Effect of dehydration and cardiac tamponade on superior mesenteric artery flow: role of vasoactive substances. The role of serotonin, catecholamines, and angiotensin in the pathogenesis of mesenteric low flow states was investigated in anesthetized dogs by measurement of blood flows with electromagnetic flow meters. During dehydration or cardiac tamponade, a disproportionate decrease in superior mesenteric artery flow was demonstrated, compared with aortic flow, but renal artery flow was relatively better maintained. Depletion of serotonin and catecholamines by pretreatment with reserpine or blocking serotonin's action with methysergide did not alter the disproportionate reduction in mesenteric flow. Disproportionate superior mesenteric artery flow during dehydration and tamponade was associated with increased levels of circulating angiotensin and virtually was abolished by bilateral nephrectomy, by inhibition of enzymatic conversion of angiotensin I to II by Bothrops nonapeptide, and by competitive inhibition of angiotensin II with 1-sar, 8-ala angiotensin II. Exogenous angiotensin administered intravenously to dogs not protected by drug treatment disproportionately decreased superior mesenteric artery flow with less effect on renal artery flow. These results are compatible with the hypothesis that increased circulating levels of angiotensin during dehydration and tamponade contribute to the disproportionate reduction in superior mesenteric artery flow in the anesthetized dog.


Thoracic problems associated with hydatid cyst of the dome of the liver. Twenty patients with hydatid cyst of the dome of the liver are presented. In ten there were significant associated intrathoracic complications including pleural effusion, pleural empyema, erosion through the diaphragm into lung, various degrees of pneumonitis or pulmonary abscess, or severe destruction of both diaphragm and right lower pulmonary lobe. Bronchobiliary fistula was demonstrated at operation in five patients. Four patients had obstructive jaundice due to intrabiliary rupture of a liver hydatid. In 19 patients the cysts in the right lobe of the liver were evacuated through a right thoracotomy and incision of the diaphragm. In four of these, additional pulmonary resection was carried out. In one patient with left pleural empyema, tube drainage followed by rib resection was instituted. Two patients had common duct drainage for relief of obstructive jaundice. In 13 patients the ectocyst cavity was drained; in seven it was filled with saline and closed. One patient required evacuation and open packing of the right upper quadrant and lower right hemithorax. Thoracotomy is mandatory in patients with hydatid cyst of the dome of the liver for easier approach to the cyst and for management of coexisting intrathoracic complications.


Renal hemodynamic response to furosemide in septic and injured patients. Furosemide frequently is advocated as a prophylaxis against renal failure in septic and injured patients; this effect is thought to be secondary to an increase in renal blood flow. This postulate was tested within 72 hours of admission in 22 previously healthy patients with acute pancreatitis (two), massive trauma (ten), or severe sepsis (ten). Renal clearances of inulin (GFR), para-amino hippurate (ERPF), sodium (CNA), osmoles (COsm), and free water (CH2O) were measured in milliliters per minute before and after the intravenous infusion of furosemide (0.5 mg. per kilogram of body weight). Renal vein PAH levels (EPAH) in eight patients were used to calculate true renal plasma flow (TRPF), true renal blood flow (TRBF), and renal vascular resistance (RVR). Furosemide caused a significant increase in urine volume, CNa, and COsm; there were no significant changes in GFR, ERPF, RVR, TRBF, and EPAH. These findings also were observed when the patients were subgrouped according to elevated, normal, or low renal plasma flow and elevated renal vascular resistance. No significant changes were seen in EPAH, thus making a redistribution of renal blood flow unlikely. These studies indicate that furosemide has only a diuretic effect and no hemodynamic effect in the kidney; it has the potential of seriously reducing the circulatory volume and causing renal failure in critical patients.


An experimental study of gastric healing following scalpel and diathermy incisions. To date there has been no reliable information available which compares gastric healing following incisions made by scalpel and diathermy. Standard incisions were made in rat stomachs, half with a scalpel and half with diathermy, following which they were closed in a standard fashion. Healing was assessed at intervals by bursting and tensile strength measurements, angiography, and histology. All incisions were healed by the tenth day. The only significant difference discovered was that histologically there was a definite lag in healing up to the fifth day in those incisions made by diathermy. It is suspected that this is due  to mucosa having been dragged into the wound edges by adherence to the diathermy knife.


Gastric mucosal contraction.

Gastric mucosal contraction. In this study the role that contraction plays in the healing of gastric wounds is explored experimentally. Superficial gastric mucosal defects made in the columnar part of rat stomachs were found to close rapidly, compared to defects carried down into the muscle layer. The collagen was packed tightly at the edges of the defects and no other factors appeared to have played a part in the closure. It is surmised that the decrease in size of the defect is due to fibroblastic activity causing contraction. It would seem likely that the myofibroblast, as described by other investigators, would be the unique cell causing this action. Further studies are required to confirm or refute this hypothesis.


Evidence for a humoral factor in unilaterally nephrectomized dogs stimulating renal growth in isolated canine kidneys. Totally isolated canine kidneys were perfused at 37 degrees C. for 240 minutes with whole blood from dogs that had undergone a sham operation or a unilateral nephrectomy 24 hours previously. Renal blood flow, glomerular filtration rate, serum sodium, and serum osmolality were not significantly different in the experimental and control preparations. Nucleic acid synthesis as measured by 3H-adenine incorporation was 75 percent higher (p less than 0.01) in the kidneys perfused with blood from the neprectomized dogs. This result supports the theory that a blood-borne factor stimulates nucleic acid synthesis and initiates compensatory renal growth.


Limitations of the Doppler cerebrovascular examination in hemispheric cerebral ischemia. The results of a directional Doppler ultrasound cerebrovascular examination were compared with arteriographic findings in 56 patients with resolved hemispheric strokes or transient ischemic attacks. Aortic arch arteriography revealed appropriate internal carotid artery lesions which were amenable to endarterectomy in 36 patients (64 percent). Of this group, abnormal Doppler findings were present in only 11 patients (31 percent). The definitive clinical applications of the Doppler cerebrovascular examination are limited to those settings in which demonstration of altered hemodynamics is decisive. In view of the apparent preponderance of embolic rather than hemodynamic mechanisms in the pathogenesis of focal cerebral ischemia, the Doppler examinations has only an adjunctive role in the evaluation of most patients with hemispheric symptoms of cerebrovascular occlusive disease. In such patients, preselection of candidates for diagnostic arteriography is an inappropriate application of the Doppler cerebrovascular examination.


Scanning electron microscopic observations of the common carotid artery of the rat. III. Heparin effect on platelets. After administration of high systemic doses of heparin verified by assay, common carotid arteries in the rat were divided and sutured. Scanning electron microscope observations of endothelial surfaces showed a decrease in platelet adhesion, as well as a reduction in the adherence of other circulatory blood elements when compared to controls. This is the first report indicating the in vivo effect of high dose systemic heparin on platelets.


New electric drill biopsy apparatus for breast tumors. A simple method of biopsy for breast tumors by means of a new electric drill is described. Biopsy with this apparatus is performed safely and accurately, and it is possible to obtain a part of suspect tumor large enough to allow histological diagnosis. This biopsy apparatus could contribute to early detection of breast carcinoma and the results of surgical treatment would be improved.


Celiac artery aneurysmectomy: case report with review of the literature. A case of celiac trunk aneurysm treated by excision and direct reanastomosis with restoration of arterial continuity, and a description of a new technique for selective visualization of the celiac artery are reported. A review of the literature with tabulation of all surgically treated cases is included. Significance of hepatic artery flow restoration is emphasized.


Vascular insufficiency secondary to ergotism. A case of ergot-induced peripheral vascular insufficiency mimicking atherosclerosis is presented and the clinical symptoms with vascular laboratory evaluation and roentgenographic findings are discussed in detail. A review of the literature of the vascular complications of ergot alkaloids is presented. After considering the various therapeutic modalities employed, a conservative, but hopefully more rational, treatment for these lesions is recommended. Although uncommon, this problem always must be considered in the differential diagnosis of the young patient, especially female, who presents with visceral or peripheral arterial insufficiency.


Reversibility of severe hepatic damage caused by jejunoileal bypass after re-establishment of normal intestinal continuity. This case report attempts to document the reversibility of advanced hepatic anatomical and clinical alterations compatible with advanced hepatic cirrhosis that occasionally develop in patients with jejunoileal bypass performed for morbid obesity. The advanced stage of this complication can be fatal unless the intestinal continuity is returned to normal.


[Oesophagotracheal fistula in a calf. Report of a case (author's transl)]. The case of a nine-month-old Dutch-Friesian heifer calf with an oesophagotracheal fistula which probably was congenital, is reported. The fistula passed obliquely from the caudodorsal to the cranioventral region, from the ventral portion of the oesophagus to the dorsal part of the trachea, into which it opened at a point one cm. cranial to the eparterial bronchus. The animal had been affected with bloat at birth and had had difficulty in drinking as a young calf. It did not show any clinical symptoms during the grazing period. It was not until the animal was housed at an age of nine months that bloat recurred as a result of inflation of the rumen by the fistula.


[Hygiene in the rearing of piglets. A study of the effect of hygiene and the bacterial content of drinking-water and feed of baby pigs on a number of health and performance characteristics on pig-breeding farms (author's transl)]. The effect of hygiene on health characteristics and performance was studied on 143 farms. In addition to subjective evaluations, the bacterial counts in the drink-water and feed were adopted as criteria of hygiene. In from 6 to 27 per cent of the cases, variations in bacterial counts were associated with variations in hygiene. Bacterial counts on a single farm varied markedly. Hygiene is to a large extent determined by the attendant. On the farms, including those on which hygiene is adequate, there is a marked increase in the number of bacteria present in the drinking-water and feed of the baby pigs. The state of hygiene of the drinking water and feed is highly unsatisfactory on a large number of farms. Of all litters, 15.08 per cent developed scouring in the first week of life, 21.69 per cent showed scouring during the third week and scouring was observed in 2.24 per cent of the weaned piglets. Correlations between the various aspects hygiene are high. Improvements in farm and drinking-water hygiene are associated with a more rapid growth of the piglets. The incidence of scouring during the third week is lower on those farms on which hygiene is satisfactory. The present study showed that there was no relationship between hygiene and litter size. Early supplementary feeding does not produce any improvement in growth of the piglets. The incidence of scouring in the third week increases and growth decreases as the bacterial count in the drinking-water increases. Clean drinking-water should be available to the animals.


[Food poisoning following consumption of canned meat prepared by a butcher (author's transl)]. A case of food poisoning possibly caused by the ingestion of canned meat is reported. Large numbers of micro-organisms (approximately 10(7)/gram), mainly Enterobacteriaceae and streptococci, were isolated from the contents of three cans. The contents of another can contained approximately 10(5) Bacillus spp. per gram. The meat preserves had been prepared in a butcher's shop and heated in a "cooking pot", the steam holes of which had been stopped up and the lid of which had been made heavier in order to reach a temperature above 100 degrees C. Inadequate sterilization and errors in processing are suggested as possible causes.


[Use of prostaglandins in suboestrus cows (author's transl)]. One hundred and fifty lactating, suboestrus cows with palpable corpora lutea from twenty herds were treated by intramuscular injection of prostaglandins. The expected date of oestrus was predicted in 150 suboestrous controls of the same herds on the basis of ovarian findings. The average interval between treatment and insemination was 8.8 days in the prostaglandin-treated and 17.6 days in the control group. The interval between treatment and insemination was shorter than eight days in 74 per cent of the prostaglandin-treated cows. Pregnancy rates in the treatment and control groups were 56 per cent and 58 per cent respectively.


T system in ascidian muscle: organization of the sarcotubular system in the caudal muscle cells of Botryllus schlosseri tadpole larvae. The organization of the sarcotubular system has been examined in the caudal muscle cells of the ascidian. Botryllus schlosseri. At variance with striated muscle of other protochordates. Botryllus muscle cells are endowed with a well-developed T system, which has a peculiar laminar structure. The thin T laminae are in continuity with the plasma membrane and extend longitudinally in the intermyofibrillar spaces. At the level of the I-band the T laminae are focally associated with SR cisternae in dyad junctions similar to those observed in invertebrate muscles. These findings are discussed in relation to the origin of the sarcotubular system in vertebrate muscle.


Structure of the epithelial - mesenchymal interface during early morphogenesis of the chick duodenum. During the period of early morphogenetic folding of the intestinal epithelium, changes in the epithelial-mesenchymal interface were observed by light microscopy, scanning and transmission electron microscopy. The epithelium in cross-section, appears first as a circle, then an ellipse and finally by a triangle prior to the formation of the first three previllous ridges. The bases of all epithelial cells are flat at the circular stage. At the ellipse and triangle stages the bases of the epithelial cells occupying the sides possess lobopodia that do not penetrate the basal lamina. The immediate mesenchymal cells subjacent to those epithelial cells on the sides of the ellipse and triangle alter their orientation to being rounded-up or perpendicular to the plane of the basal lamina. Large numbers of fine mesenchymal pseudopodia in addition to many extracellular fibrils are revealed by transmission and scanning electron microscopy at the epithelial-mesenchymal interface. The fine mesenchymal pseudopodia come into close contact but do not penetrate the ruthenium red-staining basal lamina. The possible roles of close contact between epithelium and mesenchyme, the alteration in orientation of mesenchyme cells, and of the basal lamina in tissue interaction are discussed.


A scanning electron microscope study of mouse peritoneal mesothelium. As seen in the scanning electron microscope, peritoneal mesothelial cells of the mouse diaphragm, anterior abdominal wall and intestinal serosa carry numerous microvilli. These microvilli are absent over certain areas of the cell surface and are sometimes, interlocked in meshwork patterns or coronal formation. The apical cell membranes of the mesothelium at the base of the microvilli, are invaginated by many plasmalemmal vesicles and vacuoles and carry a number of protruding spherical structures. Deep circular craters, giving the impression of stomata, are also visible.


Observations on the olfactory organ of adult and juvenile Octopus joubini. The olfactory organ has an epithelium containing many sense cells and a large subepithelial mass of receptor cells. The epithelium includes cells with cup-shaped, ciliated endings, and hollow, flask-shaped sense cells with ciliated cavities that open to the surface, through a small pore. Below the epithelium are large hollow cells with ciliated cavities and distal processes that either form patent connections between the ciliated cavity and the surface or have a ciliated ending at the surface. There are many synapses between processes in the olfactory nerve. The possible chemosensory function of the olfactory organ is discussed.


Fine structure of the epidermis of the optic tentacle in a slug, Limax flavus L. The epidermis at the tip of the optic tentacle in Limax flavus is constructed of columnar epithelial cells, distal processes of nerve cells, and scattered processes of the collar cells. The epithelial cells extend stout microvilli called plasmatic processes by Wright perpendicularly from the free surface. Each plasmic process branches into a few terminal twigs embedded in a fuzzy filamentous substance. Most nerve cells have their nuclei under the basal lamina. The distal processes of these nerve cells reach the free surface and send long microvilli to form the spongy layer under a filamentous covering. At the side surface of the tentacle the epithelial cells are cuboidal or squamous and the neural elements are fewer. Here, no spongy layer is formed; and the collar cell processes are replaced by the lateral cell processes. Peculiar secretion granules are contained in the lateral and collar cell processes as well as in their cell bodies situated beneath the basal lamina.


Localization of monoamine nerve fibres by formaldehyde fluorescence histochemistry in the posterior salivary duct and gland of Octopus vulgaris. A bright yellow-green specific fluorescence is induced by formaldehyde histochemistry for monoamines in the secretory nerve trunks of the Octopus vulgaris posterior salivary duct, and in their ramification in the gland tubules. In contrast, the motor nerve trunks of the duct contain few fluorescent elements. The muscular and connective coat of the duct is provided with fluorescent globular and varicose structures, of various sizes and colours, which become numerous in the duct branches. At least some of these peripheral structures belong to varicose monoamine nerve fibres. In the gland, on the contrary, the muscle cells surrounding the tubules are not supplied with fluorescent nerve fibres.


The form of the globiferous pedicellarial ossicles of the regular echinoid, Psammechinus miliaris Gmelin. The form of the globiferous pedicellariae from Psammechinus miliaris is described. The valve ossicle resembles that of Parechinus in its triangular valve shape and open blade form, contrasting with Echinus in these features. The present study indicates that the relationship of the valve nerve pathway to the skeletal ossicle is related to the form of the distal blade. It is proposed that subterminal teeth or a tubular blade may be alternative structural devices for strengthening the venom tooth during venom injection.


Histopathological studies on intrahepatic bile ducts in the vicinity of porta hepatis in biliary atresia. Intrahepatic bile ducts in the vicinity of the porta hepatis were histologically investigated in 9 cases of biliary atresia and the pattern of bile duct was divided into two groups. In the first group, there were a few large bile ducts which had continuity to the extrahepatic bile duct. In the second group, many small bile ducts were histologically observed, but there was no large bile duct at the porta hepatis. This type of abnormal bile ducts was seen in the cases of obliteration of bile ducts at porta hepatis.


A competitive protein binding assay for plasma 25-hydroxyvitamin D3 in normal children. In order to determine the plasma level of 25-hydroxyvitamin D3 (25-OH-D3) in Japanese children by the competitive protein binding assay, we studied binding proteins in D-deficient rats, and obtained the following results. 1) By using serum and kidney cytosol of D-deficient rats, we could obtain a standard curve with high sensitivity and accuracy which enabled us to determine the 25-OH-D3 level ranging from 0.5 to 5.0 ng. 2) The plasma 25-OH-D3 level was found to be 21.6+/-10.1 ng/ml (n=17) in healthy infants and children from 1 to 15 year-old, and 11.4+/-8.6 ng/ml (n=27) in mature neonates up to 2 days after delivery.


Effects of pentazocine on coronary hemodynamics under pentobarbital or chloralose-urethane anesthesia in dogs. The effect of pentazocine on the coronary hemodynamics was studied in anesthetized dogs. Under pentobarbital anesthesia pentazocine did not cause any significant changes in the coronary hemodynamics. Under chloralose-urethane anesthesia, however, it produced a statistically significant increase in heart rate, left coronary blood flow rate, myocardial oxygen consumption as well as myocardial oxygen extraction rate, but a decrease in coronary vascular resistance. These results indicate that the effects of pentazocine on the coronary hemodynamics are modified significantly by the drugs used for basal anesthesia.


Indication of mediastinal lymph nodes metastases by radioaerosol inhalation lung scanning in pulmonary neoplasm. Fifty-three patients with pulmonary neoplasm were studied by radioaerosol inhalation and perfusion lung scans, bronchoscopy and spirometry. The probability of lymph node metastases could be estimated by the amount of inhaled aerosol deposited at the carina. On thoracotomy, actual mediastinal lymphadenopathy was minimum, if any, in 4 patients without carinal aerosol deposition. Application of the aerosol inhalation lung scan to pulmonary neoplasm provides useful diagnostic and prognostic information regarding mediastinal lymph nodes metastases.


Hemodynamic effects of aerosol propellants. III. Vascular resistance in the canine hind limb. The question as to whether or not the hypotension observed as part of the effect of tricholorofluoromethane (FC11), dichlorofluoromethane (FC 12), dichlorotetrafluoroethane (FC 114) and methyl chloroform was due to a vasodepressor component of action, in addition to the previously documented depression in myocardial contractile force, was answered by testing these agents in an anesthetized dog preparation in which one hind limb was perfused at constant flow through the femoral artery. 5% FC 11, 20% FC 12 and 20% FC 114 decreased vascular resistance of the perfused limb, as reflected by decrease in mean femoral arterial perfusion pressure, in vagotomized but not in intact preparations. Methyl chloroform decreased vascular resistance even in intact preparations. Spontaneous blood flow in the intact femoral artery decreased following FC 11 and methyl chloroform administration in vagotomized preparations and was associated with marked decrease in mean aortic pressure. Blockade of alpha and beta adrenergic receptors with phentolamine and propranolol in the vagotomized preparation had no modifying influence of the effect of FC 11 and methyl chloroform. It may be concluded from this study that FC 11, FC 12 and FC 114 exhibit a vasodepressor activity on skeletal muscle vascular bed which is readily overcome by the hypotension-induced activation of the sympathetic system but which becomes evident when reflex activity is prevented by vagotomy. Methly choloroform exhibits a vasodepressor effect even in intact preparations probably because of concomitant depression of reflex activity through its general anesthetic action. A decrease in spontaneous femoral blood flow following FC 11 and methyl chloroform administration is referable to the accompanying severe hypotension notwithstanding concomitant vascular relaxation. Neither FC 11 nor methly chloroform directly liberate catecholamines from their sites of storage.


Studies on the in vitro metabolism of dimethylnitrosamine by rat liver. The biotransformation of dimethylnitrosamine (DMN) to formaldehyde, generally attributed to the mediation of a demethylase enzyme associated with the microsomal mixed function oxidase system, has been investigated in rat liver preparations. All of the enzyme activity was found in the postmitochondrial fraction and the microsomes contained approximately 50% of this activity. The restoration of total activity resulting from the addition of the cytosol to the microsomal fraction was found to be due to presence of diffusible, heat-labile constituents in the cytosol. Enzyme kinetic studies revealed that DMN was metabolized to formaldehyde by either a multistep or a multicomponent process. DMN demethylase was found to be relatively stable to storage in contrast to cytochrome P-450 and a number of mixed function oxidase enzyme activities. In spectral interaction studies DMN was found to form an atypical interaction spertrum with either control, phenobarbitone-pretreated or phospholipid-depted microsomal preparations. DMN had little effect on Type II spectral interaction of aniline, but noncompetitvely inhibited the Type I spectral interaction of benzphetamine and biphenyl. Whilst the mixed function oxidase enzyme inhibitors SKF 525A and metyrapone markedly reduced the metabolism of ethylmorphine and anailine, DMN demethylase was little affected by the former compound and appreciably enhanced by metyrapone. Moreover, DMN demethylase was strongly inhibited a number of hepatic mixed function oxidases, but significantly reduced anaerobic nitroreductase activity. The results of these studies reveal important differences between the properties of the enzymatic systems which metabolize DMN and mixed function oxidase substrates, and are consistent with the conclusion that the degradation of DMN to formaldehyde by rat liver preparations is a multicomponent system not rate limiting with respect to cytochrome P-450.


Chronic toxicity of methylmercury in the adult cat. Interim report. Doses of 3, 8.4, 20, 46, 74 or 176 mug Hg/kg/day were fed to groups of 8--10 adult cats, either as methylmercuric chloride or as methylmercury-contaminated fish, 7  days/week for up to 2 years. Food consumption, body weight change, blood mercury levels, haematology, urine analysis, serum blood urea nitrogen (BUN) levels and neurological status were assessed regularly in all animals. Clinical signs of methylmercury toxicity -- consisting of ataxia, loss of balance and motor incorrdination -- occured in groups receiving 176 mug Hg/kg/day after 14 weeks of treatment. Pathological findings were confined to the nervous system and consisted of loss of nerve cells with replacement by reactive and fibrillary gloisis. Terminal blood and brain mercury levels were approx. 10 ppm. There were no differences in the time required to develop clinical signs of methylmercury toxicity, tissue mercury levels or pathology between the groups of cats receiving methylmercury as methylmercuric chloride or as methylmercury-contaminated fish, at either dose level. Blood mercury levels in the remaining doses groups appeared to plateau after 40 weeks of treatment. Groups receiving 46 mug Hg/kg/day began to show some neurological impairment after 60 weeks of treatment which did not progress in subsequent weeks. No treatment-related effects were present in groups receiving 20, 8.4 or 3 mug Hg/kg/day after 2 years.


Distribution of aflatoxin B1 in tissues of mink (Mustela vison). Seven female mink (Mustela vison) were injected intraperitoneally with a single dose of 100 mug aflatoxin B1 (14 C-label and unabeled). They were sacrificed 1, 2, 4, and 24 h after dosing. Liver, instestines, stomach, lung, kidney, brain, pancrease, spleen, urinary bladder, uterus, and bile were removed and examined for the retained radioactivity. 1 h after dosing, intestines and their contents retained the largest amount of 14C-radioacivity (18.9% of the amount that was administered) which was followed by liver (13.2%) and the bile (10.8%). At this time all other tissues retained less than 1% of the administered radioactivity. Generally, the amount of radioactivity retained in all tissues declined with time. Only 1.2 and 0.6% of the administered radioactivity was found in testines and bile, respectively, 24 h after dosing; however, the liver still contained 6.6% of the initial radioactivity. Examination of subcellular fractions of liver revealed that at all time intervals most of the radioactivity was associated with the micrososmal supernatant fluid.


Long-term toxicity of the surfactant alpha-olefin sulphonate (AOS) in the rat. The surfactant alpha-olefin sulphonate (AOS) was fed to rats at dietary levels of 1000, 2500 and 5000 ppm for a period of 2 years. There were no adverse clinical signs, and survival rates were not affected by treatment with AOS. The rate of bodyweight gain was marginally lower during the second trimester of the study in both males and females receiving 5000 ppm AOS, while food intake was also marginally lower during the first year among females receiving 5000 ppm. During the remainder of the study, bodyweight change and food consumption of all treated animals was similar to that of the control animals. Investigation of the animals' eyes, blood and urine did not reveal any reaction to treatment, nor were any changes relating to treatment seen in the macroscopic pathology or organ weights of rats killed after 104 weeks. Histological examination of the tissues did not provide any evidence of toxicity or tumour induction that could be attributable to treatment with AOS.


Short-term toxicity of 1-naphthaleneacetic acid in rats. In a 90-day feeding study, 4 groups of 10 male and 10 female rats received in the diet 0,200, 1000 and 5000 ppm 1-naphthaleneacetic acid (1-NAA). Growth and food intake was reduced significantly only in males on 5000 ppm. Haematological examination yielded essentially negative results except for a non-significant reduction at the 1000 and 5000 ppn levels in the leucocyte count, mainly due to a reduction in neutrophils. No significant effects were observed in the renal concentration test, urinalysis, renal histochemistry or histology of a wide range of organs at any level of 1-NAA tested. Increased relative weights of thyroid, testes, brain and liver were confined to the 5000 ppm level. The increase in relative liver weight was not accompanied by histological liver damage and was associated with elevated liver microsomal enzyme activity. The loss of glucose 6-phosphatase (G6Pase) and increase in glucose 6-phosphate dehydrogenase (G6PDH) seen histochemically in the centrilobular region of the liver in males on 5000 ppm, accompanied by glycogen depletion in the liver, could however be indicative of liver damage. On the basis of conventional criteria, a no-effect level of 1000 ppm would have been indicated by this study but in view of liver glycogen depletion at all levels tested a no-effect level was not established.


Effect of short-term administration of lead to pregnant rats. Lead was administred to adult female rats in drinking water (0;0.1:1 and 10 ppm) for 3 weeks before mating, during pregnancy and during 3 weeks after delivery. On day 21 after delivery the mothers and their newborns were sacrified and various parameters of blood -- lead concentration on (Pb-B), hematocrit (Htc), hemoglobin (Hb), free erythrocyte porphyrins (FEP), delta0aminolevulinate dehydratase (ALAD) -- and tissue -- ALAD, free tissue porphyrins (FTP), lead concentration (Pb-T) -- were determined. In mothers a significant increase in Pb-B and Pb concentration in kidney was found in the 10 ppm group, but this increase in lead concentration was not associated with any statistically significant modification of the biochemical parameters. In newborns, lead concentration in blood and in kidney was also significantly increased in the 10 ppm group and this lead exposure was associated with a decrease of the ALAD activity in blood and an increase of FTP in kidney. On the basis of the biochemical parameters investigated one can therefore conclude that the developing organism is more susceptible to the biological action of lead than the organism of adult animals and that the "no-effect" level of lead administered during pregnancy and in the neonatal period is around 1 ppm.


[Tumor inactivation and radiobiology].

[Tumor inactivation and radiobiology]. In this paper, the inactivation of tumors and the tolerance of irradiated surrounding normal tissues is considered under radiobiological aspects. Surviving euoxic cells may be calculated by means of a simple exponential function being characterized by a reduction constant D0. This constant decreases with increasing single doses. Another exponential function allows the calculation of the probability of tumor destruction from the surviving fraction of tumor cells after irradiation. Examples show the probability curves steeply rising with the total dose, in accordance with former observations of Holthusen (S-curves). From the amount of total dose and the steepnees of the rise the values of radiation sensitivity of the particular cells may be evaluated. If there is a fraction of anoxic tumor cells, it is probable that after every irradiation a part of them is transformed into euoxic cells. In such a case, the recovery curves, depending on the degree of reoxygenation, will shift to larger values of the total doses. A good reoxygenation, therefore, is highly important for the success of the irradiation, it can be realized by appropriate irradiation programs. The regeneration (repopulation) of normal cells is of fundamental importance for the restitution of normal tissues following radiation injury. It is generally assumed that the tolerance dose is reached when the number of surviving normal cells arrives at a lower limit. Cohen's measurements at the skin of patients treated with 200 keV X-rays have been used for the calculation of tolerance doses for Co-60 gamma-rays and fast electrons. The tolerance doses depend on the amount of the single doses and result in calculated values of over 10000 rd with electron irradiation of 500 rd per week. These calculations are confirmed by the findings of Schumacher with electron irradiation.


[Histological diagnosis of gynecologic recurrences in the minor pelvis. Puncture using the tru-cut biopsy needle]. In about 60 cases demonstrating a tentative diagnosis of a palpable recidivation (cancer of the cervix), a puncture of the parametrium and of the pelvic wall was carried out with the biopsy needle "Tru-Cut". The modalities of procedure are described. Verification of cancer suspicion was achieved to a rate of 50 per cent, this percentage having increased for about 20% when the puncture was repeated. Ten per cent of the carcinomas could not be listed, and in 20% of the cases a recidivation could be excluded. There were no complications.


[Vaginal applicator combination for radium therapy of advanced vaginal and cervix carcinomas]. A vaginal applicator combination for intracavitary radium therapy in cancers of the female genitals was developed. By means of several stages which may be combined moreover with tube filters, different combinations and different radium quantities are applicable which can be adjusted to the results of medical examination using symmetric or asymmetric radium sources. The loading of the applicator combination is executed by straight genuine tube filters which were fixed by weld.


[Radio-chemotherapy of cervix carcinoma. I. Clinical part]. A prospective study was performed for a new model concerning the potentiation of radiation with Podophyllum (Proresid) and the radioprotection with Acethylhomocystein-thiolactone (Reducdyn) in cases of the squamous cell carcinoma of the uterine cervix. The study was carried out on the basis of alternated data of birth. The total number of the randomization was 256, consisting of 173 stages II und 83 stages III. All patients were irradiated with 6000 mgeh Ra and 4500 R 60Co. In addition to the irradiation one group of 128 patients received an infusion of 1g Podophyllum/day after irradiation. Another group of 46 patients was treated prior to irradiation with 1g Acethyl-homocystein-thiolactone (AHCT) and with Podophyllum after exposure. The total dosage was between 30 and 50g Pod. and 30 and 50g AHCT. It could be shown that the survival rate after three years was increased up to 15%. An earlier study revealed a five-year-survival rate of 23%.


[Growth velocity of breast carcinoma and radiographic "early diagnoses"]. Between 1960 and 1975, 53 mammary carcinomas have been observed in a collective of 15000 women a part of whom, comprising finally 80 per cent, was free from troubles (annual prophylactic examination for breast cancer). Of these 53 cases were available two up to eleven preceding mammographic series made within an observation period of 0.2 to eleven years. A "mean growth curve" was obtained empirically, based on 163 mammographic tumor measurements with tumor sizes between 2 mm and 60 mm. In the course of a development period between two and eleven years, 33 per cent of the carcinomas were seen to accelerate their further growth in comparison with the initial value; 66 per cent revealed an increasing slow-down of growth, and all tumors showed considerable changes in their growth rates. Mammary carcinomas altogether continually decelerated their growth as measured by the duplication time of the tumor volume from Tv = 309 days on the average up to an average of Tv = 381 days after two through eleven years. The mean growth curve exhibited an exponential shape which was completed by biomathematical methods and can be described by means of a Power function. It corresponds well to the rate of incidence of the mammary carcinoma which shows an identical rise in relation to increased old age. The medium growth time from a primary cancerous cell with ten micron in size up to the tumor 2 mm in diameter may be estimated biomathematically only and amounts to ten or twenty years with 23 duplication periods. The further average growth rate between the tumor sizes of two and ten millimeter, stages which can be diagnosed roentgenologically, was empirically six years; the most quickly growing tumor needed almost two years. For the purpose of early cancer detection (tumor size below 10 mm, lymph nodes histologically free from metastases), the serial mammography to be performed every 18 months or two years is the only technique which provides utilizable early recognition marks and besides does allow a simple judgement. Solely the symptoms "suspect desification, partly spiculated" in sixty per cent and "typical cancerous microcalcification" in forty per cent have been observed as the earliest signs. The reliability ("certainty") of mammography is frequently overestimated (false negative rate: 7 to 18%) and should be quoted only for collectives where control mammographies have been made over a period of five or ten years. Roentgenological controls of alterations below three millimeter in size and without an indication for biopsy ought to be performed within six months, and still sooner in case of larger alterations. It is not possible earlier than after five or ten years to judge of the radicality of a therapy, as spread cancerous cells, on he average, reveal similar growth rates as does the primary tumor.


[Isodose computations of linear and circular interstitial radiation sources]. A new program for computation and representation of isodoses around interstitial radiation sources is presented. The sources can be arranged in a line or circularly. The choice for the location of the isodose plane is restricted by a sole condition: It has to be positioned parallel to a given axis. The program comprises different possibilities for an optimal description of the isodoses.


[The action mechanism of heparin in the increase of radiation resistance of mice]. Repeated intraperitoneal heparin injections given to mice prior to a whole-body irradiation with 650 R reduce the blood coagulation time between the seventh and the 19th day after radiation injury as compared to untreated animals exposed to radiation. Controls, not having been irradiated, didn't show any measurable effect after repeated heparin administration in 60 per cent of the experimental animals, whereas in 40 per cent the hematocrit value decreased to about two thirds of the normal, this probably being caused by internal hemorrhages. The increase in radiation resistance of mice, following administration of heparin, therefore may be due to a stimulation of the hematopoietic system, beginning already before exposure.


[Regeneration of murine fibroblasts, L-929, following fractionated irradiation]. L-cells in culture were irradiated with single and fractionated doses of 200 kV X-rays. Dose effect curves were determined using the colony forming capacity as the criterion of the radiation effect. After an initial dose of 330 rd and a 3 h to 16 h incubation at 37 degrees C a restitution of the shoulder of the dose effect curves was observed (Elkind repair). 16 hours after preirradiation the dose effect curve showed a statistically significant increase of n and Dq as compared to the dose effect curve after single irradiations showing that the cells have become more radioresistant by the radiation pretreatment. The curve of the colony forming ability after a total dose of 660 rd given in two equal doses of 330 rd had an oscillating shape depending on the fractionation interval. This type of curve can be interpreted by the restitution progression model.


[Floating rates of synchronized CHO fibroblasts following 60Co gamma irradiation]. Monolayer cell colonies normally are pushing off single cells, which go into suspension. A dose-dependent increase of these cell detachments followed by readhesion and colony forming would influence the colony survival curve. Detached cells being in suspension can be verified by means of the colony forming test after decantation and inoculation of the medium. The amount of colony forming cells in the late phase of synthesis does scarcely change following 300 rds of 60Co gamma irradiation. The diminution of cell adhesion expected as a result of radiation damage could not be observed.


[Animal experiment studies on the use of ozone in irradiated and non-irradiated tumors. I. Intravenous ozone therapy of Crocker's sarcoma 180 and Ehrlich carcinoma in the white mouse]. The fractionated tangential local X-ray therapy, in cases of sarcoma 180 in white mice with a total dose of 1500 R, effects a shrinking of the tumours as well as a certain number of cures. Intravenous administration of ozone in a total dose of 0.15 times 10(-7)g, 1.5 times 10(-7)g, and 15 times 10(-7)g - by itself or together with irradiation - has as consequence neither an inhibitory effect on the tumour growth, nor an increase in radiation effect that are surpassing the diffusion width of the model and are reproducible in an exact manner. It has been possible to prove an inhibition of the tumour growth in the solid Ehrlich's carcinoma of white mice after a fractionated 2000 R irradiation, but also in these cases, no effect of the ozone application was stated.


Dominant lethals following acute spermatogonial X-irradiation in the rat. Spermatogonial X-irradiation with 0, 400 or 600 R in adult rats and 200 R in fetal rats was carried out to assess genetic damage by the test of induced dominant lethality. From postimplantation embryonic losses observed, dominant lethal rates were established to be significantly raised by a dose of 400 or 600 R. With 200 R given either to adult or to fetal rats, no excess was detected in embryonic death rates.


Preparation of 1,2-3H-21-deoxycortisol by incubation of 1,2-3H-17-hydroxyprogesterone with rat adrenal mitochondria. A method is described for preparation of 1,2-3H-21-deoxycortisol by incubation of 1,2-3H-17-hydroxyprogesterone with rat adrenal mitoochondria. The radiochemical purity of the product was established by two subsequent chromatographies, reversed isotopic dilution and oxidation to 21-deoxycortisone. The final yield of 1,2-3H-21-deoxycortisol was approximately 15%.


Syntheses of estetrol monoglucuronides.

Syntheses of estetrol monoglucuronides. Four possible monoglucuronides of estetrol (estra-1,3,5(10)-triene-3,15 alpha, 16 alpha, 17 beta-tetraol) have been prepared from appropriately protected estetrol by the Koenigs-Knorr reaction employing cadmium carbonate as a catalyst. Condensation of methyl acetobromoglucuronate with estetrol 15,16,17-triacetate provided the 3-glucuronide acetate-methyl ester in a satisfactory yield. Introduction of the glucuronyl residue into C-17 was similarly attained by the use of estetrol 3-benzoate 15,16-acetonide. When estetrol 3,17-diacetate and acetobromosugar were stirred in anhydrous toluene in the presence of cadmium salt, the reaction occurred at C-16 and C-15 yielding two isomeric monoglucuronide derivatives in a ratio of ca. 5 to 2. Removal of the protecting groups in the four glucuronide acetate-methyl esters gave the desired estetrol glucuronides, respectively. These synthetic substrates underwent readily enzymatic hydrolysis with beef-liver beta-glucuronidase to afford estetrol.


Metabolism of radioactive 17 beta-estradiol 3-methyl ether by humans. A mixture of 2-3H and 4-14C-17beta-estradiol 3-methyl ether was administered orally to a man and to a woman. 34 and 35 percent of the 3H was liberated into the body water of the man and of the woman, respectively, reflecting reactions involving position 2. The metabolism of estradiol methyl ether was qualitatively similar to that observed previously for radioactive estradiol administered intravenously to the same subjects, as judged by the measurement of various urinary metabolites by reverse isotope dilution. Evidence was obtained for hydroxylation at position 2 without demethylation by the isolation of urinary 2-hydroxyestrone 3-methyl ether which retained 33% of the original 3H. This 3H was presumably at position 1, resulted from an NIH shift which does not occur during hydroxylation of estrone or estradiol. This was confirmed by subsequent administration of a mixture of 4-14C and 3H-(methoxyl)-estradiol 3-methyl ether to the man. There was no evidence (by reverse isotope dilution) for 1-hydroxyestrone, 1-hydroxyestrone 3-methyl ether, 4-hydroxyestrone 3-methyl ether or 4-hydroxyestradiol 3-methyl ether as urinary metabolites of estradiol 3-methyl ether.


Androgen metabolism by rat epididymis. 3. Effect of castration and anti-androgens. The in vivo and in vitro metabolism of 3H-testosterone by rat epididymis and the changes in epididymal weight have been studied after castration and treatment with anti-androgens. The utilization of 3H-testosterone was greatly reduced after castration as was the formation of 5alpha-reduced 17 beta-hydroxy metabolites. The formation of the 17 -keto metabolites was unaffected. Castration had no effect on the ratio between water and ether soluble radioactivity. Administration of testosterone propionate, necessary for giving normal stimulated prostate weight (150 mug/day), restored the metabolism of testosterone to approximately normal values. Estradiol benzoate and progesterone inhibited metabolism of testosterone in vitro and greatly reduced the formation of DHT (17 beta-hydroxy-5alpha-androstan-3-one) and 3 alpha-diol(5 alpha-androstane-3 alpha-17 beta-diol) by experiments both in vivo and in vitro. No effect of cyproterone acetate could be demonstrated on either the in vitro or in vivo metabolism of testosterone. Castration for 14 days reduced the epididymal weight to about 30% of that found in intact animals. Administration of testosterone propionate restored the epididymal weight to about 80% of normal. Estradiol benzoate and cyproterone acetate given to intact rats led to a decrease in the epididymal weight. Progesterone had no such effect. In 14 days castrated rats receiving testosterone propionate all three anti-androgens reduced the weight of the epididymis. In conclusion, our results show that the metabolic conversion of testosterone in epididymis to DHT and 3 alpha-diol is dramatically dependent on the hormonal status of the animal; castration or treatment with anti-androgens causes a reduced formation of the "active" androgens whilst testosterone replacement treatment restores the metabolism of testosterone to normal.


The effect of a synthetic steroid (trienbolone) on the rate of release and excretion of subcutaneously administered estradiol in calves (18). With the objective of obtaining values for the rate of release and excretion of subcutaneously implanted estradiol and to relate them to the metabolic effect of the hormone, a study was carried out with young Jersey bull calves. After subcutaneous administration of lactose tablets (implants) containing tritiated estradiol (4 mCi in 20 mg estradiol) the activity was followed in plasma, urine and feces for 107 days. Three calves received implants containing 140 mg trienbolone in addition to the 20 mg estradiol. In the first group maximum plasma concentration of estradiol-17 beta was 3 nmol/1. In the other group it was only 0.33 nmol/1. In calves receiving estradiol as the only steroid, 95% of the activity was excreted within 20 days after implantation. In the other group collection of urine and feces had to be carried out for 107 days in order to account for all the implanted activity. No 3H could be detected in urine and feces samples collected from the estradiol group more than 31 days ater implantation. The feces and urine samples collected from calves in the estradiol-trienbolone group 107 days after implantation contained from 1.4 - 3 nCi per gram. The remarkably decreasing effect of trienbolone on the release of estradiol and its possible importance for the effect of subcutaneously administered estradiol are discussed.


Saturated metabolites of progesterone in human myometrium during pregnancy. A method for the separation and quantitative determination of epimeric 3alpha/beta-hydroxy-5alpha/beta-pregnan-20-ones by gas liquid chromatography and electron capture detection is presented. Reliability of the method and applicability to biological material was tested. In one total human uterus and 20 samples of myometrium the concentration of epimeric pregnanol-ones was determined. 3beta-hydroxy-5alpha-pregnan-20-one and 3alpha-hydroxy-5alpha-pregnan-20-one were present in similar quantitative range as progesterone and 20alpha-hydroxy-4-pregnen-3-one. A correlation between progesterone and concentration of metabolites could not be established. 3beta-hydroxy-5beta-pregnan-20-one was not detected in the tissue.


In vitro inhibition of rat liver cholest-5en-3 beta-ol (cholesterol) biosynthesis by non-mercurial sulfhydryl reagents. In vitro conversion of 2-14C-mevalonate to cholest-5en-3 beta-ol (cholesterol) in rat liver homogenates is inhibited by arsenite, beta-mercaptoethanol, dithiothreitol and ethanethiol. Two sterols containing 20 carbon atoms accumulate under these conditions. One of these is identified as 4,4 dimethyl-5alpha-cholest-8en-3beta-ol and the other tentatively identified as 4,4 dimethyl-5alpha-cholest-8,24-dien-3beta-ol. Based on these observations, these non-mercurial sulfhydryl reagents do not inhibit 5alpha-lanosta-8,24-dien-3beta-ol 14alpha demethylase.


The in vitro synthesis and secretion of alpha-ecdysone by the ring glands of the fly, Sarcophaga bullata. The in vitro secretory product of larval Sarcophage bullata ring glands has been identified as 2beta, 3beta, 14alpha, 22R, 25-pentahydroxy-5beta-cholest-7-en-6-one (alpha-ecdysone). Mid to late 3rd instar larval ecdysones were isolated and identified as 2beta, 3beta, 14alpha, 20R, 22R, 25-hexahydroxy-5beta-cholest-7-en-6-one (beta-ecdysone) and alpha-ecdysone at a ratio of 27:1. The low level of alpha-ecdysone in vivo, relative to its exclusive in vitro synthesis and secretion by the ring glands, is a function of the very active C20 hydroxylation mechanism in tissues peripheral to the ring gland. The role of alpha-ecdysone as a prohormone in dipteran metamorphosis is discussed.


Synthesis of steroidal cyclophosphamides. The Reformatsky product of estrone methyl ether and ethyl bromo-acetate was transformed by two separate routes to 21-amino-3-methoxy-17alpha-pregna-1,3,5(10)-trien-17beta-ol (9). Cyclization with bis- (2-chloroethyl) phosphoramide dichloride produced the steroidal cyclophosphamide 10. Analogous syntheses transformed androstenolone into steroidal cyclophosphamide 20 and androstenedione into steroidal cyclophosphamide 28.


Inhibition of the conversion of cholesterol to pregnenolone in bovine adrenocortical preparations. The inhibition of the conversion of [4-14C] cholesterol to [4-14C] pregnenolone by a number of steroids has been studied in bovine adrenocortical mitochondrial acetonedried preparations. At equimolar substrate and inhibitor concentrations (3.3 muM) the most potent inhibitors were cholesterol derivatives containing a nitrogen function at c-22, followed by derivatives containing oxygen functions at c-22 or c-20 or both. The presence of a hydroxyl group at c-17 or the replacement of the 3beta-hydroxyl group by fluorine reduced the inhibitory efficacy. In the presence of inhibitors that were also relatively good substrates of the cholesterol side-chain cleavage system, such as some cholesterol derivatives hydroxylated in the side-chain,the rate of [4-14C] pregnenolone formation increased with time as the inhibitor was consumed. (20S)-20,21-Dihydroxycholesterol exerted such an effect on the kinetics of [4-14C]pregnenolone formation, and yielded 21-hydroxypregnenolone which was identified by gas chromatography-mass spectrometry. The synthesis of (20R)-22-ketocholesterol, of (20R,22R)-22hydroxycholesterol, (20R,22S)-hydroxycholesterol, and of (20S)-desmosterol is described.


New bile alcohols - synthesis of (22R)- and (22S)-5beta-cholestane-3alpha,7alpha,12alpha,22,25-pentols. The synthesis of (22R)- and (22S)-5beta-cholestane-3alpha,7alpha,12alpha,22,25-pentols is described. Bisnorcholyl aldehyde was prepared from cholic acid and converted into the cholestane-pentols by a Grignard reaction with 3-methyl-3-(tetrahydropyran-2-yloxy)-butynylmagnesium bromide followed by hydrogenation and acid hydrolysis. One of the synthetic pentols, the 22R-isomer was identical with a metabolite of 5beta-cholestane-3alpha,7alpha,25-triol formed in the rabbit.


Induction of vaginal mucification in rats with testosterone and 17beta-hydroxy-5alpha-androstan-3-one. Based on histological criteria, Kingsley and Bogdanove (3) reported that the benzoate ester of 17beta-hydroxy-5alpha-androstan-3-one (5alpha-DHT), unlike testosterone propionate, is unable to induce vaginal mucification when given subcutaneously to rats. In contrats, Kennedy (4) found in estrogen-pretreated rats that both 5alpha-DHT and testosterone induced vaginal mucification as indicated by increased vaginal sialic acid concentration. To determine if esterification of these androgens altered their ability to induce vaginal mucification, ovariectomized rats, pretreated for 3 days with 0.25 mug estradiol-17beta, were treated for 8 days with either sesame oil or 7 mumoles of testosterone, 5alpha-DHT and their respective propionate and benzoate esters. All treatments except 5-alpha-DHT benzoate increased vaginal weight and vaginal mucification, as assessed histochemically and biochemically. 5alpha-DHT propionate was less effective than 5alpha-DHT while testosterone benzoate, but not propionate was less effective than testosterone. To determine if estrogens are necessary for the vaginal effects of androgens, ovariectomized and ovariectomized-adrenalectomized rats were treated with testosterone or 5alpha-DHT. Adrenalectomy did not significantly affect the vaginal response to either androgen. It is therefore concluded that androgens are capable of inducing vaginal mucification in the absence of estrogens.


Hypertension as an important factor for cerebrovascular atherogenesis in rats. A new model for studies on atherogenesis in the cerebrovascular system was obtained by using recently established stroke-prone spontaneously hypertensive rats (SHRSP). SHRSP on a hypercholesterolemic diet (20% suet, 5% cholesterol, and 2% cholic acid) had ring-like fat deposits in the circle of Willis, which were detected within a few weeks by new techniques for the macroscopical demonstration of fat deposits "as a whole" and were proved to be good quantitative indices for the initiation of atherogenesis. Experimental studies using more than 200 rats including SHRSP, experimental hypertensive rats (renal infarction hypertension) and WK rats, fed a hypercholesterolemic diet with 1% salt in the drinking water for 1 week, 2 weeks, 10 weeks and more than 10 weeks, revealed that the arterial fat deposition in the brain was affected by BP, serum cholesterol level, strain difference and age. High BP was confirmed to be more important than the other factors by the quantitative analysis of sudanophilic rings in relation to BP.


Comparison of computerized tomography and radionuclide imaging in "stroke". Forty patients were studied by computerized tomography and by radionuclide brain imaging. The final diagnosis was infarction in 29 patients, intracerebral hematoma in seven, acute SAH in one, and old cerebrovascular accidents in three. CT was far superior to RN in detecting intracerebral hematomas and distinguishing them from cerebral infarction. The results of CT and RN tests were comparable regarding the percentage of abnormalities. However, the results in the same patients were not identical in 55% of the cases, indicating a complementary role for the two tests. There was no relationship between the frequency of abnormalities on CT and the time lapse after the onset of cerebral infarction. RN uptake was not seen in patients with old cerebrovascular accidents.


Heterogeneities of regional cerebral blood flow during hypoxia-ischemia in the rat. The distribution of regional cerebral blood flow (rCBF) within the cerebral hemispheres of rats was investigated following an hypoxic-ischemic insult consisting of a 30-minute exposure to 6.5% to 7% inspired oxygen coupled with unilateral ligation of the common carotid artery and maintenance of normal blood pressure (modified Levine preparation). rCBF was estimated by means of an autoradiographic method employing 14C-antipyrine. Mean arterial PO2 values of 26.8 to 27.5 mm Hg were attained during the insult period. rCBF rose above control values in all structures of the hemisphere contralateral to carotid artery ligation. Structures of the hemisphere ipsilateral to arterial ligation exhibited rCBF values less than those of the opposite side. However, the degree to which carotid artery occlusion reduced the rCBF of a structure relative to that of the opposite hemisphere varied greatly from region to region, with the greatest decrements occurring in the lateral cerebral cortex and the caudoputamen. Previous studies in this model have shown that these regions of the hemisphere ipsilateral to carotid artery occlusion are zones of frequent histological injury. These data suggest that inhomogeneities of rCBF may in part determine the phenomenon of "selective vulnerability" of the nervous system to hypoxia-ischemia.


A pilot study of urokinase therapy in cerebral infarction. Thirty-one patients with acute cerebral infarction were treated with the thrombolytic agent urokinase for either a single or a double infusion period, each of ten hours. The effects of urokinase therapy administered at dosage rates of 1,200, 1,500 or 1,700 CTA urokinase units per pound of body weight per hour were followed by serial blood coagulation and other biochemical studies. In the dosage used, urokinase produced a prompt sustained increase, 20-fold to 40-fold, of plasma thrombolytic activity with relatively minor disturbance of the blood coagulation system. Nevertheless, hemorrhagic complications occurred in several patients and distinctly favorable therapeutic effects were not observed.


Intracranial bleeding associated with urokinase therapy for acute ischemic hemispheral stroke. Four patients undergoing urokinase infusion therapy for acute occlusive cerebrovascular disease had intracerebral hemorrhage in the ischemic hemisphere. Three patients died during the acute phase of their illness and an autopsy was performed on two. The pathogenesis of cerebral bleeding in these case reports is discussed.


Self-destructive consequences of sex-role socialization. Suicide proneness and self-destruction scales, together with measures of self-favorability and self-confidence, were administered to two samples (n = 106 and n = 213). The affective responses of the second sample (134 women and 79 men) were measured by asking respondents to circle adjectives classified for activity-passivity, positive-negativeness, and extroversion-introversion that expressed their feelings toward eight situations. Women scored lower than men on suicide proneness, higher on self-destruction, and lower on self-favorability and self-confidence. Women reacted more passively to the situations than men and more negatively to the public challenge situation. Women tend to extrovert (turn outward on others) their positive feelings in pleasant situations and to introvert (turn blame on themselves) their negative reactions to unpleasant situations. Men do the reverse. It is suggested that women are self-destructive in passive ways, reflecting their lack of self-favorability and confidence and manifested by failure to react to everyday situations in ego-building ways.


Self-attitudes and suicidal behavior.

Self-attitudes and suicidal behavior. Findings are reported concerning the hypothesized relationship between adoption of suicidal responses (ideation, threats, attempts) and antecedent negative self-attitudes. Data were provided by junior high school student (N = 3,148) responses to questionnaires administered three times at annual intervals. Antecedent negative self-attitudes were measured by a seven-item self-derogation scale at the first testing. Adoption of suicidal responses was indicated by earlier denial and subsequent affirmation of the response (self-reports). Findings indicate that suicidal behaviors are responses (whether or not subsequently continued) to experiences of negative self-attitudes in the more recent past. However, whether or not suicidal behaviors are related to self-derogating feelings in the more remote past can be seen as a function of a sex-social-class-mode of suicidal response interaction.


Recovery of the cortical evoked response following temporary middle cerebral artery occlusion in baboons: relation to local blood flow and PO2. The degree of recovery of the somatosensory cortical evoked response following a period (15 to 65 minutes) of partial ischemia, produced by temporary occlusion of the middle cerebral artery (MCA), was assessed in baboons and related to the local tissue blood flow and PO2 before, during and after the occlusion. Flow was measured using the technique of two-minute hydrogen clearance. Failure of complete recovery of the evoked response was associated with significantly greater depths of ischemia and tissue hypoxia during occlusion, and with significantly greater and persisting tissue hypoxia after occlusion, than complete recovery. Complete recovery of the evoked response also was associated with tissue hyperoxia after occlusion. The reduced postocclusive PO2 levels associated with incomplete recovery of the evoked response suggest that reduced perfusion during ischemia was sufficiently severe to cause some degree of irreversible anoxic damage. The effect of a brief (three to ten minutes) period of ventilation with air (instead of oxygen) under such low-flow conditions was to depress the evoked response significantly further; normally perfused brain, however, was unaffected by this procedure. This finding has clinical implications in regard to normobaric oxygen therapy.


Cerebral blood flow regulation: vascular resistance adjustments in the circle of Willis. Continuous measurements of systemic blood pressure (BP), cerebral perfusion pressure and CBF were accomplished in the cat during transient hypertension, hypercapnia and bilateral carotid artery occlusion. From these measurements resistance values in the circle of Willis and in the cerebral arteries distal to the circle were calculated. The results indicate that the arteries of the circle of Willis and the arteries distal to the circle of Willis dilate and contract independently.


A psychological autopsy of an indian adolescent suicide with implications for community services. This psychological autopsy of the suicidal death of an adolescent Indian boy includes a brief family background, a history of his difficulties, and a report of his psychological evaluation. There is an attempt to understand the societal and familial factors that seem to have prediposed him to commit suicide. The report includes an analysis of the resources currently available in Indian communities and a recommendation for the kinds of resources that might prevent suicide in this setting.


Aphasia in acute stroke.

Aphasia in acute stroke. Previous surveys of stroke populations have offered only cursory information on language disturbance, and, conversely, few surveys of aphasic populations have dealth exclusively with stroke or with acute phenomena. This paper describes aphasia in 850 acute stroke patients consecutively registered by the Harlem Regional Stroke Program, of whom 177 (21%) were aphasic; of these, nine were of Broca's type, 24 were of Wernicke's type, 14 were of anomic, ten were conduction, seven were of "isolation" type, and 107 were "mixed." An unexpected finding was a significant over-representation of men among the nonfluent aphasics. During the following four to 12 weeks, 12% of fluent aphasics died, and 12% remained moderately or severely impaired; among survivors, aphasia improved in 74%, and in 44% it cleared completely. During the same period, 32% of nonfluent aphasics died, and 34% remained moderately or severely impaired; among survivors, aphasia improved in 52%, and in only 13% did it clear completely. In both fluent and nonfluent groups, hemiparesis and/or visual field cut were associated with poor prognosis.


An in vitro study of prolonged vasospasm of a rabbit cerebral artery. Longitudinal stretch of the rabbit basilar artery produces local injury followed by prolonged circular constriction. After stretching and rapid release in vitro localized constrictions promptly occurred. This could be prevented by prior treatment with cyanide or calcium-free solution. Once produced, constrictions persisted for more than 72 hours. Previously induced constriction was not reversed by treatment for two hours with cyanide or by removing calcium. Histological observation indicated that constricted areas were associated with a discrete circumferential rupture of the internal elastic lamina and disruption and thinning of the underlying media. Specific catecholamine fluorescence at the adventitio-medial junction was unchanged in constricted areas. The relationship between smooth muscle cell length and resting tension of artery segments with and without constrictions was compared. Segments with constrictions had a shorter muscle length for any given resting tension, which confirms that constriction was not due to passive collapse of the vessel wall. These findings suggest that injury of cerebrovascular smooth muscle may result in essentially irreversible vasoconstriction. Such a mechanism could contribute to the pathogenesis of prolonged cerebral vasospasm after SAH or traumatic injury to the cerebrum.


Banality reinvestigated: A computer-based content analysis of suicidal and forced death documents. Suicide and simulated notes and forced-death documents were processed on the Harvard III Psycho-Sociological Dictionary. For each text, frequencies of related words were generated; these were contrasted with each other and with baseline data using z scores. The results indicated that the suicidal groups were more "deviant." Other findings are concreteness and constriction of focus for suicides--a pattern suggesting denial just prior to the deed. The forced-death group seemed to be more meaningfully in contact with life and aware of responsibility. The stimulated group appeared to be fabricating a popular stereotype rather than exhibiting empathy. Implications were discussed.


Some observations on filariasis in Western Samoa after mass administration of diethylcarbamazine. An extremely efficient diethylcarbamazine administration campaign to eradicate Wuchereria bancrofti has been carried out in Western Samoa. The use of the membrane-filtration technique has shown that a large number of people exhibit extremely low microfilarial densities, often with less than 10 in 1 ml of venous blood. It was found that one of these low level microfilaria carriers readily infected the local vector Aedes polynesiensis and that development took place to the infective stage. It was estimated that 497 infective larvae of W. bancrofti will enter the human population of Western Samoa daily from these vectors. Resumption of filariasis transmission is possible and surveillance of the human and mosquito populations should be continued for a number of years and control measures taken quickly if further transmission occurs.


Leptospirosis in Trinidad and Grenada, with special reference to the mongoose. In Trinidad, six Leptospira isolates were made from 957 febrile patients between 1968 amd 1972. In addition, CF antibodies were detected in 6-6% of febrile patients and human survey sera collected during this period. In 1972 alone, 10-4% (38/363) of sera examined had CF titres consistent with positive exposure to the disease. Grenada does not report leptospirosis, but the disease is common in mongooses in both Trinidad and Grenada. Serogroups Icterohaemorrhagiae, Pomona and Canicola are present in Grenada with 35-2% of mongooses examined being seropositive. Five Canicola strains of Leptospira were isolated from mongooses in Trinidad and serological studies showed that this was the most common serogroup from mongooses on the island. A total of 31 strains recorded from at least seven different serogroups and eight named serotypes have been isolated from humans, rats and mongooses in Trinidad. Human leptospirosis is probably more common in the Caribbean than the medical records indicate.


Epidemiology of cerebrovascular disease in Tartu, Estonia, USSR, 1970 through 1973. This study was undertaken to establish the incidence and mortality for various types of cerebrovascular disease in the population of Tartu. All medical records for this population were reviewed for the period 1970 through 1973, and those with a diagnosis of brain infarction, transient ischemic attacks, cerebral hemorrhage or subarachnoid hemorrhage were identified. Only the first stroke was considered when determining incidence. A total of 786 cases were included in the study. Without cases of transient ischemic attacks, the number was 667 (e.g., cases of stroke). Cerebral infarction accounted for 80% of all strokes, cerebral hemorrhage for 13.5% and subarachnoid hemorrhage for 6.5%. The incidence rate for stroke was higher for men than for women and significantly increased in each older age group. The rate for all persons was 184 per 100,000 population per year. The incidence of transient ischemic attacks was 33 per 100,000 population per year. The mortality rate for stroke for this population was 98/100,000 per year. The data on incidence of stroke and its type, its dependence on age and sex, and mortality rate are close to the corresponding data reported from other countries.


Studies on Mediterranean leishmaniasis. IV. The leishmanin skin test in cutaneous leishmaniasis. The leishmanin skin test was used in four different areas of the Italian Adriatic coast (Emilia Romagna, Marche, San Marino and Abruzzi), old endemic areas for cutaneous leishmaniasis. The test was found to be postitive in 80% of past infections, the 20% negative reactions being found in those who had been infected 20 or more years before. In the old endemic area of Teramo there was increasing positivity with age, with a sharp rise in the over 30 years age group suggesting that there had been a sudden break in transmission 30 years ago, coinciding with the DDT campaign of 1944-45. In San Marino in the past overt infection had occurred in a number of small microfoci, centred on houses surrounded by a larger number of inapparent infection. Control studies on a number of infectious and non-infectious diseases were all negative, and there was no relationship between tuberculin and leishmanin sensitivity.


Abnormal cerebrovascular response to altered PaCO2 in baboons with obstructive jaundice. The cerebrovascular response to hypercapnia and hyperventilation was studied in normal and jaundiced baboons by the intracarotid 133Xe injection technique. The baboons with bile duct ligation were found to have decreased CBF at all levels of PaCO2. This difference between normal and jaundiced baboons was 13% at normocapnia rising to 33% with hypercapnia and 37% with hypocapnia. The CBF values all were increased toward normal by use of an alpha-adrenoreceptor blockade (phentolamine). It is suggested that the obstructive jaundice potentiated an inherent vasoconstrictor alpha-adrenergic mechanism to oppose the effects of CO2. Also, alteration of the PaCO2 may have produced its effects on the cerebral vessels by altering this adrenergic mechanism.


Arbovirus infections in Sarawak: the role of the domestic pig. The possible role of pigs as arbovirus maintenance hosts and their importance as amplifier hosts was studied. Blood samples from 464 pigs of all ages collected in 1962 and 1964 were tested against 10 arboviruses. Antibodies to Japanese encephalitis and Getah viruses were particularly prevalent and their calculated monthly infection rates were 19-5% and 13-3% respectively. In 1969, 447 pigs were bled monthly throughout the year and the infection rates for Japanese encephalitis virus were calculated in pigs during the first year of life. Infection rates were not uniform throughout the year; the rate increases as the pig grew older and there was a marked seasonal increase in the infection rate in the period from November to January. This coincided with the seasonal major population peak of Culex tritaeniorhynchus following intense breeding of this mosquito prior to rice planting. It is suggested that, in Sarawak, the pig acts as a maintenance host of Japanese encephalitis in a cycle involving C. gelidus mosquitoes and also acts as an important amplifier host towards the end of the year in a cycle involving C. tritaeniorhynchus. It is further suggested that Getah virus is maintained in a similar cycle between C. tritaeniorhynchus and pigs.


Schistosomal pigment in human and murine infections with Schistosoma mansoni. Schistosomal pigment was studied by optical and electron microscopy in liver biopsies of patients with different clinical forms of schistosomiasis and in livers of mice experimentally infected with Schistosoma mansoni. Phagosomal and residual forms of the pigment are described. The quantity of pigment is low in subclinical and in hepatointestinal forms of schistosomiasis; it is high in young patients with the hepatosplenic form, and low in the old ones. The participation of the pigment in the pathogenesis of schistosomal lesions is discussed.


Neurotoxic effects of bites by the Egyptian cobra (Naja haje) in Nigeria. Two patients were bitten by Egyptian cobra (Naja haje). One became drowsy and developed transient ptosis 24 hours later. The other lost consciousness and died within two hours of the bite, but no cause was revealed by autopsy. A third patient developed severe transient neurological signs after being bitten by an unidentified snake. The small literature on bites by this species is discussed.


A septicaemic disease of East African snakes associated with enterobacteriaceae. A bacterial epizootic disease of snakes at a snake farm in Kenya is described. The condition shows characteristic clinical signs and post mortem lesions and is characterized by a bacteraemia and septicaemia. The mortality rate is high and newly captured snakes die within a few weeks. Attempted control of the disease is discussed briefly and attention is drawn to the significance of such a condition in a commercial enterprise.


Control of antivenom treatment in Echis carinatus (Carpet Viper) poisoning. A study of all the patients treated for Echis carinatus bites in a rural mission hospital in Northern Nigeria in June 1973 showed that not all bleeding during recovery from an Echis bite results directly from the action of the venom; thus not all bleeding requires antivenom for treatment. Evenomation by Echis in West Africa is accompanied by incoagulability of the blood. If coagulability is assessed by a simply performed test, also described, on each occasion bleeding is suspected of being due to Echis venom and if antivenom is given only when incoagulability is demonstrated, expensive antivenom may be used more sparingly and to more benefit.


The management of typhoid fever.

The management of typhoid fever. The diagnosis of typhoid fever requires clinical alertness and ready laboratory support, blood cultures being most important. Chloramphenicol remains the standard drug specific for acute typhoid fever while cotrimoxazole is a useful alternative. Both of these are also useful in the treatment of relapses. The importance of supportive treatment cannot be over-emphasized. The treatment of intestinal complication is mainly conservative. Steroid is useful in the toxic delirious state. The management of chronic typhoid carriers is still an unsolved problem. To exclude the chronic carriers from handling food and to give advice on meticulous attention to personal hygiene is still the best way of public health control.


Scrotal flap urethroplasty in the treatment of carcinoma of the penis. Another use for the scrotal skin flap is described. It is an ideal method for dealing with carcinoma of the penis and prevents meatal stricture. It may be used to provide permanent urethrostomy in cases of chronic complicated urethral stricture where other types of operative treatment are unacceptable to the patient. It is recommended for use in situations where follow-up is difficult.


Sickle cell disease in pregnancy.

Sickle cell disease in pregnancy. S-Homozygotes, SC heterozygotes, and S-beta-thalassaemia heterozygotes are the haemoglobinopathies which make up sickle cell disease. Although their clinical features are similar, as regards complications during pregnancy, Hb S-beta-thalassaemia most dangerous, the main causes of mortality being severe anemia, acute sequestration crisis, bacterial infections, painful episodes, and pulmonary bone marrow fat embolism. Folic acid and antimalarials (where these are indicated) are often successful in preventing severe anaemia. It is best to reserve blood transfusion to replace moderate loss or to correct gross anaemia quickly when this is considered severe enough to threaten life. Painful crises are particularly common towards the end of pregnancy and in treating these episodes, analgesics, antibiotics, and sometimes heparin are used. S-homozygote carries additional hazards. Because of the prevalence of pelvic contraction, fetopelvic disproportion is common and so the incidence of operative deliveries is high. Many fetuses are lost through an increased incidence of abortion and perinatal mortality. In the survivors, there is evidence of intrauterine growth retardation brought about by continuous maternal anaemia throughout pregnancy.


Applications of spectral analysis in medical ultrasonography. Spectral analysis of ultrasonic reflections from biological tissues can be used to determine basic tissue parameters for use in differential diagnosis. This paper describes the use of the technique under circumstances encountered in several types of clinical examinations. The applications are illustrated with results obtained from laboratory measurements with a system now being employed in a clinical evaluation programme. The test objects studied simulate tissues with planar boundaries, tissues with heterogeneous interior structure, and tissues causing acoustic 'shadowing' of posterior regions.


A critical analysis of ultrasonic therapy. The authors have examined the effect of ultrasonic irradiation on myopy. Fourty-two eyes of 24 patients were treated. In more than 76% of the cases, there was an average decrease of 1.04 D in refraction. When myopy was accompanied by astigmatism, this also decreased or even disappeared.


Ultrasound spectroscopy applied to blood coagulation studies. Two frequency scanning ultrasonic spectrographs utilizing time-delay signal processing techniques have been developed. These permit measurement of time delays (and hence velocity changes) in a sample in the order of 10(-8) s. The present instruments allow such measurements to be made continuously over a frequency range of 1-10 MHz. These instruments have been used to monitor changes in velocity as a function of frequency during coagulation in purified human fibrinogen solution and human plasma. It was found that velocity dispersion occurred at discrete frequencies during the coagulation process. The frequency dependent data is reproducible, although this depends to some extent upon the samples used. The instruments which were calibrated using a fixed length of coaxial cable, exhibit a high degree of reproducibility.


Controlled electrical bladder evacuation via stimulation of the sacral micturition center or direct detrusor stimulation. Electrical stimulation of the spinal cord and of the detrusor was compared in 5 'acute' dogs. Strong detrusor contraction and rise in intravesical pressure were obtained either way but, with spinal cord stimulation, concomitant rise in urethral resistance prevented micturition. Stimulation with a bladder pacemaker induced detrusor contraction high enough to overcome outflow resistance, thus was more effective in initiating voiding.


The suspensory apparatus of the female bladder neck. Lateral cystourethrograms have shown a forwards-downwards displacement of the bladder neck in bladder base insufficiency, a type of stress incontinence. In search for the structure which in normal subjects prevents this displacement, a series of 10 dissections of the female pelvic floor was undertaken. The formerly described structures: The pubo-vesical ligaments and the precervical arc are shown. As a new finding it is demonstrated how these structures are dependent on an upwards-backwards suspension by a strong ligament in the fascia over the levator muscle.


Pressure measurements in organic sphincteric zones. A new method of measuring pressure is presented which serves to determine the opening pressures in organic sphincter areas and to investigate the behavior of the high-pressure zone and its susceptibility. By means of a pressure-measuring device which is introduced into the sphincter area, the opening pressure, which may be equated to the constant cloding pressure, can be determined by known increases of pressure. The method is described in detail, and the use of this manometric procedure is demonstrated with reference to the lower esophageal spinncter.


Bladder and urethral recordings in acute and chronic spinal cord injury patients. Three groups of patients with upper motor neuron lesions were studied. A first group consisted of 19 patients with complete lesions and 3 patients with incomplete lesions. All had an unbalanced bladder function which required surgical interventions. A second group consisted of 9 patients with chronic complete lesions who achieved balanced bladder function spontaneously. A third group consisted of 11 patients in the acute stage of injury. Polygraph recordings of pressure within the bladder, urethra, rectum and external anal sphincter were carried out with the help of video-tape monitoring and radiographic image intensification. Special catheter ballons with radiopaque markings were employed for pressure measurements. The behavior of the external urethral sphincter during spinal shock and the sequence of return of sacral somatic and visceral motor reflexes during recovery from spinal shock were investigated. It was shown that in spinal shock, the majority of patients retained sacral segment somatomotor reflex activity, in the absence of visceromotor activity, and that resistance values at the external urethral sphincter remained high. The highest resistance recorded in the membranous urethra was found to be located at the distal external sphincter, just before the bulb of the urethra.


Detection of urine loss using the Exeter recording nappy and other similar devices. A technical evaluation of the Exeter recording nappy has been carried out with particular reference to (a) linearity, (b) reproducibility of calibration, (c) the effect of variation in the position of moistened zones produced by consecutive leakages and (d) the effect of variation in the electrical conductivity of the liquid detected. The clinical use of the nappy is also discussed. A miniature alarm coupled to a similar pad arrangement has been developed as a training system for the geriatric incontinent patient and patients with neurogenic bladders. A 'pad and pant' version of an enuresis alarm has also been designed which had advantages over the conventional under-sheet type.


Dysfunction of the bladder neck: a urodynamic study. Urodynamic investigations were performed in 9 males, suffering from dysfunction of the bladder neck (detrusor bladder neck dyssynergia). The parameters of micturition were compared with the values in normal males and in patients with prostatic obstruction. By introducing a new factor, the maximum opening time, we found a characteristic pattern in dysfunction of the bladder neck, making selection of patients for endoscopic incision of the bladder neck possible. The maximum and mean flow rates increased significantly in 5 patients treated with incision of the bladder neck. The diagnostic value of voiding cystourethrography and urodynamic investigation is discussed.


[Actinomycin-D therapy in testicular cancer (author's transl)]. In early stages of the disease the prognosis of testicular cancer has been improved mainly by the introduction of radical surgical procedures. Cytostatic treatment of metastasising testicular cancers has only been of limited value. Actinomycin D has been shown to be one of the most potent agents in malignant teratomas. Own results are presented for 21 eligible patients who received actinomycin D alone. One complete remission and 4-partial remissions were achieved giving an overall response rate of 19%. This precentage seems to be low compared to similar data in the current literature. The result may be explained by the selection of the patients with a high percentage showing far advanced disease before therapy was initiated. However, comparing the data presented with those from our own study on combination chemotherapy and with the more recent results in the literature, single agent chemotherapy does not seem to be the method of choice in metastasising testicular cancer. Improvement of the results by the integration of combination chemotherapy, hormonal therapy and irradiation will have to be based on prospective, controlled studies.


[Significance of digital examination in early diagnosis of prostate carcinoma (author's transl)]. Digital palpation of the prostate is not suitable for positive differentation between benign and malignant lesions of the prostate. Whenever a conspicuous finding is observed during a physical examination of the prostate a fine needle aspiration cytology is mandatory for eluidation of the disease. This procedure is simple and inexpensive, has a low rate of complications and high diagnostic validity.


[Stauffer syndrome, paraneoplastic hepatic dysfunction syndrome associated with renal cell carcinoma (author's transl)]. In two patients with renal cell carcinoma, the following biochemical changes were found independently of hepatic metastases: increased alkaline phosphatase activity, rise in bromsulfothalein retention, hypoalbuminemia, increase in alpha2-globulin, and prolonged prothrombin time (Stauffer syndrome). In both cases the syndrome was found to be the first sign of the renal cell carcinoma. In one patient liver function returned to normal after removal of the neoplasm, in correlation with the good recovery. In the other case the abnormal laboratory findings persisted after total renal surgery. Clinically, diffuse pulmonary metastases occurred. Both case histories show the high significance in knowing Stauffer syndrome and its value for early diagnosis and operative success.


[Simultaneous occurrence of a malignent teratoma in the left testis and a seminoma in the right testis (author's transl)]. A twenty-three year old patient had simultaneously a left sided seminoma and a right sided malignant teratoma. Two years later a left nephrectomy had to be carried out because of left paraaortic and renal metastases. The patient received radiation therapy and cytostatic therapy with Velbe, Actinomycin D and Prednisone and survived five years with few symptoms. He died with multiple metastases following paraplegia due to a T 4/5 lesion.


[The clinical significance of extratesticular originating tumors (author's transl)]. A case of large retroperitoneal metastasis of a seminoma is demonstrated. The primary tumor was impossible to recognize clinically. The extremely scarred primary tumor was at last discovered histologically in the normal appearing testis on the same side. This experience leads to the conclusion that the diagnosis "extratesticular originating testicular tumor" not be accepted unless a "burned-out" tumor can be exluded histologically in the ipsilateral testis.


[Late complications of the intestine after radiotherapy of bladder carcinoma]. Immediate reactions of the intestines during or after radiotherapy of the pelvis are very common. Later complications requiring surgical intervention are seldom found. Out of 101 patients with bladder carcinomas, we observed 4 with severe irreversible intestinal changes. These had been operated and had received post-operative radiotherapy. On 3 patients a sigmoid stenosis had to be resected under the protection of a colostomy. On the fourth patient an ileovesical fistula was closed primary.


Ureteroureterostomy and unilateral nephrostomy. Alternate rapid method of diversion. Ureteroureterostomy with a Silastic nephrostomy has been utilized in 3 patients as a temporary diversion. It is a short procedure which is performed transabdominally and is well tolerated. It may be indicated in selected patients who will not be able to handle an appliance and cannot tolerate major surgery. This is not a panacea for urinary diversion, but in selected cases it may be applicable.


Innervation of trigonal area of canine urinary bladder. Adrenergic and cholinergic histochemical staining techniques and in vitro muscle strip responses to adrenergic and cholinergic stimulation and blockade have failed to demonstrate any neuromorphologic or neuropharmacologic differences between the musculature of the canine trigone and that of the underlying detrusor. There is no evidence to suggest that a functional potential could be attributed to the trigone separate from that of the related bladder base.


Uninhibited neurogenic bladder in adults. The uninhibited neurogenic bladder is a common entity. It is characterized by urge incontinence, frequency, enuresis, and recurrent urinary tract infections. The diagnosis can only be made by a thorough urologic investigation, including cystometrography. A sound treatment program involves the use of anticholinergic medication to abolish uninhibited contractions, frequent voiding to keep intravesical pressure low, and antibiotic treatment when indicated for concurrent infection.


Electrohydraulic cystolithotripsy.

Electrohydraulic cystolithotripsy. The protocol and technique of electrohydraulic cystolithotripsy with the SD-1 for the crushing of the bladder calculi is outlined. In our opinion, the instrument is safe and an effective adjunct to the urologist. Urate, phosphate, and carbonate calculi are easy to crush. Oxalate and uric acid stones are more resistant to fragmentation. The procedure is superior to the conventional methods with blind or optical lithotriptors. The method is easy to learn, and application of this technique may be combined in the same session with other urologic procedures; this procedure opens up a new avenue in the treatment of urinary calculous disease.


Hydrocelectomy. Evaluation of technique. A quick, simple, safe, and efficient means of hydrocelectomy is presented. The technique consists of extruding and fixing the testicle into a scrotal pouch. Twenty hydroceles were repaired without complication or recurrence.


Penile prosthesis: psychologic factors.

Penile prosthesis: psychologic factors. A thirty-one-year-old paraplegic male requested a penile prosthesis. Psychiatric evaluations were done of both the patient and his wife. Within seventy-two hours of his arriving home with the prosthesis installed, his wife left their house to seek a divorce. The implications of this event for selecting patients for such devices are explored. Reservations are expressed about a prosthesis being inserted for patients married after the onset of impotence.


Penile reconstruction in irradiated patient. Reconstruction of a penis using a modified Gillies technique was performed on a forty-one-year-old man who had a total penectomy, inguinal node dissection, and 6,000 rads of cobalt-60 irradiation for carcinoma of the penis. The three different surgical techniques for reconstructing the penis are discussed in detail. It is our belief that reconstruction of a urethra and placement of a baculum in penile reconstruction after radiation therapy have more disadvantages than advantages. The literature is reviewed.


Hereditary nephritis associated with vesicoureteral reflux and vaginal duplication. The concomitant occurrence of vesicoureteral reflux and hereditary nephritis has not been previously reported. A case of a patient with hereditary nephritis, vesicoureteral reflux, and vaginal duplication is presented and the related literature reviewed. It is suggested that familial reflux may occur significantly in families with hereditary nephritis.


Radiographic evaluation of renal excursion with respiration. An unusual case stimulated investigation of radiographic changes in renal axis resulting from respiratory excursion. Prospective study of 20 "routine" excretory urograms revealed no statistically significant differences in renal axis whether the film was taken in full expiration or inspiration. Clinical implications and a review of pertinent literature are discussed.


Effect of frequent ejaculation on semen characteristics in rams. Sixteen Suffolk rams were ejaculated repeatedly for a period of eight hours during the month of November. Ejaculates were examined for semen characteristics. Volume density and number of sperm per ejaculate declined significantly in successive ejaculates. Motility and percentage abnormal sperm were not affected by frequent collection. It is concluded that the number of sperm per ejaculate, after the eighth ejaculate, could fall below that required for fertilisation to occur, particularly in progestagen treated ewes.


Isolation of mycoplasmas from the respiratory tract of horses in Australia. Mycoplasmas were isolated from two of 43 nasal swabs taken from live horses, and from one of 28 tracheal swabs taken from slaughtered horses. The slaughtered horse that yielded mycoplasmas had no gross pathological changes in the respiratory tract, but the nasal isolations were made from horses with rhinitis. The three mycoplasmas could be distinguished by cultural characteristics, and probably they represent three different species.


Snout-rubbing as a vice in weaned pigs.

Snout-rubbing as a vice in weaned pigs. Snout rubbing led to ulceration and necrosis in pigs subjected to it. Only animals of specific colouring were attacked.


The contribution of horned cattle to carcase bruising. Five trials were conducted to evaluate the effects of the presence of horns on cattle on carcase bruising. In each trial there were three groups of cattle, hornless, horned and mixed (some with hrons and some without). The weight of bruised tissue trimmed from the carcases of the cattle in the horned groups was significantly greater than that trimmed from the carcases of the cattle in the hornless groups. When horned and hornless cattle are mixed the hornless animals in the mixed group sustain significantly more bruising than animals in a group consisting soley of hornless animals while the horned animals in a mixed group have a similar degree of bruising to cattle in a group consisting solely of horned cattle.


Cervical scoliosis and kidney lesions in sheep following dosage with vitamin D. A case of cervical deformity of lambs following dosage with vitamin D was investigated. The lesions of a scoliosis are described together with the kidney lesions. It is suggested that doses of vitamin D normally considered to be non-toxic to sheep may prove to be so under certain conditions.