one of the possible indeices of dysbacteriosis in intestinal diseases]. A study of the incidence of detection of bacteria of the Citrobacter genus in chronic intestinal diseases with the clinical and bacteriological manifestations of dysbacteriosis indicated that the mentioned conditioned pathogenic bacteria were revealed with the same frequency as bacteria of the Proteus genus which served as the commonly accepted index of intestinal dysbacteriosis. Comparative analysis of the intestinal microbial flora of the patients led to a supposition that bacteria of the Citrobacter genus could be found not only in the associations with other microbes, but also as a definite individual group of bacteria during the infectious disease and antibiotic therapy in case of disturbance of normal intestinal biocenosis; this could occur even in the absence in these patients of the known bacteriological indices of dysbacteriosis, thus becoming one of its manifestations.


[Carrier state of the causative agents of infectious diseases and its significance in the development of the epidemic process]. Carrier state of the causative agents of the infectious diseases is regarded as a universal phenomenon in infectious pathology. Immunological mechanisms of this phenomenon are discussed. On the basis of analysis of an epidemic process in the streptococcus and staphylococcus infections, and also in influenza and acute respiratory diseases the author formulated the concept on the genotypical and phenotypical nonhomogeneity of the interacting species of the organisms--the parasite and the host. The action mechanism on the epidemic process of the "mixing factor" of humans was shown.


[Immunoreactivity to the products of normal microflora. I. Observations on stability of the level of normal human antibodies to common antigens of enterobacteria]. A four-fold (in the course of one year) examination of the blood sera was carried out in 81 children aged under 11 years with the aid of the indirect hemagglutination reaction permitting to record 7S-antibodies to common intracellular protein antigens of enterobacteria. In 64 cases (79%) the antibody titres remained constant for one year. Variations in the titres were seen in 17 cases and were not over two (14.8%) or four-fold (6.2%) serum dilutions. Results of observations pointed to marked stability of the individual levels of immunoreactivity to the antigenic products of normal automicroflora constantly present in the organism.


[Use of ADT-toxoid with decreased antigen content for the immunization against diphtheria and tetanus of children with contraindications to the inoculation of APDT vaccine. I. Revaccination of children with allergic reactivity]. A single inculation of ADP-toxoid with diminished antigen content (5 Lf of diphtheria and 5 BU of tetanus components) for diphtheria and tetanus revaccination of children aged from 1 to 11 years with allergic reactivity provided a marked immunological efficacy with an insignificant reactogenicity. The revaccinating effect was also marked in case of a prolonged lapse of time--up to 10 years (observations period) from the last vaccination. Children with allergic reactivity with contraindications to the administration of APDT vaccine and APDT vaccine and ADT-toxoid of conventional composition can be effectively revaccinated with ADT-toxoid with decreased antigen content on condition of careful clinical observation.


[Peculiarities of carbohydrate metabolism in rabbits following prolonged immunization with viral antigens]. Prolonged, for a period of 5 cycles, immunization of rabbits with tick-borne encephalitis virus, reproduced in the brain of albino mice, caused diabetogenic reaction of the carbohydrate metabolism. It was expressed in hyperglycemia, reduction of hexokinase activity and of glycolysis of hepatic tissue and activation of phosphorylase, glycogenolysis and pentous way of carbohydrate transformation. Metabolic changes were accompanied by a reduction of insulin activity of the immunized rabbit serum. An analogous administration of a more pathogenic virus (of western equine encephalomyelitis) led to changes (equal in value) in the functional condition of the pancreas with much lesser shifts in the biochemical idices of the carbohydrate metabolism.


[Methods of assessment of the epidemic process intensity]. For a more complete and proper assessment of the intensity of the epidemic process in infections with polymorphic clinical picture it is suggested, that, along with morbidity analysis one should calculate the affection level and the ratio of the manifest and inapparent forms (infection carrier forms). For this purpose suitable formulas of calculation are recommended. A possibility of the use of this method for evaluation of the intensity of the infectious process in various groups of persons, depending on age, season, etc., and also for the assessment of the efficacy of antiepidemic measures in dysentery and other infectious diseases was noted.


Essential fatty acids and prostaglandins. Arachidonic acid takes part in a number of complicated enzymic processes in which not only the prostaglandins but also the intermediate products of their biosynthesis have important physiological effects. The prostaglandin-synthesizing system can convert a large number of nonnatural substrates, leading to the formation of substituted prostaglandins, some of which have interesting pharmacological properties. The prostaglandin-synthesizing system is found both in the higher animals and in lower animals such as the corals and mussels. So far there have been no indications that this system occurs in the plant kingdom, even in those plants which are able to produce arachidonic acid. It is attractive to assume that this arachidonic acid-prostaglandin system functions as a regulator of certain membrane functions for which there is no parallel need in the plant.


Prostaglandin endoperoxides and thromboxanes: role in platelets and in vascular and respiratory smooth muscle. 1. Two groups of unstable (t 1/2 = 5 min) endoperoxides, PGG and PGH compounds, have been isolated and shown to be precursors of the prostaglandins. 2. A new group of compounds (thromboxanes) derived from the endoperoxides has been discovered. Thromboxanes have so far been found in platelets, leucocytes, lung tissue, spleen, kidney and umbilical artery. In platelets the thromboxane constitute the major products derived from the endoperoxides. 3. A highly unstable (t 1/2 = 30-40 s) intermediate, thromboxane A2, between the endoperoxides and thromboxane B2 has been detected. Structural work indicates that it has a bicyclic oxaneoxetane structure. 4. Thromboxane A2 induces platelet aggregation and causes contraction of the isolated rabbit aorta. Rabbit aorta contracting substance (RCS) discovered by PIPER and VANE consists mainly of thromboxane A2 and to some extent of the endoperoxides PGG2 and PGH2. 5. Endoperoxides and thromboxanes are essential for platelet aggregation. Platelet cyclo-oxygenase deficiency gives rise to a hemostatic defect due to an abnormal release mechanism. 6. The endoperoxides have unique actions on vascular and air-way smooth muscle. The effects are not due to conversion to the stable prostaglandins (PGE, PGF etc). 7. The biologically active compounds formed from polyunsaturated fatty acids via the cyclo-oxygenase catalyzed pathway can be divided into three groups depending on the stability, viz. the stable prostaglandins (PGE etc.), the endoperoxides (PGG and PGH) and the thromboxanes.


The effects of linoleic acid and prostaglandin E1 on arterial thrombosis. The effects of dietary linoleic acid on arterial thrombus formation in rats were compared with the inhibitory effect of intravenous or intraaortic administration of PGE1, a potent inhibitor of platelet adhesion and aggregation. The "rat aorta-loop" model proved to be a useful method to induce a stable thrombus, obstructing the aortae of standard-fed rats with an obstruction time (OT) of about 96 h. Increasing the amount of dietary linoleic acid from 2.5 cal% to 30 cal% doubled OT to about 200 h. A constant intravenous PGE1 infusion of 10 mug/h increased OT significantly from the control value of 126.6 h to 160.1 h. When the same amount of PGE1 was infused intraarteriallu, the increase in OT was higher and doubled to 255.7 h. Using the "Filtragometer method" - in which platelet aggregatibility is measured in flowing human venous blood - a significant decrease in platelet stickiness was found in a group of patients consuming 12 cal% linoleic acid as compared to a similar group of patients with only 4 cal% linoleic acid in the diet. As similar results were obtained in patients with diabetes mellitus and in survivors of a myocardial infarction, increasing the amount of dietary linoleic acid may be of great therapeutic value for patients at risk of arterial thrombotic processes. These data support the hypothesis that part of the excess of dietary linoleic acid can lead to increased PGE1 concentrations.


Prostaglandins and polyunsaturated fatty acids in heart muscle. 1. Dietary lipids modify fatty acid composition of cardiac lipids. Polyunsaturated fatty acids replace less unsaturated fatty acids in phospholipds. 2. Mortality following isoproterenol-stimulation increase with decreasing amount of arachidonic acid in cardiac phospholipds. 3. In normal human heart muscle the ratio of essential, omega-6/nonessential, omega-3 fatty acids diminshes from age 17 to age 50 years. 4. In sudden cardiac death the ratio of prostaglandin substrate, C20:4, to prostaglandin inhibitor, C22:6, is frequently much higher than expected.


Comparative effects of prostaglandins E1, E2, A1, F1 alpha and F2 alpha on the resistance of coronary vessels during intracoronary administration. The effects of prostaglandins E1, E2, A1, F1 alpha, and F2 alpha on the coronary vascular resistance during intracoronary administration were studied in anaesthetized, open-chest dogs. PGE1 in doses of 0.1 - 3-10 mug/kg in single intracoronary administration produced a potent and comparatively long-lasting direct decrease of the resistance of the coronary vessels and a decrease in the systemic arterial pressure. The PGE2 and PGA1 actions on the coronary vessels were less potent. At variance with PGE1 and PGE2, the hypotensive effect of PGA1 is more expressed than its action on the resistivity of coronary vessels. PGE1 alpah and PGF2 alpha do not show any significant influence on the resistivity of the coronary vessels. The results of the investigations also permit to establish a correlation between the chemical structure and action of prostaglandins on the coronary vessels and to conclude that one of the most important functional groups that determines the prostaglandin action on the coronary vessels most decisively is the keto-group at C-9 of cyclopentane ring. As coronary dilatator agents in anaesthetized dogs, the activity of the prostaglandins ranged in the order E1 greater than E2 greater than A1 greater than F1 alpha greater than F2 alpha.


Action of prostaglandins on heart arrhythmias. Depending on the type applied, prostaglandins have different cardiovascular effects both with regard to blood pressure and inotropic action. Results from experiments on animals show that the antiarrhythmic effect seems to be relatively uniform. So far our own clinical investigations have been carried out on 18 patients with disturbances of the heart rhythm predominantly due to organic causes. The response to PGF2 alpha infusions in dosages of 0.5-3.0 mg was not uniform. At constant heart rates, transitory regression of distrubances in the heart rhythm occurred, most pronounced in ventricular extrasytoles. Positive results became particularly evident in patients suffering from myocardial infarction, partially coinciding with the administration of cardiac glycosides. The antiarrhythmic effects cannot be explained by non-specific quinidine-like actions which was also confirmed by the lacking prostaglandin action on the diastolic stimulus threshold.


Cardiac actions of arachidonic acid.

Cardiac actions of arachidonic acid. The cardiac actions of arachidonic acid (AA, C 20:4), the precursor of prostaglandin E2 (PGE2) and F2 alpha (PGF2 alpha) were studied in isolated atria and papillary muscles of guniea-pigs as well as canine Purkinje fibers. In contrast to the cardio-depressant actions of some short and long-chain fatty acids (octanoate, oleate) AA (10(-6)-10(-4) M) increased sinoatrial rate and contractility in guinea-pig atrial preparations. This cardio-stimulant action of AA was accompanied by an increase in the amplitude and maximum rate of rise of the intracellularly recorded atrial action potential. Some increase in the resting membrane potential and a slight prolongation of the action potential duration could also be observed. AA did not induce any pace-maker activity in isolated papillary muscle of guinea pigs or in isolated Purkinje fibers. Similarly to AA, PGE2 and PGF2 alpha (2.1-10(-8)12.1-10(-5) M) were also found to increase atrial rate and contractile force. The stimulating actions of AA were reduced by application of high concentrations of indomethacin (5-10(-5) M).


Effects of prostaglandins in canine endotoxin shock. Endotoxin shock was produced in healthy, adult mongrel dogs by the intravenous injection of 1.5 mg/kg of E. coli endotoxin. The 24 hour survival of untreated animals was 34% and was not enhanced by volume replacement with low molecular weight dextran. Treatment with dextran and prostaglandin A1 or E1, although effecting significant hemodynamic improvements, did not increase survival.


The etiology and pathogenesis of atherosclerosis. A series of photomicrographs shows that deposits of cholesterol crystals in the walls of arteries as well as in other tissues have a strong irritative effect on collagen tissue. This process is probably the very cause of the atherosclerotic plaque. Cholesterol deposits are especially abundant in hypercholesterolemia. This may be due to various factors, the most important of which is a faulty diet containing too much saturated fat. Replacement of such fat by polyunsaturated fat will lower the blood cholesterol level. From preventive point of view, it would appear advisable to change the dietary habits of the entire population in countries with a high frequency of atherosclerotic vascular diseases.


Stimulation and inhibition of renal PG biosynthesis: effects on renal blood flow and on plasma renin activity. In the present investigation prostaglandins (PGs) were determined in the renal cortex and the functional effects of the renal PGs on renal hemodynamics and on the renin-angiotensin system were evaluated. The levels of PGs, determined by mass fragmentography, were in the medulla: PGE2 4.36 +/- 1.04 mug/g and PGF2 alpha 1.6 +/- 0.50 mug/g and in the cortex: PGE2 0.19 +/- 0.04 mug/g and PGF2 alpha 0.21 +/- 0.07 mug/g. The unequivocal demonstration of PGs in the renal cortex forms a biochemical basis for a role of PGs in the regulation of renal hemodynamics and of the renin-angiotensin system.


Clinical application of prostaglandins in obstetrics and gynecology. After a short discussion on the development of the prostaglandins, the application especially of F2 alpha and E2 in the field of obstetrics and gynecology were debated. Predominantly clinical data on the induction of abortion in the second trimester of pregnancy as well as the induction of labour at term are reviewed. The individual methods of application are discussed. Additionally, possible future areas of use, such as the regulation of menstruation and new prostaglandin derivates are discussed.


Postoperative wound infection in 32,000 clean operations. The frequencies of postoperative wound infection in clean operations have been registered at a county hospital (Falun, Sweden) during a 15-year period (1958-1972). A total of 64,000 operations were done and about 32,000 of these have been registered as clean operations. In 1968 the wards were transformed from 12-bed rooms to 5-bed rooms and the operating theatres were rebuilt. All premises were equipped with high pressure air ventilation including lock system. Furthermore, a new intensive care unit and a new awakening unit were built. The overall postoperative wound infection (sepsis) rate during this 15-year period was 1.7 percent. The infection rates in the 5-year period before and in the 5-year period after opening of the new buildings were the same: 1.6 percent. After adding postoperative infections (sepsis) and postoperative inflammatory reactions, the total rates were almost the same: 4.1 percent before and 4.2 percent after. A slight rise in staphylococcal infections has been registered. This rise might suggest that the expected positive effects of the new buildings have been counteracted by other exogenous and endogenous factors. Some of these factors have been discussed (rise in mean age etc.). On the basis of this investigation it seems likely that the management (in all respects) of the surgical patients is still of the greatest importance, regardless of fine new buildings.


Urinary phosphate excretion after total thyro-parathyroidectomy in thyroid carcinoma. It is well established that deficiency of parathyroid hormone causes an increase of the tubular reabsorption of inorganic phosphate. Earlier evaluations, however, are based on animal experiments or in clinical studies where the degree of a postoperative hypoparathyroidism is not clearly defined. Eight patients with thyroid cancer have been operated on with a total thyroparathyroidectomy, biopsy of all identified parathyroids and autotransplantation of these glands. During a postoperative period of 3-5 days there is an arrest of the paraghyroid function before the glands have a new vascular supply. The levels in the serum and urine of calcium, phosphate, sodium, potassium, magnesium, chloride and creatinine were recorded. The excretion of phosphate diminished to unmeasurable values, indicating a complete tubular reabsorption of phosphate. After 5-6 days, when the autografted parathyroids began to function, phosphate reappeared in the urine together with a slow increase in S-Ca. No substitution with calcium or vitamin D was given in the postoperative period.


Embolization to the superior mesenteric artery. Arteriography and embolectomy in four cases. Four patients were operated upon for embolization to the superior mesenteric artery. Preoperative arteriography was performed in all cases. Two patients who had had symptoms prior to operation for six and eight days respectively died postoperatively. One patient died 2 1/2 months after the operation from her underlying heart disease, while one patient was discharged with intact bowel function. The value of preoperative arteriography and the principles for surgical treatment are discussed.


Thigh neuralgia as a symptom of obturator hernia. A material of 8 patients with obturator hernias is presented. In 7 of the patients a neuralgic pain in the thigh was the main symptom and a hyperesthesia in the cutaneous segment of the obturator nerve was also common. A recognition and an early operation of this condition is important, since the mortality is high when an intestinal obstruction has complicated the disease.


Pathophysiology in the acute afferent loop syndrome. A study in rats. The afferent loop syndrome, i.e. occlusion of an afferent intestinal loop after a Billroth II partial gastrectomy, was induced in rats. After various time intervals the animals were killed and the haematocrit and serum osmolality were determined. The content of the occluded loop was analysed with respect to volume, bacterial flora and osmolality. In some cases a sample of the content was incubated at 37 degrees C and the osmolality determined at regular intervals. Groups of animals were studied in this way after 30 min or 1, 4, 8 or 12 h of occlusion. The haematocrit rose with time after the occlusion. The osmolality of the plasma and of the content of the occluded loop did not increase. The volume of fluid in the occluded loop increased continuously with time--from an average of 0.5 ml in the control cases to 6.1 ml after 12 h of occlusion. Experiments in vitro showed that the initial osmolality of the content of the loop was 300 mOsm. After incubation of the samples this increased by 43 to 146 percent. The bacterial content of the loop, including Clostridium perfringens, increased significantly. The results indicate that a marked breakdown of substances takes place in such an occluded intestinal loop, which increases the osmolality. As a result fluid is immediately attracted to the loop to keep the osmolality constant. A combination of this fluid increase due to osmosis and contractions of the intestinal wall leads to a pressure in the occluded loop which considerably exceeds the pressure in the common bile duct due to secretions from the pancreas and liver.


Surgical treatment of perforations of the sigmoid colon. Previous reports show evidence that perforation of the sigmoid colon with diffuse peritonitis, when conventionally treated (i.e. by suture, drainage, and proximal defunctioning colostomy) is associated with a high mortality. Recent investigations, however, indicate that the mortality can be lowered considerably if acute resection or exteriorization of the affected segment of the bowel is performed. Fifteen patients with perforated lesions in the sigmoid colon associated with diffuse peritonitis were treated with drainage and right transverse colostomy during the 10-year period 1963-72 with five deaths. In comparison, during the last years, ten patients with perforation and diffuse peritonitis were treated with acute resection or exteriorization of the affected segment of the bowel without any mortality. Though the two patient series are not completely comparable, the results imply that removal or exteriorization of the affected bowel is to be preferred in the surgical treatment of most perforated lesions in the sigmoid colon, even if the perforation is associated with diffuse peritonitis.


Transomental strangulation. A rare case of an internal hernia. A case report of a transomental herniation of the small intestine is given. Thirty-six cases of this type of intestinal obstruction are reported in the literature. The history was that of an intestinal obstruction and the diagnosis was settled at laparotomy, as in most of the reported cases. The etiology is obscure by (a) abdominal trauma, (b) inflammation, and (c) congenital defects in the omentum appear to be the most likely.


The spread of viral hepatitis in Italian dialysis units. In order to evaluate the spread of viral hepatitis to dialysis patients and staff, 83 out of the 134 dialysis units operating in Italy at present were surveyed. The results were statistically evaluated. Of the 81 Italian centres surveyed, 66 were affected by viral hepatitis. There were 450 cases of infection among patients on regular dialysis treatment (9.7% of all dialysed patients). Of these 450, 163 had icteric viral hepatitis (116 HBsAg positive), 145 has non icteric hepatitis (100 HBsAg positive) and 142 were HBsAg carriers. The mortality rate among the dialysis patients with hepatitis was 9.1% with death occurring most frequently in icteric cases. Of the 133 cases of viral hepatitis observed among medical and nursing staff, 103 of these were HBsAg positive. Moreover, there was a higher risk of hepatitis infection observed in patients on regular dialysis treatment by multi-patient central system plate dialysers, in carriers of exteriorized arteriovenus shunt in patients who were submitted to frequent dialysis sessions and haemotransfusions.


Stimulation of hepatic RNA synthesis by phenobarbital. Administration of phenobarbital in rats is followed by an in vitro stimulation of hepatic ribosomal protein synthesis. The increase of polyribosomes which is also observed is paralleled by a phenobarbital-dependent enhancement of uridine incorporation into ribonucleic acids. Sedimentation of either ribosomes or ribosomal RNA extracted from ribosomal subunits through sucrose gradients reveals stimulation by phenobarbital of 3H-uridine incorporation into messenger RNA as well as into ribosomal RNA. These experiments together with the findings of stimulation of RNA polymerase activity and blockade of the effects of phenobarbital by the administration of Actinomycin D indicate a primary action of phenobarbital on RNA synthesis.


Methanol-soluble glycoproteins in human liver and brain. After disc electrophoresis on 15% polyacrylamid gels of water-soluble and theta 50% methanol-soluble proteins from human liver or brain we have found two protein bands which have not been described in the literature before. These two protein fractions have been eluated from a Concanavaline A-Sepharose column. In this paper we present data showing that one of the two protein fractions is found in greater amounts in human liver than in human brain.


Liver blood flow. metabolic heat production and body temperature before, during and after phenobarbitone administration. Using an improved apparatus based on Grayson's principle of internal calorimetry, conductivity as a measurement of liver blood flow and metabolic heat production in the liver as a measurement of liver tissue metabolism were recorded in the conscious rat before, during and after phenobarbitone administration. In addition, rectal body temperature was measured under the same experimental conditions using an electronic thermometer. Liver blood flow increased by a mean of about 100% above control values in rats treated with phenobarbitone 30 mg/kg daily for 4 days. In contrast, changes in metabolic heat production showed no clear tendency and remained more or less constant. However, body temperature rose significantly during phenobarbitone administration up to 38.9% C and this temperature changes showed the same time course as liver blood flow and parameters of microsomal enzyme activity. Therefore it is suggested that metabolic heat production is not a very important factor in influencing the increase in liver blood flow following enzyme induction. On the other hand the increase in body temperature observed in the present study might be an important factor in influencing the increase in blood flow to the liver.


Liver fascioliasis, a "mysterious" disease. Report of a case. A case of human fascioliasis diagnosed during the invasive phase is presented. The disease was suspected clinically and the findings of immunological, laparoscopical and histological examinations confirmed the correct diagnosis.


The retention of bile constituents in biliary stasis. The biliaro-lymphatic reflux of bilirubin and bile salts is present in the dog only in the first 24 hrs of complete biliary obstruction. The reflux has been demonstrated also in rats, but it is absent in dogs with functioning gall bladder, when bile pressure does not attain the "secretory pressure". Alkaline phosphatase and GOT do not regurgitate in bile stasis into the lymph. The biliaro-lymphatic reflux of bile pigments and bile salts stops in consequence of the cessation of their secretion into the bile. This is corroborated by the observation that in the rat the excretion of BSP into the bile ceases after a prolonged bile stasis. The uptake by the hepatocytes of BSP and other substances does not stop, however, after several days of complete biliary obstruction. The bile constuents are released in prolonged bile stasis from the liver cells directly into the sinusoidal blood. This is probably the consequence of some damage of the cell function.


[The significance of the veins for transcapillary fluid balance]. Various results from experimental as well as from theoretical studies challenge the classical concept of the Starling hypothesis of fluid balance between blood and tissue. Although most of these considerations are based on work with animal preparations, the following points appear to be applicable to human physiology: 1. The values of pressure as measured directly in venules, prohibit reabsorption of fluid from the interstitium. In addition, due to the increased permeability of the venular vessel wall to macromolecules, filtration of plasma proteins takes place at the venular end of the capillaries. 2. The overall permeability of the vessel walls to the proteins, is up to 20 times smaller than was previously assumed. Therefore, the total amount of filtered fluid is reduced to the volume range of the lymphatic transport. 3. The total amount of filtered proteins is brought back to the blood circulation via the lymphatic system. Thus, there is unidirectional slow movement of macromolecules with free fluid from the capillaries across the interstitial space toward the terminal lymphatics. However, exchange of small molecular substances such as water, gases, minerals and sugar by diffusion, is practically unlimited by the blood-tissue barrier. 4. As a practical example, the pressure values in the superficial veins of the human leg clearly exceed the limits for reabsorption of fluid from the tissue. The absence of edema in the normal human legs remains unexplained, if the lymphatic transport is not taken into account as an essential part of the system. Thus, the dynamic equilibrium of the fluid exchange is disturbed, either by increased transcapillary filtration (e. g. increase in venous pressure or microvascular permeability), by impaired lymphatic capacity or by a combination of these two factors.


[Lymphological aspects of the pathophysiological basis of edema formation]. A merely lymphological analysis of edema, would be as onesided as a merely phlebological, a merely nephrological, or a merely endocrinological analysis. Heart, arteries, veins, microcirculation, lymphatics, and the whole mesenchym, with the connective tissue ground substance and the cells, form an inseparable unity. Only a complex analysis which considers all connections, makes it possible to unterstand the various edemas--in favour of a reasonable therapy.


Stimulation of lower esophageal sphincter pressure (LESP) by cimetidine -- a double-blind study. Using the rapid pull-through technique the effect of 400 mg cimetidine perorally on lower oesophageal sphincter pressure was studied in a controlled trial in 14 subjects. Cimetidine caused a significant rise of the integrated basal pressure. The response to 0.6 mug/kg pentagastrin was augmented by cimetidine whereas under atropine sulphate infusion this effect could not be demonstrated. Cimetidine may act on LESP by blocking inhibiting receptors.


Autoradiographic study with 14C-labelled pentagastrin in the rat. An autoradiographic light-microscopic study was made to attempt to follow the course of metabolism and elimination of glycine labelled pentagastrin in rat. It was found that even 10 seconds after the intravenous injection of 14C-labelled pentagastrin, activity can be observed in the liver and in connection with the parietal cells of the gastric mucosa; the radioactive grains remain in the hepatocytes for a prolonged period, whereas they disappear very quickly from the stomach. Activity can be detected in the renal tubuli 2 minutes or more after labelled pentagastrin administration.


[The value of venous capacity measurements in the diagnosis of venous function]. Phlebography, has been compared with the results of venous capacity measurement taken from 150 patients, 76 women and 74 men. The measurement of the venous capacity is a appropriate screening method to determine any irregularities of the deep venous hemodynamic. It is possible to attain a more exact indication for the phlebography. Maximum expression of the values of venous capacity, is however, contained in the functional periodical controls of the pathologic processes of the deep venous system.


Vagotomy and experimental duodenal ulcers. Truncal vagotomy prevents secretagogue-induced duodenal ulcers in the rat. Without a drainage procedure it results in gastric stasis which predisposes to hypersecretory produced gastric ulcers.


[The effect of tissue resistance on rheography]. Herewith a formula for the computation of the relative stroke volume in limbs is derived, taking into account the differences between the electrical resistivity of blood and tissues, respectively. In order to properly estimate the influence of this difference in resistivity, the appropriate variables were measured in 20 different persons. Results from these tests indicated that the value for tissue resistivity, on the average, was about 30% above that of the resistivity of blood. Consequently, computations of the stroke volume in limbs that neglect this essential difference in resistivity, contain a systematical error in measurement, amounting to 30%. It is the purpose of this paper to portray a method of considerably reducing this error, without the necessity--in each specific case--to measure blood resistivity.


Endoscopic and surgical treatment of the colonic polyps. Endoscopic surgery of the gastrointestinal tract has become in the last years one of the most important procedures in the treatment of some digestive diseases. In view of the positive results obtained by means of the diagnostic coloscopy, an extension of this modern method for therapeutic purposes has been considered appropriate. At the Digestive Endoscopy Centre of the 3rd Surgical Clinic of University of Rome, 1337 coloscopies have been carried out, of which, 1236 were routine, 86 urgent and 15 intraoperative cases. Operative coloscopy was carried out in 310 routine and 16 urgent cases. From a technical point of view, operative endoscopy in the colon is particularly difficult and requires considerable experience. It is our opinion that this method can give useful and interesting contributions to the diagnosis and therapy of some lesions of the large intestine, provided suitable surgical conditions are available with all the necessary equipment. Following these criteria, it is possible to avoid complications such as haemorrhage and intestinal perforation. Our experience in this field is undoubtedly positive, since there has not been any complication but it is necessary to perform operative coloscopy under fluoroscopic control. With regard to coloscopic polypectomy it is the opinion of the authors that this procedure has a therapeutic value in benign polyps and when superficial cancerization has not invaded the muscularis mucosae in the head of the polyp.


[Phlebographic diagnosis of leg edemas]. The most important preliminary examinations are: the visualisation of the valves of the veins by retrograde strain phlebography, determination of the degree of the recanalisation of the deep veins and the outflow of the pump of the calf muscle. Venous edemas: congenital absence of the valves of the veins, intramural thrombosis, postthrombotic edemas, division into four degrees, combined venous-lymphatic edemas.


[Detection of venous occlusions of the leg and pelvis by means of nuclear medicine]. Based upon experience with 563 patients, the 131 I fibrinogen test has proven a reliable method for the diagnosis of acute leg vein thrombosis. Investigations correlated by means of roentgenological phlebography performed by routine technique in 83 patients showed similar results in 77% of the cases. Analyzing the negative results of 23%, we consider 19% of the discrepancies to be due to faulty phlebographic and 4% to faulty fibrinogen results. Phlebography may reveal false positive results in recurrent thromboses and false negative results in thrombosis of the lower legs. The fibrinogen test may reveal false positive results after trauma, fractures, and in cases of superficial phlebitis and arthritis. Pelvic venous occlusions are detectable by radionuclid venography. This method is non-invasive (injection of 99m Tc albumin particels or microspheres in less than 1 ml, by means of a very thin needle into a dorsal foot vein). A lung scan is obtained in every examination. The results conformed in 89% of 250 patients with those obtained from Doppler ultrasonic investigations. Two thirds of all pelvic vein thromboses were located on the left side. Perfusion defects of the lungs were probably caused by pulmonary embolism (lung scanning) and were found in an average of 54% of all leg and pelvic vein thromboses (in thrombosis of the lower legs in 35%, of the thigh in 57% and of the pelvic vein in 70%). These figures are in good conformity with pathological-anatomical data concerning the frequency of pulmonary emboli and infarctions in leg and pelvic vein thrombosis.


The function of the exocrine pancreas after exogenous and endogenous stimulation in Billroth II patients. Maldigestion phenomena in patients subjected to a Billroth II (B II) operation are in part attributed to an atrophy of the pancreas due to inactivity. In order to investigate this, a Lagerlöf tube was introduced under endoscopic control into the afferent loop, and the function of the exocrine pancreas studied after endogenous and exogenous stimulation. During endogenous stimulation of the exocrine pancreas by means of a Lundh test meal, no significant differences in the secretory pattern of the Billroth II patients as compared with healthy test subjects were found. In contrast, during exogenous stimulation, the output of trypsin and chymotrypsin in healthy subjects was significantly greater than in the B II patients. Since, in comparison with maximal stimulation, the endogenous secretin released by the jejunal mucosa in response to the intake of food, effects only approximately 25% of the bicarbonate production and endogenous pancreozymin effects some 50% of the enzyme output, the maldigestion phenomena observed in B II patients are inpart understandable.


The effect of pressure changes inside the antrum on lower esophageal sphincter (LES) pressure in man and dog. The pressure change inside the lower esophageal sphincter (LES) in response to pressure changes inside the antrum was investigated in man and in dogs with antral pouches. In dogs with innervated antral pouches a pressure increase of 20 cm H2O inside the antrum produced an increase in LES pressure of 14 +/- 7 mm Hg, whereas an antral pressure of 80 cm H2O caused a decrease of 26 +/- 12 mm Hg in LES pressure (x +/- SD). Truncal vagotomy abolished LES response to the various antral pressures. In dogs with denervated antral pouches antral pressure changes did not influence LES pressure. In the dogs gastrin levels rose due to antral pressure increase; this was less pronounced in the dogs with denervated antral pouches than in the dogs with innervated antral pouches. In man a short antral pressure increase revealed a decrease in LES pressure. This effect was not seen in patients after selective proximal vagotomy.


[Peripheral lymphangiopathies - 15-year follow-up]. 353 patients suffering with peripheral lymphangiopathies were observed. In 276 patients with histological examinations, 201 portrayed obliterative LAP. 85% were females, which indicate a ratio of nearly 1:4. The etiologic factors are unknown. A therapeutic trial with a combination of saluretics and small doses of corticoids, is discussed.


[Isotope diagnosis for the determination of lymphatic flow of the lower extremity]. A semiquantitative method using radiocolloids is described for the investigation of prefascial and deep lymphflow of the shank. The method indicated is simple. The low radiation dose permits its application in pediatrics. The separate investigation of deep and superficial lymphflow using radiocolloids is a valuable method for the study of impaired lymphflow in chronic lymphedema.


[Surgical treatment of acute thrombosis of the leg and pelvic veins]. Indications for thrombectomy in acute thrombosis of the deep veins of the pelvis and lower extremities are: 1. Phlegmasia coerulea dolens with imminent danger of venous gangrene. 2. All cases: a) with contraindications for a therapy with fibrinolysis, b) after therapy-failures with thrombolytic therapy, c) thrombosis of more than 3 days duration. 3. In cases associated with tumours or trauma. If a thrombectomy can only be partially achieved, or in cases with an old thrombosis, a temporary arteriovenous fistula is performed. In cases with phlegmasia alba and the inexistence of danger for an extremity treatment with fibrinolysis, this is preferable in the first three days after onset, if general conditions permit this treatment. Results of venous thrombectomies are particularly astonishingly good in phlegmasia coerulea and it is therefore mandatory to transfer all fresh cases of thrombosis of the deep veins of the peelvis and lower extremities to an angiologic center in order to differentiate cases for fibrinolytic therapy, from those which require surgical intervention.


[Compression treatment in venous and lymphatic flow disorders of the leg]. Based on our investigations, the mode of action of compression bandages is discussed ant the physiological and physical principles of this therapy are reviewed. The different basic forms of compression therapy, for example, non-elastic bandages, elastic bandages, use of foam rubber and sponge rubber inserts as well as compression stockings, are mentioned. The side effectes of compression therapy are treated and the indications for compression therapy in superficial and deep thromboses, postthrombotic syndrome and lymphedema are discussed.


[Therapy of lymphedema].

[Therapy of lymphedema]. The discovery of the role which histiocytes play in the extralymphatic proteolytic mastering of stagnating plasma proteins, renders possible a new, almost causal therapy of lymphoedema as well as of other high-protein oedemas. The effect of this therapy is proven by animal experimental, and has also been clearly demonstrated in secondary lymphoedema of the higher extremities after mastectomy.


Psychophysiological studies of a geographically defined population. In the Berlevag project attemps have been made at using psycho-physiological and cognitive measures as indexes of psychiatric morbidity.--With skin conductance response, psychotics and neurotics showed signs of autonomic inhibition compared with conduct disorders and normal controls. All groups except psychotics showed cognitive effects in conditioning. No differences between the groups could be established for stereotype indexes, but the Berlevag sample appeared to have unusual high stereotypy indexes. With word associations the patient groups were markedly different from controls, with most deviations in psychotics and least deviations in conduct disorders.--A comparison of word associations in samples of the Oslo and the Berlevag populations suggested that the associative network was very similar in the two populations. There are differences with regard to verbal fluency, response types and reaction times.--It is unresolved whether these differences measure psychiatric morbidity or reflect a culture-dependent character of the word association test.


New methods for determining suggestibility. New method for determining suggestibility is described which elicits anesthesia in the finger tips by verbal suggestion. Suggestion is applied during simultaneous tapping and the effect is evaluated by feelings in the active hand or fingers (besides changes in feeling) and by motor disturbance (inhibition). The first results are reviewed which indicate that though the method has a relatively high threshold it can disclose also some intergroup differences. We believe that this is an objective method, its objectivity is primarily due to the fact that the investigated subject cannot anticipate what kind of result the suggestion is supposed to yield.


An attempt to evaluate changes in heart rate in situations induce by symbolic stimuli in children. Ninetyfive 10 year-old pupils were shown 4 film scenes about first aid in accidents arousing anxiety about possible injuries and fear about the fate of the protagonists. Simultaneously with showing the film heart rate was recorded in the boys who had been previously divided in three groups with a different level of anxiety, according to their rating in the CMAS questionnaire. HR response was observed during the course of the whole film as well as in the sections related to the critical moments of the event -- the moments of injury. -- The mean HR values during projection of the film had a differently steeply rising tendency according to the groups with a different level of anxiety, however, interindividual HR variability as a whole was not influenced by the film. Mean group HR values around the critical moments of the story did not differ statistically significantly (they decreased moderately from the little anxious to the more anxious group). However, after a sufficiently effective scene the group of more anxious children exhibited a significant increase in interindividual variability.


Computer programs suitable for processing behavioral data characterized by alternation of two states. A program system is described which is suitable for processing behavioral and psychophysiological data characterized by alternation of two states (the transition between which is instantaneous). It is adapted for a LINC D.E.C. computer and is composed of a control program and several system programs computing different statistics and performing necessary input and output operations with the data.


[Activation-dependent characteristics of the electroencephalogram during visual information--processing: Results of an automatic interval analysis (author's transl)]. EEG signal from fronto-occipital derivation was recorded in 16 Ss during a mental performance test (modified "Konzentrations-Leistungs-Test" including four levels of performance). A balanced changer-over design was used. Interval histograms in four frequency bands (theta, alpha, beta-1 and beta-2 bands) were determined on the basis of peak detection. A total of 44 characteristics were derived and tested (multi-factor analyses of variance, multiple mean comparison and rank tests). Twenty eight of these characteristics were proved to be dependent on activation. In the visual information-processing performances chosen, it could be demonstrated that the intraindividual changes of the spontaneous EEG activity were related predominantly to the perceptual components of the performance. On the other hand, the influence of the performance rate and of the mental-arithmetic itself was of minor relevance. During higher activation an increase in the relative abudance of the theta-band activity was also observed.


[The orbitotemporal region in the cranium of Chelydra serpentina Linnaeus (Chelonia) and Lacerta sicula Rafinesque (Lacertilia)]. An analysis of the ontogenesis of the chondrocranium gives the following homologies in the skull of Lacerta and Chelydra: (see article). It is shown that the extracranial position of the cavum epiptericum in Lacerta corresponds to the stage of maximal development of the chondrocranium in Chelydra. But further development brings about a dermal sidewall in the orbitotemporal region, b,ilt up by descending parietal flanges which incorporate the epipterygoid. This not only allows the pila antotica to degenerate but also incorporates the cavum in the cranial cavity.


Effects of hypophysectomy and short- and long-term propylthiouracil treatment on the rat thyroid. The morphology and histology of the post-pharyngeal part of the gastrointestinal tract of the ferret were studied. The oesophagus was a distensible muscular tube. Its mucosa was lined by keratinizing stratified squamous epithelium. The muscle coat was striated throughout except mear the cardia. A cardiac sphincter was present. The stomach was morphologically and histologically very similar to that of man. The duodenum appeared C-shaped and had a mesoduodenum. The bile and pancreatic ducts formed a common duct in the wall of the duodenum. The sphincter of Oddi was present. Brunner's glands were present in the pyloric part of the stomach, and up to the common opening of the bile and pancreatic ducts in the duodenum. The intestine could be differentiated macroscopically and microscopically into small and large intestines. The small intestine distal to the duodenum formed coiled tubes suspended by a mesentery. It was not possible morphologically to differentiate jejunum and ileum. Histologically, however, the distal portion was identifiable as ileum by increasing numbers of goblet cells, and Peyer's patches in the submucosa. Villi were present in the mucosa throughout but there was no spiral or circular fold. The large intestine was a straight dilated tube lying in the left flank and extending from the splenic flexure to the anus in the median plane. It was suspended by a short mesocolon except for the rectal portion in the pelvis. The ileo-colic junction was differentiated morphologically and histologically. There was no caecum, appendix, taeniae coli or appendices epiploicae. The large intestine was not differentiated topographically into ascending, transverse and des


Effects of hypophysectomy and short- aing electron-microscopic study. The follicular architecture of the thyroid gland of the rat following experimentally induced states of hypo- and hyperactivity was investigated by scanning electron microscopy and the findings correlated with both light and transmission electron-microscopic observations. By scanning electron microscopy, the microvilli on the apical surfaces of the follicular cells showed the most striking changes; following hypophysectomy, the cells were flattened and the microvilli had decreased in both size and number, whereas following propylthiouracil (PTU) administration the epithelial cells were enlarged, and marked hyperplasia and hypertrophy of the microvilli was present. Of particular interest is that the changes observed following PTU appeared to be identical in short- and long-term PTU-treated rats. Similarly, the heterogeneity of the follicular cells observed within the follicles was maintained under the various experimental conditions. Although the functional significance of these observations is not quite clear, it appears justifiable to assume that a reduction of luminal surface area of the follicular epithelial cell may hinder, whereas an increase may facilitate transport process across the apical cell membrane.


Development of the squamosomandibular articulation in the Mongolian gerbil (Meriones unguiculatus). The early development of the squamosomandibular articulation in the Mongolian gerbil was investigated from its inception through the 8th postnatal day. Pregnant gerbils were sacrified beginning on day 18 through day 23 of gestation by chlorofrom inhalation and the fetuses were extirpated and decapitated. Neonatal gerbils, 1-8 days of age, were also sacrificed. The severed heads were frozen in a cryostat and sectioned at 14mum in frontal and transverse planes and stained in 1% aqueous Safranin 0. The anlage of the mandibular joint along with membranous bony deposits lateral to Meckel's cartilage in the vicinity of the presumptive body and ramus first appeared on the 18th gestational day. Condylar chondrogenesis occurred on the 20th prenatal day, and by day 22 of gestation chondrocytic hypertrophy was noted preparatory to osteogenesis. The presumptive articular disc was observed on the 21st gestational day while an upper and lower synovial cavity was discernible on the 22nd prenatal day. The squamosa and zygoma were first noted on the 20th postcoital day. There appeared to be a developmental lag from onset through completion of the gerbil squamosomandibular joint formation in comparison with that reported for the mouse and rat.


Lymph drainage of sinu-atrial node in man and dog. THE LYMPHATIC VESSELS OF THE SINU-ATRIAL (SA) node were investigated after injection of Indian ink plus gelatine in 62 canine and 31 human hearts, the latter of subjects aged between 21 and 80. Lymph was found to be chiefly drained from the SA node of the dog by a vessel which collected lymph near the left margin of the SA node and ran between the superior vena cava and the right circumference of the aorta into the left cardiac lymph collector and through it into the left cardiac node. Approximately in two thirds of cases this main lymph drainage was supplemented by smaller lymphatic branches running into the right traceo-bronchial nodes. In man, the main route of lymph drainage from the SA node is represented by one or two vessels which run to the right and upwards along the superior vena cava into the inferior tracheo-bronchial nodes (of the bifurcation), lying near the right bronchus. Little branches draining lymph into the cardiac collector are found rarely. It has become evident from histological sections that the lymphatic vessels run between the cells of the conduction system and the collagenous fibres of connective tissue and are not numerous.


[Crystallization of fibrils, chondroid and osseous mineralization in desmal osteogenesis and intervertebral disk]. We reported on similar findings concerning the intercellular substances in the early desmal osteogenesis in cattle fetuses and rats and in the intervertebral disc of cats. In 0oth regions fibrils change their structure. In early desmal osteogenesis the bone fibrils are synthetized by osteoblasts, derived from mesenchymal cells. Later the fibrillar structure is lost and substituted by a homogenous substance. Chondroid starlike mineral deposits which are composed of needles appear in the vicinity of the cells. The chondral needles are longer and smaller than those in the bone. Finally the chondral needles are removed by mineraloclasts. During the next step frbrils reappear. They are accompanied by needles in their longitudinal axis. In adult cat the fibrils of intervertebral disc cross directly in bone. The fibrils of fibrocartilage are partly swollen and escorted by starlike mineral deposits. Between the bone fibrils partly amorphous mineral deposits are found generally needle-like along the fibrils. The nucleation of minerals takes place at random. The crystal growth is correlated to the structure and composition of organic intercellular substances and their morphological shape differs correspondingly, being chondroid in the fashion of stars, amorphsus and osseous when in contact and parallel to the fibrils.


Study of motor units and arrangement of myons of human musculus plantaris. It was seen in ten specimens that their plantaris muscle had different sizes of myons, whicnother were found. The number of motor units of the plantaris was counted in five subjects after transverse section of the muscle and nervous fibers of each of them. Considering the number of motor fibers as 60% in each nerve, the average value of muscle fibers per motor unit was 372, which is quit a small number. The fact led us to think that the plantaris muscle has a very refined function.


Effect of compensating filters on the isodose charts of rat and guinea-pig phantoms irradiated with "fission-neutrons". Isodose charts were calculated for rat and guinea-pig phantoms exposed to a modified fission spectrum with a most probable energy of 1.3 MeV. Infinite tissue equivalent cylinders (r = 2.5 and 3.3 cm) and a plane source emitting neutrons according to a cosine distribution were assumed and an albedo code was used. Combined effect of (tissue-equivalent or polyethylene) compensating filters (or simply filters) and a bilateral irradiation or rotation was studied. Bilateral irradiation and the use of a filter resulted in a uniform irradiation of a rat phantom (Dmax/Dmin less than 1.15), while a uniform irradiation of a guinea-pig phantom could be obtained by the combined use of filters and rotation. If rotation is possible a Dmax/Dmin less than 1.05 ratio can be achieved. Filters + rotation should be used in all circumstances when geometrical restrictions do not prevent the installation of a rotation equipment. In this case bilateral irradiation + compensating filters are advisable. Unilateral irradiation of small laboratory animals (mouse, rat, guinea-pig) should be avoided.


Modified preparation of thiolsubtilisins and their purification on Agarose-mercurial column. A common procedure for the preparation of Novo and Carlsberg thiolsubtilisins is described which, particularly in the case of the Novo enzyme, involves modification of previous procedures so that preparations of higher yield and purity can be obtained. The serine enzyme and the protein degradation products, which are still present in the improved preparations and may interfere with some kinetic measurements, are removed by purification on an agarose-mercurial column.


Quantitative determination of methionine in proteins: gas chromatography of methylthiocyanate liberated by cleavage with cyanogen bromide. A rapid non hydrolytic method was developed for the estimation of methionine residues in peptides and proteins. The method is based on the gas chromatographic determination of methylthiocyanate liberated in the reaction of cyanogen bromide with the methionine residues. In contrast to the amino acid analyzer technique this method allows selective determination of methionine in the presence of methionine sulphoxide and sulphone. It was tested with both purified proteins and protein-containing crude samples (legume seeds) and was compared with different analyzer techniques.


Cervical myelopathy in rheumatoid arthritis. Preliminary analysis of a follow-up study of one hundred patient with rheumatoid arthritis has lead to the following tentative conclusions: AAS is a common complication of rheumatoid arthritis. The incidence of AAS correlates with the duration of the disease. AAS is not necessarily associated with progressive myelopathy. AAS does not significantly affect survival in rheumatoid arthritis. AAS alone is not an indication for surgical operation, but this should be considered when there is intractable pain or progressive myelopathy.


Cervical myelography with a new resorbable contrast medium: Amipaque. Cervical myelography with Amipaque was carried out on 1000 patients using the suboccipital puncture. The quality of the films is excellent and provides detailed informations on the spinal cord pathology and the cervical rootlets as well. Side effects are trivial and no case of epilepsy was observed in our group of patients.


Changes in clinical signs after decompressive laminectomy in cervical spondylosis with myelopathy. One to seven years after decompressive laminectomy a global improvement of symptoms is observed in ten patients out of 17. The importance of the diagnosis criteria is emphasised. Only the complete clinical form of sensitive and motor disablement has been considered. Attempts were made to quantify the degree of handicap and to follow the modifications of the elementary signs in the postoperative state. The operative results were better when the surgical intervention was performed early in the course of the illness.


Treatment of neurogenic orthostatic hypotension with a monoamine oxidase inhibitor and tyramine. The clinical response of treatment with a chemical preparation of tyramine and tranylcypromine, a monoamine oxidase inhibitor, is described in six patients wit neurogenic orthostatic hypotension. Previous therapy with fluorocortisone, ephedrine, elastic garments, postural training and, in one patient, an anti-G suit was unsuccessful. Oral and intravenous tyramine produced no pressor response. However, after treatment with tranylcypromine five of the patients when supine showed a marked rise of blood pressure to intravenous tyramine which was sustained for over two hours when they stood up. Tyramine given orally with tranylcypromine produced a moderate rise of blood pressure in the supine position which was sustained for over 3-4 hours in the erect position enabling patients to walk about without symptoms of orthostatic hypotension. Measurement of circulating adrenaline and noradrenaline during therapy suggested that the pressor response was due to release of noradrenaline. Three patients have had marked improvement for four, fifteen and twenty-four months respectively. In a further patient, therapy has been successful in treating his orthostatic hypotension although his mobility has been restricted due to cerebellar ataxia. One patient developed a confusional state during treatment and the therapy was stopped. The only patient in whom the drugs produced no pressor response had orthostatic hypotension with evidence of adrenergic innervation of blood vessels, but failure of noradrenaline release. It is suggested that the pressor response to a monoamine oxidase inhibitor and tyramine should be examined in patients to a monoamine oxidase inhibitor and tyramine should be examined in patients with neurogenic orthostatic hypotension in whom conventional therapy is unsatisfactory and those who respond should receive a trial of this treatment.


Bismuth encephalopathy.

Bismuth encephalopathy. Bismuth encephalopathy, characterized by the constant association of acute confusion, myoclonus, severe ataxia and dysarthia has reached "epidemic" proportion since its first description in 1974. The clinical aspects the pathogenic hypothesis, the diagnostic criteria as well as the report of a typical case are described by the authors, who stress the similarities with encephalopathies induced by other metals.


Progressive ponto-bulbar palsy with deafness. A clinico-pathological study. Progressive ponto-bulbar palsy with deafness is a rare disease. It seems to be an abiotrophic process with autosomal recessive inheritance in most instances. Only one autopsy case had been briefly described (Lelong et al., 1941). The clinical features and the pathological findings of a new case are reported. The structures primarily involved are the grey matter of the brain stem and the spinal cord, including to some extent the optic tracts and most of the fiber tracts in the brain stem with exception of the pyramidal tracts.


Changes in regional cerebral blood flows produced by dexamethasone in patients with brain metastases. Four patients suffering from brain metastases were studied by brain scintigraphy carotid angiography and rCBF measurement, before and after one week of treatment with dexamethasone. It was noted that the neurological signs and the blood perfusion around the tumor were improved but that the volume of the lesion, as judged from the angiogram was unmodified. It is suggested that the corticosteroids reduce tissue pressure before actually diminishing the volume of the brain oedema.


Virus-cell interaction in oligodendroglia, astroglia and phagocyte in progressive multifocal leukoencephalopathy. An electron microscopic study. A 46-year-old female, with an 11 year history of malignant lymphoreticular disease, developed a neurological illness clinically manifested by a focal mass lesion in the left frontal lobe. In biopsied tissue, immunofluorescence study revealed the presence of JC antigen in the glial cells. Histologically, the lesion was characteristic of PML consisting of PML consisting of focal necrosis in the subcortical white matter, numerous fat laden macrophages and marked hypertrophy of oligodendrocytes and astrocytes. By electron microscopy, hypertrophic astrocytes contained intranuclear viral particles consistent with papova virions and aggregates of intracytoplasmic viral particles consisting of a single to several virions tightly surrounded by a single membrane. The membrane appeared to have been derived from that of the cellular vesicles. Fusion of the virus-associated membrane to the astroglial plasmalemma occurred when the virions appeared to shift towards extracellular space. The virioncontaining astrocytes showed cytoplasmic "fibrillar hypertrophy" similar to the characteristic gigantic astroglias of PML. This fact would provide an additional evidence that these gigantic cells, although lacking identifiable viral structures, were the result of anaplastic transformation by JC virus. Many virus-bearing astroglias were noted to be in the early stage of cellular necrosis, of "edematous degeneration". This further indicates that the JC virus is capable of inducing both lytic and abortive astroglial infections. Many oligodendroglias were hypertrophic due to the presence of intranuclear viral particles and markedly increased numbers of microtubules and free ribosomes in the cytoplasm. Membrane-bound intracytoplasmic viral particles were also noted in the oligodendroglias. Some fat laden macrophages contained large intracytoplasmic viral bodies, presumably originating from phagocytized virus-bearing cells.


Cerebral lymphomatoid granulomatosis. A report of two cases, with disseminated necrotizing leukoencephalopathy in one. Neuropathologic findings in 2 cases of cerebral lymphomatoid granulomatosis with sequelae are presented. A 30-year old male with macular rash and pulmonary lymphomatoid granulomatosis responded to Prednisone terapy but developed acute intracranial hypertension with coma. A necrotizing hemorrhagic lesion was evident in the left putamen surrounded by diffuse and perivascular atypical lymphoplasmacytic infiltration. An 18-year old girl developed pulmonary lymphomatoid granulomatosis, diplopia, slurred speech and right hemiparesis. Brain scan, angiography and EEG suggested a left fronto-parietal mass assumed to represent lymphomatoid granulomatosis. She responded well to cerebral irradiation, intrathecal methotrexate and cytoxan but relapsed with seizures and increasing respiratory insufficiency. At autopsy, stigmata of cerebral lymphomatoid granulomatosis were absent but a parenchymatous degeneration consistent with disseminated necrotizing leukoencephalopathy following antileukemic therapy in children, was found.


Aggregated plasmalemmal vesicles and microvilli in human astrocytoma. Plasmalemmal vesicles and microvilli or filopodia in human astrocytoma were examined with thin-section and freeze-fracture techniques. The plasmalemmal vesicles, although sparsely scattered in distribution, were often aggregated in a curvilinear, semicircular, or circular fashion, and the involved plasma membrane was often protruded externally like a mound. Microvilli or filopodia were cross-fractured when fracture travelled within the plasma membrane resulting in a fracture face interrupted by numerous holes of cytoplasms. The microvilli were distributed in a concentrated manner on the free surface of the cell and often closely oriented in a linear, curvilinear, or circular fashion. They varied in size, form, and length. When they were arisen from a common hillock of the plasma membrane, its fracture face was elongated, up to 0.8 mu in length. Fenestrae were occasionally visible in attenuated cytoplasm which surrounded peripheral vacuole in the cell.


Development of onion bulb neuropathy in the Tremebler mouse. Morphometric study. The Trembler mouse is a neurological mutant showing dominant inheritance. The periopheral nerves show a delay in myelination, segmental demyelination and the development of an onion bulb neuropathy. Using electron microscopy a comparative morphometric study of nerve fibres in the sciatic nerve in normal and Trembler mice was made. The animals ranged in age from 3 days to adult. The following features were noted: 1. Mean axon diameters of the Trembler mice were smaller than normal at all ages. 2. Myelination was delayed and myelin was thinner than normal in the Trembler mice. 3. The ratio of myelin thickness to axon diameter was reduced in Trembler mice. 4. There were no significant quantitative or qualitative differences observed between middle and distal levels of Trembler nerves. The balance of evidence from these findings and the previous morphological studies is in keeping with the suggestion that the primary lesion resides in the Schwann cell.


Stereology, a complement to experimental neuropathology. I. Introduction into stereology. II. Ultrastructural-morphometric investigations (baseline data, axotomy) on the superior cervical ganglion of the rat. This paper first gives a short introduction into the principles of stereology. It shows then its actual application to the assessment of ultrastructural-morphometric data of the normal superior cervical ganglion of the rat (base-line data) and after axotomy. In the early phase after axon transsection the volumetric composition of the superior cervical ganglionic neuron remains constant. Only the volume density of the lysosomal forms is significantly increased from 0.9--3.2%. Ultrastructural morphometric analysis of the rough endoplasmic reticulum does not provide any information on quantitative changes underlying the phenomenon of central chromatolysis.


Light and electron microscopic investigations on a transplantable tumour of the rat, induced by transplacental administration of ENU (ethylnitrosourea). With a single dose of 80 mg/kg ENU, a tumour originating from the trigeminal nerve was induced transplacentally in the offspring of a Sprague-Dawley rat. The neoplasm diagnosed as a neurinoma, was transplanted over 20 passages to 5 six-month-old Sprague-Dawley rats in each case. During this time, the biological behaviour of the tumour as well as its histological appearance were followed. Ultrastructural observations were made of the 20th passage. The tumour caused multiple metastases in the lung and in the lymph nodes of the neck in 30 animals. Recurrences were formed within a week, metastases of the lung appeared from then on in all cases. During the time of transplantation, the neurinoma dedifferentiated histologically so markedly that it was no longer possible to classify the neoplasm as a neurogenous tomour after 20 passages. Ultrastructurally, poorly differentiated Schwann cells could nevertheless be recognized.


Lysosomes in normal and degenerating neuroblasts of the chick embryo spinal ganglia. A cytochemical and quantitative study by electron microscopy. Lysosomes were studied by both cytochemical and quantitative methods in normal and degenerating neuroblasts of the chick embryo spinal ganglia. In normal neuroblasts (primitive and intermediate neuroblasts) both primary lysosomes and autophagic vacuoles were found; these organelles were usually located in the region containing the Golgi complex. In degenerating neuroblasts lysosomes appeared sharply decreased in number with respect to normal neuroblasts. Moreover, lysosomes were always evident as intact organelles surrounded by a membrane and the acid phosphatase activity appeared localized exclusively within these bodies. A diffuse distribution of acid phosphatase activity was only found in a limited number of cases during the terminal stage of the process. Possibly in these cases the enzymatic activity depended on the cells which enveloped the degenerated neuroblast remnants. The present results indicate that lysosomes do not play a primary role in the degenerative process studied.


High binding of CS2 sulphur in spinal cord axonal fraction. The binding of carbon disulphide sulphur was studied in the spinal cord and its axons of four control and four phenobarbitone pretreated adult rats 3 and 6 h after an intraperitoneal injection of 650 mumol of CS2 in olive oil. The binding of CS2 carbon was measured in the same fractions of two adult control rats 4.5 h after a similar administration of 1.3 mumol of the compound for reference. The specific binding of sulphur was highest in the axons of control animals 3 h after the injection while binding was 17.5% smaller in the axons of phenobarbitone treated animals. The uptake of sulphur was higher in the spinal cord homogenate of the pretreated animals in comparison to control rats. Sulphur was removed from the axonal fraction at a rate of 5.1 natoms/mg of protein/h. Phenobarbitone treatment increased the disappearance of sulphur in the control animals while the rate in the treated rats was 4.9 natoms/mg of protein/h. Phenobarbitone treatment increased the disappearance of sulphur in the spinal homogenate from the removal rate of 0.22 natoms/mg of protein/h in control animals to 0.37 natoms/mg of protein/h in treated rats. The binding of CS2 carbon was negligible 4.5 h after the injection in the axonal fraction. The present data indicate that the release and binding of CS2 sulphur may be responsible for the toxic neural manifestations in chronic CS2 poisoning.


Experimental cerebral ischemia in Mongolian gerbils. v. Ultrastructural changes in H3 sector of the hippocampus. Mongolian gerbils exposed to relatively short (7 or 15 min) unilateral or bilateral occlusions of the common carotid artery develop, 20 h after release of the clipping, characteristic morphologic changes in the H3 sector of the hippocampus. Ultrastructural study of these changes revealed an eccentric shift of the nuclei associated with chromatolytic perikarya which showed a dense accumulation of lysosomes and mitochondria in their central parts. The Golgi apparatus was recognizable only by clusters of vesicles, and this change was associated with a negative thiamine pyrophosphatase reaction.


A pathologic and clinical study of adenosquamous carcinoma of the larynx. Report of four cases and review of the literature. Four cases of adenosquamous carcinoma are described. Emphasis is put on the rarity of this histological type of tumour which was first described in the larynx by Gerughty et al. (1968) who reported three cases. An exhaustive histological documentation of the neoplasm accompanies the discussion of its pathomorphological characteristics, histogenesis, differential diagnosis, prognosis and treatment. Stress is laid on the extreme aggressiveness of the neoplasm and on its high biologic malignancy. Elective treatment is radical surgery. The tumour in question is a distinct anatomo-clinical entity with its own connotations and therefore must be distinguished from the most common squamous cell carcinoma of the larynx.


Effect of partial lesions of nucleus caudatus on food intake in cats. The experiments were performed on 15 cats divided into 3 groups. In the animals from group I with lesions placed in the medial part of the head of caudate nucleus (NC), hyperphagia and hypodipsia developed. In the group II, with lesions in the ventral part of the head of NC, hyperphagia was observed. In the group III, with lesions in the dorsal part of the head of NC, hyperdipsia developed. These data indicate that caudate nucleus (NC) is a part of the system regulating food intake. Differentiation of disturbances following lesions placed in different areas of NC may be due to simultaneous damage of two opposite systems in which NC is included: the dopaminergic nigrostriatal system and the noradrenergic system.


The effect of local acclimatization to cold on the intensity of vasomotor reaction caused by locally applied vibration. In two groups of men, acclimatized or non-acclimatized locally to cold, hand skin temperature and the arterial blood pressure were measured during exposure to locally applied vibration of strictly defined parameters. It was found that in acclimatized subjects the intensity of vasomotor response was smaller than in non-acclimatized ones. The results obtained indicate that local acclimatization to cold may be a factor alleviating the action of locally applied vibration on the peripheral vascular system.


Delusional hyper-identifications of the Frégoli type. Organic pathogenetic contributors. Seven patients with the Frégoli syndrome were described. These patients were studied clinically and by routine laboratory tests, electroencephalograms (standard and sleep recordings, sphenoidal electrodes), echoencephalograms, air-encephalograms, brain scanning, and psychological methods (Wechsler, Rey and Benton tests). The following basic conclusions were drawn: All patients were psychotic and in most cases schizophrenia constituted the nosological setting in which the Frégoli syndrome developed. The paranoid element was marked in all cases. All patients were single, young and, with one exception, male. Clinical evidence as well as electroencephalographic, air-ence-phalographic, echoencephalographic, and psychological findings suggest that a strong organic component contributes to the patho-genesis of the Frégoli syndrome.


Feeding habits and their physiological determinants. Relationships between consumer's preference for sweetness of drinks and certain physiological parameters. Investigations determining the preferred saccharose concentration in drinks (CP(S)), gustatory threshold values, blood glucose level, basal metabolism rate and body weight index (im) were carried out with 83 cadets, aged 21--23 years. CP(S) was directly proportional to the gustatory threshold for sweet tastee, blood glucose level and basal metabolism and the correlation found in all three cases was statistically significant (p less than 0.01). The accuracy of CP(S) estimation by cadets was strictly related to their threshold difference for sweet tast depending also on smoking.


A study of 49 sterilized females.

A study of 49 sterilized females. Forty-nine women sterilized for eugenic, medical or socioeconomic reasons were studied in the Outpatients Department of a Women's Hospital. Results indicate that in a considerable proportion of cases, physical as well as mental condition was negatively affected. The most significant factors which influenced the outcome of the operation were the personality of the subjects and the reasons for which they were sterilized. It is emphasized that before this operation is undertaken, a full psychiatric assessment should be performed and a social report obtained.


Lithium therapy in Israel.

Lithium therapy in Israel. Lithium therapy for manic-depressive patients started in Israel in 1967. A questionnaire survey in 1975 had a response frequency of 50%. Of the 314 patients diagnosed as manic-depressives, 239, or 76%, received lithium carbonate treatment.


Abnormalities in the orienting response in senile dementia. Forty-five female patients with the diagnosis of senile dementia and subdivided according to degree of mental deterioration were paged over a loudspeaker placed directly to the right or to the left of the patient. In the most demented subgroup, motor and/or verbal orienting responses often failed to appear. A turn towards the loudspeaker used was more often evoked in the least deteriorated subgroups. Turning in inadequate directions is tentatively explained in terms of dysfunctions within the auditory system and with reference to the disorientation of the patients. Twenty of the senile dementia patients were also compared with 20 healthy aged persons concerning habituation of orienting responses when exposed to 15 stimulations with intermittent light. The demented patients did not habituate significantly whereas control subjects did. The defective habituation of the patients is tentatively explained in terms of their memory disturbances and low capacity to interpret sensory data.