[Anesthetic technics for surgery in otoneurology]. A description is given of a technique named "Protected Sleep", which produces a deep and residual analgesia and neurolepsia, without interfering with spontaneous respiration. A deep, stable and reliable neuroanesthesia is achieved by means of a partial pharmacodynamic blockage of the neuro-humoral reaction system. It is recognisable by the following features: 1 degree a smooth transition through pre-, per- and post-operative stages, avoiding in particular immediate awakening; 2 degrees a relative arterial hypotension, low venous pressure good peripheral circulation and tissular perfusion; 3 degrees light hypothermia; 4 degrees completely spontaneous respiration. This last factor is, to our way of thinking, of great importance: The venous return remains physiologically unchanged during inspiration in the peroperative as well as in the pre- and postoperative phases, enabling the maintenance of a constant, low venous pressure. Furthermore, should danger exist, the preservation of spontaneous respiration facilitates the immediate control of the respiratory centre. In this way we can obtain: 1. An almost perfect bloodless surgical field with good conditions for dissecting. 2. A low cerebro-spinal fluid pressure. 3. Decreased brain volume. 4. Absence of postoperative haemorrage. 5. Little of no postoperative oedema. 6. Little or no postoperative hyperthermia. "Protected sleep" is a pharmacodynamic technique realised mainly through administration of  a combined and sufficient dose of pethidine, N-allyl-normorphine and levome promazine. For induction, a given dose of diazepam is combined with a single dose of succinyl-choline, to facilitate intubation, followed by a large dose of the narco-neuro-leptanalgesic mixture. For maintenance, nitrous oxide, oxygen, methoxyflurane and additional doses of the mentioned mixture are administered. Undirectional gas flow, without rebreathing, is provided, using the Ruben valve. In this paper on neuroanaesthesia, the technique of "Protected Sleep" and the pre-, per- and postoperative management and positioning of the neurosurgical patient are described in detail.


Surgical treatment of Meniere's disease. Results are reported of the effect ov various surgical methods on vertigo in Meniere's disease. Minor preocedures like sacculotomy or application of NaCl crystals in the round window may effect a cure, but often results in deaf ears. Vestibular nerve section seems to offer the best of vertigo, while generally still preserving residual hearing.


Participation of blood born cells in rat Masugi nephritis. Participation of blood born cells in rat Masugi nephritis was investigated with ultrastructural demonstration of peroxidase, in addition to conventional light and electron microscopies. Polymorphonuclear leukocytes appear immediately and transiently after injection of nephrotoxic serum. Hypercellularity in the early stage of the disease is consisted mainly of monocyte-macrophage. Proteinuria and infiltration of few monocytes are persistent through the course up to 124 days and focal sclerosis with hyaline material appears in the later stage.


Participation of monocytes in glomerulonephritis in acute serum sickness of rabbit. Acute serum sickness in the rabbit was studied with special reference to the role of monocytes in the inflammatory process in the glomerulus. It was revealed that macrophages were the major factor in producing glomerular hypercellularity in acute serum sickness. Proliferation of intrinsic glomerular cells or accumulation of polymorphonuclear leukocytes (PMNs) was minimal. Ultrastructural characteristics of these phagocytic cells were described. Macrophages engulfed various inflammatory products such as fibrin and cell debri in the glomerular capillary. Colloidal carbon administered at the active inflammatory stage was found to be mostly engulfed by macrophages, little by mesangial cells, and was not seen in endothelial or epithelial cells and PMNs. The selective ingestion of the carbon particles by these macrophages made it possible to differentiate them from glomerular cells. This in turn indicated that the macrophages were derived from neither endothelial nor menangial cells and that they were of blood monocytic origin. It was suggested that monocytic cells participated in glomerular inflammation but they, on the other hand, contributed to the repair of glomerular injuries through their active role for phagocytosis.


The effect of ultrasound on Meniere's disease. Among 22 patients with Meniere's disease treated with ultrasonic irradiation, only eight showed extinguished caloric reaction. Long-term therapeutic effect had been obtained in all the patients, Histological examination of the lateral semicircular canal and the crista ampullaris from five patients previously treated with ultrasound for Meniere's disease showed the following changes: (1) In the subepithelial tissue in crista ampullairs no signs of degeneration were found. The nerve fibres were normal. (2) The sensory cells with nerve-endings and supporting cells also appeared normal. (3) The secretory cells showed pronounced cellular vacuolization and increased intercellular space. (4) The lateral semicircular canal was completely obliterated with destruction of the membranous canal. It is concluded that the therapeutic effect may be due to the creation of an endolymphatic fistula.


Zonation of the adrenal cortex. I. Isolation of mitochondria from the zona glomerulosa of the bovine adrenal cortex. Isolation procedures for mitochondria from the zona glomerulosa of the bovine adrenal cortex are described in comparison to those isolated from the zona fasciculo-reticularis. The cristal membranes of mitochondria in the zona glomerulosa in situ are tubular or tubulo-vesicular, whereas those of mitochondria in the zona fasciculo-reticularis in situ are vesicular. When mitochondria are isolated from the former zone, they invariably showed a condensed configuration regardless of isolation media, whereas those isolated from the later zone in a ST medium showed an orthodox configuration. When Ca2+ was added to mitochondria isolated form either zone in an STE medium in the condensed configuration, transition from the condensed to the orthodox configuration took place; the cristel membrane of mitochondria from the zona glomerulosa became tubular or tubulo-vesicular and those of mitochondria from the zona fasciculo-reticularis became vesicular. Purity of mitochondria thus obtained from the zona glomerulosa was examined by electron microscope and marker enzymes. Coupling efficiency of mitochondria was found to be remarkably affected by temperature during the isolation procedures and a choice of substrates.


Zonation of the adrenal cortex. II. Effect of BSA on coupling efficiency of mitochondria isolated from the zona glomerulosa of the bovine adrenal cortex. Effect of bovine serum albumin on coupling efficiency of mitochondria isolated from the zona glomerulosa of the bovine adrenal cortex in various media was examined polarographically and electron microscopically. Albumin restored the coupling efficiency of mitochondria isolated from the zona glomerulosa regardless of isolation media when succinate or malate was oxidizable substrate. Respiratory controls greater than 5 were obtained. Albumin, however, had no effect when glutamate, beta-hydroxybutylate and pyruvate were the oxidizable substrates. The conditions have been found under which mitochondria of the zona glomerulosa stay in the orthodox configuration and yet coupled.


Nature of juvenile polyps in the large intestine. Forty-five juvenile polyps were found among approximately 390 mucosal polyps of the large intestine. Various degrees of epithelial pseudostratification were found among juvenile polyps and the larger-sized polyps of both juvenile type and adult one tended to have a more advanced degree of epithelial pseudostratification. The glands of both juvenile polyps and adult ones revealed a closely resembled or almost identical pattern of size-distribution-pattern of the glandular size in both normal mucosae and hyperplastic mucosae of long-standing ulcerative colitis. Transition of juvenile polyps into adult ones was suggested by the cases with increase in numbers of glands and their orifices to the surface of the polyp and there were some polyps showing an intermediate form between juvenile polyps and adult ones. On the basis of histologic characteristics and age incidence of the patients, it may be said that a juvenile polyp is an immature variant of an adult polyp.


Adrenal pheochromocytoma with both benign and malignant components. A case of adrenal pheochromocytoma is reported characterized by polygonal basophilic granular cells of benign type, plump eosinophilic granular cells of transitional type, and spindle-shaped cells of malignant type. In the primary tumor the neoplastic cells of each type revealed a distinctive topographical distribution. All gradations between the latter two varieties of cells were found, especially in the vicinity of the transitional cell area. Multiple metastases were present in the liver and lungs, where only anaplastic spindle-shaped cells could be found. Ultrastructurally, the benign cells contained predominantly large, rather light, secretory granules with a coarsely granulated core. In the malignant cells, the number, size, and intensity of granules varied considerably from cell to cell or even within a single cell. In general, the malignant cells had a higher frequency of smaller granules with electron-dense homogeneous cores. Moderate amounts of noradrenalin but not significant dopamine or adrenalin could be demonstrated from a metastatic nodule in liver. We postulate that this adrenal medullary pheochromocytoma was benign originally and underwent malignant transformation shortly before the patient's death. This is based upon the patient's clinical features and the peculiar structures of the primary tumor.


Anoxia-induced changes in the resting potential of the cerebellar cells in tissue culture. Membrane potentials of Purkynĕ cells, granular cells, astrocyte cells and oligodendrocyte cells were measured in the cerebral tissue culture under normal conditions and after anoxia. An increment of the membrane potential value with age of culture was found. After anoxia the resting potential decreased with exception of 2-week Purkynĕ cells and granular cells. The highest anoxia-induced decrease of the membrane potential of all the cells studied was observed in 3-week tissue culture.


The effect of activation of central adrenergic receptors by clonidine on the excitability of the solitary tract neurons in cats. The effect of i.v. administered clonidine (10-15 mug/kg) on the evoked potential recorded in the dosal part of medulla oblongata, during carotid sinus nerve stimulation, was studied in chloralose-urethane anaesthetized cats. Clonidine influenced the amplitude and configuration of the evoked potential and the changes were parallel to the blood pressure depressor response. However, the blood pressure drops, evoked by i.v. infusion of papaverine, did not influence the potential. It is concluded that the synaptic transmission from the carotid sinus nerve to the second order neurons in the solatary tract area can be modulated by the clonidine-induced activation of central adrenergic receptors.


Effects of electrical stimulation of the hippocampus on the behavior of cats and their defensive conditioned responses in a shuttle-box. In seven cats the effect of posterior hippocampal stimulation on the number of passings over a transverse bar in a shuttle-box was determined before and after induction of a conditioned avoidance reaction in the same experimental situation. The effect of hippocampal stimulation on the reaction was also studied applying it during the conditioning stimulus. It was observed in these experiments that a behavior imitating the conditioned reaction acquired during training, appeared in most cases during stimulation. It was also found that only strong stimulation of the posterior hippocampus applied together with the conditioning stimulus inhibited the reaction.


Studies on the transmission of vibrations in human organism exposed to low-frequency whole-body vibration. Investigations were carried out in a group of 20 males with a definite morpho-physiological type, at two selected ranges of acceleration values chosen according to ISO criteria in the range of 2-20 Hz. In the subjects exposed to vibration the values of vibration acceleration were measured in different points along the spine at the levels of S3, L3, Th7, C3 and at the vertex. The investigations demonstrated that the frequency is the parameter of crucial significance for the propagation of vibrations in the human organism. Vibration within the frequency range up to 12 Hz affects the whole human organism, while the vibrations above 12 Hz have only a local effect.


The influence of minimal physical activity on some physiological parameters at rest in human subjects. Minimal physical activity was used as a preliminary procedure before measuring some physiological parameters at rest. Minimal activity preceding the analyzed rest period causes a decrease in the mean heart rate (by 5.4%), respiratory rate (by 3.5%), O2 uptake (by 2.5%) and respiratory quotient in parallel determinations in the same individuals reducing particularly the standard deviations of mean values. These changes are similar to those found after prolonged training.


Studies on the exocrine function of healthy human pancreas: pancreatic juice and its certain components. The exocrine function of healthy pancreas was studied continuously during 9 days in a 28-year-old man. Pancreatic juice was collected by means of a drain passed into Wirsung's duct. The 24-hour volume of the juice was 1118 +/- 117 ml. In daytime the mean rate of juice secretion was 56 ml/hour and in the night it decreased to 20 ml/hour. Amylase and lipase activity in the pancreatic juice was very high and significantly higher in nocturnal secretion. Administration of 2% HCL or secretin (1.5 mu/kg) increased the volume of juice by 30 ml in the following hour without changes in the activities of amylase and lipase. Atropine ephedrine and pancreatin reduced the juice volume by 20-40 ml but the enzymatic acitivity decreased only after atropine. The rise in the juice volume was associated with an increase in its HCO3 concentration and a fall in CL- concentration. The levels of Ca++, K+ and Na+ as well as protein were also determined and it was found that protein concentration in the juice ranges from 0.1 to 4.1 g/100 ml.


The effect of estradiol on carbohydrate utilization during prolonged exercise in rats. Female--castrated and male-sham operated rats were subjected to five hours of swimming. It was found that estradiol administered to female rats promotes a supercompensatory pattern of glycogen recovery in the myocardium at the end of the fifth hour of exercise. The hormone markedly delayed the glycogen mobilization from the liver during the first hour of swimming. Glycogen level in m. biceps femoris was essentially unchanged by estradiol both at rest and during exercise. Estradiol signifcantly increased glycogen level in m. masseter of resting rats. Hypoglycaemia developing at the end of the fifth hour of exercise was less pronounced in the estradiol--treated female rats than in the animals from other groups. It may be concluded that estradiol exerts a "sparing" effect on carbohydrate reserves during exercise in rats.


Pharmacological analysis of the abomasum-rumen reflex in sheep. Contractions of the dorsal sac of the rumen and abomasum were recorded in the sheep with chronic fistulae. It was found that during reflex inhibition of rumen contractions, induced with stimulation of chemoreceptors in the abomasum, an increased sympathicotonia plays an essential role and the beta-adrenergic receptors mediate the reflex.


On the effects of gymnemic acid in the hamster and rat. The gustatory activity of the chorda tympani proper nerve has been recorded before and after the application of gymnemic acid to the tongue of hamster and rat. Concentrations of pure gymnemic acid ranging from 1 mg/ml to 10 mg/ml have been used. In the hamster gymnemic acid suppressed the response to solutions of sucrose especially, but it also caused, at higher concentrations, a general suppression of the tast response. The depression caused in the response to sucrose was directly related to the strength of the gymnemic acid and inversely to that of the sucrose solution. In the rat a suppression of the response to saccharin was obtained but no suppression of the taste response to sucrose by gymnemic acid was observed.


Influence of trypsin on cytostatic effects of cyclophosphamide in rats with Guerin tumours. Trypsin in a dose of 5 mg/kg had no significant effect on tumour growth. Given simultaneously with cyclophosphamide the enzyme was found to reduce considerably the weight of tumours and to decrease the levels of DNA and RNA as compared with the group of animals receiving only cyclosphosphamide. These effects were correlated with histological examinations of tumour tissue. Trypsin was also shown to prevent the development of toxic effects of cyclophosphamide on the haemopoetic system. Probable mechanisms of the observed changes are discussed.


Dynamic properties of primary auditory fibers compared with cells in the cochlear nucleus. The dynamic properties of the responses of single primary auditory fibers were compared with those of single cells in the cochlear nucleus. The stimuli were tones (at the unit's characteristic frequency, CF) that were amplitude-modulated with pseudorandom noise. The dynamic properties were described by the cross-covariance and integrated cross-covariance functions between the recorded discharge rate and the modulation. These two measures have earlier been shown to be valid approximations of the system's impulse and step response function, i.e. the change in discharge rate in response to a short impulsive increase (or decrease) in the stimulus intensity and a step increment (or decrement) in the stimulus intensity. The cross-covariance function computed from the responses of fibers had a narrower peak than that of cells indicating that a brief change in stimulus intensity gives rise to a faster change in the discharge rate of fibers than that of cells. The nodulation of the discharge rate of cells for a certain degree of amplitude modulation of the sound is usually greater than that of cells. The modulation of the discharge rate of cells for a certain degree of amplitude modulation of the sound is usually greater than that of fibers. The range of stimulus intensities where a change in stimulus intensity gives rise to a change in discharge rate rate is smaller for fibers (about 30 dB) than what was shown earlier for cells (70-80 dB). The cross-covariance function computed from the slow wave responses recorded from the surface of the cochlear nucleus in response to an amplitude-modulated tone has individual peaks that reflect distinct classes of units with regard to latency of unit dishcarges.


Aggregation fo blood platelets and increased hydraulic conductivity of pulmonary exchange vessels. Pulmonary microembolization secondary to platelet aggregation has been suggested to be a pathogenetic component of the shock lung syndrome. In vitro experiments have also shown that platelets can release factors with a permeability-enhancing activity. We studied the effect of collagen-induced platelet aggregation on the hydraulic conductivity of thexchange vessels in isolated, blood-perfused rabbit lungs. The net rate of fluid filtration in each pair of lungs was determined during standardized elevations of left atrial pressure before and after platelet aggregation induced by intraarterial collagen infusions. Such infusions were followed by a significant, but transient increase in the net rate of fluid filtration. These lungs were papaverinized so that collagen infusions caused only minor increases in inflow pressure. Separate experiments indicated that the observed increase in pulmonary arterial pressure could not explain the increase in net filtration rate after collagen infusion. When platelet-poor plasma was used as a perfusate no change in the net rate of fluid filtration was observed after collagen infusion. The conclusion from these experiments is then that intravascular platelet aggregation induced by collagen infusion caused a transient increase in the permeability of the pulmonary exchange vessels.


Influence of bradykinin and drugs blocking alpha and beta-adrenergic receptor on the stimulating effect of nialamide and L--DOPA. It has been found that kinins increase psychostimulatory effects of Nialamide and L-DOPA as well as psychoinhibitory effects of propranolol without any changes in phentolamine action. Phentolamine and propranolol decrease stimulatory effects of Nialamide and L-DOPA only when they are given jointly with bradykinin.


The effect of some ions on the muscle fibre resting potential in the cricket Acheta domesticus. Experiments were carried out on the skeletal muscle fibres of the cricket Acheta domesticus using conventional microelectrode methods. Both potassium and ammonium ions depolarized the fibres but with a considerable divergance from the slope of 58 mV. Calcium ions hyperpolarized the fibres. High concentrations of magnesium ions or dramatic increase in the osmotic pressure of the bathing medium exerted no influence on the resting potential. It seems likely that skeletal muscle fibres of Acheta domesticus at rest are multionic electrodes, but the role played by various ions needs further studies.


Choline acetyltransferase activity and weight of salivary glands in rats at different ages. The choline acetyltranferase activity underwent marked changes during the life span: in the submaxillaries, the total enzyme activity increased 70-fold from birth up to the age of 3 months and it then remained constant throughout the rest of the observation period, i.e. up to 28-29 months; in the parotids, in contrast, it continued to rise beyond the age of 3 months and the highest value was reached at 24 months. The weights of the glands increased markedly up to 3 months. The gain in weight was less pronounced thereafter.


Influence of oxygen hyperbaria on the activity of complement in human's sera. Studies on the effect of hyperbaric oxygenation on serum complement activity were carried out in 133 young men aged 20--22 years, quartered and given the same board. For this purpose the 50% hemolysis method was used, the determinations being made prior to the hyperbaric exposure and 72 hours, 5 days and 10 days thereafter. The exposure took place in a pressure chamber, where the respective groups studied underwent a 60 min oxygenation at normal pressure, highpressure oxygenation at 2.8 atmospheres and the effect of the air at the same pressure. For proper assessment of the results the studies were also performed in candidates for divers and frogmen, in trained divers and frogmen and in control, non-diving subjects in whom only complement activity determinations were made. It was found, that in the subjects who were never previously exposed to the effect of hyperbaric conditions, a rise in the complement activity occurred subsequently to the exposure to high-pressure oxygenation at 2.8 atmospheres; the complement level returned to normal limits within 10 days.


The effect of CO2 on peripheral airways. In each of ten healthy young subjects breathing different concentrations of CO2 in O2, four alveolar CO2-tension levels were obtained, ranging from about 20 mmHg when hyperventilating in O2 to 50 mmHg. Maximum expiratory flows at 60% total lung capacity were measured at each level and corrected for the influence of the expired gas on the flow. The corrected maximum flow decreased significantly when the alveolar CO2 tension was below 30-35 mmHg, while there was only slight or no influence of CO2 on the maximal flow when the tension was above 35 mmHg. The decrease is taken as evidence of a constrictor effect on peripheral bronchi of hypocapnia.


The effect of serotonin and transcapillary pressure on the capillary permeability in the rete mirabile of the eel (Anguilla vulgaris l.). Measurements of transcapillary exchange of high-molecular dextrans, K+ and THO in the rete mirabile of eel (Anguilla vulgaris L.) have been made under steady-state conditions while the transcapillary pressure was varied and pharmaca added to the perfusates. Raising the transcapillary input pressure increased the exchange of dextrans and K+ but lowered that of THO. Histamine and ouabain had no effect on the transcapillary exchange of the test molecules. The highest dose (100 mug/ml) of serotonin reversibly increased the capillary permeability of D-75 000, K+ and THO while the medium dose (50 mug/ml) only raised the transcapillary exchange of K+ and THO. The lowest dose (10 mug/ml) had no permeability effect. Our main conclusion is that serotonin reversibly increases the area of the intercellular pores by affecting the capillary wall directly.


Plasma renin activity following central infusion of angiotensin II and altered CSF sodium concentration in the conscious goat. To study central influences on the renal release of renin, angiotensin II was infused into the lateral cerebral ventricle of conscious hydrated goats. CSF sodium concentrations was increased or lowered by similar infusions of hypertonic NaCl or of isotonic fructose solution. Infusion of angiotensin II in doses from 0.5 to 1 mug caused a drop in plasma renin activity (PRA) and elicited a rise in blood pressure, antidiuresis, natriuresis, and thirst. Intraventricular infusion of hypertonic NaCl also supressed PRA, induced antidiuresis, natriuresis, and an inconsistent rise in blood pressure. Lowering of CSF [Na+] by infusion of isotonic fructose caused a rise in PRA and was followed by a water diuresis in the non-hydrated animal. The fructose infusions caused some decrease in renal K+ excretion but no consistent change in renal Na+ excretion. The results indicate that angiotensin II and changes in sodium balance modulate renal renin release also via the central nervous system.


Molecular forms of gastrin in antral mucosa, plasma and gastric juice during vagal stimulation of anesthetized cats. Gastrin was released by electrical vagal stimulation in anesthetized cats. Antral mucosa, blood and gastric juice samples collected during vagal stimulation were subjected to gel filtration in order to characterize the different molecular forms of gastrin. In antral mucosa component III (gastrin-17) predominated. Besides, the antrum contained 5 per cent component II (gastrin-34, "big" gastrin), 1 per cent component I and trace amounts of component IV (gastrin-14 or "mini" gastrin). Immediately after vagal stimulation, component III (gastrin-17) appeared in the gastric venous effluent followed within a few minutes by component IV (gastrin-14). Component I and II (gastrin-34) were not detectable in any of the plasma samples. We suggest that component III (gastrin-17) is released from the antral mucosa and is then rapidly metabolized to component IV (gastrin-14) possibly to a significant extent in the fundic region of the stomach. Large amounts of component III (gastrin-17) were found in the vagally-induced gastric juice. Only very small amounts of degradation products were present, indicating that cat gastrin is relatively resistant to peptic degradation and acid hydrolysis.


Local reflex in microcirculation in human cutaneous tissue. Blood flow in cutaneous tissue measured by the local 133Xenon washout technique decreased about 35 per cent during venous stasis of 40 mmHg in three normal subjects. The response was unaffected by block of the nerve three cm proximally to the labeled area. When the tissue was infiltrated with lidocaine or with phentolamine, blood flow remained constant, indicating that the decrease in blood flow is due to an arteriolar vasoconstrictor response to increase in venous transmural pressure. Local venous stasis elicited a vasoconstrictor response in an adjoining area not affected by the stasis. The response was blocked by lidocaine applied to the side of stasis. In 2 chronically sympathectomized patients, the vasoconstrictor response was abolished in the denervated limbs but present on the non-operated side (1 patient with unilateral sympathectomy). The results indicate that the vasoconstrictor response to an increase in venous transmural pressure is due to a local nervous mechanism involving sympathetic adrenergic fibres, most likely a sympathetic axon reflex.


Effect of strength training on EMG of human skeletal muscle. The effects of an 8 weeks period of systematic progressive strength training on the EMG activity of the leg extensor muscles (vastus lateralis and rectus femoris) were investigated in 8 healthy male subjects (22-31 yrs). After training there were indications (n.s.) of a decline in integrated EMG (IEMG) during maximal isometric knee extension as well as in the IEMG vs isometric force relationship. The averaged motor unit potential (AMUP) did not demonstrate any significant changes due to the strength training regimen. In conformity with earlier findings no or only minor alterations were observed in anthropometrics, muscle enzyme activities and fibre composition. The fibre area ratio indicated a specific effect of the training stimuli on the fast twitch muscle fibres. Thus, EMG-analyses, as employed in the present study, did not provide any conclusive additional explanation as to the mechanisms behind the well established gains in muscle strength performance induced by the applied strength training program.


Cerebral utilization of glucose, ketone bodies and oxygen in starving infant rats and the effect of intrauterine growth retardation. Cerebral arteriovenous differences of acetoacetate, D-beta-hydroxybutyrate, glucose, lactate and oxygen and brain DNA content was measured at 20 days of age in intrauterine growth retarded (IUGR) rats and normal littermates after 48 and 72 h of starvation. Cerebral blood flow (CBF) was measured with labeled microspheres in other comparable groups of IUGR and control rats. CBF was similar in IUGR and normal littermates (0.57+/-0.09 and 0.58+/-0.10 ml/min respectively). After 48 h of starvation, arterial glucose was significantly lower in IUGR than control animals but the arterial concentrations of ketone bodies were similar. After 48 h of starvation, cerebral arteriovenous difference of beta-hydroxybutyrate was significantly higher in control than IUGR rats also when expressed per mg brain DNA as was the fractional uptake of D-beta-hydroxybutyrate. After 72 h of starvation, arterial concentrations of ketone bodies were significantly lower in IUGR rats than controls but the fractional uptake of D-beta-hydroxybutyrate was increased compared to IUGR rats starved for 48 h. The average percentage of calculated total substrate uptake (mumol/min) accounted for by ketone bodies increased in control animals from 31.1% after 48 h of starvation to 41.0% after 72 h of starvation. In IUGR rats these percentage values were 26.5 and 25.7 respectively. After 72 h of starvation the fraction of total cerebral uptake of substrates accounted for by ketone bodies was significantly higher in control that IUGR rats. As total cerebral uptake of substrates was similar between IUGR and control animals it is concluded that IUGR rats are more dependent on glucose as a substrate for the brain during starvation.


Cerebral metabolic state after discontinuation of nitrous oxide supply in artificially ventilated rats. Previous results from this laboratory have shown that when administration of 70% nitrous oxide is discontinued in artificially ventilated rats, cerebral oxygen uptake increases by about 40% at 5 min and by about 80-90% at 30 min, and that this increase is blocked by previous adrenalectomy. In the present experiments, nitrous oxide was withdrawn for 45 s, 2 min 45 s, or 15 min, in non-adrenalectomized animals, and for 5 min in adrenalectomized animals, and the tissue was frozen in situ for subsequent measurements of labile phosphates, glycolytic metabolites, citric acid cycle intermediates and associated amino acids and ammonia. The results allow the conclusion that upon withdrawal of nitrous oxide in non-adrenalectomized animals, there is an increase in metabolic rate at an essentially unchanged metabolic state. In adrenalectomized animals, discontinuation of nitrous oxide supply did not induce changes in any of the tissue metabolites measured. We conclude that 70% N2O neither influences the metabolic rate of the tissue, nor its metabolic state.


Liver hemodynamics and liver function in cats during graded hypoxic hypoxemia. In 15 cats, anesthetized with chloralose and curarized, liver hemodynamics and liver function were followed during graded hypoxic hypoxemia. Hepatic arterial and intrahepatic portal venous conductance were not influenced by hypoxia, whereas severe hypoxemia increased gastrointestinal conductance. Total liver blood flow remained constant and hypoxemia was compensated for by an increase in hepatic extraction of oxygen approaching 100%. Only when the hepatic venous pO2 fell below 5-10 mmHg did hypoxemia decrease liver function. The results indicate that the sinusoidal perfusion is homogeneous.


[Reconsideration of the Latin lover. An etno-communicational vignette with a moral]. The latin lover is a model of the self-fulfilling prophecy: you have to believe in him to be able to find him. The sequence that produces the latin lover includes the following ingredients: a) the "neutral" face-to-face distance for Latins is similar to the "seductive" face-to-face distance of non-Latins (more specifically, of Anglo-Saxons and Nord-Europeans); b) non-Latins do not detect the influence of their own cultural stereotype, the "Latin Lover", in their perception of the other's behavior; c) if the non-Latin choses to contribute his/her own share of seductive behavior, he/she will label that performance as a "response" to the message attributed to the Latin; d) the Latin, in turn, is forced by the pressures of his own cultural stereotypes to respond to a seductive advance with more seductive behavior; he labels his own behavior as a "response" to uncalled for behavior on the part of the non-Latin; e) that readiness to escalate seduction reinforces, in the eyes of the non-Latin, the first meaning attributed to that spacial choice behavior of the Latin. The case illustrates certain notions of communication theory, especially issues of "punctuation" and text-context relationships.


[Policy of mental health in Latin America]. The author reviews the current epidemiological concepts in Latin America, assesses the general mental health levels and sets forth some basic proposals aiming at the allocation and use of scarce resources, incorporating as an important one the community itself. The classic models for Mental Health Programs, defined through their basic infrastructures are analyzed: a) The Institution-Pscychiatric Hospital, aimed mainly at tertiary prevention, custody, and biologic therapy, and having high costs with reduced benefits; b) The Mental Health Unit, aimed mainly at secondary prevention, providing several services, and having high costs with good benefits; and c) The Comprehensive Program, aiming mainly at primary prevention, providing several specialized services together  with the use of the resources of the community itself, and having low costs with high benefits. An  overview of Mental Health indicators shows the following rates of prevalence: a) neurosis, 15%; b) alcoholism, 5%; c) epilepsy, 2%; d) psychosis, 1%; e) dementia, 1%; f) mental retardation, 1%. The total prevalence rate for the six basic psychopathological entities is 25%, in the population of more than 15 years of age. The minimal requirement of psychiatrists for that degree of prevalence is about 80/one million inhabitants, that is, an increase fourfold to fivefold of the present number. To attain this goal, at least 50 years are required, during which mental health services are likely to maintain their present deficits, unless a new conception of mental health services is used. The author proposes the generalized use of Comprehensive Programs, as the only possibility of providing within periods reasonably short an adequate service. The importance of incorporating the mental health resources of the community is stressed. The experiences made in Chile during three different governments, having different political and ideological basis, are briefed, showing the evidence of a number of advantages to be gained with the proposed system, in a relatively short timespan--less than 10 years.


[Protofantasy].

[Protofantasy]. The author reviews Freud's postulations on proto-phantasies, and traces the evolution of several concepts related to them, in the aim of showing that there is a common purpose along the whole theoretical development: to uncover or to explain the innate archaic legacy, its role and its effects within the Psychic Apparatus of men. The first formulations of the idea of proto-phantasies in Freud's works are as early as his letters to Fliess and the Traumdeutung (1900), where it is stated the hope that the interpretation of dreams can lead to the discovery of innate elements received from ancestors. The idea is reformulated in further works, among which, "A Souvenir of Leonardo da Vinci Infant", "Totem and Tabu", and "Three Essays", "The Loss of Reality in Neuroses and Psychosis", "The History of a Child's Neurosis", Mass Psychology and Ego Analysis", "The Ego and the Id", "An Outline of Psychoanalysis", and "The Malaise in Culture". The author spots the successive developments, and proposes an order based on the everpresent assumption that man has an important legacy: the primal imagery bequeathed by the species, constituting the unconscious organized memories shared by all members of the human race. The final conclusions stress the importance of primal phantasies and the possibility that its study broadens the scope of psychoanalitic theoretical and clinical developments.


[Treatment of depressive and anxiety neurosis with a new psychotropic drug: Nomifensin]. The effect of Nomifensin (Hoechst 36984), a new psychotropic agent different from tricyclics and MAO inhibitors, was studied in patients with depressive-anxiety syndromes. Thirty three patients (22 female, 11 male), average age 40 years, were studied for five weeks in an open trial. The educational and occupational levels of the samples were determined. Follow-up was carried out with Wittenborn Psychiatric Rating Scale, Hamilton Rating Scale for Depression, Zung Self-Rating Scale and PEN Personality Inventory. No other drug was allowed to be taken along with Nomifensin, except for a benzodiazepine derivate in case of disturbed sleep. The average dose was 67 mg/day. The changes in Hamilton and Zung Scales were statistically significant, after the first week of treatment with Nomifensin. Only the N Scale of the PEN showed a a before/after treatment significant difference. The r=0.63 correlation obtained between Zung and Hamilton Scales is discussed. The drug showed to have thymoleptic action within the first week of treatment and an additional on the anxiety symptoms, frequently associated to reactive depressions.


[Medical discharge from a hospital].

[Medical discharge from a hospital]. Admission and discharge procedures are prominent aspects in the assistential care of hospitalized patients. A great deal of attention has been paid to the reasons why they stay overtime when they apparently are ready for discharge. Lab routine delays and other technical difficulties have been traditionally blamed for failing to operate on schedule. However, even when studies are completed and diagnosis and treatment performed, the patient still remains overtime. This paper presents a research on discharge from a medical ward of a general hospital. According to rules, they were not supposed to stay more than two weeks, time enough for usual diagnostic and therapeutic procedures. However, 18 out of 121 patients were exceeding the limit  and were subject to the present investigation. The Medical-Psychological Interconsult was the research instrument. The patient, the family, the doctor and the nurses were interviewed in each case. In every one of the 18 cases, problems were found in the doctor-patient relationship, as well as other difficulties in different institutional levels. The value of a multidisciplinary approach in problems of this kind is emphatically stated (clinicians, psychologists and medical auditors).


[A scientific-cultural approach to the Gestalt concept]. In the descriptions of the gestalt process formulated by F. S. Perls (Gestalt Therapy Verbatim, Real People Press, Lafayette, 1969) and other gestalt psychologists, it appears as if the gestalt formation was a general and universal tendency of living and non living matter as well. Broadly speaking, they state that a gestalt is something that in itself wants to be formed and completed, something which emerges as a distinct entity (figure) from a undifferentiated environment (background). From experience we know that perceptions of any kind, have this as a prerequisite: the perceived object or process has to out of equilibrium with the environment, otherwise it remains undetectable. On the other hand, the second law of thermodynamics prescribes that the tendency for spontaneous isolated processes is exactly the opposite. With time, processes tend towards equilibrium, things tend to equalize, heterogeneity tends to become homogeneity, order into disorder. Thus these two very important "rules of the game" for natural processes are seemingly contradictory. While one states that matter tends to differentiate into figure and ground, the other states that exactly the opposite is what will occur - with time, all distinction and differentiation will disappear. Of the many problems posed by biological entities to the physical sciences, their obvious differentiation within the growth span of the organism, is a flagrant violation of the second law and hence they, as a whole, escape the realm of thermodynamics. Only living organisms can go against the second law. Living organisms tend to form gestalts and they perceive the world through the formation of gestalt pairs. However, the first man-made creature that knowingly could obviate the results prescribed by the second law, was Maxwell's Demon. He can produce heterogeneity from homogeneity since he can handle information. In Maxwell's hypothetical experiment, his Demon can pick out fast molecules from slow molecules taking a system initially in equilibrium to a new state in which there are differences. Information, in its mathematical context or neg-entropy is thus essential to systems that are out of equilibrium with their environment. In particular this is true of biological organisms. At an early stage genetic information is all that is required to produce differentiation. With growth and differentiation other forms of information come into play. From an engineer's point of view, energy without information does not serve in the production of work. From a psychotherapist's point of view, energy without information does not serve in the production of growth. In all schools of psychotherapy, the therapist can be considered as a Maxwell Demon; the outcome depending on the particular bias of his school. Gestalt Therapy with its strong emphasis on the "awareness of the ongoing process" relies heavily on all organismic functions as the means of producing information relevant to the patient...


[The unmasking of consciousness by means of criticism of illusion and ideology]. The author contends that the constitution of Psychology as a Science requires the elucidation of the conceptual instruments to be used in the approach of its specific theoretical object. In order to meet that requirement, three main methodological subjects are considered: I. The image, conceived as embodiment of the illusory and the deceptive, vs. the image as "the imaginary". Images are defined as representations determined a priori as the sole possibility of understanding reality. The distinction is made between two modes of this gnoseological process: the one, apparent, the other real. The first one, image as a representation having no correspondence whatsoever with reality, conveys only deceptive features: illusion at the individual level, and ideology at the broader scale of the socioeconomical class. Illusion and ideology are subject to parallel in that both mask reality, uncovering a part of it in order to hide the whole; and they imply each other in that to each illusion of individual consciousness corresponds a single socio-economical ideology. The unmasking must be performed both at the individual (illusion) and the collective (ideology) levels, through a conceptual work under a clear conception of knowledge and its methods, leading to an actually objectivating neutral act-Husserl. II. The imaginary as a project of irreality. Accepting that the image has a double function: a) an essential (gnoseological) one, and b) an unesential, supplementary one, as the support of illusion and ideology, there is yet a double manner for the concealment: a) subjective or belonging to the psychological level, and b) objective-intersubjective level, or actual social level. The image provides the object for the "belief", being thus the basis for the creation of a super-reality, an invention over another invention, with the goal of fulfilling desire. This goal implies failure in itself, as desire is always beyond the reality that seeks its fulfillment. The process of illusion can be explained by the triple link: desire-imagination-illusion, leading to belief. In desire there is a double work: a) a positive one, or trend towards the appropriation of the object; and b) a negative one, or the all-present frustration leading, precisely, to illusion. III. Desire and discourse: dialectics of possibility. Reality provides a limit-border to desire: it sets the frontiers of impossibility. Only the discourse provides a program, a planification of the being-desire. But desire exceeds the limits of possibility, and sets the underlying framework on which the impossibility of desire is expressed. Two different answers have been attempted from a logical-gnoseological-methodological stand point, consisting of reductionisms or pseudo-answers. Firstly, intellectualism, professing to reduce everything to rational cathegories and their logico-formal methods; and secondly, naturalism, professing to reduce everything to a factic-empirical scheme and to its experimental method...


[International pilot study on schizophrenia, its implications for Latin America]. This is a succint description of the International Pilot Study on Schizophrenia, sponsored by the World Health Organization and conducted in field research centers located in 9 different countries. The main objective of this study was the development of standard procedures for case finding, assessment of damage caused by Schizophrenia and observation of the course and outcome of the disorder. Starting in 1968, groups of approximately 120 patients who met the criteria both for inclusion and exclusion were studied in each center. They were subject to study by means of several instruments and were given a clinical diagnosis. On that basis, comparative analysis within and between centers were conducted, as well as reliability tests for the procedures used. Two follow-ups took place at 2 and 5 year intervals in order to obtain information about the course and outcome of cases. The emphasis of this presentation is placed on the findings at the Cali (Colombia) field reserach center and their comparison with the global results of centers in the rest of the world. In that context, the findings show that centers in developping countries are at least as capable for conducting research work as those in the developped countries. There is also the suggestion that mental disorders in developping countries apparently tend to more benign course and outcome.


[Secondary prevention of alcoholism in an urban area. An evaluation of 3 models: asylum, integration and incorporation into mental health]. Three models for the secondary prevention of alcoholism were considered: Asylum or Institution, Mental Health Unit and Comprehensive Program. All three were carried out using similar resources, at the same urban area, in succesion. Data were gathered from two sources: daily registers of Outpatient Services and clinical records, being the former of better quality. The Comprehensive Program, whose main characteristic is the integration of the community in the effort to solve its mental health problems, proved to have the greatest efficacity, according to the items selected for evaluation. The detection of new alcoholic patients was three or fourfold the two other models had; the detection was produced at much earlier stages, and the therapeutic performance and results were significantly higher. The costs, global as well as per capita, were much lower, and the use of institutional resources much more rational. The Mental Health Unit model meant a good professional performance at the specialized Psychiatric Services but showed rather poor results in detecting new cases, and costs much higher than those of the Comprehensive Program. The Asylum or Institution model showed the poorest levels of efficacity in all items, and the higher costs. The paper also analyzes some possible biases stemming from the general assumptions at the basis of the chosen evaluation system. It emphasizes the importance of general community leaders in primary prevention in reducing secondary prevention needs through education of the general population.


[General aspects of planning and care in mental health]. This paper reviews some general concepts on Planning, especially in public and welfare sectors, stressing those concerning the major flaws in the argentine system of mental health. The author considers the definition of planning levels, and sets forth three: general plan, program and project. The correlative implementation is also considered. The importance of feed-back from adequate evaluation is stressed, emphasizing three aspects: a) evaluation of dynamics, rate and extent of decrease, increase or stagnation; b) assessment of efficacity of factors involved; c) control and stabilization of goals already attained. The necessity to develop a human ecology, encompassing socio-cultural and psycho-social factors is stressed, together with fostering theoretical research and the use of its results by implementation agents. Several differences among prevailing mental health actions are pointed out which allow a distinction between two typical models: clinical and sanitarist. The main differences between them lye on: standard location of working sites, nature of basic actions, field of action, hypothesis for working, including ethiological and ecological assumptions, theoretical and methodological framework. A series of criteria for evaluating sanitary techniques and strategies are set forth, among which: operative procedures, length of treatments, degree of therapeutic concentration, and general pragmatic criteria. The indicators reviewed are: degree of efficacity, covering, degree of perseverance in treatments, cultural barriers between patient and therapist, delegation of functions into special, first-rate sanitary agents, needs for the training of mental health workers. An attempt is made at developping general evaluation criteria for mental health planning, and several indicators are proposed, among which: a) cost/efficacity ratio, including in costs the use of economical, human and physical resources; b) preventive capacities of the community; c) capacities for the community to generate new types of organization and social dynamics able to cope with increasing mental health demands; first-rate personnel and mental health agents performance and training; e) assessment of "distances" between theoretical planning and actual implementation outlines; f) requirements of time for the implementation of programs.


[Activity of a new neuroleptic, penfluridol (R-16341) in long-term treatments]. The difficulties of regular drug intake in long term treatments for psychotic patients gave rise to the need of using medicines at the longest possible intervals, facilitating thus adequate control and regularity. Penfluridol is a neuroleptic meeting that requirement: it is necessary only one dose per week. This paper reviews the results of Penfluridol in 26 patients (20 inpatients and 6 outpatients), ages between 17 and 54 with a mean of 36.8, sex feminine, and the following diagnoses: schizophrenia, paranoid: 14, simple: 8, hebephrenic: 3, catatonic: 1. The patients, divided in two groups of 13 each, had one oral dose a week, of between 10 and 100 mg, during 90 days. The first group took only Penfluridol, suppressing any other medicaments. The other group added Penfluridol to the prescriptions already in use. The results, as described in tables I and II, were evaluated according to 36 items. The general evaluation was positive with no negative biases. The side effects were scarce and temporary: insomnia in 7 cases during the first week, and extra-pyramidal symptoms in another 7 cases, that were controlled with antiparkinsonians. The conclusion is that Penfluridol is a valuable contribution to longterm treatments in psychoses.


[Jacques Lacan: The turn of the Obligado or the return of the unavoidable]. "La Vuelta de Obligado" (Obligado bend of Paraná river) is the name of a battle fought by local rebels against the colonial invading navy. The victory was due to a witty device: the patriots stretched a cable across the river and succeded in stopping the foreign float. The event is the paradigm of the everlasting fight of under-developped countries against powerful colonial metropolis. The author examines the conditions of local fight against colonizing cultural and scientific ideas, being his main content that scientific advancement needs not be an instrument of scientific imperialism. He analyzes in detail several factors currently impeding the use of scientific discoveries and improvements, focusing into concrete "obstacles" (in Bachelard's meaning) to betterment of Psychoanalytic knowledge. The obstacles are: 1. All-pervading transference. The rule adapted from Melanie Klein theories emphasizing hic et nunc validity of materials from the patient, neglects the fact that the analyst is also moved by desire, and that the patient's productions are not fragments of behavior able to be reduced to the present situation, but vectorial motions, always open and always re-opening into something defined since the beginning as forever lost. 2. Increasing activity for the analyst. The current hypothesis concerning the possibility of analyzing everything, encouraging the analyst's hyperactivity, does not allow for theoretical evaluation of the means and ways of manifestation of unconscious drives through gaps in the discourse. 3. Pan-counter-transference. The conception of counter-transference as an instrument is against Freud's contention, defining it as a reciprocal transference that must be fought in the same way as the patient's. 4. Belittling of theory. The thesis against theory, on the grounds that Psychoanalysis deals with affects and the affective life of patients, forgets that there is always some system for understanding the world and, for want of a theory, an ideological system is always ready to provide the grid underlying all concepts used. 5. Not-analyzing. The automatic "translation", lacking the search for new links to replace the ones that analysis dismantles, leads to denaturalizing the practice and keeping intact the patient's imaginary consistent universe. 6. Intergrationism. Other theories cannot be integrated to Psychoanalysis as they have different objects and different frameworks. Conversely, Psychoanalitic concepts cannot be formulated in other theories conceptual corpus for the same reason. The exception are the sciences having similar fields and methods of analysis, such as Semiotics or Linguistics. In their case the articulation of concepts becomes possible, but still requires the previous command of Psychoanalytic Theory in its full depth. 7. Communicationalism. The most common of all integrations with other sciences is the one linking Psychoanalysis with Communications Theory...


[Psychological approach to the prevention of war]. War is a complex social situation due to the interplay of multiple factors. Economical and political ones are of utmost importance, but human attitudes and motivations must be also taken into account. Being desirable to modify human transactions in such a way that they do not interfere with the basic right of everyone to a condition of physical and mental well-being, war must be abolished. The author contends that an understanding of behaviour through Psychology can be helpful in that aim. Aggression is considered the principal psychological cause of war. It is worth while to differentiate between aggression as an instrument for attaining a special end, and as pure hostility. Only in the first form, it is held here, does it play an important role in war. Psychogists must deal also with a wide range of states of mind that can be "served" by aggression: feelings of inferiority or insecurity, fear, greed, projections, compensations, rationalizations, etc. Scientific approach is not the only one Physiology brings to war prevention. It is equally important the wide dissemination of its conclusions among the general public. Information on the dynamics that prompt people to decide war would make it easier to control. This applies not only to political or military leaders, but also to civil populations. Concerning those two possible contributions of psychologists, scientific and educative, it is suggested the extensive use of psychodramatic techniques. Their richness lie in the lifelike experiences they convey to the participants, and particular aptitude to promote changes of attitudes. Investigation and information on the psychological processes related to war should be undertaken by international organizations of social scientists, acting simultaneously in several countries. Some of the initial steps they could further: 1) that prevention of war be a current subject matter in psychological courses; 2) that the World Health Organization take interest in this subject; 3) that psychologists participate in international political and economical bodies in order to clarify the psychological factors leading to war.


[Trends of mental health in Latin America]. The paper attempts at a general assessment of mental health conditions in Latin America. Starting from methodological considerations the author points out at the difficulties for obtaining reliable data, gathered with compatible basis and the basical hindrances for building the concepts of health and illness, and for finding indicators reflecting the real health and welfare levels. The available data are discussed, together with their significance and scope. Stress is laid upon the meaning of prevalence and assistance data, which reflect only the problems of one sector of the population. The meaning of suicide and homicide is also discussed, and their use as indicators, together with data on occident rate, is suggested. The prevalence of alcoholism, psychosis and neuroses is examined, together with their role in the procedures for assessing mental health levels. Mental retardation and epilepsy are also considered. The author examines also human, technical and physical resources and facilities devoted to mental health, as well as training of personnel in the field. On the basis of statistical figures, it is showed a general deficit in all areas. As a conclusion, the author stresses the need to pay more attention to mental health problems and proposes a series of criteria in that sense.


Simultaneous arthrography of the talocrural and talonavicular joints in children. I. Technique. A method is described by which simultaneous arthrography of the talocrural and talonavicular joints is performed on neonates and small infants with a high degree of success and a very low risk of complications. From films exposed in exact, standardized projections, valuable and highly reproducible information is obtained about the configuration of the talus, the shapes and mutual relationships of the joint surfaces, and any obliteration of the recesses. One disadvantage of the method is the need for general anaesthesia.


Simultaneous arthrography of the talocrural and talonavicular joints in children. II. Comparison between anatomic and arthrographic measurements. Simultaneous arthrography of the talocrural and talonavicular joints was performed on 32 autopsy foot specimens from 19 children of ages up to 3 years. Measurements concerning the size and shape of the talus were made on the films and the results were compared with corresponding measurements made on the anatomic specimens. The differences between the results and the reliability of the radiographic method as analysed by duplicate and triplicate examinations are discussed.


Normal width of cranial sutures in the neonate and infant. An objective method of assessment. A material of 107 normal skull films have been used to determine the normal range of the cranial sutures in the age group 0 to 45 days of age. Assessment is based on the lateral view and includes evaluation of both coronal and lambdoid sutures as well as the degree of V-shape of the coronal sutures. Values obtained are easily classified as normal, borderline or pathologic by use of a simple diagram.


Angiography of the femoral artery following percutaneous catheterization in infants and children. Iliac and femoral arteries previously exposed to percutaneous catheterization were examined by angiography in conjunction with re-catheterization in 44 infants and children, most of them with heart disease. Frequency and extension of thrombotic changes were analysed, as well as the relationship between occurrence of thrombotic complications and age, haematocrit value, catheterization time, and tendency to arterial spasm. Only age and arterial spasm were significant for the occurrence of thrombotic complications. Injury of the intima was considered to be the primary cause of these complications.


Mucosal folding in upper urinary pathways following ureterolithiasis. Mucosal folds in the ureter or renal pelvis were demonstrated in 2 children and 27 adults with urolithiasis. It appeared from the sequence of events observed in these cases that the folds occurred in a redundant mucosa following an episode of mural stretching. Urinalysis, including bacterial culture in the majority of cases, showed infection in only 3 of the adults.


Kidney size in children. A method of assessment. A method for assessment of kidney size in pediatric practice is presented. Length of the kidney is correlated to length of the lumbar segment L1 to L3 including the intervertebral spaces comprised by these vertebrae. The result may either be expressed in standard deviations or as a kidney ratio. The method makes comparison with films from previous examinations or other hospitals feasible without access to any other data than those available in the film. The method also serves the purpose of properly assessing the growth of the kidneys.


Kidney size in children with unilateral urinary duplication. Absolute kidney length and the ratio of right to left kidney lengths were estimated by the method of Eklöf & Ringertz in a series of 142 patients with unilateral renal duplication. The anomalous kidney was frequently found to be larger than the contralateral one, particularly when associated with ectopic ureterocele, which was present in 34 patients. Nevertheless, a substantial number of reduplicated kidneys had a length below mean, some of them actually below -2SD.


Lymphoid hyperplasia of the colon in childhood. A retrospective inspection of films from colon examinations revealed evidence of lymphoid hyperplasia in 24 of 229 infants and children. The condition is more frequently demonstrated at double contrast examination than with the conventional barium enema. Analysis of symptoms and signs and information obtained at follow-up suggests that this condition is usually, if not always, benign in childhood.


Heart volume and haematocrit value following aorto-pulmonary anastomosis in children with Fallot's anomaly. In 16 children with Fallot's anomaly and Waterston anastomosis, the effect of the shunt was examined repeatedly up to 2 years after operation. Change in heart volume was correlated with the haematocrit value. In 14 of the cases the function of the anastomosis was also evaluated on cardioangiography. Serial heart volume measurements were found useful to evaluate the function of the anastomosis.


Spinal cord vascularity. V. The venous drainage of the spinal cord in the rat. The anatomy of the spinal cord venous system has been investigated by stereomicroscopy in rats subjected to arterial or venous injections of a coloured contrast medium. The results demonstrate the arrangement of the intrinsic and the extrinsic spinal cord veins to be different from that of the arteries, a feature consistent with previous descriptions in man. An exact knowledge of the venous anatomy is considered essential in evaluating the origin of experimental vascular lesions associated with impaired spinal cord circulation.


Lymphatics of the diaphragm in the dog.

Lymphatics of the diaphragm in the dog. Lymphography of the diaphragm was performed in 35 dogs. A main diaphragmatic duct passed in a postero-anterior direction, receiving several branches from the diaphragm. It passed to a double mammary internal channel ending at the upper end of the sternum, where a group of nodes were constantly present, and beyond this a lymphatic plexus was filled.


Abnormal basal angle of the skull in sex chromosome aberrations. The basal angle was measured on skull films in 252 patients with hormonal disorders and sex chromosome aberrations. In cases of hormonal disturbance the basal angle was normal. In patients with Turner's syndrome (45,X chromosomes) the basal angle was enlarged while in patients with Klinefelter's syndrome (47,XXY chromosomes) and in those with extra X or Y chromosomes it was definitely reduced. A close relationship exists between the sex chromosome number and the size of the basal angle.


Angiography in carcinoma of the renal pelvis and the ureter. Angiographic findings in 21 cases of renal pelvic carcinoma are presented. Important characteristics include neovascularity, visible capillary phase, vascular encasement, wide pelviureteric artery and absence of arteriovenous shunting. Angiography may also be of value for the differential diagnosis of ureteric obstruction as demonstrated in 5 of 6 patients with carcinoma of the ureter.


Gastric motility and emptying following parietal cell vagotomy and selective gastric vagotomy. Experimental investigation. After parietal cell vagotomy in dogs antral motility and gastric emptying time is unaffected. Addition of a drainage procedure changed the motility considerably by decreasing the force of contractions and diminishing the number of peridtaltic waves. After cutting the antral nerves complete atony occurred, but emptying rate was unaltered as the contrast meal passed passively through the anastomosis. Selective gastric vagotomy without drainage caused atony and significantly prolonged emptying time.


Xeroradiography and conventional radiography in examination of the larynx. Comparison of the visibility and radiation dose at xeroradiography and ordinary conventional radiography have been made in experimental and clinical examinations of the larynx. The investigation indicates that xeroradiography cannot replace positive contrast examination and gives a considerably higher radiation dose than conventional radiography.


Adverse effects of stationary grids.

Adverse effects of stationary grids. By means of simple tests, the mechanisms of image impairment due to stationary grids were demonstrated. Several contributing factors were found. The fact that the grid strips are not clearly visible in the film does not indicate that image quality is not lowered by the grid. To a certain degree it demonstrates that the image quality is so low that not even the grid lines are perceptible.


Uptake and retention of 133Ba and 140Ba-140La in mouse tissues. The distribution of barium in the mouse has been determined qualitatively by whole-body autoradiography after i.v. administration of 133BaCl2 solution. The quantitative distribution of 104Ba and 140La has been analyzed after i.p. injections of the two nuclides in equilibrium by measuring the activity in excised organs in a two-channel scintillation counter. Approximate doses to the eyes and different parts of the skeleton have been calculated.


Epidermoid carcinoma of the larynx. VI. Histologic grading in the clinical evaluation. A multifactorial microscopic grading of malignancy was performed on a clinically well examined series of 129 patients with laryngeal carcinoma. The microscopic score was statistically significantly correlated to the frequency or regional lymph-node metastases and to the death rate. It afforded important supplementary information for the T-classification and for the prognosis. Microscopic grading is an essential supplement to the clinical evaluation of risk groups.


Radiation therapy of nasopharyngeal carcinoma in East Africa. Results of irradiation, 1 to 3 years after treatment, are presented in 64 cases of nasopharyngeal carcinoma in East Africans. Two types of anatomic point indices are presented. Both correlate well with the results. Prophylactic irradiation of the mediastinum and both axillae was not followed by any evident improvement of the results.


Local prognosis after combined external and interstitial radiation therapy for carcinoma of the tongue. Of 36 patients with early carcinoma of the tongue treated with interstitial irradiation, 25 were controlled, 10 recurred and one developed local necrosis. Of 57 advanced cases treated with telecobalt therapy followed by interstitial irradiation, 15 were controlled, 20 recurred and 22 developed local necrosis. The frequency of necrosis following the combined irradiation was unacceptably high. Interstitial therapy alone may be a more adequate method for the primary tumour.


Diagnostic value of gallium-67 in malignant lymphoma. The results of lymphangiography and other radiologic procedures are compared with those obtained by 67Ga scintigraphy in staging of 27 patients with Hodgkin's disease and 31 patients with non-Hodgkin's lymphoma. A high degree of correlation was found between lymphangiography and 67Ga scintigraphy. Exact localization, however, was only possible by lymphangiography. In some cases, the extent of disease found on scanning appeared to be smaller compared to radiography. Within the chest 67Ga scintigraphy and conventional radiography give almost similar results. Differentiation between neoplastic and inflammatory lymph node involvement is impossible.


Pulmonary contraction following 60Co irradiation of mammary carcinoma. Pulmonary contraction, as measured by elevation of the right superior interlobar fissure, was investigated in 38 patients with carcinoma of the right breast, treated by radical mastectomy followed by irradiation with 60Co. Contraction of the right upper lobe was observed to extend over a minimum of four years although at a diminishing rate.


Mantle treatment. Absorbed dose measurements in patients compared with dose planning. In vivo dose measurements were performed in the hypopharnyx-oesophagus for 60 adult patients receiving mantle treatment with 60Co. The measurements of absorbed dose in more than 1 600 points were analysed and compared with dose plans for the same patients. For the technique used the mean difference between in vivo measured and planned absorbed dose is within +0.4 and -1.3 per cent with a standard error of the mean of 0.4 per cent.


Acute poisoning with dextropropoxyphene. Clinical symptoms and plasma concentrations. Out of 14 cases of poisoning assumed to be due to dextropropoxyphene-containing drugs, propoxyphene and its main metabolite norpropoxyphene could be demonstrated in 11. The concentrations of the drugs were determined shortly after admission and then after 2, 4, 6 and 10 hours (in four cases also after 16 hours). The highest plasma concentration of propoxyphene, 0.74 mug/ml, was found in one case of fatal poisoning. Another patient with a plasma concentration of 0.51 mug/ml showed signs of severe respiratory depression but survived after respirator therapy. In the patients with lower plasma concentrations the poisoning had a benign course. In most cases the plasma concentration of norpropoxyphene exceeded that of propoxyphene even in the first blood sample.


Relationship between plasma aldosterone concentration and plasma potassium in patients with essential hypertension during alprenolol treatment. Plasma aldosterone concentration (PAC), plasma renin concentration (PRC), plasma potassium, plasma sodium and blood pressure (BP) have been measured in 22 patients with essential hypertension before and after treatment for one month with alprenolol. PAC, PRC and BP decreased and plasma potassium increased significantly during treatment. Plasma sodium, however, was unchanged. Changes in PAC were inversely correlated to changes in plasma potassium. No relationship could be demonstrated between PAC and plasma sodium. Mean BP was inversely correlated to PAC during alprenolol treatment, but bot before treatment. No relationship was found between changes in BP and changes in PRC. The results suggest that plasma potassium is an important regulatory factor for aldosterone secretion during alprenolol treatment. Other factors, however, must have a modulating influence and since the renin- angiotensin system is not suppressed to very low values, this system is possibly the most important of these factors. It is suggested that aldosterone secretion is not of primary importance in BP regulation during alprenolol treatment.


The effects of different dose regimens of niceritrol of serum lipid concentrations in man. The lipid-lowering effects of 3 g of the nicotinic acid derivative pentaerythritoltetranicotinate (niceritrol) given either 1 g X 3 or 1.5 g X 2 have been evaluated in 18 subjects with hyperlipoproteinaemia. When 1 g niceritrol was given three times daily, the serum TG concentration fell from 3.14 +/- 0.48 to 1.86 +/- 0.18 mmol/1 (41% reduction) and the serum cholesterol concentration from 282 +/- 9 to 227 +/- 11 mg/100 ml (20% reduction). The same daily dose, given 1.5 g twice, did not significantly lower the serum TG concentration, and serum cholesterol was lowered by only 12%. Niceritrol tablets prepared with a dissolution time of 60 or 90 min had identical lipid-lowering properties. Although patients may find it practical to take niceritrol only twice daily, such a dose regimen has considerably less effect on elevated serum lipids than a thrice-daily regimen.


Extreme elevation of transaminase levels in acute heart disease-a problem in differential diagnosis? Five patients admitted to the Coronary Care Unit at the Department of Medicine, Serafimerlasarettet, who developed extreme elevation of transaminase levels, are discussed in terms of problems in differential diagnosis. All five had manifest right ventricular failure on admission and four also had hypotension. Three of the patients died, two survived. The three post-mortem examinations showed extensive infarctions of the left ventricle and septum. The two survivors had had a prolonged ventricular tachycardia and a probable silent infarct, respectively. It is concluded that the extremely high transaminase levels sometimes seen in acute cardiac disease are predominantly due to sizeable amounts released by the liver as a result of central necrosis of the liver cells. The probable prerequisite for the development of central necrosis of the liver in acute cardiac disease is usually the combination of right ventricular failure and hypotension, which in turn are most often due to extensive left ventricular infarcts.


Hyperlipidaemia and reduced fibrinolytic activity associated with thromboembolic complications in a family. Although not significantly correlated,  the occurrence of reduced fibrinolytic activity and capacity in hyperlipidaemics has often been described. Hyperlipidaemia and reduced fibrinolysis might well enhance the possibility of thromboembolism. Such a coincidence of risk factors has probably caused thrombotic disease in a family, as described in this case report and family investigation.


A comparison of two methods for estimating bone loss. The presence or absence of osteopenia, as judged by routine X-ray examination of the lumbar spine supplemented by X-ray evaluation of calcaneus, has been investigated in 73 female subjects who also had photon absorptiometry done on calcaneus and antebrachiúm. Comparison of the two methods reveals that there is no close relationship between the results. Photon absorptiometry for evaluating bone mineral content has proven its precision and accuracy, while conventional X-ray film evaluation of bone mineral seems to lack a proper foundation.


Serum glucose determination with dextrostix and the eyetone reflectance meter. A simple, modified procedure for the Dextrostix-Eyetone system has been evaluated in order to enable the system to measure the concentration of glucose in serum as well as in whole blood. A reduction of the ordinary time of reaction on the Dextrostix from 60 to 45 sec gave serum glucose determinations by the Dextrostix-Eyetone system that correlated almost perfectly with those obtained by a specific conventional laboratory procedure. Thus, the coefficient of correlation was 0.99 and the regression line very close to the ideal line. As the modification is very simple and does not involve any changes in the adjustment of the instrument, it is recommendable in all cases where only serum samples are available.


Serum vitamin B12 levels in the aged.

Serum vitamin B12 levels in the aged. In an attempt to throw light on the question of age-related variations in the normal blood content of cobalamin and on the frequency of deficiencies of antimegaloblastic nutriments in the elderly, 273 geriatric patients have been investigated. Low serum vitamin B12 values were found in one third of these patients, due to latent pernicious anaemia in five and malabsorption in seven cases, and probably caused by nutritional deficiency of folate or cobalamin in 78 cases. In that part of the series with apparently normal vitamin B12 levels, the mean value (379+/-14 pg/ml) was lower than the mean (456+/-20 pg/ml) for a younger control group. However, this cannot be taken as a sign of a physiological lowering of the cobalamin values with age, as nutritional deficiencies could not be ruled out in this part of the series. It is concluded that serum vitamin B12 assays should be performed rather liberally in the aged. Patients with nutritional deficiency of cobalamin or folate should be treated, even if frank megaloblastic anaemia is not present.


Iron therapy in patients undergoing maintenance hemodialysis. Twelve patients in maintenance hemodialysis, receiving long-term oral iron therapy, have been treated with i.v. iron dextran, in order to evaluate the effect on the Hb level. Both Hb and hematocrit were unchanged before and after the iron dextran infusion (p greater than 0.5, p greater than 0.7, respectively). Oral iron therapy is usually sufficient to maintain an adequate iron balance in dialysed patients and should be preferred to parenteral iron in view of the better utilization and absence of side-effects. The indication for parenteral iron should be limited to patients with impaired gastrointestinal iron absorption.


Hemodynamic influence of multiple congenital arteriovenous fistulas. Report of a case. A 16-year-old girl complained of sensations of weight, swelling warmth and freqeunt sweating from her right arm and hand. Varicose veins were seen on the dorsal aspect of her right hand, her right arm was longer than the left. Since birth she had a capillary hemangioma involving her right shoulder. Right arm and aortocervical arteriograms disclosed large arteriovenous fistulas. Cardiac output was markedly increased. No cardiac enlargement was seen at X-ray examination. The prognosis and future management of the patient are discussed.


Immediate and long-term results of emergency aortic valve replacement in acute bacterial endocarditis. A surgically treated material comprising 18 patinets with heart failure from aortic insufficiency during acute endocarditis has been reviewed. At the time of operation the mean duration of heart failure was 3 weeks and duration of endocarditis 9 weeks. Blood culture was positive in half of the patients, 39% had predisposing valve disease, 14 (78%) had a preoperative heart catheterization. The peroperatively measured regurgitation averaged 55%. All 18 patients had an artifical valve implanted, and the mean observation time for 13 long-term survivors was 3 1/3 years. There were 3 postoperative and 2 late deaths. A long-term survival rate of 73% strongly supports early surgical treatment in patients with aortic insufficiency and heart failure during acute endocarditis.


Sarcoidosis of the spleen.

Sarcoidosis of the spleen. To determine the frequency of splenic involvement in sarcoidosis, fine-needle aspiration biopsies of the spleen have been performed on 71 patients and enlarged in 6. Splenic sarcoidosis was demonstrated in 53% of all patinets, and in 67% of those with and in 47% of those without known extrathoracic manifestations. No complications occurred with this simple bedside procedure. In sarcoidosis, fine-needle aspiration biopsy of the spleen is a valuable diagnostic tool, especially when visible or palpable lesions are absent. Its use is recommended before the use of mediastinoscopy, bronchoscopy, lung biopsy or laparoscopy.


Observations on the different calcium metabolic patterns in sarcoidosis. A metabolic and kinetic study. Combined calcium balance and 47Ca turnover studies in sarcoidosis (4 patients) and vitamin D intoxication (1 patient) disclosed three different patterns of calcium metabolism. On patient with sarcoidosis had a normal metabolism of calcium, and two patients presented the usual pattern of intestinal hyperabsorption, hypercalcemia, and hypercalciuria. The fourth patient with sarcoidosis and the patient with vitamin D intoxication, both studied during spontaneous remissions, presented the third pattern. The main features here were hypercalcemia despite normal intestinal absorption of calcium, enlarged exchangeable calcium pool, accelerated accretion and resorption rates, hypercalciuria, and a distinctly negative calcium balance. This pattern of remission seems to represent a mobilization of extraosseous or metastatic calcifications, rather than a resorption of bone calcium.


1-Alpha-hydroxycholecalciferol-induced changes in the renal heandling of phosphate and the serum parathyroid hormone level. The effect of 1-alpha-hydroxycholecalciferol (1alpha-OH-D3) on the renal handling of phosphate and the immunoreactive parathyroid hormone in serum (i-PTH) has been studied in 10 patients with a wide range of glomerular filtration rate (GFR), maximal tubular reabsorption of phosphate (TmP) and i-PTH. The patients were treated with 2 mug 1alpha-OH-D3 per day for approximately 80 days. Before and after this period of treatment, the TmP, i-PTH, 51Cr EDTA clearance, extracellular volume, standard bicarbonate, and serum calcium were measured in each patient. The TmP/GFR ratio was used as an index of the renal handling of phosphate. The index increased significantly (mean 26.5%, p less than 0.01) during the treatment, while i-PTH decreased significantly (mean 37.0%. p less than 0.01). An inverse significant correlation was demonstrated between TmP/GFR index and i-PTH both before (r = -0.87, p less than 0.001) and after (r = -0.79, p less than 0.01) the administration o alpha-OH-D3, while none of the other factors investigated were correlated to the index. It is concluded that 1alpha-OH-D3 increases the TmP/GFR index and reduces i-PTH in a parallel manner and it is therefore suggested that the 1alpha-OH-D3-induced changes in the renal handling of phosphate may be explained as being mediated solely via the suppression of i-PTH.


Clinical and laboratory findings in subjects with hypercalcaemia. A study including cases with primary hyperparathyroidism detected in a health screening. Primary hyperparathyroidism (PHPT) was the most likely diagnosis in 68 non-thiazide-treated patients with hypercalcaemia detected in a health screening. The group comprised 55 females and 13 males, with a mean age of 55.0 +/- 0.7 (S.E.M.) years. On a pair basis these patients (the observation group) were compared with a series of 68 age- and sex-matched normocalcaemic subjects (the control group) selected from the health screening register. Renal calcui and reduced creatinine clearance were encountered less frequently in the observation group than in many reports of hospitalized patients with PHPT. Compared with the control group, the observation group comprised a greater number of subjects with renal calculi (usually multiple and bilateral), constipation, mental depression and reduced creatinine clearance. The ECG Q-T interval was shorter in the observation group than in the control group. No differences were found with respect to the occurrence of gastritis and/or peptic ulcer, poly-dipsia, polyuria and general muscle weakness. On the basis of this and a previous study it was concluded that at least 3% of the 15903 subjects participating in the health screening suffered from "asymptomatic" hypercalcaemia and most probably from "asymptomatic" PHPT.


Menopausal age of females with hypercalcaemia. A study including cases with primary hyperparathyroidism, detected in a health screening. The mean age at natural menopause of 7 328 women participating in a health screening conducted by the Stockholm City and County Council was 50.2 years. The corresponding age encountered for a subgroup of 49 women with hypercalcaemia (very probably due to primary hyperparathyroidism) confirmed in repeated determinations was 45.7 +/- 0.4 (mean +/- S.E.M.) and significantly lower than that (50.1 +/- 0.4 years) of a normocalcaemic age-martched control group (p less than 0.001). The health screening was performed about eight years after the women's menopause. The observation and control groups showed a significant difference with regard to the serum calcium level but no difference was found with respect to marital, parital or socio-economic status or disorders that may result in early or late menopause.


Acetylator phenotype in patients with hydralazine-induced lupoid syndrome. The acteylator phenotype has been determined (isoniazid half-life) in 31 patients, 25 of them women, who had exhibited a lupus erythematosus-like syndrome during treatment with hydralazine. Twenty-nine patients were slow acetylators, one was rapid (probably spontaneous SLE) and one uncertain. Only two patients had been given more than 200 mg of hydralazine daily. The mean duration of therapy was 32 months at the onset of symtoms. These were not serious but rather long-standing. Our study confirms that patients who risk developing hydralazine lupus are slow acetylators, especially females, treated with more than 100 mg daily. Rapid acetylators seem to develop this side-effect rarely, if at all.


Problems encountered in long-term treatment with anticoagulants. The course of long-term anticoagulant therapy in 114 out-patients has been evaluated over a three-month period. The evaluation was based on the registration of information from the clinical records and from two personal interviews with each patient. The patients had attended the Anticoagulation Clinic for 141 weeks on the average. The prothrombin complex activity (PP%) level was siginificantly lower in patients with bleeding episodes. An apparently higher PP% level in patients with thromboembolic manifestations was not significant. No bleeding was observed when the PP% was above 25. Warfarin resulted in relatively bleeding episodes and more PP% values within the desired range (10-25) than phenprocoumon and bishydroxycoumarin. The role of age, but not of moderate hypertension, as a risk factor was confirmed. A probable adverse interaction of the anticoagulant and other drugs was found in 37.5% of the situations in which an interaction could be expected according to the literature.


Oesophageal dysfunction in male patients with angina-like pain. Twenty-eight male patients referred to work ECG due to chest pain, all with a positive oesophageal symptom questionnaire believed to detect oesophageal dysfunction (OD), have been subjected to a graded work test and an oesophageal manometry test and answered a questionnaire believed to detect effort angina. Ischaemic heart disease (IHD) was defined as earlier infarction on ECG at rest or a pathological effort ECG. OD was defined as a positive acid perfusion test, hernia or a clear dysmotility in combination with a lower sphincter incompetence. Twenty patients had a positive effort angina questionnaire. Among these, OD was more common (n = 13) than IHD (n = 8). Five of the 20 patients had signs of both IHD and OD. Eight patients had a negative effort angina questionnaire; OD was found in 7 and IHD in 1 of these patients. It is concluded that in cases with angina-like chest pain OD should be considered.


Plasma levels and effect on heart rate and blood pressure of metoprolol after acute oral administration in 12 geriatric patients. Metoprolol, a cardioselective beta-blocking agent, has been given orally to 12 geriatric patients with moderate hypertension. Drug levels of metoprolol as well as the effect of the drug on resting heart rate and BP were studied. Metoprolol was given in a dose of 20 mg, and 8 of the 12 patients also received a 50 mg dose. After the 20 mg dose the peak drug plasma concentration varied between 5 and 80 ng/ml (mean 33), and after the 50 mg dose between 14 and 212 ng/ml (mean 111). This variation is much greater than that seen in earlier studies on healthy volunteers and on a group of non-geriatric hypertensive patients. Plasma half-life of metoprolol averaged about 3.5 hours after both the 20 mg and the 50 mg dose; this does not differe from the plasma half-life in earlier studies in younger age groups. The variability observed in the study might be explained multifactorially, e.g. by different body weight, absorption and/or first-pass effect of the drug.


Clinical diagnosis in patients with smooth muscle antibodies. A study of a one-year material. Out of 17 109 sera tested for autoantibodies by indirect immunofluorescence, 236 contained smooth muscle antibodies (SMA) with a titre of greater than or equal to 1/25. The majority of these sera, from 190 patients, reacted both with smooth muscle and renal glomeruli and the specificity of these SMA is against actin. 91% of high-titred sera (greater than or equal to 1/100) with IgG antibodies giving this staining pattern were derived from patients with chronic inflammatory liver disease, mainly chronic active hepatitis. In the group with a titre of 1/25, non-liver diseases such as joint diseases were more common and liver conditions occurred only in 55%. Sera with SMA of IgM class weremostly derived from patients with acute viral hepatitis.


Serum triglycerides and fatty acid incorporation into human adipose tissue (TIAT). Their relations with adipose tissue characteristics and glucose tolerance. Fatty acid incorporation into adipose tissue (FIAT), the metabolic process assimilating plasma triglyceride fatty acids liberated by lipoprotein lipase, was recently found to be lower in hyper- than in normotriglyceridaemia. In the present report, the relation of FIAT to glucose tolerance and adipose tissue morphology and fatty acid composition has been studied in a popoulation of men with normo- and hypertriglyceridaemia, using needle biopsy specimens. In addition, the associations between plasma triglyceride concentration and these factors as well as FIAT were examined by statistical methods. FIAT and GLIAT (glucose incorporation into adipose tissue) activities per cell were positively correlated with fat cell diameter but not with fat cell number. FIAT activities per cell and per unit surface area were lower in hyper- than in normo-triglyceridaemic subjects. The k-value of the i.v.glucose tolerance test and glycerol release from adipose tissue did not correlate with FIAT or GLIAT activities. The proportion of stearic acid in adipose tissue was negatively correlated with the serum triglyceride level and with fat cell diameter, but positively correlated with FIAT. Linolenic acid in adipose tissue correlated positively with the k-value. The negative correlation between serum triglycerides and FIAT remained when the other variables which were significantly correlated with FIAT or the serum triglycerides were entered in partial correlat-on analysis. These results suggest that although low FIAT activity is related in part to other characteristics, it occurs in hypertriglyceridaemia independent of glucose tolerance or various characteristics in fat. With serum triglyceride concentration as dependent variable, stepwise regression analysis was performed, entering all other variables as independent ones. The highest multiple --value was 0.76 (p less than 0.001) and it was obtained with three adipose tissue parameters: FIAT (or GLIAT), content of linolenic acid and of stearic acid. The other parameters did not give rise to any further improvement in the prediction of the serum triglyceride concentration which is better than 50% (R2 = 0.57).


Extreme digitalis intoxication.

Extreme digitalis intoxication. A case of massive digoxin intoxication is described. The concentration of digoxin in plasma, 15.5 ng/ml, is one of the highest observed in an individual not having heart diease who survived the intoxication. During the first two days there was complete heart block but only moderate hyperkalaemia. The advantage of temporary pacemaker treatment under these conditions is emphasized.


Nephrotic syndrome due to subacute glomerulonephritis -- association with hydrocarbon exposure? A 59-year-old man developed a nephrotic syndrome 40 days after hydrocarbon exposure of 3 days' duration. Renal biopsy gave evidence of a subacute proliferative glomerulonephritis. A lasting remission was obtained with immunosuppressive therapy. The case history is discussed in the light of recent studies indicating a causal relationship between hydrocarbon exposure and glomerulonephritis. The reversible nature of the disease in the present case is discussed in relation to the disease in experimental animals induced by a single administration of heterologus antigen.


Electrophoretic patterns of insoluble proteins in the sensory cerebral cortex of visually deprived and normal kittens. Insoluble proteins were investigated in the visual cortex (area 17) and somatic sensory cortex of one month old kittens. Visual deprivation did not affect the electrophoretic pattern but changed percentage distribution of proteins in both cortices. Some of the alterations seemed to appear only in the visual cortex, which is morphologically and functionally deficient in deprived kittens. Electrophoretic patterns of normal kittens differed from those of normal adult cats.


Relationship between the peculiarities of elaboration and retention of brightness discrimination and the serotonin content in the rat brain. The role of serotonin in memory consolidation was investigated by comparing the serotonin content in the brain of young and old animals which differed in the duration of consolidation process and by comparing the serotonin content in the brain with the efficiency of retrieval of memory traces in animals of the same age. Old rats had the serotonin content higher in the hippocampus and lower in the hemispheres, diencephalon, midbrain and medulla as compared with young ones. Elaboration of brightness discrimination increased the brain serotonin content in old animals and decreased it in young ones. Inverse correlation occurred between the serotonin content in the hippocampus, midbrain and the medulla and retention of conditioned reflexes in rats of the same age. No correlation occurred between the serotonin content in the cerebral structures and the rate of conditioning.


Differentiation learning as a function of stimulus intensity and previous experience with the CS. Discrimination between 50- and 70-dB white noise was investigated in rats under three training procedures employing a conditioned emotional response (CER) technique. When a CER was initially established to the CS(+) and then the CS(-) was introduced, clear generalization of the CER from CS(+) to CS(-) was observed at the beginning of differentiation learning. When both CSi were simultaneously introduced from the beginning of training, subjects acquired the CER to both intensities. Only then, did differential response to intensities occur as an effect of CER extinction to the CS(-). Habituation of the white noise intensity used during differentiation learning as the CS(+) exerted only a small effect on the course of training. Under all training procedures differentiation of the 50-dB CS(+) and 70-dB CS(-) was more difficult than between the 70-dB CS(+) and 50-dB CS(-). This finding was related to both slower. acquisition of the CER when the less intense CS was paired with shock and to a marked decrease of suppressive properties of the weak CS(+) together with CER extinction to the more intense CS(-). Even by the end of differentiation learning intensity relations between CSi during criterion sessions exerted a strong effect on the magnitudes of suppression ratios.


The effect of bovine fibrinopeptides on the central action of chlorpromazine and amphetamine in rats. A mixture of fibrinopeptides A and B did not evoke any significant central effects when given by intraperitoneal injection, whereas it increased psychomotor activity when injected into a cerebral ventricle. The fibrinopeptides when given by intraperitoneal injection interacted with amphetamine to increase locomotor activity and with chlorpromazine to decrease both locomotor activity and body temperature. It is suggested that the release of fibrinopeptides in various clinical conditions where there is increased fibrinogen-fibrin conversion may lead to an altered sensitivity to centrally acting drugs.