Upper airway obstruction--a report on sixteen patients. In sixteen patients with upper airway obstruction, breathlessness was a symptom in all with maximum mid vital capacity flow rates in inspiration or expiration of 1-7 litres per second or less. With one exception, all these patients had stridor. The stridor was inspiratory in nine, expiratory in one and both inspiratory and expiratory in two. There was no diagnostic difficulty in the twelve patients with extrathoracic airway obstruction and in this group tests of inspiratory flow (forced inspired volume in one second, peak inspiratory flow or maximum mid inspiratory flow) were of most value in following the progression of the disease and the response to treatment. Flow volume loops were particularly useful where extrathoracic obstruction and diffuse intrapulmonary airway obstruction co-existed. The two patients with intrathoracic upper airway obstruction caused considerable difficulty with diagnosis and both were initially thought to have, and treated unsuccessfully for, asthma. In each patient flow volume loops showed a low flow expiratory plateau, diagnostic of severe intrathoracic airway obstruction but recorded in the absence of any clinical or radiographic features of emphysema. An obstructing lesion of the intrathoracic trachea was therefore suspected and this was confirmed by tracheal tomography. In one patient serial expiratory flow volume curves demonstrated the combination of intrathoracic upper and lower airway obstruction. Two patients had tracheal stenosis in the region of the suprasternal notch. Each showed a characteristic twin humped expiratory flow volume curve and in one patient the stenosis was demonstrated both physiologically and radiologically to move in and out of the thorax. The importance of a standard posture during serial measurements is emphasized. The ratio of forced expired volume in one second measured in millilitres, to the peak expiratory flow measured in litres per minute, was of limited value if differentiating upper from lower airway obstruction in these patients. It is concluded that upper airway obstruction is likely to become more common and that respiratory function tests, in particular the flow volume loop, play an essential part in the recognition and management of this problem.


Penicillamine nephropathy in rheumatoid arthritis. A clinical, pathological and immunological study. Fourteen patients who developed persistent proteinuria while on penicillamine for rheumatoid arthritis, were collected over a period of one year. Eleven patients had a frank nephrotic syndrome and three had a lesser degree of proteinuria but no oedema. The patients had received penicillamine (mean daily dose 1015 mg) for less than one year (mean 7-5 months) when the nephropathy was detected. Clinical investigations have been correlated with renal biopsy material. Light microscopy detected no abnormalities except for minimal hypercellularity in a few patients. In markde contrast, the electron-microscope revealed numerous electron-dense deposits (EED's) in the outer layer of the basement membrane. Immunofluorescence showed the presence of IgG and complement in the basement membrane, the intensity of which correlated with the number of EED's. The pathological picture was essentially the same in those patients with the nephrotic syndrome and those with proteinuria. In this series, we found no evidence that penicillamine induced renal damage by any other mechanism except immune complex deposition. Serological tests revealed little evidence for complement activation or consumption and platelet aggregation was the only positive direct test for circulating immune complexes. Renal biopsies were performed at differing intervals after the cessation of penicillamine therapy, which allowed assessment of the natural history of the pathological lesion and revealed a striking persistence of EDD's in some patients. Two patients showed an almost identical picture initially and at re-biopsy one year later. Persistent proteinuria was also a feature of the group as a whole. The pathological picture has similarities with that of idiopathic membranous glomerulopathy. This study suggests that the use of penicillamine in rheumatoid arthritis may induce persistent renal damage.


Assessment of urinary tract obstruction using a perfusion technique. A perfusion technique is described which enables differentiation in a dilated upper urinary tract between one which is obstructed and one which is not. It has been found invaluable in the assessment of patients prior to surgical intervention and has saved many patients from an operation.


Anatomy and radiologic diagnosis of perihepatic abscesses. The radiologic diagnosis of perihepatic abscess is one of the most important diagnoses the radiologist is called upon to make. The author defines, simply and accurately, the spaces around the liver, and simplifies the radiologic diagnosis of abscesses within these spaces. He establishes a radiologic routine which aids in this task.


Radiologic diagnosis of disordered esophageal motility: a unified physiologic approach. Fluoroscopy and cineradiography of the esophagus with swallowed contrast media are indispensable in the study of normal and abnormal contractions of the esophagus, and when performed by experienced radiologists they are believed to be superior and easier on patients than motility studies with pressure recordings.


Normal and abnormal motility of the stomach. The analysis of gastric motility makes possible the distinction between purely anatomic changes and those of a functional nature with or without associated morphologic alterations. Hence, through evaluation of gastric and duodenal motor function contributes significantly to the radiographic examination of the upper gastrointestinal tract.


Radiographic changes after small bowel bypass for morbid obesity. The presence of multiple intestinal air-fluid levels and the distention of jejunum and colon are common and expected sequelae of small bowel bypass procedures for morbid obesity. The radiologist must be familiar with these findings in order to avoid the misdiagnosis of bowel obstruction.


Transhepatic percutaneous cholangiography. Transhepatic percutaneous cholangiography continues to be a significant tool in the diagnosis of jaundice. It allows direct, easily achieved graphic delineation of the biliary system. Although specific diagnosis may not be possible, the site and extent of obstruction and the differentiation from intrahepatic parenchymal disease may be determined with a high degree of success.


Radiology of the pancreas, 1976: sonography and ductography. In recent years ultrasonography and endoscopic retrograde cholangiopancreatography (ERCP) have assumed pre-eminent roles in the radiographic evaluation of patients with pancreatic disease. This article survays the present status of these techniques based on clinical experience at the Massachusetts General Hospital and a review of the literature.


[Radiological methods in diagnosis of colitis (author's transl)]. Short reference is made to the problem of preparing the colon for x-ray examination when colitis is suspected. The optimal roentgenologic examination technique of the colon is demonstrated. This technique requires: multiple large survey films (35 by 43 cm) of the colon - filled with barium and post evacuation; the focal film distance should be at least 150 cm; in addition, double contrast studies with air as well as spot films of the entire rectal and sigmoid area to prevent overlapping of bowel loops. The diagnostic and technical failures of colonoscopy are pointed out but its value as a supplementary examination is emphasized and recognized.


[Radiographic signs of colitis with consideration of angiographic findings (author's transl)]. Description of radiographic lesions in the various stages of ulcerative colitis as well as the deviating alterations of granulomatous colitis are represented. Radiographic signs are discussed with regard to their diagnostical importance. The value of angiography for the differential diagnosis of colitis is pointed out.


Immobilization in pediatric radiography. A new pediatric chair immobilizer has been designed to provide positive immobilization that is easy to work with and apply. It can be used for subjects of various sizes, and can be rotated 360 degrees for easy positioning. It provides safe restraints, saves valuable time and helps the technologist to obtain better radiographs.


[Surgical treatment of colitis (author's transl)]. The main reason for poor results in treatment of ulcerative colitis may be found in the well-meant hesitation of the clinician to ask for surgical intervention. 233 cases are discussed, particularly the absolute and relative indications for surgery. For complicated cases of colitis, as well as for the so-called "colitic invalid" only operative treatment with an ileostomy offers optimal results. The high mortality of toxic megacolon as a consequence of the acute form of ulcerative colitis is discussed. The high post-operative mortality as a result of toxic mega-colon was significantly reduced by Turnbull's substitution of a multi-stage operation for the formerly used one-stage technique.


[Clinical and roentgenological aspects of toxic megacolon (author's transl)]. Ulcerative colitis may occur on several forms. Toxic megacolon is roentgenologically characterized by dilatation usually in the area of transverse colon and toxic symptoms. At the first appearance of these symptoms the patient should be treated or operated upon. Under normal circumstances the roentgenological diagnosis may be obtained only by a full erect or a left lateral decubitus film of the abdomen. A barium enema could lead to performation of the colon, peritonitis or provocation of toxic megacolon. In doubtful cases the examination should be performed with water-solubel contrast media (i. e. Gastrografin, Propyliodon etc.) The therapeutical internal and surgical possibilities are discussed.


Highlights from a socioeconomic survey of radiologic technologists in North Carolina. A survey of radiologic technologists in North Carolina shows that, in general, technologists fare better economically when working in hospitals than in radiologists' offices. It is not surprising to note that salaries increase with an increase in job responsibilities and for those who participate in continuing education. At the time of the survey in early 1975, only 35 per cent of those responding were involved in some form of continuing education program. Further studies are needed to better define some of the implications noted in the survey.


Radiation therapy technolgoy manpower survey. A survey of 270 radiation therapy facilities in the United States in 1975 was made by the University of Vermont to identify needs in terms of curriculum, new or expanded programs and radiation therapy technology manpower. From the 64 per cent return there is evidence to support the current "Essentials," and to increase educational opportunities for potential radiation therapy technologists to satisfy the demand for more certified technologists as expressed by those who responded.


[Diverticulosis of the sigmoid colon from the radiological point of view (author's transl)]. Diverticulosis is one of the most common diseases of the colon. Its importance arises from complications. In countries of the Western hemisphere the incidence is 10-20% beyond the age of 50. Among the natives of Africa and South-Eastern Asia it is practically unknown. It is suggested that the disease is caused by low residue diet, modern living conditions. and constitutional disorders. 500 barium enemas revealed 13,4% patients with diverticula including a 5-year-old child and a 32-year-old woman. The incidence of diverticulosis among patients over 40 years of age is 19,6%. The sex distribution is 1 : 1,9 male to female. The complications are demonstrated by case histories: Diverticulitis with ileus, foreign body trap, sub-acute perforation, sigmoid-vaginal fistula, sigmoid-bladder fistula, sigmoid-uterus fistula in a 5-year-old girl.


[Diverticulosis - Diverticulitis from the surgical point of view (author's transl)]. Diverticulosis from surgical point of view means treatment of complications. Treatment of primarily acute and chronic diverticulitis without complications should be conservative in the beginning. Primarily or secondarily complicated cases should undergo proper surgical resection. In these cases a step-by-step procedure has to be considered. Suspicion of simultaneous diverticulosis with carcinoma demands operative clarification.


Radiographic duplication: simple method of minimizing radiation dosage to the patient. It is practical and inexpensive to have a simple duplicating station in every radiological department. An attempt should be made to salvage every overexposed film rather than to re-examine the patient. Duplication with intensified light is 33 1/3 per cent faster than with any other method reported thus far.


[Particularities of sigmoiditis with regard to pharmaco-radiography (author's transl)]. The sigmoid colon differs from the remaining colon anatomically, functionally and by increased incidence of disease. Occasionally it may be very difficult to differentiate diverticulitis of the sigma from a malignant tumor. It is felt that hypotonic sigmoidography improves the diagnostic accuracy. Selective angiography of the inferior mesenteric artery may be of further diagnostic help. Pharmaco-angiographic examinations with Eupaverin yielded no better results.


[Clinical aspects of inflammatory diseases of the large bowel with reference to coloscopy (author's transl)]. Ulcerative colitis and regional colitis Crohn are the most frequent inflammatory diseases of the large bowel in Europe. Clinical differentiation of these disorders are difficult. Diarrhoe with bloody stools are predominant. In cases with Morbus Crohn anorectal fistulas and involvement of the terminal ileum are frequently found. In cases with ulcerative colitis anorectal fistulas are more rare but in this disease a carcinoma of the colon often develops, especially when the course is severe and the involvement of the colon is extended. Clinical symptoms, courses and complications of both diseases are described. In differential diagnoses endoscopic procedures especially coloscopy play an important role. In cases of ulcerative colitis about 90% the rectum is involved. Spontaneous haemorrhage of the colonic mucosa with edema and pseudopolyps are typical endoscopic findings. Most cases with Crohn's disease show flat and irregular ulcers within a normal mucosa. In later stage a "cobble stone" relief is demonstrable. Endoscopy and guided biopsy are not only important for differential diagnosis but also for treatment and prognosis.


Roentgenology of the colon in Crohn's disease. Air contrast studies of the lesions and their development. 201 patients with Crohn's disease underwent air contrast examination of the colon. The Diagnosis was histologically confirmed in each case. Most of the pathological changes of Crohn's disease of the colon are manifested as alterations of the mucosal surface. These changes are excellently demonstrated by the air contrast technique. The roentgenologic findings in colonic Crohn's disease are being discussed as well as cecal deformities and rectal changes. Some conditions that may mimic colonic Crohn's disease are summarized. Finally the advantages and disadvantages with the air contrast technique are given.


Failure of indomethacin to reduce hypercalcemia in patients with breast cancer. Prostaglandin synthetase inhibitors have, in the past, been shown to inhibit osteolysis caused by breast carcinoma tissue in vitro. We therefore assessed the effect of Indomethacin and aspirin on some parameters of calcium metabolism in patients with breast cancer. Neither drug reduced the serum calcium in pateints with hypercalcemia, nor reduced skeletal destruction as measured by the urinary hydroxy proline: creatinine ratio and urinary calcium in normocalcemic or hypercalcemic patients with osteolytic metastases. A possible reason for the discrepancy between results obtained in vitro and in vivo is that there are two phases of bone destruction in breast cancer; the early phase dependent and the late phase independent of prostaglandin synthesis.


In vivo suppression of prostaglandin biosynthesis by non-steroidal anti-inflammatory agents. In vivo effects of orally administered inhibitors on prostaglandin and F levels were determined in seven organs of the rat. Ibuprofen showed suppression in most tissues three hours after dosing with a return to control values by twenty-four hours. Flurbiprofen and indomethacin showed potent suppression at both three and twenty-four hours after dosing. 3-Acetonitrile, 4,5-bis(p-methoxyphenyl)-2-phenyl-pyrrole showed moderate suppression only in the stomach and duodenum at three hours after dosing with a return to control values by twenty-four hours. Acetaminophen incorporated as a control showed statistically significant suppression only in the liver after twenty-four hours.


The possible mode of action of phostaglandins. XII. Differential effects of phostaglandin F2alpha in inducing premature evacuation of conceptos in the intact and castrated pregnant rat. A single injection of 2.0 mg/kg prostaglandin F2alpha(PGF2alpha) on day 18 of pregnancy was consistent in inducing premature labor by 72 h following the injection. Conversely, castration before PGF2alpha on day 18 of pregnancy made the animals almost inert to PGF2alpha and only 20% of the treated animals showed premature evacuation of the conceptus. Injection of 10mug of estradiol cyclopentylpropionate (ECP) on day 18 was, however, found to be effective in emptying the gravid uteri of 100% castrated pregnants by 72 h. Indomethacin, a consistent inhibitor of prostaglandin biosynthesis and release, along with ECP in an identical experimental situation was found to be ineffective in reversing the ECP-induced premature parturition in castrated pregnants. The importance of intact ovary for the action of PGF2alpha concerning premature labor in rats has been discussed.


Effects of analogues of prostaglandins E2 and F2alpha on uterine luminal fluid accumulation in the estrogen-treated ovariectomized rat: an indirect measure of cervical tone. Experiments were performed to determine if prostaglandins were able to reduce cervical tone in the rat. Cervical tone was assessed indirectly by measuring uterine luminal fluid accumulation in ovariectomized rats implanted subcutaneously with Silastic capsules containing crystalline estradiol-17beta. When given subcutaneously in separate experiments, 16,16-dimethyl-prostaglandin E2, methyl ester, and 15(S)-15-methyl-prostaglandin F2alpha, analogues of prostaglandins E2, AND F2alpha, respectively, caused the loss of uterine luminal fluid. Fluid accumulation in uterine horns ligated at the cervical end did not differ in control and treated rats, whereas in non-ligated horns the prostaglandin analogues reduced fluid accumulation, suggesting the cervix as their site of action. For both prostaglandin analogues, the effects on uterine luminal fluid accumulation were seen within 45 min of administration and were related to the dose administered. The effects of submaximal doses of the analogues were additive. These results suggest that prostaglandins are able to reduce cervical tone in the estrogen-treated rat.


The effect of reported prostaglandin synthetase inhibitors on estradiol-stimulated uterine prostaglandin biosynthesis in vivo in the ovariectomized rat. Aspirin, indomethacin and naproxen have been shown to inhibit the release of prostaglandins E and F (PGE and PGF) from the estradiol-stimulated uterus of progesterone-pretreated ovariectomized rats. Under the present experimental conditions indomethacin (1 mg/rat) was found to be a potent inhibitor of PGF and E biosynthesis, but the duration of action was less than 24 hours, after which a rebound above control levles was observed.The  compounds were without effect on estradiol-stimulated increases in uterine wet weight. delta'THC did not inhibit estradiol-stimulated PG biosynthesis but produced a significant rise (P less than 0.01) in PGE levels in uterine venous blood. A hypothesis is suggested to explain some of the pharmacological effects of delta'THC.


Release of prostaglandin F, regression of corpora lutea and induction of premature parturition in goats treated with estradiol-17beta. Premature parturition was induced in five pregnant goats infused intravenously with 4.65-8.4 mg estradiol-17beta but not in one treated with 5.85 mg estradiol-17alpha. A single intramuscular injection of 12 mg estradiol benzoate (8.8 mg estradiol-17beta equivalents) was also effective. These doses were estimated to provide plasma concentrations of estradiol-17beta in the physiological range for animals at sponteneous parturition. Circulating plasma concentrations of progesterone decreased and lactogenesis occurred before all instances of induced parturition but no such changes resulted from infusion of estradiol-17alpha. Placental delivery was normal in all animals but neonates of more than 10 days prematurity were non-viable.


Arterial walls generate from prostaglandin endoperoxides a substance (prostaglandin X) which relaxes strips of mesenteric and coeliac ateries and inhibits platelet aggregation. Fresh arterial tissue generates an unstable substance (prostablandin X) which relaxes vascular smooth muscle and potently inhibits platelet aggregation. The release of prostaglandin (PG) X can be stimulated by incubation with arachidonic acid or prostaglandin endoperoxides PGG2 or PGH2. The basal release of PGX or the release stimulated with arachidonic acid can be inhibited by previous treatment with indomethacin or by washing the tissue with a solution containing indomethacin. The formation of PGX from prostaglandin endoperoxides PGG2 or PGH2 is not inhibited by indomethacin. 15-hydroperoxy arachidonic acid (15-HPAA) inhibits the basal release of PGX as well as the release stimulated by arachidonic acid or prostaglandin endoperoxides (PGG2 or PGH2). Fresh arterial tissue obtained from control or indomethacin treated rabbits, when incubated with platelet rich plasma (PRP) generates PGX. This generation is inhibited by treating the tissue with 15-HPAA. A biochemical interaction between platelets and vessel wall is postulated by which platelets feed the vessel wall with prostaglandin endoperoxides which are utilized to form PGX. Formation of PGX could be the underlying mechanism which actively prevents, under normal conditions, the accumulation of platelets on the vessel wall.


A method for measuring the unstable thromboxane A2: radioimmunoassay of the derived mono-O-methyl-thromboxane B2. A radioimmunoassay was developed for a mono-O-methyl derivative of thromboxane B2. The antibodies showed high specificity for this compound and cross reacted only 1.2% with thromboxane B2 and less than 0.1% with prostaglandins and prostaglandin metabolites. The method had a sensitivity of 7 picog. The radioimmunoassay was employed in studies where thromboxane A2 was generated in human platelets and immediately converted into mono-O-methyl thromboxane B2 by treatment of the sample with a large volume of methanol. In some of the experiments, thromboxane B2 was simultaneously measured by a separate radioimmunoassay. Using these two assays it was demonstrated that thromboxane A2 could be detected only during the earlier stages of the platelet aggregation, whereas thromboxane B2 rapidly reached a constant level. In a separate experiment, the half-life of thromboxane A2 in buffer was found to be 32.5 + 2.5 (S.D.) sec at 37 degrees C; the compound was more stable at lower temperatures. The t1/2 for thromboxane A2 was also considerably longer in plasma.


Thromboxane A2 and prostaglandin H2: potent stimulators of the swine coronary artery. Thromboxane A2 was generated by incubation of arachidonic acid with a suspension of human platelets. The filtrate contained 266 +/- 46 ng/ml (n=10) of thromboxane A2 and 25 ng/ml or less of prostaglandin endoperoxides (prostaglandins G2+H2). Thromboxane A2 was 2-10 times more potent than prostaglandin H2 and 9-102 times and 26-308 times more potent than prostaglandins E2 and F2alpha, respectively, in causing contractions of the superfused swine coronary artery.


Biphasic effects of phospholipase A2 on platelet aggregation. Effect of prostaglandin synthesis inhibitors and essential fatty acid deficiency. Phospholipase A2 has a biphasic action upon the aggregation of rat platelets. In the first phase, occurring after shorter incubation periods with the enzyme, aggregation is enhanced. Longer incubation periods lead to an inhibition of the aggregation. The first phase disappears after the addition of indomethacin whereas the second phase persists. Incubation of platelets with phospholipase A2 leads to serotonin release. Prostaglandins are formed without platelet aggregation. Whereas the same effects occurred at the high dose of phospholipase A2 when platelets of essential fatty acid deficient rats were used, a difference was seen at the lower dose. It is concluded that in the first phase, arachidonic acid is liberated and transformed into aggregation inducing intermediates which are formed in the prostaglandin synthesis. In the second phase, changes may occur in the outer membrane which lead to diminished sensitivity to aggregating agents.


Separation of prostaglandins E2 and F2alpha from their pulmonary metabolites by thin-layer chromatography. A simple thin-layer chromatographic system has been developed separate PGE2 and PGF2alpha from 13, 14-dihydro-PGF2alpha, and other pulmonary metabolites of prostaglandins. The separation is achieved on Kieselgel-60 F-254 plates impregnated with both silver nitrate and boric acid. The system should be of use in the purification and tentative identification of primary prostaglandin.


Cardiovascular actions of prostaglanding F2alpha; 15-me-F2alpha; F1alpha; F2beta and F1beta in the cat. Prostaglandin F2alpha (5mug/kg, i.v.) causes an increase in pulmonary arterial pressure, decrease in systemic arterial pressure, and reflex bradycardia in the anesthetized cat. The same dose of the 15-methyl analogue of PGF2alpha produces the same triad of effects but of greater magnitude and duration. Although prostaglandins F1alpha, F2beta and F1beta also cause the same cardiovascular effects as F2alpha, there is a decrease in potency for all parameters measured, with PGF2alpha greater than PGF1alpha greater than PGF2beta greater than PGF 1beta. When compared to the actions of PGF2alpha in producing an increase in pulmonary arterial pressure, PGs F1alpha, F2beta and F1beta were less potent by approximately 10, 100, and 1000 fold respectively.


[The late effects of radiotherapy for enlargement of the thymus in early infancy (author's transl)]. In a survey of 380 subjects irradiated over 20 years earlier for enlargement of the thymus, no increase in mortality for malignant tumours were noted. There was a high incidence (3.75%) of benign thyroid diseases, though this could not be attributed to irradiation with any degree of certainty. There were no significant karyotype differences between 36 subjects and 32 controls.


[Thanatophoric dwarfism (author's transl)]. Two cases of thanatophoric dwarfism, one associated with cloverleaf skull diagnosed in the uterus and complete with histological findings are reported. Differential diagnosis with respect to similar forms of dwarfism and the genetic problem are discussed.


[A case of metatropic dwarfism (author's transl)]. A case of metatropic dwarfism is presented. Particular reference is made to the differential diagnosis of this form.


[Difference between dental plaque formation by Lactobacillus Sp. and Strep. mutans]. Human teeth were suspended in a basal medium with sucrose 10%; they were incudated for formation of dental plaques "in vitro". The microorganisms used were: Strep. mutans, Lactobacillus salivarius var. salivarius and a mixture of them. The following aspects were stablishad by scanning electron microscopy: 1) The teeth inoculated with Strep. mutans had coccoid forms, lying on an organic film with spheric spaces in some sectors, and irreguar forms in others (Fig. 1). 2) The teeth inoculated with Lactobacillus salivarius had rod forms attached to the adamantine surface (Fig. 2, 3). 3) Teeth incubated with the mixutre had rod forms over a granular film (Fig. 4). 4) The control teath did not have plaque (Fig. 5). This experience shows that the extracellular polisacharide, reticulated or granular (mutano) appeared only in teeth incubated with Strep. mutans alone (Fig. 1) or mixed with Lactobacillus (Fig. 4). On the other hand Lactobacillus appeared attached on the enamel surfaces, perhaps due to cohesive adhesive forces (Fig. 2). Two different interpretation or the formation of dental plaques that take place on the enamel free surfaces of teeth are presented.


[The concept of risk in influenza (author's transl)]. The evaluation of morbidity risk is difficult in influenza because of a lack of accurate quantitative information and of a high variability of the virus. The level of specific herd immunity towards epidemic strains is an important factor of prevision. As far as mortality is concerned, there is a net and regular increase of risk up from the age of 45. In addition to elderly, other high risk categories are known such as patients suffering of a number of organic deficiences or chronical conditions, pregnant women and children. The best evaluation of efficacy of vaccines is the study of incidence reduction in a vaccinated group in comparison to unvaccinated controls. Present vaccines are really efficient to reduce the risk of getting the disease, except in the case of an antigenic shift, which means the activity of a new antigenic component. These advantages are to be weighted to the small risk of vaccine reactions, which are not frequent and usually benign. Several vaccination strategies can be used. In France, it has been decided to recommand vaccine to priority groups: people over 65 and deficient patients. This policy is eqlivalent in many western countries (West Europe, USA); it is not efficient in preventing or delaying epidemics.


[The concept of risk in perinatology. Results of epidemiologic surveys (author's transl)]. A national survey of pregnancy and childbirth was conducted in 1972 in France from which for the first time risk factors for all pregnancies and practical consequences for prevention were obtained. Risk factors were determined by multivariate analysis for stillbirth, prematury, and low birth weight infants. Two groups of women were found to be at higher than average risk. The first included those under 18 or over 40 years old, or having a history of previous stillbirth or infant with birth weight less than 2 500 g. The 13% of all pregnant women in this group had double the overall population rate of stillbirth, prematurity and low birth weight infants. The second group, 7% of all pregnant women, included widowed, divorced, and separated women, as well as immigrant workers or wives of immigrant workers. These two groups of women, as well as those with pathological findings during pregnancy should be more closely followed during pregnancy as specified by law. However, the survey showed that the surveillance of high risk pregnancies is on the whole inferior to that of the overall population. Several solutions have been proposed to remedy this situation: -- to double the number of obligatory prenatal examinations, to 10 per woman, for all pregnancies, which would double the present total number of prenatal examinations from 4 000 000 to 8 000 000; -- to apply the legislation to women with high risk pregnancies by increasing either the inducements (educating these women and their doctors, more reembursements of costs), or constraints (requiring more medical appointments, home visits, or financial sanctions).


[The concept of risk in the field of youth suicide (author's transl)]. From personal works on suicide attempted by teenagers and recent literature review, the authors try to define risk factors for suicide. They discuss factors which may lead to primary prevention interventions and those which are predictive of repeated suicide.


[Use of the risk factor concept in cardiovascular diseases (author's transl)]. The essential implication of the notion of risk factor is that preventive action should be undertaken if certain factors, predisposing to cardiovascular diseases are present in an individual or in a group. Risk factors are thus categorized from the pragmatic point of view, according to the relative ease and practicability of prophylactic intervention -- and their justification. A brief review of the risk factors of the major cardiovascular diseases (coronary heart disease, hypertension, chronic pulmonary heart disease, stroke, rheumatic heart disease and congenital malformations) shows that the risk factor concept is the basis of preventive cardiology.


Hyperglycaemia; a risk factor for hypertension. The epidemiological evidence for an association between diabetes mellitus and ischaemic heart disease is reviewed briefly. The relationship between blood sugar after challenge and blood pressure is described, with particular reference to studies in populations of U.S. and Jamaican adults and Dutch children.


[Carcinogenic risks and prevention of cancer (author's transl)]. Epidemiologic studies supported by experimental research have made it possible to draw up an epidemiological outline of the different types of cancer. From the standpoint of prevention, carcinogenic factors can be investigated according as they apply to collective or individual life, according to their relative etiological importance, and to the incidence rate and gravity of cancers involved. The most efficient procedures concerning about more than 50% of human cancers appear to be the campaigns against tobacco and alcohol consumption, systematic screening and treatment of precancerous lesions of uterine cervix and changes in the nutritional habits.


[Some considerations concerning the concept of risk in public health (author's transl)]. The use of risk in Public Health consists schematically of two steps: the calculation of risk, and then action intended to reduce it. The calculation, taking into account the largest possible number of risk factors, can produce a risk value adjusted to the individual. Action was, in past, directly oriented by risk factors which caused the risk. But, now, that the approach to risk has become more indirect by taking into consideration predictive factors without a causative role, their use in action to reduce risk requires discussion. Thus it has seemed necessary to examine the situation in several pathological fields; substantial differences in uses of risk values were found according to the field taken into consideration. The point in common remains the attempt of an ideal approach guided by an overall assessement of cost and effectiveness, involving the cost of determining the risk and the advantages and costs of the resulting action.


[The concept of risk in epidemiology. Point of view of a public health officer (author's transl)]. The author stresses the importance of epidemiological investigation in Public Health, particularly in Public Health planning. He underlines the multiple contraints (economic, political, etc...) which epidemiologists may encounter and which may cause disappointments. Nevertheless he concludes that epidemiology will play a decisive role for years to come.


[Chronic obstructive bronchitis: definitions, risk factors and prevention (author's transl)]. Chronic obstructive bronchitis is defined as persistent diffuse airways obstruction frequently associated with chronic expectoration. This disease is particularly disabling and its medico-social burden implies that measures be taken. Risk factors of chronic obstructive bronchitis can be classified according to their presently known importance: tobacco, professional exposure, air pollution, viral and bacterial respiratory infections, poor socio-economic and cultural conditions, upper and lower airways infections during childhood, other environmental factors, genetic factors. Prevention needs that research be developed, in particular for factors, as hereditary ones, relations between childhood and adult respiratory diseases and characteristics of the "susceptible smokers". Knowledge of risk factors previously quoted allows to propose public-health actions. Firstly, true preventive action of general nature: fight against tobacco consumption, reduce atmospheric pollution, improve work and life conditions. Secondly, in order to prevent the disabling state of chronic bronchitis, it would be necessary to take care of patients at the initial state. A control trial is proposed to determine the level of symptoms and of reduction of ventilatory values at which an action is needed and the best "preventive therapeutical" protocol to be applied to these patients.


[Platelet anti-aggregating activity of furosemide (author's transl)]. The effect of furosemide on platelet aggregation, factor 3 availability, and response to hypotonic stress has been studied. Furosemide greatly inhibits platelet aggregation, with ADP, epinephrine, collagen, ristocetin, thrombin and serotonin. The use of heparin as anticoagulant does not alter this effect. Furosemide action is not conducted through calcium chelation. Platelet factor 3 availability is not modified by furosemide. There is a direct correlation between furosemide concentration and inhibition in the second phase of platelet response to hypotonic stress. The possibility of a disorder furosemide induced on the platelet metabolism, is suggested.


Action of the antipsychotic drugs thiotixene and thioridazine on isolated mitochondria. Thiotixene and thioridazine antipsychotic drugs produce a stimulation of mitochondrial respiration in state 3 and state 4 resulting in a complete respiratory control loss, only accompanied by slight alterations of oxidative phosphorylation. This effect may be of biological significance in the action mechanism of the drugs.


Measurement of enzymatic activities in turbid suspensions by double beam spectrophotometry. A method for the determination of enzyme activities in turbid suspension is described, based on the use of a double beam or double wavelength spectrophotometer in one or two cell mode. It measures the disappearance of NADH, coupled to the activity of the enzyme, at a 340 wavelength or at a 340 minus 374 mmu wavelength pair. The method has been applied to the determination of pyruvate kinase activity, in the presence of isolated mitochondria, and other possible applications are discussed.


Action of heparin on lecithin:cholesterol acyltransferase activity in normal subjects. The triglyceride decrease and free fatty acid increase by lipoproteinlipase post-heparin effect does not modify the Lecithin:Cholesterol Acyltransferase activity in vitro, using homologous substrate, in normal subjects. These findings agree with the unmodified proportion of esterified cholesterol and relative proportion of phospholipids on thin layer chromatographic fractioning after heparin. The conclusion is reached that heparin has no action on Lecithin:Cholesterol Acyltransferase activity in normal subjects.


Effects of glycerol and glucose on the kinetics of glycerol utilization by adipose tissue in the rat. To study the kinetics of glycerol utilization by adipose tissue in vitro as function of the concentrations of both glycerol and glucose in the incubation media, pieces of epididymal fat pad from fed rats were incubated for different times in Krebs Ringer bicarbonate supplemented with 1-14C-glycerol and purified albumin. An increase in the concentration of glycerol in the medium produces a decrease in the formation of 14CO2 and 14C-lipids from 1-14C-glycerol. When the decrease in the specific activity of the tracer is considered to calculate the respective velocities, it turns out that glycerol actually enhances the rate of synthesis of both CO2 and glyceride glycerol. Glucose enhances the rate of synthesis of CO2 and fatty acids from glycerol but decreases the rate of glyceride glycerol synthesis from the same substrate. While the Km of the glycerol effect is much lower that the physiological concentrations of glycerol the Ka and Ki of the glucose effects are above or close to its concentration in blood. The results are discussed in terms of the competitive effects of glucose and glycerol for the synthesis of alpha-glycerophosphate and the necessity of glucose for lipogenesis from glycerol in adipose tissue.


Hemolymph iron in Crustacea decapoda during the intermolt cycle. A study on the iron content in the hemolymph of Austropotamobius pallipes and Carcinus maenas has been made. The hemolymph iron content and the total iron binding capacity were investigated in males and females of both species. The values obtained for hemolymph iron content in the males were between 154 and 430 mug/100/ml and in the females between 134 and 431 mug/100/ml. The total iron binding capacity for the males was between 472 and 762 mug/100/ml and for the females between 390 and 698 mug/100/ml. The variations occurring in both parameters during different stages of the intermolt were also studied. The first increase in hemolymph iron coincides with the postmolt stage. During the intermolt, the need for iron decreases as the rate of tissue synthesis becomes lower. Finally an enormous increase in the hemolymph iron content was observed during the molt.


[Diet effect on fatty acids composition in trout (salmo gairdnerii). rev. esp. fisiol., (author's transl)]. The effect of diets with different fatty acids composition on muscular and hepatic fatty acids of rainbow trout (Salmo gairdnerii) was studied. The effect was higher on muscular fatty acids than on hepatic ones. The lack of correlation between dietary and liver fatty acids in diets with a high level of linoleic acid, showed a better utilization of this acid by the liver. The change in muscular fatty acids pattern was observed within a week of diet change, showing a significant tendency to approach the new dietary fatty acids pattern.


Effect of inhibitors on the intestinal active transport of glucose in tortoise. Glucose intestine active transport in tortoise Testudo hermanni robertmertensi Wermuth has been studied in vitro in the presence of known sugar active transport inhibiting substances. The final Serosal/Mucosal gradient is practically the same in aerobic and anaerobic conditions. A 10(-4) M concentration of DNP inhibits active transport of glucose and increases O2 uptake; a 10(-3) M concentration reinforces transport inhibition and lowers O2 uptake to normal values. Nullification of glucose active transport was not achieved by any of the DNP essayed concentrations. NaF greatly inhibits both glucose active transport and O2 uptake, whereas phlorizin inhibits transport and does not affect respiration. Tortoise intestine is able to obtain the required energy for its glucose active transport through both aerobic and anaerobic metabolism. Besides its oxidative phosphorylation uncoupling action, DNP also appears to affect glycolysis. Glycolysis inhibition and intestinal epithelial alteration may be responsible for the strong inhibition caused by NaF. Phlorizin seems to inhibit sugar transport by competence on the sugar carrier, at membrane level, without disturbing cellular metabolism.


Morphological and ultrastructural aspects of the innervation of rat ureter. The fine innervation of rat ureter has been studied by means of hystological and electron microscopic technique. Different thickness of the different layers of the ureter have been observed. Nerve filaments with minor proportion of myelinic fibres are found in the adventitious layer. Amyelinic fibres, with very fine collaterals whose terminal portion could not be seen, exist in the muscular layer between the external longitudinal fibres and the internal circular ones. Nerve fibres are rarely observed in the centre of the internal circular layer, although it is possible to see terminal buttons, with neural tubules and vesicular formation. These buttons have been observed in some cases beside the muscular membranes, given rise to the hypothetical existence of a synaptic relationship between both membranes. The presence of fine amyelinic filaments, underneath the basal membranes, have also been shown. No ganglionic structure has been observed in the various layers of the ureter, or nerve elements in mucosa.


[Determinatives of the understanding and judging of the speech-impaired's language on the part of speech-functioning people.-An empirical study (author's transl)]. The purpose of the study was to find out the individual and social factors influencing the understanding and judging of the speech-defective's language by speech-functioning persons. In contrast to prevailing opinions, it was proven that the evaluation is not controlled by "adopted" prejudices, but by the real understanding of linguistic and paralinguistic components of language. Within this context, the level of understanding and the significance of these two components in view of the evaluation depends on the sociolinguistic milieu to which the speech-functioning individual belongs.


Chemical structure and aldosterone receptor affinity of canrenoate-potassium metabolites in rabbits. Two new major metabolites of canrenoate-potassium (III) were isolated from rabbit livers, in addition to the known metabolite canrenone (II). One metabolite (MA) contains two additional oxygen atoms of unknown location. The second metabolite (MB), which was previously shown to interfere with a plasma aldosterone radioimmunoassay, is identified as 20-hydroxy canrenone. Canrenone (II) and metabolite MB showed significant affinity to rat kidney cytosol aldosterone receptors and might both contribute to the pharmacological effects of canrenoate-K (III).


Heavy metal enhancement of airway sulfate absorption in the perfused rat lung. The effect of heavy metal cations in enhancing the absorption of sulfate ions from the airways of the isolated, ventilated and perfused rat lung (IVPL) into the lung vasculature was studied. The cations investigated included Cd++, Co++, Hg+++, Ni++, Fe+++, Mn++ and Zn++. The cations increased the sulfate ion absorption from the rat IVPL 199-264% as compared to absorption in the presence of Na+ ions. An exception was Mn++, in which absorption did not differ significantly from the Na+ control. The uptake of sulfate ions from the vasculature of the IVPL could not be demonstrated.


Tissue distribution of bovine 125I-superoxide dismutase in mice. Intravenously injected 125I-bovine superoxide dismutase in mice is essentially cleared from organs in 24 h. The 125I activity per g of tissue at 1 h varies among organs with the brain and kidneys showing the lowest and highest levels, respectively. Within tissues, degradation occurs so that, at 1 h after administration, 5-74% of the 125I activity remains associated with the enzyme, depending on the tissue. A small amount of the labelled enzyme is found in washed cells of thymus, lung, spleen, liver and brain.


In vitro alteration of the subcellular distribution of 3H-reserpine in the rat forebrain by delta 9-tetrahydrocannabinol. delta 9-Tetrahydrocannabinol (delta 9-THC) has been reported to attenuate both reserpine-induced serotonin depletion and reserpine-induced hypothermia. We have observed that delta 9-THC preincubation led to a dose-responsive increase in the amount of 3H-reserpine bound to a crude mitochondrial fraction of rat forebrain. The experiments reported here further characterize this phenomenon. Preincubation with delta 9-THC produced a shift in the localization of 3H-reserpine from the incubation medium and the microsomal supernatant (decrease of 66%) to the crude mitochondrial (CM) pellet (increase of 154%). The CM pellet was subfractionated both by differential centrifugation after osmotic shock and by layering on a five-step discontinuous sucrose gradient and centrifuging at 80,000 x g. Osmotic shock with 0.032 M sucrose and centrifugation revealed that the delta 9-THC-induced increase in 3H-reserpine was contained in both the synaptic vesicle fraction (247%) and the fraction containing myelin, ruptured synaptosomes and mitochondria (324%). Separating the CM fraction into five component parts showed that delta 9-THC increased the 3H-reserpine bound by about 275% in the three fractions containing myelin, membrane fragments or mitochondria. Even more dramatic increases (greater than 1000%) were observed in the two fractions containing cholinergic and non-cholinergic nerve endings. In addition, we have determined that many other drugs which are believed to have membrane mediated mechanisms have no effect on the amount of 3H-reserpine bound to the crude mitochondrial fraction. Although other possibilities exist, these data support the hypothesis that delta 9-THC retards the action of reserpine by altering the normal distribution of reserpine in various membrane components of the rat brain.


Thromboxane - synthesizing activity in guinea pig lung microsomes. The microsomal fraction of guinea pig lung contains the enzymatic activity that converts arachidonic acid to thromboxane B2. The properties of guinea pig lung enzyme are generally similar to the human platelet enzyme, except the lung enzyme is unstable at 37 degrees C. No difference in total enzymatic activity is observed in the normal and sensitized guinea pig lungs.


VI. Separation of cannabinoids by sequential thin layer chromatography. Using a series of solvent systems, one neutral and non-polar, another basic and a third acidic, in a sequential thin layer chromatography (TLC) scheme we developed, cannabinoids can be resolved by their major functional groups into natural neutral, hydroxylated or alcoholic neutrals and acidics.


Alcohol-membrane interaction in the brain: norepinephrine release. The nerve endings of mouse brain were loaded with 3H-norepinephrine (3H-NE) by intraventricular injection of 3H-NE. After dissection of brain, the synaptosomal particles were isolated and used for NE-release studies. The NE release process was stimulated by K+ and Ca++ but was antagonized by Na+. Acetylcholine at low concentration also decreased the release of 3H-NE. Ethanol at low concentrations (0.1-0.5%) decreased the amount of synaptosomal NE release whereas at higher ethanol concentrations (1-4%) the NE release was increased. This biphasic response of NE release in the presence of ethanol could be the effect of ethanol on related active cation transport systems such as Ca++-transport.


Increased urinary excretion of D-glucaric acid in alcoholism. Alcoholic patients were found to have increased urinary excretion of D-glucaric acid while drinking. The excretion of D-glucaric acid returned to normal after discontinuation of ethanol intake, and the increase in the excretion could be reproduced by the administration of ethanol. Determination of the urinary excretion of D-glucaric acid may be useful in detecting the ingestion of ethanol or drugs when this information is not available by other means.


Prostaglandin E2 production by renomedullary tissue of DOCA, Goldblatt and spontaneously hypertensive rats. The realtionship between in vitro prostaglandin production by renal medullary tissue and hypertension was investigated in three models of hypertensive rat, i.e., DOCA, Goldblatt and SHR. Medullary minces were incubated for 30 minutes. Following incubation tissue PGE2 concentration was quantified using mass fragmentography. Media PGE2 concentrations were quantified using radioimmunoassay. Concentrations of PGE2 in tissue from Goldblatts and SHRs were significantly less than normotensive controls. The concentration of PGE2 in media after incubating SHR tissue was significantly less than normotensives. The data suggest that alterations in PGE2 metabolism are similar in Goldblatt and SHR hypertension.


Monocyclic peroxides as inhibitors of arachidonic acid and prostaglandin endoperoxide analog initiated aggregation of human platelets. Arachidonic acid initiates the irreveresible aggregation of human platelets on conversion to the bicyclic prostaglandin endoperoxides, PGG2 and PGH2. An enzyme in arterial walls catalyzes the conversion of PGG2 and PGH2 to PGX, which inhibits human platelet aggregation. Preincubation with monocyclic peroxides (3-(alpha-hydroxyethyl)-1,2-dioxane, 3-(alpha-hydroxypropyl)-1,2-dioxolane or 3-methyl-3-(hydroxymethyl)-1,2-dioxolane) completely inhibited arachidonic acid initiated aggregation. Similarly, two analogs of PGH2, (15S)-hydroxy-9 alpha, 11 alpha-(epoxymethano)prosta-5Z, 13E-dienoic and (15S)-hydroxy-11 alpha, 9 alpha-(epoxymethano)prosta-5Z, 13E-dienoic acids, initiated irreversible aggregation of platelets. but were completely blocked by the monocyclic peroxides. Aggregation initiated by ADP or epinephrine was also completely inhibited by the cyclic peroxides. Aggregation of human platelets appears initiated through an endoperoxide receptor which can combine with either the natural bicyclic prostaglandin peroxides or the synthetic monocyclic peroxides. Natural inhibitors, such as PGX, may well be monocyclic endoperoxides similar to the compounds studied here.


Effect of adriamycin on the activity of the succinate dehydrogenase-coenzyme Q10 reductase of the rabbit myocardium. Rabbits were injected with adriamycin 3 days/week/7 weeks. Heart tissues of treated rabbits showed myocardial degeneration, but the tissues of controls were normal. The deficiency in the activity of the succinate dehydrogenase-coenzyme Q10 reductase in the heart tissues of the rabbits treated with adriamycin was higher (0.001 less than P less than 0.01) than that for control tissues. These data indicate a correlation of at least a part of the cardiotoxicity of adriamycin in cancer patients to inhibition of CoQ10-enzymes, since coenzyme Q10 is indispensable to bioenergetics in the myocardium of both humans and rabbit.


Effect of ethanol on impulse activity in isolated cerebellum. We tested the question of whether ethanol's known action on the cerebellum is direct or indirect, via neural pathways. The cerebellum of rats was denervated by large electrolytic lesions of the peduncles. Ethanol (1 gm/kg, intraperitoneally injected) generally depressed impulse activity of neuronal populations in the cerebellar cortex, whereas such activity increased in saline-injected controls.


Effect of short- and long-term treatment with cocaine on rat brain tryptophan hydroxylase. Short-term (5 days) treatment with cocaine (10 mg/kg, i.p.) inhibited the soluble tryptophan hydroxylase while the particulate enzyme was essentially unchanged. In contrast, long-term (45 days) treatment resulted in an increased activity of the particulate enzyme and a return to normal of the soluble enzyme activity.


The effect of the occlusion of liver lymphatics on hepatic blood flow. In the dog after the ligation of the thoracic duct and of the lymphatics of liver hilum hepatic blood flow decreased in 2hrs by 30.6 per cent. The flow reduction is due to the increase of arterial and venous inflow resistances and of the prehepatic splanchnic arteriolar resistance. The vascular reaction in lymph stasis differs insofar from the reaction seen during biliary duct obstruction that in the latter condition hepatic artery flow is increased. A preexistent lymph stasis does not abolish the increase in the hepatic artery flow produced by raised biliary tract pressure. The differences between the flow reactions observed in bile stasis and in lymph stasis are explained by the accumulation in the latter condition of a protein rich fluid in the liver tissue.


[Conditions affecting the renal excretion of manganese by humans (author's transl)]. The renal excretion of manganese is investigated for different urine flow rates in adults of both sexes with normal and disturbed kidney function. Mn is determined by emission spectral analysis. During antidiuresis with a mean urine flow rate of 0,97 +/- 0,66 ml/min (SD) the average excretion of Mn is 11,4 +/- 19,4 ng/min for 1,73 m2 body surface area. With an indifferent urine flow (4,43 +/- 2,11 ml/min) the average Mn excretion is 13,5 +/- 19,3 ng/min. For this type of diuresis Mn excretion and urine flow rate are slightly positively correlated. A further increase in urinary excretion of Mn is observed during osmotic diuresis. In this case 160,6 +/- 180,5 ng Mn/min are eliminated for an urine production of 22,2 +/- 6,8 ml/min. The difference of the mean excretion values is highly significant (P less than 0,01) between indifferent urine flow and osmotic diuresis, insignificant between antidiuresis and indifferent urine flow, and significant (P less than 0,01) between antidiuresis and osmotic diuresis. Down to a clearance value for inulin of less than 30 ml/min and for PAH of less than 200 ml/min and 1,73 m2 body surface area, the Mn excretion is largely independent of the renal hemodynamics.


The effect of coumarin on the liver weight of thermally injured rats. Coumarin (a benzo-pyrone) has been shown to significantly increase liver weights 2 days after its injection. It is believed that coumarin belongs to a group of reticulo-endothelial system stimulants which increase the numbers of phagocytosing sites by increasing the number of phagocytic cells.


[Induction of tumors of the stomach in mini-pigs by methylnitrosourea administration (author's transl)]. The oncogenic effect of N-methyl-N-nitrosourea was studied in Hanford miniature-pig. The compound - dissolved in 0,9% NaC1 (pH 6,1 - 6,2) and supplemented with 1% NaH2PO4 - was administered per os to the animals in intervals of two weeks during 4,5 years. Finally the animals, which had behaved clinically inapparent during the whole run of the experiment, were sacrificed and autopsied. All animals of the experimental group had developed stomach tumours, whereas control animals showed normal conditions of gastric mucosa. Except one, all tumours were grouped macroscopically as multiple, exophytic, papillary, cauliflower-like neoplasms of the mucosa, located predominantly within cardia- and fundus-regions. Histologically they are to be classified generally aal characteristics of an early malign dedifferentiation. One - above excepted - tumour proably belongs to the class of malign neurinomas. The results of the experiment demonstrate in general that the obvious organotropic properties of certain oncogenic nitrosamides might be in a way also species-depending ones. This perception seems to be important in view of morphogenesis as well as of etiopathogenesis of stomach tumours.


[Investigations in streaming blood of the alert animal and man. II. Investigations on the mechanism of water resorption from the gut into the portal vein blood in the rat (author's transl)]. Arteriovenous differences (AVD) of electrolyte concentration in the gut are followed by continuous conductometry of ultrafiltrates of portal venous and aortic blood. Intraduodenal application of tap water amounting to 0.5, 1,0 or 2,0% body weight lead to extremely variable reactions both in time course and dimension of AVD. Whereas large and fast changes can be described by a single exponential term, small and slow changes show saturation effects. Evidence is presented, that these differences correspond to permeability changes, both for water in the direction: lumen to blood and for electrolytes in the direction: blood to lumen. Thirst has an enhancing effect on AVD. A dual resorptive pathway is proposed to fit the data.


[Combined ultrastructural morphometric and biochemical investigations on the rat liver after ligation of the bile duct (author's transl)]. In the present study an ultrastructural morphometric analysis of the rat liver 1, 3 and 7 days after bile duct ligation was performed. Corresponding biochemical investigations included the determination of the cytochrom P 450 contents in the microsomal fraction. In the serum of the rats the activities of GOT and GPT were determined. The quantitative results have shown that the decreased P 450 contents of the microsomal fraction coincided with a considerable increasement of the surface of the smooth endoplasmic reticulum. The smooth endoplasmic reticulum was significantly increased from 1.83 m2/cm3 hepatocytes to 3.49 m2/cm3 hepatocytes after 3 days and remained on this level after 7 days. These results may be considered as quantitative evidence for the term hyperplastic, hypoactive endoplasmic reticulum. - As a second important result our quantitative investigations have shown that the increasement of GLDH activity in the serum especially 1 day after ligation of the bile duct coincided with a signficantly increased mitochondrial volume at this time.


A muscular dystrophy-like condition in rabbits. During the examination of 69 male and 18 female rabbits a hitherto unknown muscular condition was found in one female and 19 male animals, otherwise healthy. The aetiology of the condition is unknown, but is is assumed that it is a sex-linked, hereditary anomaly. The histopathological changes are mostly restricted to the distal end of the quadriceps femoris muscle and resemble muscular dystrophy of man.


Different response of hepatic energy change and adenine nucleotide concentrations to hemorrhagic shock. The adenine nucleotide and mitochondrial metabolisms of the liver were studied in hemorrhagic shock of rats. In reversible shock, the energy charge (ATP+1/2ADP/ATP+ADP+AMP) levels fell more rapidly than the total adenine nucleotide concentrations and decreased to 64% of controls 2 hours after shock. However, the oxidative phosphorylation of isolated mitochondira was only slightly inhibited. The energy charge levels were restored to normal values immediately when the shed blood was reinfused, while the concentrations of adenine nucleotides increased gradually and reached normal at 2 hours later. In irreversible shock which took up 70% or more of the withdrawn blood to maintain pressure of 40mm. Hg, the energy charge, adenine nucleotide concentrations and mitochondrial oxidative phosphorylation decreased considerably and were not restored by the reinfusion of the remainder of shed blood. It is suggested that the energy charge can respond rapidly to changes in an available oxygen and the adenine nucleotide concentrations and that an impairment of mitochondrial oxidative phosphorylation plays an important role in leading to irreversible hemorrhagic shock.


[Morphological findings in tourniquet-shock (author's transl)]. Studies on 15 adult rabbits revealed that after removing a 3 hours lasting tourniquet of the left hind limb, the average survival time is 3,6 hours, whereas after a tourniquet lasting 4 hours animals die on the average within 22,8 hours in tourniquet shock. The maximum of interstitial edema and myolysis - estimated by light microscopy - was reached in the ischemic muscles of the hind leg after a 3-6 hours period of recirculation. Extraordinary strong muscle lesions regulary were found in the adductor. In all animals shock lungs could be demonstrated in which hyaline membranes were absent however. 54% of all animals partly showed extensive necroses of liver epithelial cells. Necrosis of cardiac muscle fibres were found in one animal only. In the kidneys merely slight degenerative lesions were identified in the thick descending and ascending limb of Henle's loops, kidneys of longer surviving animals contained many casts.


Preliminary studies on a rat kidney phospholipase A2 activating a renin preinhibitor. A phospholipase A2 activating a phospholipid renin preinhibitor into a lysophospholipid renin inhibitor has been isolated from rat kideny and partially characterized.


Circadian rhythm of colonic motility in the cat. Since circadian patterns of colonic motility are largely unknown the electrical activity of the colon musculature was recorded in 6 unanesthetized cats during day and night. All parts of the colon exhibited 6 patterns of electrical activity: spikes, oscillations, omnipresent regular slow waves, and three composite patterns, i.e. a minute-rhythmic activity, activity complexes of 1 to 18 minute duration and a nyctohemeral pattern. The circadian rhythm was different between the proximal and distal colon resulting in activity gradients. These were directed in an aborad direction from 7 to 9 a.m. and from 9 p.m. to midnight. Most of the defecations of the 6 cats occured in the late evening until 1 a.m. Spike activity of the distal colon predominated from 3 to 4 a.m. and from 11 a.m. to 5 p.m. It is concluded that a circadian rhythm exists in the motility of the cat colon. Differences in the activity between the proximal and the distal colon and resulting activity gradients may offer an explanation for the influences of the time of day on the timing of defecations.


[Connective device for continuous recording of myoelectric changes of the gastrointestinal tract (author's transl)]. A new connecting-device is described, which was developed in order to record electrical activities of the gastrointestinaltract in animal experiments (24 dogs). The device is implanted in to the abdominal wall and connected to the indwelling bipolar electrodes. Measurements were carried out up to 30 days after operation without any complications.


Correlations between lung-transfer factor, ventilation, and cardiac output during exercise. In nine healthy and young subject of either sex, undergoing three or four rounds of muscular exercise of increasing severity on a bicycle ergometer, the authors investigated the behavior of the lung transfer factor (Dlco), pulmonary ventilation (V), alveolar ventilation (Va), and cardiac output (Q). In all instances they found a positive linear correlation between DLCO and oxygen consumption (VO2), at least up to 70% of maximum oxygen consumption (Vo2max) (r=0.935;p less than 0.001). Dlco was found to increase linearly as a function of increasing V (R=0.898;P LESS THAN 0.001) AND EVEN MORE SO OF INCREASING Va (r=0.919; p less than 0.001). Also the relationship between Dlco and Q appeared linear in all subjects (r=0.926; p less than 0.001). On the other hand, individual Dlco values showed considerable scatter at equal Vo2, V, Va, and Q values. Among the factors responsible for the increase of Dlco during muscular exercise, in addition to increased ventilation and cardiac output, the authors suggest the possible role of the greater desaturation of mixed venous blood and variations of hemoglobin affinity for CO.


Reliability in pneumotachographic measurements. The warming-up of room air in the pneumotachograph during inspiration phase and the different components of gas and water vapour in the expired air compared to the inspired air are the most important influences on the measured flow volume in routine pneumotachographic measurements. In a physical and mathematical analysis these influences were calculated in order to estimate whether there is an important or negligible difference between the inspired and expired flow volumes. (1) During inspiration the temperature effect of the heated pneumotachograph on volume extension is compensated close to 50% by the temperature effect on gas viscosity. (2) During expiration the effect of body temperature on the total viscosity (in comparison to viscosity at room temperature) is mostly compensated by the different O2 and CO2 compositions of the expired air including the effect of the water vapour. Comparing the corrected flow equation for the inspiration and the expiration phases, the actual difference between the inspired and expired flow volumes will be of 1.2% in routine measurements. This result matched very well that of BARRES and GAUGE [1961] obtained with a lung model.


[Analysis of flow-volume curves in asthmatic patients and their application in pharmacodynamic tests (author's transl)]. Study of the influence of some parameters upon flow-volume curves and pressure-type body plethysmography during inhalation tests (acetylcholine; metaproterenol) in 10 asthmatic patients (5 males and 5 females). Although the specific conductance decreased when bronchoconstriction was induced and returned to values superior to those measured before provocation when a bronchodilator was administered, changes in specific conductance did not always parallel those of flow-volume curves (V/V), maximum expiratory volume/sec (VEMS) and mid-miximum expiratory flow rate (MMEFR). All the parameters of V/V used here are well correlated with VEMS and MMEFR but not so with the specific conductance. The inverse correlation between the time constants of V/V and residual/total pulmonary capacity (VR/CT) before provocation and the significant decrease after provocation, indicate that V 60 (or 70%) CT and V 75% vital capacity (CV) are most valuable for the evaluation of physiopathological ventilatory changes occurring in bronchoconstriction.


Surface properties of amniotic fluid and fetal lung maturity. Surface activity of 75 amniotic fluid samples from pregnancies which ended before term or at term with small-for-date newborns was measured in the surface balance. The results were correlated with the clinical symptomatology and the birth weight of the newborn. The surface properties of the lungs of those infants who had died were assessed by the buble stability method (Pattle), by recording of pressure-volume diagram and by measurements of surface activity of lung extracts. The results indicate that gamma-min is the essential parameter in determining the degree of fetal lung maturity. In cases with gamma-min values of amniotic fluid above 27 dyn/cm, a 100% respiratory distress syndrome (RDS) incidence is to be expected; values between 23 and 27 dyn/cm have a 70% values between 17 and 23 dyn/cm have a 30% incidence of RDS and in all cases with values below 17 dyn/cm, RDS may be rules out. When induced delivery before term is considered, this method of determining the degree of fetal lung maturity is, therefore, of significant prognostic reliability.


[A method of estimating alveolo-arterial gradient and arterial pressure of CO2, without analysis of blood]. In 31 normal and 378 patients suffering from various bronchopulmonary diseases, a relation was established experimentally between TCO and the alveolo-arterial gradient of CO2. From TCO and CO2 output, this relation allows to obtain a reproducible estimation of the alveolo-arterial gradient and of the arterial pressure of CO2 by a non-bloody method with sufficient clinical accuracy. Moreover, this methods permits to interpret TCO steady state more easily and especially so under unusual ventilatory conditions.


Primary pulmonary sporotrichosis.

Primary pulmonary sporotrichosis. A case of pulmonary sporotrichosis is described with secondary involvement of the rectum which was misdiagnosed as tuberculosis for a number of years. The authors suggest that every nondiagnosed chronic cavitary disease in the lung should include appropriate tests for sporotrichosis.


Severe Mycoplasma pneumoniae pneumonia.

Severe Mycoplasma pneumoniae pneumonia. Four cases of severe Mycoplasma pneumoniae infection are reported which were treated in a single hospital over the course of 4 years. The difficulties in the diagnosis of M. pneumoniae infections are eminently demonstrated by these cases. Because of the fact that it generally takes 2-o weeks to make this diagnosis, the physician must utilize clues of limited reliability. If gram stains and culture of sputum fail to demonstrate any bacterial pathogen and the patient has a chest X-ray compatible with this diagnosis as well as a white blood count less than 15,000/mm3, M. pneumoniae infection may be present. A good antimicrobial choice in such  a situation is erythromycin.


[Amnesiac aphasia. Study of 25 cases].

[Amnesiac aphasia. Study of 25 cases]. Twenty-five patients with "amnesic aphasia" were studied. The language difficulty is not related either to intellectual deficit, generalised memory disturbance or visual impairment but is a specific verbal memory defect. Amnesic aphasia also involves lack of perception of linguistic units which is caused by impairment of comprehension and erasure of the acoustico-mnesic traces of words. The responsible lesions are in the left temporal region. The authors maintain that, from the physio-pathological point of view, these lesions do not destroy the cortex and sub-cortex, as in focal necrosis, but cause cortical dysfunction selectively affecting the mnesic traces of words.


[Multiple sclerosis with reduced and with normal levels of complement in the blood. Clinical and genetic correlation]. The authors describe the results of immunological assay of complement factors C3, C4 (the usual path of activation of complement) and of B factor (the alternate path of activation) in 61 multiple sclerosis patients not receiving corticoids, 52 normal controls and 217 patients with other neurological disorders. Hypocomplementaemia (fall in factor C3 related to a fall in total haemolytic activity) was found in 29.5 p. 100 of the patients not on corticotherapy at the first assay, and in 36 p. 100 of the patients when repeated assays were carried out. Hypocomplementaemia is significantly more frequent in multiple sclerosis than in the normal population (0 p. 100) and in neurological patients (9.6 p. 100). In 13.1 p. 100 of the multiple sclerosis patients there was a decrease in B factor: 50.3 p. 100 of the multiple sclerosis patients exhibited no quantitative abnormality of the main factors of complement (normocomplementary multiple sclerosis). The group of multiple sclerosis patients with hypocomplementaemia was characterized by the incidence of other abnormalities in the complement system: cleavage of the C3 factor and a fall in B factor in 60 p. 100 of the cases. A more frequent increase in IgE and measles antibodies was found also while the normocomplementary multiple sclerosis patients more frequently had higher levels of IgA. Genetically, the group with hypocomplementaemia is related to a significant increase in the incidence of the HL-A W18 group while the normocomplementary multiple sclerosis patients appear closely related to the HL-A7 group. Familial investigations show that hypocomplementaemia is usually present in the ascendents and collaterals and that it seems to be transmitted with the HL-A haplotypes. Four families gave evidence of transmission with the W18 group. This transmission sometimes occurs together with transmission of an increase in IgE and/or of measles antibodies. In two pedigrees, one of the ascendents carried in his serum an activator of the alternate path of complement. There does not appear to be any prognostic difference between the two groups. In multiple sclerosis with hypocomplementaemia, the facts suggest a complex immunological abnormality, transmitted genetically to the subject and existing prior to the illness, comprising both elements of deficient and excessive immune response. The recognized presence of a gene of immunological reactivity and of genes of synthesis of complement on the 6th chromosome, in proximity with genes of histocompatability (HL-A and M.L.C.) provides a theoretical basis for this supposition.


[Behavioral manifestations induced by electric stimulation of the anterior cingulate gyrus in man]. The electrical stimulation of a restricted part of area 24 in awake man elicits important behavioral changes. The present study is dealing with 83 epileptic patients whose brain activity was recorded in SEEG conditions, with a view to possible neurosurgery. In order to determine how seizures originate and propagate, 116 multileads electrodes (65 right, 51 left) were stereotaxically inserted in the anterior part of the cingular gyrus. 521 stimulations were performed. In 362 cases, this stimulation induced a particular behaviour which was characterized by an arousal, motor activities (involving fingers and hand, mouth, legs, eyes, associated movements of hand mouth, highly integrated movements), thymic modifications and hallucinatory manifestations. Topographical organization of the effective area in the cingular gyrus and the relation between the electrical responses and stimulation parameters are studied.


[Recurrent polyneuropathy with a 19-year course, associated with a benign IgG monoclonal gammapathy]. A case of recurrent polyradiculoneuritis in a 54-year-old man is described. It is exceptional because of its lengthy development over a period of 19 years and by its association with a paraprotein of the IgE type without anyother anomal. Corticotherapy had a favourable effect on the clinical symptoms but did not affect the amount of monoclonal immunoglobulin in the serum. The nosological position of this neuropathy and the type of gammapathy are discussed. An immune mechanism seems likely, but no proof of a link between the neuropathy and the gammapathy could be found.


[Prolonged traumatic and vascular coma: prognostic and therapeutic indications based on hemodynamic and metabolic studies]. From haemodynamic and metabolic investigation of 65 comatose subjects following cranial traumatism or cerebral vascular accident, the following prognostic and therapeutic indications emerged: The isolated increase in oxygen pressure in the jugular vein to above 50 mm Hg, the simultaneous decrease in circulation of the brain to below of 30 ml/100g/min., and of the brain consumption of oxygen to below 1.5 ml/100g/min., combined with a loss of autoregulation and a decrease in carbon dioxide reactivity indicate that prognosis is very poor. Induced arterial hypertension, associated with hyperventilation, partially corrects brain hypoperfusion in coma from bulbo-pontine lesions. Sodium penthiobarbital and sodium gamma hydroxybutyrate and have the effect of reducing oxygen metabolism which might have some therapeutic value during the acute phase of coma. Clomipramine which has a stimulating effect on oxygen metabolism should be kept in reserve for the chronic phase of prolonged coma.


[Diagnosis of cerebrovascular disorders using stannous technetium pyrophosphate]. A total of 122 cases of various neurological diagnoses (among which 72 cerebral infarcts, 7 intracerebral hematomas and 38 intracranial tumors) had two separate brain scans, performed within 48 hours of each other after the administration of pertechnetate and technetium stannous pyrophosphate. The comparison of the resulting seans indicates that, in addition of an osseous accumulation, the pyrophosphate localizes greatly in ischemic cerebral lesions, especially those observed during the second week of evolution. It seems that the uptake of pyrophosphate reflects the area of anaerobic changes whereas the accumulation of pertechnetate depends on the disruption of the blood brain barrier. The scintigraphic diagnostic of cerebral infarctions is greatly improved.


[Total removal through the ventricle in 2 cases of pallidocaudal arteriovenous abnormalities under deep hypotension]. Two cases of A.V.M. situated in the pallido-caudal area and directly nourrished by the anterior perforated space arteries have been investigated using three angiographic techniques: selective internal carotid angiography, angiotomography including pneumoencephalography and angiography under deep hypotension at 30 mm Hg (mean pressure) induced by sodium nitroprusside. These investigations led to the conclusion that the A.V.M. could be removed through the lateral ventricle. Both were radically removed using the retrograde technique under deep hypotension and the operative microscope. Both patients are alive without additional neurological deficit.


[Comparative study of A, B, and H substances in stromas with and without lipid removal. Studies of the erythrocyte membrane]. Human erythrocyte membranes were prepared by hypotonic hemolysis and extracted with water pH 7, EDTA and mercapto-ethanol solutions pH 8. The complex residue which contains lipids, proteins and the A, B, H antigens was dissolved in SDS and analysed by preparative acrylamide gel electrophoresis in the presence of SDS. Each fraction was assayed for A, B or H blood-group activity by hemagglutination inhibition tests. Two experiments were done for each blood-group A, B, O. One with entire ghosts, another after extraction of the ghosts residue with a mixture of chloroform-methanol. The comparison of results showed that the distribution of proteins and blood-group antigen activity among the different fractions is not modified and that, in the two experiments, the elution of H substance is delayed by comparison with elution of A and B substances. The blood-group A, B and H antigens are known to be glycosphingolipids and are not entirely eliminated by treatment of the ghosts with cloroform and methanol. It has recently been reported [7] that these antigens are complex glycosphingolipids with hydrophilic character and remain in the aqueous phase after extraction of the erythrocyte membrane with organic solvents.


[Cad antigen in the French population].

[Cad antigen in the French population]. An investigation of Cad phenotypes in the French population had been carried out in 1973, in four Blood Transfusion Centers (Mulhouse, Nancy, Paris, Versailles), B and O red cells were tested with the Dolichos Biflorus lectin. Out of 78.528 donors, 56 were found to have the Cad antigen on their red cells. The mean frequency was 0,07%. Nevertheless, this frequency varied among the four above mentioned Blood Transfusion Centers: the observed differences were probably due to the preparation procedure of the Dolichos biflorus extract. The family investigation permitted the analysis of four families with at least three Cad individuals. The independence of the Cad system and of Auberger, Gc, Hp, C'3, PGM, Pac and ADA was demonstrated. A quantitative agglutination study on these Cad samples using the Dolichos biflorus lectin,and a selected AB serum showed a high variability of the erythrocyte Cad Strength, even within one family. Most Cad samples were found polyagglutinable when a sensitive technique and selected AB sera were used. All adult sera contained an anti-Cad1 antibody, except Cad1 individuals. Although strong Sda reactivity was always found in Cad red cells, the anti-Cad and anti Sda specificities were not identical: this was demonstrated by the absorption and inhibition tests of anti-Cad and anti-Sda reagents absorption and inhibition tests of anti-Cad and anti-Sda reagents with Sda material. From thf Cad red cells, there was no evidence of the existence of separable anti-A1 and anti-Cad agglutinins in the Dolichos biflorus lectin.


[Typing and detection of antibodies in the PLA system (platelet). Application to the study of neonatal thrombopenia by feto-maternal PLA allo-immunisation]. A platelet indirect radio-active Coombs test has been described. The technique for purification and labelling the antiglobulin has been precised. This test allows the typing of platelets in the PLA system and the study of sera from mothers of thrombocytopenic child. As examples, four families of neonatal thrombocytopenia are reported, with PLA1 negative mother. In the serum of three of these mothers, we could demonstrate anti-PLA antibodies in spite of a negative platelet complement fixation. This test has many advantages compared to other tests such as platelet complement fixation, assay for blocking antibodies or antiglobulin consumption: it gives objective and quantitative results and is highly reproducible, anticomplementary serum may be tested. It has enabled us to select PLA1 negative donors for exsanguino-transfusions of thrombocytopenic children born from PLA1 negative mothers.


[Frequency of hepatitis after extra-corporeal circulation]. In cardio-vascular surgery the risk that the hepatitis-B (H.B.) virus be transmitted was measured in 3 groups of patients (Professor Ch. Dubost), before and since systematic screening for HBS antigen in donors' blood. The same questionnaire was sent to each patient in each group 6 months after extra-corporeal-circulation (ECC), in order to determine the efficiency of HB virus screening tests. The present study gives the following results: --in the first group (no screening for HBS antigen in donors' blood), the frequency of icteric hepatitis was 6.7% (26 cases of jaundice, probably due to hepatitis viruses, out of 386 ECC); --in the second group (screening for HBS antigen in donors' blood by immuno-diffusion (often made after transfusion of fresh blood) the frequency of icteric hepatitis after transfusion of HBS antigen positive blood); --in the third groups, icteric hepatitis was less frequent (4.6%) since systematic screening for HBS antigen by counter-electrophoresis and complement fixation was performed (29 cas out of 629 ECC). Additionally, viral hepatitis appeared more frequently in men than in women, and among older patients than younger ones. Recovery was generally complete in 2 months; however, the evolution of the disease was severe in 3 cases and fatal in one case. In sum, after ECC, hepatitis still remains a frequent side-effect, compelling blood centers to use th most sensitive screening tests now available for HBS screening: radio-immuno-assay and reverse passive haemagglutination tests. As a consequence of the present study, these 2 techniques are being applied on a daily basis in our laboratory for HBS antigen screening tests are ineffective in preventing the transmission of other strains of viral hepatitis by blood transfusion.


[Comparative study of technics of screening of carriers of HBs antigen]. The purpose of this study was to compare the results of 3 reverse passive haemagglutination techniques currently used by blood centers for the HBS antigen screening in donors' blood. A comparison was also made with 3 other techniques: Radio-immuno-assay (RIA), Counter-electrophoresis (CEP), Complement fixation (CF). The sera from 2.028 blood donors were screened by all those techniques, as well as 105 known sera, used as references (87 HBS antigen positive sera with different titers, 18 HBS antigen negative sera) and coming from 4 origins: NIH-Bethesda, Centre National de Transfusion Sanguine, Paris; Hôpital de la Pitié-Salpêtrière, Paris; Hôpital Broussais, Paris. The reverse passive haemagglutination techniques were shown to be slightly less sensitive than RIA and definitely more sensitive than CEP and CF, since 18 sera were HBS antigen positive with RIA (0.88%), 10 or 12 with haemagglutination (0.40-0.59%), 8 with CF (0.39%) and 7 with CEP (0.34%). The frequency of false positive results changed with the haemagglutination technique used (0.84% for WH.HBS, to 2.3% for Hepanosticon) and involved confirmatory tests (absorption and/or neutralisation). In sum, the sensitivity, specificity and practicability of the 3 haemagglutination techniques were shown to be nearly identical, with a slight but sure advantage for the WH.HBS in our experiment. Thus reverse passive haemagglutination techniques seem, at the present time, to be the best ones for HBS antigen screening when RIA cannot be applied.


[Polymorphism of factor B of the properdin system (C3PA, GBG, and Bf) and histocompatibility-complement linkage]. Several recent studies have shown that the genetic polymorphism of factor B of the Properdin system (GBG or Bf) is closely linked to the major histocompatibility complex (MHC). The genetic polymorphism of Bf, a component of the alternate pathway of complement activation, is revealed by "immunofixation" technique after prolonged high voltage agarose electrophoresis. In this report, we describe technique for the Bf grouping and give the results in two families showing the linkage between HL-A and Bf loci. The study of a family with a recombinant between the second HL-A locus (SD-2) and the major MLC locus (LD-1) provides evidence that the Bf locus is not located outside the MLC's because the Bf allele remains linked to the SD-2 allele. In this family, a crossover occurs between Bf and LD-1, and since crossovers between Bf and SD-2 have already been discovered, it is now possible to locate the Bf locus between SD-2 and LD-1. The Bf phenotypes were determined in the serum of 247 normal unrelated caucasian individuals from the area of Strasbourg. The calculated allele frequencies in this population are: BfS=0.757, BfF=0.219, BfS1=0.014, BfF1=0.010. These allele frequencies are intermediary between those found by ALPER and RITTNER. The linkage between MHC and the complement system is now even more evident after the discovery that genes involved in the synthesis of the second and fourth complement components also belong to the MHC on the chromosome 6. These linkages were demonstrated by the study of several families with hereditary C2 deficiency in the U.S.A., and one family with C4 deficiency discovered in Strasbourg. C2 deficiency was found to be associated with three kinds of HL-A haplotypes (HL-A 10, W18; HL-A 2, W18 and HL-A2, 4A2) and the LD-7a specificity. In the family with C4 deficiency, the C4 deficient gene is associated with the HL-A haplotype 2, T3, W10 and a new hitherto unknown MLC type "Re". The linkage between C4 and MHC has been demonstrated recently also in the mouse (the Ss protein in the complement C4 fraction in the mouse) and in the guinea pig. The significance of the genetic linkage between some important components of the complement system and MHC is still unknown. It appears necessary to study all the genetic markers located within or in the vicinity of the MHC region on the chromosome 6 in investigations of the relationship between "pathologic states and HL-A antigens".


Corticosteroid therapy in rhinoplasty.

Corticosteroid therapy in rhinoplasty. 3 years experience in corticoid treatment of more than 796 cases of rhinoplasty is reported. A remarkable reduction of oedema after surgery was observed. The application of 40 mg Corticoid crystalline suspension on each side of the nose following surgical procedure is recommended.


Nasal ventilation measured in forced respiratory flow. First results of measurements of a forced respiratory flow for the evaluation of nasal ventilation performance are provided. The obtained data indicate that the chronometric registration of the flow-volume-curve provides a clearer indication as to the dynamism of nasal respiration than the measurement of statistical nasal resistance or, in other words, the respiration flow with a specific resistance.


Nasal challenge.

Nasal challenge. Seven years' experience of nasal challenge is presented. On the basis of a material of 1492 controlled provocation tests performed on 715 patients, practical problems concerning the performance period of the provocation, application methods, allergen preparations, interpretation of the results as well as the relevance and correlation of different investigation methods of allergic rhinitis are discussed.


[Endemic goiter in the province of Castellón de la Plana, incidence in 1958 and 1974]. The authors report the dramatic regression in endemic goiter that has taken place in the Spanish provice of Castellón de la Plana, comparing data obtained in 1958 and 1974 with present-day data. They stress the fact that the plenomenon has occurred without a previous prophylaxis program.


[The problem of acalculia: a study of a case]. 1)The Authors describe a case of acalculia and emphasize some peculiar aspects, the study of which was facilitated by being the patient a mathematics teacher. 2) The patient was unable to perform arithmetic operations (addition and subtraction) but was able to carry our more complex and algebric operations. The acalculia was associated with constructional apraxia. 3) These findings are discussed and the hypothesis is suggested that simple mental arithmetic calculations need spatial operations which are not required for more complex mathematical reasoning and that the ability for calculation may decline by the very same progression, one level after the other, as the language.


[Experimental comparative study on the antiepileptic effect of clonazepam, sodium dintoine and phenobarbital administered parenterally]. A comparative study of the antiepileptic action of Clonazepam, phenythoin-natrium and phenobarbital has been performed in acute experiments in rabbits. The effort of the three drugs, administered intravenously, was studied on a) the epileptic activity induced by electrical stimulation of the amygdala, b) the interictal and c) ictal epileptic activity of an amygdaloid chemical focus (penicillin in gel). Clonazepam has a definite higher capacity, than the other drugs examined to prevent or to reduce the phenomenon of generalization of epilepsy. However, its effect has a shorter duration.


[Acquired aphasia with convulsion anomalies in the developmental age: clinical neuropsychological and electroencephalographic study of a case]. A four year old boy presented three epileptic seizures of psychomotor type; immediately after he began to show a progressive and rapid dissolution of speech, until he became completely aphasic after few weeks. Since then, repeated EEG examinations have always shown anomalies of epileptic type, located on the left hemisphere, at times on the right, at times bilaterally asynchronous. The neurological, psychic, audiological, chemical-biological and neuro-radiological (bi-lateral carotidogram and penumoencephalogram) exams did not show any other anomalies. After an observation period three years, the AA. underline the following evolutive aspects of the case: 1) The aphasic syndrome is on the way to slow improvement both in its expressive component and in its perceptive component. The recovery of speech seems to follow, with a slower rhythm, the stages of acquisition of the speech in the normal subject. 2) Diversely from other cases of the literature, no positive correlation exists between the gravity of the aphasic syndrome and that of the EEG anomaly: they have worsened while the disturbance of the speech have partially regressed.


[Nosography of the Laurence-Moon-Bardet-Biedl syndrome]. The Author presents two cases of Laurence-Moon-Bardet-Biedl syndrome, characterized from a rare psychopathologic symptom consisting in a state of delirium (first case); by lack of obesity and oligophrenia (first case), and of familiarity (second case).


[Rheumatoid arthritis and trauma. 5 cases]. The authors report 5 cases of post-traumatic rheumatoid polyarthritis. After the traumatism had initiated the first stages of ordinary inflammation, chain reactions, perhaps by means of an "immune" field, intervened to transform it into a self-maintained rheumatoid inflammation. In fact, the etiopathogenic problems of post-traumatic rheumatoid polyarthritis have not yet been elucidated and it cannot be said either that the question of legal compensation for it is any nearer solution. The growing importance of traumatisms in everyday life and of compensation for them, and the gravity of the condition and its disabling sequelae require that great caution should be exercised in the search for criteria for attributing the disease to the traumatism: the almost indefinite evolution of the disease with time makes the choice of the consolidation date arbitrary.


[Fatigue fractures of the femoral neck and pubic rami. Analytical and critical study apropos of 97 case reports from the literature and 5 personal cases]. This investigation involved a study of fatigue fractures of the neck of the femur and of the pubic branches based on the one hand on 97 cases from the literature, which were diagnosed mainly on radio-clinical criteria, and on the other hand on 5 personal cases for which a quantitative histological analysis was undertaken by needle biopsy of the bone of the iliac wing. After describing these fatigue fractures in an unusual site, the authors undertake a critical study taking account of the histological information that was available. They show that only a histological study makes it possible to differentiate clearly fatigue fractures from insufficiency fractures, particularly when the later occur concurrently with a clinically and radiologically latent osteoporosis.


[Latent bone lesions in divers. Comparison of results in a survey of 105 divers and 105 control subjects]. The results of a systematic radiological study of the shoulders and hips of 105 naval divers are reported and compared with those of recorded during a comparative study carried out in non-diver control subjects of a similar age. Almost half the divers had small bone lesions such as dense islets or bordered geodes. These appeared more frequently in divers than in the controls. Their precise natur remains hypothetical, in the absence of histological criteria, but it is possible at least for the bordered geodes, that they represent tiny centres of osteonecrosis.


[Insight into Crohn's disease].

[Insight into Crohn's disease]. After noting that Cohn's disease has a long history behind it, the authors show a real increase in the frequency of the disease, apparently more marked in the Anglo-Saxon countries than in France. The etiopathogenesis of the disease is completely unknown. It seems that subjects suffering from Crohn's disease present an exacerbated xenic reaction. There are strong arguments in favour of a genetic contribution. The association with ankylosing spondylarthritis and thus the HLA system is particularly interesting. Following a breif review of the clinical signs and of the complications of the disease, the authors emphasize the diagnostic value of a scoring system. The evolution is very variable: quiescence which does not mean cure, progressive and continuous aggravation, alternation of outbreaks and remissions. Symptomatic, medical therapy is certainly effective but is efficacy is limited. Medical therapy aimed at the etiopathogenic factors is without foundation. Surgical intervention, sometimes immediately beneficial, is accompanied by a 50% frequency of recurrences in a ten-year period. Crohn's disease, fatal in 5% of cases, sometimes handicapping severely the development of the individual, is worthy of further rheumatological study.


[A special form of lupus disease. Deep cutaneous lupus. Apropos of 2 cases]. Deep cutaneous lupus is a clinical form of lupus disease for which a very old description has recently been brought up to date. Two new cases are reported here and a review of the literature makes it possible to analyse the clinical, biochemical, histological, and immunological features of this panniculitis. Different from the Weber-Christian syndrome, it is characterized by repeated eruptions of nodules and/or subcutaneous plaques, and histologically by vasculitis, lymphocyte infiltration, and sometimes te presence of immunoglobulins on the basal dermal membrane and around the vessels.