Hand orthotic device influence on fine neuromuscular control. With the aid of electromyography, voluntary control of fine neuromuscular activity of deltoid and extensor digitorum communis muscles was studied in patients with motor dysfunction of the upper limb. A sequential training procedure was carried out both while the patient was wearing and not wearing a hand orthosis, during a static posture and dynamic hand movements. There was no difference between the levels of neuromuscular control achieved while wearing and not wearing the orthotic device, but the quality of the neuromuscular control was superior in the proximal limb muscle to that in the more distal muscle.


Sweating responses of normal, paraplegic and anhidrotic subjects. Dynamic sudomotor response to changing ambient temperatures (30 C to 45 C) was measured on eight unacclimatized subjects including five normals, two paraplegics and one anhidrotic patient. Mean sweating rates, computed from five simultaneously observed local rates, were used to compare the overall sudomotor response to heat exposure of the three groups. In the normal subjects, an average rise of 0.34 C in oral temperature and 2.5 C in mean skin temperature was found in a period of 65 minutes. The paraplegics developed a higher rise in both oral and skin temperatures due to a lower sweating rate in the insentinent region. (Insentient describes the sensory state of the skin below the level of the lesion where the subject has no awareness of surface stimulation). A relatively higher sweating rate was observed on the forehead and the cyclic sweating behavior of the insentient skin was not synchronous with that in the sentient. (Sentient describes the state where partial or total awareness is elicited by stimulation). The anhidrotic patient showed a twofold increase of moisture loss from the skin but no cyclic pattern of sweat gland activity on exposure to heat. In this case, hyperthermia developed with a rise in oral temperature of 1.1 C in 52 minutes versus 0.4 C rise in the controls in a period of 63 minutes.


Hip abnormalities in cerebral palsy: radiological study. A total of 237 hips of children with cerebral palsy were examined annually for three years. The severely involved spastic children and those who had never stood were more susceptible to hip abnormality. Apparent coxa valga (whose phenotype consists more of anteversion and less of true coxa valga) is closely related to the hip abnormality.


Sexual loss in relation to other functional losses for spinal cord injured males. To understand more fully the importance of sexual loss for spinal cord injured patients, paraplegic and quadriplegic men were asked to rank order functional losses associated with their respective injuries. In addition, staff members of the rehabilitation team were asked to predict the relative importance of these functional losses to their cord injured patients. The data indicate that relative to actual patient perceptions, staff predictions tended to overemphasize the relative importance of normal genital sexual functioning. Some implications of these findings for comprehensive rehabilitation programs are discussed.


A miniaturized load cell for lower extremity amputees. The PRS-Moore Load Cell for below-knee and above-knee amputees that gives an audible warning when the wearer applies more than the predetermined weight on the affected limb is described. The sensing unit is a screw-adjustable compression spring that is enclosed in a machined housing that fits inside a machined base. Several prototypes have been produced and are now undergoing clinical analysis.


Body composition changes in women: effects of high and low exercise intensity. Twenty college-age women participated in a ten-week physical training program involving two intensities of exercise. Eleven women trained at a relatively high exercise intensity (HI) of 840 kgm/min while nine women trained at a low exercise intensity (LI) of 420 kgm/min. Body composition and residual lung volume changes were analyzed before and after the training program for both groups. There were no significant changes in body weight, body density, percent body fat, lean body weight and residual lung volume for the HI group. The LI group exhibited a significant increase in body density (0.0026 density units) and significant decreases in percent fat (1.1%) and residual lung volume (67 ml). Closed circuit metabolic measures indicated that the HI group was working anaerobically for at least a portion of each minute. Results of the study support the contention that to reduce body fat stores an exercise program of low intensity and long duration is required.


Cultural factors affecting urban Mexican male homosexual behavior. Some aspects of the mestizoized urban culture in Mexico are linked to male homosexuality in support of the theory that cultural factors play an important role in the kind of life styles and sex practices of males involved in homosexual behavior. The following factors are considered relevant: the sharp dichotomization of gender roles, dual categorization of females as good or bad, separate social networks maintained by males before and after marriage, proportion of unmarried males, and distribution of income. One result of the sharp dichotomization of male and female gender roles is the widely held belief that effeminate males generally prefer to play the female role rather than the male. Effeminacy and homosexuality are also linked by the belief that as a result of this role preference effeminate males are sexually interested only in masculine males with whom they play the passive sex role. The participation of masculine males in homosexual encounters is related in part to a relatively high level of sexual awareness in combination with the lack of stigmatization of the insertor sex role and in part to the restraints placed on alternative sexual outlets by available income and/or marital status. Males involved in homosexual behavior in Mexico operate in a sociocultural environment which gives rise to expectations that they should play either the insertee or insertor sex role but not both and that they should obtain ultimate sexual satisfaction with anal intercourse rather than fellatio. In spite of cultural imperatives, however, individual preferences stemming from other variables such as personality needs, sexual gratification, desires of wanted partners, and amount of involvement may override the imperatives with resulting variations in sexual behavior patterns.


Orgasmic frequency and plasma testosterone levels in normal human males. Twenty males participated in a 2-month study examining the relationship between 8 a.m. plasma testosterone levels and orgasmic frequency. Within subjects, higher levels of testosterone are associated with periods of sexual activity. Over subjects, however, the direction of the relationship is reversed. Mean testosterone levels were higher for sexually less active individuals.


Masturbation and sexual fantasies in married couples. This article reports some aspects of sociosexual behavior, as a small part of an intensive study of 38 married couples. The persons' experiences and formulations are the primary material in an effort to humanize sexological research. This article reflects the Danish psychological-psychiatric tradition with emphasis on personal interviews instead of questionnaires, inventories, or tests. The analyses are based on differences between husband and wife and between men and women as groups. A number of qualitative thematic differences in personal experience with respect to masturbation and sexual fantasies are reported. Attention is drawn to thematic differences in the psychological significance of these aspects of sexuality which are, in part, dependent on the sex of the subject.


Personality correlates of male sexual arousal and behavior. This study explores the relationship between male sexual behavior and personality factors, as measured by the MMPI and Sensation Seeking Scale. Subjects were 20 male volunteers, ages 19-58, with a history of long-term sexual relationships. Subjects kept a daily record of sexual behaviors. Frequency of these behaviors was correlated with MMPI and Sensation Seeking (SSS) subscales. Results indicate that both introversion and depression show significant correlations with autoerotic stimulation and arousal, but not with heterosexual activity. There is no significant correlation demonstrated between hypomania and sexual activity. The Boredom Susceptibility subscale of the SSS correlated significantly with the number of sexual partners.


Women among men: females in the male homosexual community. The study uses empirical data to generate a preliminary theoretical analysis of the types of interaction and relationships that exist between male homosexuals on the one hand and lesbians and female heterosexuals on the other. Both males' and females' accounts of why they associate with one another in the male gay community are also examined. Methods appropriate to the description of interaction and the collection of accounts of behavior were used: participant observation and interviewing.


Bisexuality in women.

Bisexuality in women. In-depth interviews with women having a history of bisexual behavior and/or a bisexual self-identification revealed only moderate correspondence between behavior and identity. A general description is provided of the sexual relationships of the respondents. The major focus is on the wide diversity of self-identified bisexual women, especially in terms of self-perceived sexual and emotional needs, circumstances precipitating heterosexual and homosexual behavior, and ideological supports for a bisexual life style. Heterosexual behavior among homosexual women is discussed in terms of economic necessity, experimentation, and the response of the lesbian community. Homosexual behavior among heterosexual women is discussed in terms of responses to different kinds of situational exigencies and the rationalizations used to deal with the experience while insulating the heterosexual self-identification.


Cervical spine injuries. Diagnosis and classification. Roentogenographic techniques in the evaluation of the patient with a cervical spine injury entail several considerations that should be respected in defining and classifying the lesion according to the mechanism of injury. Unilateral or bilateral facet dislocation with separation of posterior elements usually implies disruptive flexion injury. Anterior wedging of a vertebral body indicates flexion with some degree of compression. Comminution of the vertebral body indicates a predominant compressive element to the injury. An anterior-inferior marginal fracture indicates extension injury. Impaction of the inferior articulating processes or fracture of the pedicle producing a more horizontal appearance of the facet indicates disruption of interspinous ligaments and the probability that significant instability exists. Studies should not be terminated until complete visualization of all cervical segments has been obtained, including the cervico-thoracic junction.


Surgical stabilization of the cervical spine after trauma. Surgical stabilization should be individualized for each patient. The procedure used should provide both immediate and prolonged stability at the site of instability. The choice of procedure depends on knowledge of the structures providing stability and of the mechanism of injury. Pure flexon injuries without comminution or disruption of ligaments are stable and do not require surgical treatment. Flexion-rotation dislocations, with either unilateral or bilateral facet dislocation, should be treated by posterior open reduction and fusion if they cannot be reduced by a closed method or if there is demonstratable motion on three-month flexion-extension roentgenograms. A comminuted burst ("teardrop") fracture produced by axial loading of the vertebral bodies should be stabilized by an anterior cortical strut graft for early mobilization and realignment of the spinal column to prevent progressive deformity.


Congenital causes of duodenal ulcers in adults. In seven cases of congenital anomalies in adults, duodenal obstruction and peptic ulcer disease developed. There were two cases of congenital duodenal web, two of hypertrophic pyloric stenosis, two of annular pancreas, and one of a preduodenal portal vein. The diagnosis is seldom made preoperatively. In the four patients who had preoperative gastric analysis, the acid secretions were increased. Those patients who underwent endoscopy had changes consistent with hypertrophic secretory gastrophy and duodenitis. We believe that treatment should be directed toward relief of the duodenal obstruction and the reduction of basal acid secretion by truncal vagotomy in all such cases.


Esophageal disruption from blunt and penetrating external trauma. Eleven patients suffered esophageal perforations from external trauma. This series includes the first report of esophageal perforation that resulted from a cervical flexion-hyperextension injury. The other ten patient had penetrating trauma. Early signs were subtle. Small amounts of mediastinal and cervical air tended to be overlooked or erroneously attributed to other causes, such as associated pneumothorax. Once suspected, the possibility of esophageal disruption was not always pursued with optimum vigor. There was undue reliance on contrast media radiography. There were two patients with falsely normal esophagograms. All patients healed well when treated witreatment of choice.


The pros and cons of outpatient breast biopsy. A review of the 130 breast biopsies performed on women during the past three years at the Martin Luther King, Jr, General Hospital showed that 90 were performed on outpatients and 40 on inpatients. Of the 90 outpatient procedures, 61 were under local anesthesia and 29 under general. Only three outpatient biopsy specimens were malignant and required subsequent patient admission to the hospital for mastectomy at an interval of 9 to 14 days. In all three, the axillary nodes were uninvolved. In two, no residual tumor was found in the mastectomy specimen.


Delayed vein repositioning. A procedure for improving inadequate radial-cephalic arteriovenous fistulas. Patients undergoing hemodialysis, whose radial-cephalic arteriovenous fistulas (RCAVFs) were unsatisfactory because of poor accessibility, were treated by surgical repositioning of the full length of arterialized cephalic vein in the forearm. Marked improvement in accessibility for more than one year was achieved in 15 of 18 delayed venous repositioning operations. This procedure is recommended for improving certain types of inadequate RCAVF.


Carcinoma of the colon and rectum. A review of results of surgical treatment in 164 patients. This report is a retrospective review of the authors' experience with colonic and rectal carcinoma in 164 patients from 1954 to 1968 with a five-year follow-up. The operative approach utilized principles of early vascular isolation, wied-colon and mesenteric reseciton, and minimal tumor manipulation in curative operations; palliative procedures were aggressively employed. Of the 164 patients, 104 with lesions almost equally divided between colon and rectum had resections with curative intent. The overall five-year survival rate after curative resection was 55%, and included eight hospital deaths that were usually related to cardiopulmonary complications. Lymph node involvement appreciably decreased the survival rate from 72% without node involvement to 39% with node involvement. Patients with rectal lesions experienced more favorable results than those with colonic lesions. Palliative procedures in 46 patients enhanced comfort, but few patients survived longer than one year. Wound and anastomotic complications were infrequent.


Traumatic rupture of thoracic aorta. Diagnosis and management. Of six cases of thoracic aortic rupture, four were acute and two were chronic. In the four acute cases, suspicious findings were an appreciably widened mediastinum, upper-extremity hypertension, change in pulse amplitude, or, more hopefully, generalized hypertension, left intraclavicular systolic murmur, and loss of posterior aortic shadow on chest x-ray film. Preoperative angiography was essential. Three of four acute aortic transections (one with aortic arch involvement) had complicated associated injuries that necessitated delay in aortic surgical repair; antihypertensive drugs, including propranolol hydrochloride, were used for support in the interval. Perfusion by femoral vein-femoral artery cardiopulmonary bypass was used. All four patients were operated on successfully without residual complications. Two patients with chronic conditions were recommended for surgery; one was successfully operated on, using aorto-aortic bypass. Another patient, 27 years postinjury, refused operation. Postoperative arteriograms were performed for baseline observations of graft and suture-line characteristics in all cases.


An evaluation of mediastinoscopy as a guide to diagnosis and therapy. A retrospective study was made of 230 consecutive unselected mediastinoscopies done during the years 1969 through 1975 in an attempt to identify guidelines for selective use of mediastinoscopy. Findings at mediastinoscopy were correlated with pathologic diagnosis, location and size of the lesion, presence or absence of enlarged lymph nodes on chest x-ray film, and findings at subsequent thoractomy when performed. On the basis of this review, the following lesions seem amenable to diagnosis at mediastinoscopy: bilateral hilar adenopathy (24 of 25 in this study); central lesions (30 of 45); peripheral lesions with adenopathy seen on x-ray film (nine of 22); and infiltrates (eight of 24). Mediastinoscopy is not recommended for peripheral lesions without adenopathy seen on x-ray film.


Permanent atrial pacing. Epicardial approach - "pinch-on" electrodes. Atrial pacing, while recognized to have therapeutic indications, has not been easily accomplished because there have been no simple and reliable electrodes available. A short parasternal mediastinotomy provides sufficient exposure for easy application of "pinch-on" electrodes to the presenting fold of the right atrium. Special attention is given to the recording of electrical indexes of the pulse generator and electrodes (voltage threshold, calculated impedance, and intrinsic amplitude of the P wave) with testing apparatus, most of which is conveniently brought to the operative table. Less than ideal results are not accepted, and immediate replacement of the electrodes into adjacent areas of the atrial myocardium is performed with ease. Five patients have tolerated the procedure without complication. These electrodes and this operative procedure have proved to have been successful over a six-month term of observation.


Division of the pyriformis muscle for the treatment of sciatica. Postlaminectomy syndrome and osteoarthritis of the spine. Division of the pyriformis muscle at its tendinous insertion was employed for the treatment of sciatica in 14 patients with postlaminectomy syndrome and osteoarthritis of the spine. Of these patients, 85% had satisfactory results. It is logical that the pyriformis muscle can play an important role in the production of sciatic associated with intraspinal lesions. Tension on the sciatic nerve, which passes in close approximation to the pyriformis muscle anteriorly, can be relieved by division of the pyriformis muscle.


Inhibition of influenza RNA synthesis by virazole (ribavirin). Virazole (ribavirin) inhibits the RNA synthesis of an influenza A virus (fowl plague). Neither virion RNA nor complementary RNA are produced. Although the effect of virazole can be counteracted by guanosine the inhibitor does not interfere with the uptake or incorporation of labelled guanosine into chick embryo cells, nor does replacement of glucose by mannose amplify the effect of virazole. Thus virazole seems not to act via an interference with the GTP pool. Synthesis of Semliki Forest virus RNA is not affected by virazole.


[The topography of Gomori positive neurosecretory elements of the hypothalamus of the lemmings Dicrostonyx torquatus and Lemmus sibiricus]. Under study was the structure of the hypothalamo-hypophyseal neurosecretory system in two species of lemmings of the Wrangel island: the collared lemming, (Dicrostonyx torquatus) and the Ob lemming (Lemmus sibiricus). Inspite of the similarity in the general organization of this system in all rodents, certain species features were found in the topography of neurosecretory elements in the animals studied. In the Ob lemming there is a great similarity in the structures of the neurosecretory system with the albino rat than in the collared lemming. In both species of lemmings, and in the collared lemming in particular, the supraoptic nucleus is located more dorso-caudally and the paraventricular one-more dorsally. A greater amount of neurosecretory cells is found which from additional groups. The hypothalamo-hypophyseal and extrahypothalamic pathways are well pronounced. The postoptical nucleus is considerably developed. In the collared lemming it is almost equal to the supraoptic one in the amount of cells composing it. The ratio of the cells in the supraoptic and postoptic nuclei is suggested to be related to the level of the water-salt metabolism and the specific ecology of lemmings.


[Morphometric and electron microscopic studies of the secretory granules of neurosecretory cells of the supraoptic and paraventricular nuclei of white rats and mice]. The morphometrical and electron microscopic analysis of secretory granules in the perikaryons of neurosecretory cells of the supraoptic and paraventricular nuclei in male rats and mice has shown than in the cells of these nuclei in both species of animals there occur secretory granules of the same kind and size. Therefore this method fails to determine which of them contain oxytocin and which of them contain vasorpressin. The neurosecretory granules located in the Golgi apparatus zone are of a less size and have more osmiophilic cnetral material than the granules localized on the periphery which mainly have granular central material and are of a greater size. The distinctions in the size and type of secretory granules are associated with certain stages of their "maturation". Granular particles appear to be "swallen", more active forms of storing neurohormones. The presence of larger granular particles in the supraoptic nucleus of mice allows to suggest greater reactivity of this nucleus than in rats which is likely to be associated with a higher ability of mice, as compared with rats, to adaptate to disturbances in water-salt metabolism.


[Severbal new problems in evolutionary histology]. The classical evolutionary histology as a most important section of theoretical morphology created by workd of A.A. Zavarzin, N.G. Khlopin and A.V. Rumiantsev needs a revision on the basis of achievements of modern morphology, first of all the experimental morphology which have accumulated a vast factual material on a repeated (regenerative, transplantational, inflammatory) morphogenesis, brought about on the basis of the constructive (plastic) activity of tissues which escaped the researchers' attention in the classical period of development of evolutionary histology. A demand to create a new system of the tissue, based on characteristics of their plastic (constructive) activity became urgent. The proposed attempt of the evolutionary classification of tissues comes from the experience of researches of the constructive (plastic) activity of tissues, with the Darwin--Severtsov rule of the dependence of every individual and phylogenetic change of the organization of its pre-existing state taken into consideration.


[A brief outline of the evolution of lymphoid tissue and its immunocellular reactivity in vertebrates]. The steps of the phylogenetic development of the lymphoid tissue and its immunolcellular reactivity were studied. It was shown that a gradual change from lymphoid multifunctional cells disposed diffusely in primitive lower vertebrates to the concentration of lymphoid cells into complicatedly arranged lymph nodes was taking place. Common features and species (group) peculiarities of the structure of the lymphoid tissue and its immunological reactivity were studied. The similar succession of immunocellular reactions has the phagocyte reaction as the first link. Then goes the lymphocyte reaction with a following transformation of lymphocytes to blasts and their further differentiation and proliferation into young forms of cells of the plasmocyte row. The antibody-forming cells were found in all the vertebrates studied and their morphology was under research. Species peculiarities of lymphoid cells and their immunoreactivity were studied.


[Comparison of the histochemical bases of epidermis differentiation in vertebrates]. It was been shown that in the line of forms of amphibia, reptiles, mammals, including man, the histochemical differentiation of the epidermis is related with changes in protective and transitory zones. For instance, in amphibia the accomodation to the terranian medium is accompanied by establishment of the vertical histochemical gradient in the epidermis which is manifested by accumulation of a protein rich in cationic and sulfhydril groups in the protective zone. The epidermis of reptiles is characterized by presence of high concentrations of a protein rich in cystine in the protective zone. The transient zone is formed on the border of the protective and germinative zones. The epidermis of mammals retains in general features the histochemical type of differentiation of the protective zone which had appeared in reptiles. However, the transient zone of the mammalian epidermis has a high concentration of proteins rich in histidine and arginin. The histochemical differentiation of the human epidermis is related with the distribution of the hairy integument.


[Endocrine cells of the mucous membrane of the fundus region of the stomach of hibernating rodents]. The gastric mucous membrane was studied in the hibernating animal Citellus erythrogenys in different seasons (during 7-8 months a year the animal is in hibernation and its digestive tract is not functioning). During hibernation the general amount of enterochromaffin-like cells decreases and their composition changes: the number of active cells diminishes and that of less active cells grows. Such dynamics of cells suggests the participation of enterochromaffin-like cells of Citellus erythrogenys in the regulation of gastric secretion (in rats and mice these cells contain histamine stimulating the mucous membrane glands). The amount of true enterochromaffin cells is not sufficiently changed and they seem to be not directly related with digestion but to be producers of serotonin which (together with serotonin of the brain) takes part in sustaining the mechanisms of appearance and supporting of winter hibernation.


[Anatomo-histologic findings clarifying the phylogenetic relationships between salmonoid fish (Salmonoidei)]. The comparative anatomo-histological analysis of the medial gut of Osmeridae and Plecoglossidae after Iwai (1962) has revealed a great similarity in the structure of this entosomatic organ suggesting their phylogenetically close nature. On the contrary, the fine structure of the medial gut in these two families substantially differs from the structure of this organ in Salmonoidee. Pronounced distinctions were found between the structure of the medial gut of smelts and that of the pike (Esox lucius Linné). The complicatedly differentiated medial gut of the pike is so different from the primitive gut of modern smelts that the hypothesis (Starks, 1930; Berg, 1940) on the origin of Ecosoidei from ancient Osmeridae does not seem probable. The data obtained by the anatomo-histological analysis in combination with data of other sciences should be taken into consideration when creating the natural system of Salmonoidei, since they contribute to more exact character of their phylogenetic relations.


[Ultrastructure of pigeon peripheral blood cells]. The ultrastructural organization of erythrocytes, thrombocytes and white cells (pseudoeosinophils, eosinophils, basophils, lymphocytes, monocytes) of the peripheral blood was studied in the pigeon Columba livia. The specific granules of eosinophils do not contain crystalloid structures characteristic of eosinophilic granules of certain respresentatives of fishes and mammals. Specific basophilic granules are of a large size and have homogeneous osmophilic matrix. The ultrastructure of agranulocytes (lymphocytes and monocytes) have no substantial distinctions from the similar cells of other representatives of vertebrates.


[An experimental-morphologic study of the regenerative capacity of the nematode Pontonema vulgaris (Bastian, 1865)]. In free esea nematodas Pontonema vulgaris (Bast). end portions were cut off and internal organs were damaged without disturbing the integrity of the cuticle (at the level of the oesophagus, anterior and medial parts of the gut and at the tail level). Reparative processes were registrated under conditions of "closed" traumas only. Removal of degenerating cells and a closure of the wound in the gut was brought about due to the active shift of the intestinal epithelium edges towards one another. The rest of degenerating cells found themselves in the gut lumen and were gradually adsorbed by entodermal cells. A deficiency of the intestinal epithelium cells is made up due to mitotic division of these cells in the epithelium areas adjacent to the site of the trauma. Regeneration in females was found to be more rapid than in males.


[Morphodynamics of the nervous system in the regenerative processes of Convoluta convoluta (Turbellaria, Acoela)]. By means of the method for revealing cholinesterases the alterations in the nervous system of Convoluta convoluta after mechanical lesion were studied. After a transversal transection of the animal into two pieces the anterior part of the body acquired the normal form within 3-4 days; the nervous system underwent inconsiderable transformations associated with a formation of a plexus in the injured area. The posterior parts of the body regenerated slowly. During the first days disintegration of the resting parts of the nervous system was observed. Later on the diffuse cholinesterase activity suggesting the beginning of the brain formation was manifested in the wound field. Plexus strands "grow" in the caudal direction from the brain in parallel with its development. Within three weeks the nervous system of the animals which had restored their mouth opening, body shape and normal behaviour consists of the brain and plexus not arranged in nervous trunks. The reaction of the nervous system to the ablation of a part of the brain and to a continuous mechanical injury were studied. The data obtained show a high morphological lability of the nervous system of Convoluta convoluta, its ability to radical structural rearrangements.


[Vascular-nervous relationships in the valves of the heart]. Method of silver nitrate impregnation was used in order to study 50 preparations of not-changed atrioventricular valves of the heart of domestic bulls and 30 preparations of the same valves of adult humans. It has been shown that in heart valves there are certain relationships between striated muscle fibres, blood vessels and nerve  elements. The nerve structures of the valves are represented by nerve bundles of different thickness. In their composition there are comparatively thin non-myelinated and thicker myelinated fibres. Towards the free edge of cusps the nerve bundles become thinner and the nerve trunks give off separate thin nerve fibres disposed along the vessels of a capillary type and in some places getting around them. In certain portions of cusps the nerve bundles, some of which have zigzag sinuosity, cross blood vessels in different directions. In man the major mass of blood vessels and nerve elements are disposed near the base of the valve cusps, accompanying the muscle fibre bundles penetrating from the base side. In the bull heart valves an amount of blood vessels and nerve elements is found in considerable portions of the cusps not connected with muscle fibres.


[The segmental structure of human kidneys]. The architectonics of renal arteries and veins and the structure of the calyx-pelvis complex were studied by the method of polychromic injection of tubular systems of the kidney followed by corrosion (200 kidneys). Basing on specific features in the structure of the systems in question, 4 sectors and 4-12 segments were found. In many segments two-six subsegments can be revealed (usually 2-3). The segmentary arteries and veins are described.


[Innervation of the human internal carotid arteries under normal conditions and in stenosis]. The neurohistological investigation of a portion of the internal carotid artery removed in operation on the occasion of occlusion revealed afferent, cholinergic and adrenergic nerve elements randomly located in the examined area. The histochemical and electronmicroscopic investigation of the superior cervical sympathetic ganglion removed from 42 patient operated on the occasion of occlusion of the carotid artery revealed a depletion in the ganglia of synaptic active zones, focal absence of catecholamines and neurohistological materials suggests that a substantial role in the process of stenosing of vascular walls is played by sophisticated effects of innervation connections upon the vessel sheaths.


[A functional-morphologic analysis of reactive changes in nerve fibers during development of collateral circulation in nerves]. After stopping the blood circulation along the femoral artery the collateral blood circulation is developing unevenly in different nerves. It depends on the architectonics of blood vessels of the zone. In time the intravenous anastomosis in the distal part of the ischiatic nerve sharply increases. It is pulsing and compressing the nerve bundles and may have a negative influence on nerve fibres. Reactive morphological changes of the axis cylinder, myelin incisions and Ranvier's constrictions are found in such a nerve. The analysis has shown that the changes noted have a character of local non-specific process accompanying physiological manifestations of parabiosis.


[New findings on the innervation of nerves proper]. The study by the author and his co-workers of the innervation of the sheaths of extraorganic (spinal and cerebral) and intraorganic nerves has shown that their nervous apparatus is differentiated in accordance with differentiation of epi-, peri- and endoneurium. The peculiar features of the innervation of sheaths of different nerves correspond to their functions and pathoplastical individuality and manifest themselves by uneven complexity, concentration and microtopography of nerve structures in the sheaths and by distinctions in the development and reactivity. Interrelationships and correlation was established between the specific functional readiness of nerve conductors and the structural organization of their sheaths' nervous apparatus. The phenomenon of reciprocal innervation of nerves was established in experiment as well as earlier reactive and compensatory-reparative processes in the nervous apparatus of nerve sheaths as compared with their conductors.


[Changes in the microcirculatory bed of the compact substance of bones following local mechanical pressure, gravitational stress and hypokinesia]. Effects of different stimuli upon the structure of the microcirculatory bed of the compact substance of long tubular bones were studied in 89 animals (rabbits and cats). Prolonged local pressure on the bone resulted in transformations characterized by lacunar resorption of the compact substance in the site of application of the force and endosteal bone-formation on the opposite side of the same part of the bone. Hypergravitation caused a considerable transformation of the microcirculatory bed and the histoarchitectonics of the bone compact substance. Smooth and linear perivascular resorption took place around dilated vessels in osteon canals. It resulted information of resorption cavities. In addition, processes of bone formation took place. Due to effects of hypokinesia the transformation of the compact substance is of a regressive character. The fibrous structures of the bony tissue and blood vessels lose their regular orientation and acquire chaotic direction.


[The system of bony canals as the basis for the angioarchitectonics of bones]. The spatial interrelationships of osteon canals were studied in corrosion preparations with the help of rastral electron microscopy. The structure of microvessels, their belonging to a definite link of the microcirculatory bed, the interaction of vessels and their position with respect to the osseous matrix were studied in bone sections impregnated with silver nitrate after V. V. Kuprijanov. Haversian canals in the compact substance of the bone are longitudinally oriented, can duplicate and form a single system of canals. The neighbouring canals of osteons might be bound by means of Volkmann's canals. The investigation of the Haversian canals in serial sections has shown that the diameter of the same canals of osteons can change at different levels, the diameter of the osteons themselves remaining unchanged. This seems to speak of uneven development of osteons in their different parts. In the Haversian canal there are one-two or occasionally three vessels having all three links of the morphocirculatory bed. The course and ramification of the vessel are identical to the shape of the osteon canal which includes them. The vessels are closely connected with the bony matrix by means of connective tissue bundles directed from the canal wall to the vessel wall. These bundles appear to serve as a peculiar anchor or amortizing apparatus and its elasticity might be a factor of a change of the shape and direction of the canal vessels in the bone development process.


[The disposition of the apices of the roots of multirooted teeth in the alveolar processes of the upper jaw]. Specific features of the disposition of root apexes of premolars and molars in the alveolar process of the upper jaw were studied in 148 skulls and 67 tooth-jaw cuts. The least thickness of the alveolar process was found to be at the level of the first premolar (10,41 +/- 0,33 mm), and the greatest--at the level of the first molar (14,075 +/- +/- 0,456 mm). Strong correlation of the alveolar process was established between the levels of the premolars and the last two molars. The distance from the apexes of cheek roots of the first molar to the bottom of the maxillary sinus is 2,05--2,92 mm, and the palatal roots -- 2,02 mm. On roentgenograms the molar roots are often projected on the sinus bottom.


[Experimental morphologic findings serving as a basis for use of xenogenic dura mater for plastic surgery of blood vessels]. Heterotransplants of the human dura mater were used to replace circular and lateral defects of the thoracic and abdominal aortas, carotid and iliac arteries in experiment. Operations were performed in 106 dogs. Observations of permeability of the vessels, morphological and histochemical studies were carried out at different periods after operation (from 1 day to 2 years). The xenogenous dura mater has well pronounced plastic properties--it is solid, elastic, characterized by low antigenicity. During transplantation there appear no hard inflammatory--destructive changes in reconstructed vessels and the surrounding tissues. The transplant is gradually substituted by recipients tissues characterized by high specialization. They are rich in elastic and smooth muscle fibres, have good blood supply and innervation. The dura mater is a good material for plastics of vascular wall defects.


[Changes in nerve structure on one side of the body following section of the inferior alveolar and sciatic nerves on the opposite side of the body in dogs]. The author describes changes of the lower alveolar and ischiadic nerves on the non-operated side after cutting such nerves on the opposite side of dogs, as well as changes in the organs innervated by them. The observed dystrophic changes in the nerve fibres on the non-operated side turn into more severe and non-reversible changes due to abnormal stimulation. Changes of masticatory organs appearing after cutting the lower alveolar nerve have bilateral manifestations being more pronounced on the same side especially in the case of a simultaneous dissection of the lower alveolar artery. These investigations contribute to possible interpretation of cases of symmetrical caries, development of dento-maxillary deformations on both sides.


[The effect of portal hypertension on the structure of the pancreas in rats during the early periods of the experiment]. The model of Hiari disease obtained by a 50% constriction of the rat's posterior portal vein under the diaphragm was used in order to study the response of different structures of the pancreas on the 1st, 3, 5, 7, 15th days of experiment. The arterial vessels were found to have fairly active responses to venous congestion. The greatest load in sustaining microcirculation falls to large arteries, so they are more subjected to dystrophies, the severeness of which is proportional to the thickness of the vessels walls. In later terms of the experiment smaller arterial vessels are involved. Within a month blood circulation in the organ deteriorates and there appear small hemorrhages. The venous congestion results in a change of the structure and secretion of the acinous and insular cells of the pancreas.


[Duration of synostosis of the ischiopubic synchondrosis]. A table of the developmental rate of synostosing pubic-ischiatic synchondrosis is made on the basis of analysis of 305 pelvis roentgenograms of children from 2 till 14 years of age. The obtained data may be used in clinical differential diagnosing between such process and osteochondropathy of pubic-ischiatic synchondrosis as well as for determining the bone age of children


[Carcinoids of the rectum].

[Carcinoids of the rectum]. A total of 8 carcinoids of the rectum were investigated. The group of carcinoids was not uniform even when their anatomical localization was the same. Depending upon the histological structure of carcinoids two main morphological variants were singled out: cellular-alveolar and band-solid. In some part of the tumoral cells of all carcinoids there were revealed lipids, mucus, at the same time in no case argentaffine granulation was observed. Muculent stromas were characteristic of all carcinoids of this localization. Invasion of the muscular layer, their size being more than 2 cm, should be considered as a sign of malignancy of carcinoids. The presence of fat and mucus the absence of argentaffine granulation in cells of the tumour cannot be regarded as proofs of malignancy of carcinoids.


[The chief types of calcinosis of the coronary arteries of the heart]. On the basis of histological and some histochemical investigations of the coronary arteries of 150 persons who had died in the age of 10-79 year it was established that the main types of calcification of these arteries were the following: calcification of the inner elastic membrane (it can be determined only in a histological investigation); microgranular calcifications observed, as a rule, in the region of atherosclerotic plaques; laminar calcification which develops on places of necrotic areas in the fibrotically-changed intima of the arteries. Laminar calcification is responsible for the gravest forms of calcinosis. Calcification of atherosclerotic plaques, identified in macroscopic investigations of the arteries as microgranular, was closely connected with the evolution of atherosclerotic plaques and not infrequently progressed with their sclerosing. Vascularization of the changed vascular wall and the degree of its calcinosis were found as a rule to be inversely proportional.


[Postmortem changes in the endothelial contour of the surface of large human arteries]. Changes in the relief of the endothelial surface of the common carotid artery common iliac artery in man in the postmortem period were studied by the method of scanning electron microscopy. It is established that the normal relief of the inner surface of the vessels could be studied only during the first few hours after death. Rapidly developing postmortem changes lead to drastic distortion of the stratified endothelial surface and to desquamation of the endothelial lining. On the 2nd and 3rd day of the postmortem period the relief of the inner surface of the vessel is determined by the elements which are incorporated into the composition of the subendothelial layer of the intima.


[Histochemical properties of the heparin-protein complex of mast cells and the state of the blood coagulating system in a primary lesion focus of non-specific ulcerative colitis]. Histochemical characteristics of polyanionic-cationic complex of mast cells, morphology of the microcirculatory bed of the large intestine, and a functional state of the coagulating blood system in the general blood flow and in the focus of primary inflammation were studied in patients with nonspecific ulcerative colitis. In the mast cells of the diseases intestine there was found a heparin-albuminous complex, saline resistance of the latter considerably exceed that in the norm. In the focus of primary inflammation deficit of active heparin and rise in coagulating characteristics of the blood were revealed. In the microcirculatory bed of the intestine angioniatosis, stasis, and thrombosis were observed. Impairment of complex-formation in the mast cells with appearance in their cytoplasm of the resistant heparin-albuminous complex apparently caused the local deficit of heparin and initiated the thrombogenesis in the microcirculatory bed. Thrombosis of the vessels led to hemorrhages, bleeding, disorder of the vascular wall feeding and its necrosis.


[The morphology and morphogenesis of alcoholic cirrhosis of the liver]. A total of 42 biopsy specimens of the liver (blind and spot) in 32 patients with alcoholic cirrhosis of the liver were investigated. Morphological, portal, postnecrotic, and mixed types of cirrhosis were established. The portal type of cirrhosis is most common. On the basis of repeated analyses of biopsy materials of the liver it may be assumed that the development of cirrhosis of the liver of alcoholic etiology is connected with multiple attacks of acute alcoholic hepatitis. Abstention from alcohol consumption resulted in stifestations of exacerbation of cirrhosis. On the other hand, continuation of alcohol consumption contributed to progressing of cirrhosis, which following several attacks of alcoholic hepatitis, may change its morphological type: portal cirrhosis "transforms" into the postnecrotic or mixed type. The data obtained clarified the role of ethanol in progressing alcoholic cirrhosis of the liver, which according to the initial mecranisms of its development in postnecrotic, since every attack of acute alcoholic hepatitis is accompanied by coagulative (fields of alcoholic hyaline, or Mallory's bodies), or by colliquative (balloon dystrophy) necrosis of hepacytes.


[Esthesioblastoma of the nose].

[Esthesioblastoma of the nose]. Morphological investigations of biopsy materials in 8 cases of esthesioblastomas of the nasal cavity were carried out. The three morphological variants of the tumour are described: esthesioneuroepithelioma, esthesioneurocytoma, and esthesioneuroblastoma. Rare occurrence of esthesioblastomas, peculiar features of their histological structure and difficulties of diagnosis in histological verification are emphasized. Lymphosarcoma is recommended to be differentiated from nondifferentiated cancer and sympathoblastoma. An important differentially-diagnostic procedure is considered to be a positive reaction to argentation (for identifying neurofibrils).


[Pathologic anatomy and morphogenesis of the "pagoda" syndrome]. A rare case of congenital intestinal obstruction of hereditary nature, the so-called "pagoda" syndrome, is described. This syndrome consists in atresia of the initial department of the jejunum, considerable shortening of the intestine and in a peculiar deformation of the remaining part of the small intestine and its mesentery. The pattern of the blood supply of the intestine and its morphology support the suggestion that this syndrome is underlayed by agensia of the anterior knee of the middle intestine of the embryo, and its teratogenetic termination period does not exceed the first four weeks of embryogenesis.


[Congenital adrenocortical hyperplasia]. The authors report about 3 cases of the congenital adreno-genital syndrome in first-born children with a high weight at birth (3900, 3600, and 4200 g) who perished in early infancy. One child, who was considered to be a boy, died of septic postoperative complications; during the operation the uterus, ovaries, tubes, phenomena of pseudofemale hemaphroditis were observed. The considerably enlarged adrenals were gyral, goffered and their cortex consisted of cells of the fetal zone. Two other boys, who perished at the age of 3 1/2 and 2 1/2 months, were sick from the birth. In the clinical picture there prevailed anorexia, dehydration, regurgitation, periodic vomiting, convulsions, clonic spasms, Hyponatrema, hyperkalemia, sudden arrest of the heart, rose no suspicion in pediatricians with respect to the salt-losing form of the adreno-genital syndrome. Post-mortem examination revealed congenital hyperplasia of the adrenals, whose cortex consisted of the fetal zone cells.


[Classification of tumors of the blood systems--hemoblastoses]. The article presents a review of new concepts of pathogenesis of leukemia and changes in the schemic of hemopoiesis, which lead to the need to re-examine the existing classification of leukemia. In view of the fact that histogenetic independence of stromal and hemopoietic elements has been proved, there is no need any more for the generalizing term "reticulosis". The authors substantiate the need for differentiation between some acute an chronic leukemias and to consider them as independent nosological forms grouped according to morphological and pathogenetic characteristics and a specific treatment required. These forms, for example, include acute lymphoblast leukemia in children, among acute leukemias - hair cell leukemia, and among chronic leukemias- diseases of heavy chains. Criteria for their identification, as well as probable sources of separate forms of leukemias are described.


[Cells secreting hydrogen ions into the renal tubules]. The ultrastructure of the epithelial cells of the renal tubules and of parietal cells of the stomach in intact rats was compared with that in animals with acute metabolic acidosis and animals kept on dry food. The studies were conducted on white male rats weighing 120-150 g. Acute metabolic acidosis was induced by a single intraperitoneal injection of 1 ml of a 1% solution of ammonium chloride. Pieces of the tissue for electron microscopy were fixed with OsO4 and poured with araldit and epon-812. The studies conducted revealed the ultrastructural similarity between the dark cells of the distal gyrous tubule and collecting tubes with parietal cells of the stomach. This similarity was seen from the one-type distribution of mitochondria of the smooth-walled vesicules and appearance in acidosis of intracellular and intercellular tubules. Such cells were not revealed in the proximal tubules, however, consideration of the results obtained and the literature data makes it possible to suggest that all cells of the proximal part of the nephron secret H+-ions, this being one of their functions. In the distal gyrous tubules and in the collecting tube this function is realized by specialized dark cells.


[Epithelial tumors of the urinary bladder]. Morphological, electron-microscopy, and histochemical investigations of the normal human mucous membrane of the bladder and 450 vocus epithelial tumours of the same localization were carried out, which made it possible to work out additional criteria for determining the degree of differentiation of tumourous cells. The structural-functional features of tumourous cells observed were used as histochemical and ultrastructural markers of the degree of maturity of different transitional-cell tumours and were taken into account in the course of the development of the pathoanatomic classification of epithelial tumours of the bladder in man.


[Morphologic changes in the kidneys of calves with respiratory mycoplasmosis]. The kidneys of 144 naturally diseased calves and those of 47 experimentally infected with Mycoplasma bovirhinis calves were investigated by histological and immunomorphological methods. The kidneys of calves with respiratory mycoplasmosis were often found to be involved in the pathological process, and at the initial stage of the disease and at its height prolifirative, membranous-prolifirative glomerulonephritis, and at later stages proliferative-fibroplastic glomerulonephritis developed. The secondary glanular kidney is a most often outcome of glomerulonephritis. The authors hold that lesions of glomerules were caused by immunopathological mechanisms.


[A change in the dendrite apparatus of the central nervous system under the influence of several extreme factors]. Electron-microscopy studies of the lateral dendrite processes of the pyramidal cells of the cerebral cortex hemispheres in rabbits exposed to thermal effects, total irradiation, and to combination of these two factors, were carried out. Destructive changes in the lateral dendrite processes, consisting in their smoothing, translocation of the dendrite apparatus into the dendrite trunk, desorganization of the dendrite apparatus, were noted. The above mentioned changes in the dendrites were not accompanied by any marked impairment of the axodendrite synapses, which testified to a relative stability of the axodendrite synapses in the cerebral cortex hemispheres.


[Intrauterine destruction of the brain by molds]. Pathohistological changes in the brain of 15 fetuses and newborns caused by intrauterine damage with mouldy fungi, identified according to their morphological characteristics as aspergillas, are described. The predominant localization of the mycotic foci was the periventricular zone of the lateral ventricles. Special attention is given to grave lesions of the brain's vessels and the ependyma of the lateral ventricles. A collation of pathomorphological data with the results of clinical examination of the mothers and children was carried out.


[Mucoepidermoid tumors of the bronchi].

[Mucoepidermoid tumors of the bronchi]. A total of 14 observations on mucoepidermoid tumours of the bronchi were studied. Patients were of the age of 29-75 years. Nine tumours were exophytic, 3-- endobronchial, 2--of the type "Iceberg". A definite interdependence was observed between the anatomic form of the tumours and histological structure thereof. All the variants of the multi-stratified structures (pseudoepidermoid, spindle-cellular, clear-cellular, and others) were characterized by the absence of cornification, and they fully comply with the notion of ateleplasia suggested by V.G. Garshin. Similarly, in mucigenesis there was not observed metaplasia, but maturation of cells in the direction natural for the respiratory epithelium. Mucigenesis could be realized in two ways: in glandular tubes or by mucification of individual cells of the pseudoepidermoid layers. In the latter case the polar differentiation of cells was absent. Mucoepidermoid tumours may develop both from mucous glands and from tegmental epithelium of the bronchi.


[The structure of the mucous membrane of the human duodenum with aging]. Features of the duodenal mucosa structure in aging were studied. Investigations were carried out on the basis of aspiration biopsy materials taken from 30 elderly (60-74 years) and 9 senile persons. The duodenal mucosa in persons aged 20-26 years was studied as controls. No gastrointestinal disorders were recorded in the anamnesis of all the persons under study. It is established that with advancing age in the duodenal mucosa atrophy processes start to develop. The number of goblet cells in the crypts and on the villi decreases. The function of Paneth's cells and that of duodenal glands weakens. The epithelium still retains considerable mitotic and amitotic activities, however, possibilities for replacing the rapidly wearing out epithelium of villi in old age are limited.


[Acute renal failure in the so-called myorenal syndrome]. Post-mortem morphological studies of the kidneys from 2 patients, who due to complications occurring in the post-operative period (operation cryothalamectomy) developed the myorenal syndrome and acute renal insufficiency, were carried out. Changes were noted in all parts of the nephron, stroma and vessels of the kidneys. The most characteristic of the myorenal syndrome was accumulation of a great number of pigmental cylinders in the lower parts of the nephrom with focal delatation of the departments located above. In pathogenesis of acute renal insufficiency in the myorenal syndrome along with impairment of the renal hemodynamics a mechanical block of the tubules with decomposition products of myoglobin is also of importance.


[A microphotometric study of the kinetics of the histochemical reaction to lactate dehydrogenase]. The aim of the work--to ascertain and substantiate concentrations of the main components of the incubation medium used for identification and quantitative evaluation of the activity of lactate dehydrogenase in cryostat sections. Studies were conducted using cryostat sections of the rat's liver as thick as 5, 10, 15 mcM with concentration in the incubation medium of lactate 25--125 mM, NAD 2--12 mM, nitrobleu and tetranitrobleu tetrazoles 0.3--5 mM, and also under conditions with addition of pyruvate in concentrations from 0.3 to 100 mM. The cytospectrophotometric method was used for evaluation of kinetic parameters of the histochemical reaction. The data on the dependence of the rate of tetrazole reduction upon the concentration of substrate, cofactor, thickness of the section and the level of the end product of the pyruvate reaction in the incubation medium were obtained. The main kinetic parameters of the enzymatic reaction in liver sections--value of Michaelis' constant and the concentration of the substrate at which the maximal rate of the reaction was observed--were calculated. Recommendations for selection of an optimal composition of the incubation medium, ensuring the strictly quantitative evaluation of the activity of an enzyme in cryostate sections are suggested.


[The gnotobiologic approach to the study of the body's non-specific resistance to infection]. A new methodological approach to the study of the organism resistance to infection with the use of experimental animals with controlled microflora (germfree and other categories of gnotobiotic animals) is considered. Characteristics of the state of natural resistance of germfree animals, revealing considerable defects of cellular and humoral protection mechanisms, are given. Findings of experimental studies into inflammation, phagocytosis and other reactions of nonspecific resistance in gnotobiotic animals, disclosing complex mechanisms of formation of these reactions under the influence of microflora, are presented. The etiological and pathogenetic role of the microbial factor in the development of infectious diseases and in the formation of mechanisms of protective reactions at various levels of integration of the organism are discussed. Conclusions concerning prospects of the gnotobiological approach in investigating the role of the microbic factor in pathology are set forth.


Anterior floor meningoencephaloceles surgical treatment. Experience based on eleven cases. The authors relate their experience in the anterior floor meningoencephaloceles surgical treatment, excised by the intracranial pathway and extradural approach. They compare their results on five cases operated according to this technique, with other six cases treated in the same Department using other surgical procedures and with those in the literature.


[Intracranial cerebral herniations and secondary lesions in the brain stem]. Intracranial cerebral herniations with secondary lesions in the brain stem are reported. The secondary lesions founded on the upper brain stem of 23 encephala with cerebral herniations are described. Hemorrhages in arteries were seen in all the brains. The lesions points to a mechanical etiology, the caudal displacement of the brain stem being the most important factor. Areas of ischemic infarction were found in the brain stem in all the cases; it is suggested that they were produced by factors other than the causative of the hemorrhagic lesions.


[Recovery of voluntary motion in the upper extremity following hemiplegia in patients with cerebrovascular accident. Prognostic evaluation]. The study aims the registration and anlaysis of the main facts which occur during recovery of the voluntary movements in the upper extremity, in patients with hemiplegia following cerebrovascular accident, and it also intends to evaluate the prognosis. Of particular interest was the comparative recognition of the spontaneous recovery of voluntary motricity in different segments of the upper extremity in 88 patients, not previously selected, with hemiplegia after cerebrovascular accident, admitted to the hospital at the acute stage. Of the 88 hemiplegic patients studied whose further evolution has been fairly followed 56 cases (group 1) experienced clinical improvement, either with partial or total remission of neurological manifestations and complete recovery of all voluntary movements in the different upper extremity joints, while 32 patients (group 2) with persistent neurological symptoms, particularly spasticity, showed a slighter clinical improvement, as well as only partial recovery of upper extremity movements. The clinical quantification of neurological signs applied in this study, has made possible to report the main significant changes developed during the 88 patients recovery. This criteria has allowed to emphasize the degree of the spontaneous remission of symptoms and the determination of the critical level of stabilization "plateau". The analysis of the data supplied by the two groups led to the following conclusions: a) the critical level of remission of symptoms and the spontaneous recovery of voluntary movements ocurred around the 70th day after the installation of hemiplegia; b) the 256 average score acquired 70 days after the onset of the hemiplegia represents the critical level stabilization (plateau); c) although the presence of early initial movements, immediately after the installation of hemiplegia, is a valuable data for the prognosis, the characterization of early movement patterns is of most important meaning; d) patients with hemiplegia after cerebrovascular acident who present the thumb flexion-extension and opposition movements showed a better prognosis than those whose initial movements were represented by the elbow flexion and/or arm flexion-adduction.


[Chronic depression and temporal lobe dysrhythmia]. Making a bibliographic review about epileptic depression, the Author found that ictal, pre, post-ictal and inter-ictal forms are described. The last one, named by Grecu and Kalman "Episodic temporal depression", is accepted as lasting for hours, days or weeks. The present work analyses two patients with episodic depression, one with permanent (3 years) and later episodic form and another with permanent depression only (13 years). The comparative study of the 4 patients, the EEG results and the effect of antiepileptic treatment permise to conclude that even the episodic and the permanent depression were of epileptic etiology, with temporal lobe localisation. Based on the symptomatology found in the 4 patients, the Author admits the hypothesis that the epileptic depression is characteristic and that it should be possible to distinguish it, clinically, from other depressions. It is suggested, for this permanent form, the name "permanent temporal depression".


[Intermittent claudication by the narrowing of the spinal canal]. The cases of four patients with intermittent claudication due to compression of the cauda equina are reported. The cause of this syndrome is considered to be a compression of the cauda equina by a thickening of the ligamentum flavum. The clinical, neuro-radiological and surgical characteristics are discussed.


[Leber's disease. Genetic study of a family]. In this paper it is done the genetic study of a large family that segregates the hereditary optical atrophy gene. The modality of the hereditary transmission is the sex-linked recessive form (Leber's form). Five generations were studied, with a total of 134 individuals. Thirteen are affected (12 men: 1 woman). The study of the heredogram allows the observation of the high occurrence of women carriers and the affected men with descendents (2 married men in the heredogram) exhibit normal offspring (22 individuals, being 16 men and 6 women). One affected woman carrier is also observed. Such observations are in accordance with the literature. This study allows one to conclude by the high importance of genetic counselling, considering that the normal women carriers, which occur in great number, segregate the gene to individuals who will manifest the atrophy.


[Mental deficiency and malformations in a child with 5/13 chromosome translocation]. An unusual case of mental retardation and physical malformations with chromosome abnormalities in a 9 year old boy is reported. Chromosomal analysis showed either breakage and delation from some gens to 5p and/or 13q; genic mutation or, perhaps, efect of position in re-adjusted chromosomic segments.


Total hearing rehabilitation.

Total hearing rehabilitation. The history and development of the hearing and dispensing system in this country is outlined in relation to the status of dispensing today. We enumerate the problems within the traditional system, various attempts to correct them, and advantages of variations of the traditional system. This article presents a concept of total hearing rehabilitation, including the direct dispensing of aids based on the professional otolaryngological-audiological team working together within the clinic setting. Based on the results of 20-months' experience in dispensing, we advocate a reexamination of professional roles involved in provision for hearing aids.


Tympanic neurectomy for parotid fistula. Complete excision of the trophic secretomotor parasympathetic nerve supply of the parotid gland produces abolition of its salivary secretion and ends in atrophy of the gland units. We report 20 patients treated by tympanic neurectomy to relieve the distressing problem of parotid fistulas. The tympanic nerve was identified and excised at its appearance through the hypotympanic floor. In seven of our cases, we found an early division of the main nerve that crossed the promontory anteriorly-hence, the importance of excising the tympanic nerve as proximal as possible. All patients observed for more than two years had complete dryness and cure of their fistulas. We describe the basis of tympanic neurectomy and its results compared with other forms of treatment.


Functional eustachian tuboplasty: a new surgical technique. Until recently, there was no answer for the "physiologic" stenosis of the Eustachian tube (occurring in 20% of all cases of tubal occlusion). We describe a newly devised surgical procedure-tensor palati tendon "strengthening"-for the management of physiologic stenosis of the Eustachian tube. After the initial dissection of 20 cadavers, the basic surgical procedure was worked out. Then, the experimental study was conducted in four dogs to evaluate the effects of this new operation on the Eustachian tube functions as well as on the soft palate movements. Finally, four patients with physiologic tubal stenosis were treated successfully. The follow-up period ranged from 16 to 20 months. Strict selection of patients is encouraged.


The air caloric test. A parametric study. We studied the normal air caloric response's intensity and variability. Intensities of "preliminary standard" (47 C, 25 C, 60 seconds, 10 liters/min) air and standard bithermal water responses were the same, but the air responses were more variable. Control experiments suggested that the tendency of the air stream to equilibrate toward ambient may account for much of air's relatively high variability. Increasing the air irrigation's duration, flow rate, and separation from body temperature increased response intensity. Air's test-retest variability decreased when flow rate and duration increased and when temperature approached ambient. Therefore, we suggested that irrigating temperatures be chosen as close to ambient as possible and duration and flow rate be made as large as possible. From a table equating air and standard bithermal water responses, we selected tentative clinical air irrigation parameters of 27.5 C, 45.5 C, 100 seconds, and 13 liters/min.


Primary squamous cell carcinoma of the parotid gland. Primary squamous cell carcinoma of the parotid gland occurs infrequently. A retrospective study at the University of Michigan indicates an incidence of 0.3% for all parotid tumors during a 25-year period. This conforms to the data presented by other large series. Before a diagnosis of primary squamous cell carcinoma can be made, mucoepidermoid carcinomas and metastic squamous cell carcinomas must be excluded.


Collapsing ears and acoustic reflex measurement with circumaural ear cushions. Ears that collapse from audiometer ear cushion pressure may show elevated stapedial reflex thresholds. In such cases, erroneous judgments about the status of a patient's hearing are possible. Experiments on 15 normal ears suggest that the use of a circumaural ear cushion on the impedance audiometer headset is an effective method of eliminating outer ear closure and the resulting spurious thresholds, when the proper correction values by frequency are applied to the audiometer dial reading. In this study, correction values for reflex-eliciting stimuli are established and their use in a child with collapsing ears is reported.


Dilator naris function: a useful test of facial nerve integrity. The dilator naris muscle is an active participant of respiration in man. Its level of function appears to vary directly with ventilatory resistance. Three cases are reported to illustrate the use of the respiratory function of this muscle as a clinical test of seventh nerve integrity when its volitional function cannot be elicited.


Ménière disease and cerebral impairment. A recent series of findings based on psychological test patterns suggests that the behavioral disturbance seen in Ménière disease is, in many instances, predicated on organic cerebral impairment. If this proves to be the case, an important source would have been uncovered that could account for some of the behavioral difficulties associated with Ménière disease. The present study challenges the previous reports, suggesting that these findings emerged because of imprecise methodologic procedures. The results based on our psychological test patterns reject prior conclusions that there is demonstrable evidence for organic cerebral impairment in patients with Ménière disease.


Maggot therapy for subacute mastoiditis. We describe a patient with intractable subacute mastoiditis who was treated successfully by maggot therapy. Maggot debridement of intractable wounds was very successful before the introduction of antibiotics. We describe the indications for use, materials and methods for the rearing of sterile larvae, the modes of action, and the complications of maggot debridement.


Masking level differences encountered in clinical populations. Methods for measuring masking level differences (MLDs) at 500 Hz and for spondees were used with 290 subjects: 50 persons with normal hearing and 240 patients with various diseases. Of particular interest was whether techniques currently in clinical use could be used with ease, dispatch, and profit in determining MLD size. The methods selected, which were variations of Békésy audiometry and speech reception threshold procedures, proved clinically feasible. Results revealed differences in behavior from one group of subjects to another. Although MLDs were not affected by cortical lesions, they were very often abnormally small for patients with eight-nerve tumor, Meniére's disease, or multiple sclerosis. The high incidence of abnormally small MLDs in populations with normal sensitivity to pure tones and speech but with evidence of subcortical central lesions, such as patients with multiple sclerosis, suggests that the MLD tasks can be of diagnostic value in detecting retrocochlear lesions. However, in persons with hearing loss or significant interaural differences in threshold sensitivity, or both, the MLD tests are not always reliable in differentiating cochlear from retrocochlear disease.


Studies in infant behavioural audiometry. II. Six-week-old infants. The behaviour of 90 clinically normal 6-week-old babies previously studied as neonates was video-recorded while they were presented with sequences of sound stimuli. The stimuli varied in sound pressure level, bandwidth and rise time, and included two voice signals and a no-sound (control) trial. Video records were made both for the whole body aspect and for a 3 1/2 X 'close-up' of the head. Later, the video records were shown to 6 observers who were allowed to see the babies for 10 s at each trial. The first 5 s was a prestimulus observation period, and the second 5 s usually contained a sound stimulus. Between the trials, the observers were given 20 s in which to record (i) prestimulus activity, (ii) confidence in response, and (iii) movement details (data for [iii] not reported here). Different segments of the baby's body were observed on different occasions as detailed in our neonatal report. The response confidence ratings were analysed, using aspects of signal detection theory, to show differences amongst various body segments (p less than 0.001), sound pressure levels (SPL) (p less than 0.001), band widths (BW) (p less than 0.001), and rise times (RT) (p less than 0.001). There were significant interactions between SPL and BW (p less than 0.05) and SPL X RT (p less than 0.001). The 3 factor interaction (SPL X BW X RT) was also significant (p less than 0.001). A 90-dB broad-spectrum noise band was by far the most effective stimulus. The response to different sound stimuli was affected by the baby's posture (lying or sitting) and by prestimulus activity state. The results are discussed in relation to our previous neonatal study.


Children's perception of temporally distorted sentential approximations of varying length. The purpose of this study was to investigate the abilities of second-grade and fourth-grade children to auditorially process three orders of three- and five-word sentential approximations, which had normal interstimulus intervals (ISI) and ISIs of 200 and 400 ms. Results showed that percent correct scores decreased as a function of increasing sentence length and ISI, and decreasing order of sentential approximation and grade level. The results are discussed relative to theoretical notions of short-term memory and auditory perceptual processing as well as potential clinical applications.


Lower body negative pressure: the second manned Skylab mission. Results of orthostatic evaluations of the crew of Skylab 3 with lower body negative pressure (LNBP) stress tests during their 59-d mission are reported. The test protocol was identical to that used in the first manned Skylab mission and the latter Apollo flights. Except for an inflight increase (rather than a decrease) in resting heart rates, results were essentially parallel to those observed in crewmen of the shorter Skylab 2 mission. Exaggerated elevations in heart rate and decreases in pulse pressure during LBNP stress inflight and immediately postflight corresponded to lowered orthostatic tolerance. Large decrements in resting calf size inflight and in total leg volume postflight indicated significant headward fluid shifts as had already been seen in the Skylab 2 crewmen. In addition, decreases in calf circumference gave no certain indication of a plateau over the 59 d inflight. On the other hand, percentage volume increase in calf size during LBNP stress inflight was greater than those in either preflight or postflight tests. Hypotheses elaborated after the Skylab 2 mission seem to have been substantiated, but several enigmas await data from the last and longer mission for clarification.


Intelligibility of distorted speech sounds shifted in frequency and time in normal children. Distorted speech sounds were presented to normal children aged 4-11 years and to young adults in such a way that 20 monosyllables were distorted with a 'speech stretcher' which produced frequency expansion and compression and also time expansion and compression. The experiment was performed to observe the intelligibility of such distorted speech sounds and the development of the discrimination ability in normal children. The results were as follows: (1) discrimination decreased sharply with increasing frequency change in both frequency-expanded and frequency-compressed speech; (2) discrimination was relatively unaffected by time expansion. However, with time compression there was a gradual decrease in discrimination at 50% time compression followed by a rapid deterioration at 75% time compression; (3) for a given percentage of distortion, frequency shift degraded intelligibility of speech sounds more severely than time shift, and (4) discrimination ability clearly increased with age in normal children. There was no significant difference between boys and girls.


Quantitative electrocardiography during extended space flight: the second manned Skylab mission. To assess the effects of space flight on cardiac electrical properties, vectorcardiograms (VCG) were obtained on the Skylab crew at regular intervals during the 59-d flight (SL3) and during the pre- and postflight periods. The Frank lead system was used and observations were made at rest; during 25%, 50%, and 75% of maximum exercise; during a short pulse of exercise (150 W, 2 min); and after exercise. Data from 47 in-flight tests were analyzed by computer and compared to preflight and postflight values. A statistically significant increase in QRS maximum vector magnitude (all SL3 crewman); and an increase in resting PR interval (all SL3 crewmen) occurred. During exercise, the PR interval did not differ from preflight. Exercise heart rates in flight were same as preflight, but increased in the immediate postflight period. No major changes in QRS, T, or ST vector direction occurred. The scientist pilot had premature ventricular beats sporadically during the flight. This astronaut also had intermittent periods of atrioventricular junctional rhythm throughout the flight. The increase in QRS maximum vector magnitude resembles the electrocardiographic changes associated with athletic conditioning and may be related to increased ventricular volume secondary to centripetal shifts of fluid and/or the in-flight isotonic exercise program. Prolongation of the PR interval at rest with normalization of exercise suggests that there was increased vagal tone or suppressed sympathetic influence during the flight.


Most comfortable listening level presentation versus maximum discrimination for word discrimination material. The purpose of the present study was to determine if most comfortable listening level (MCL) presentation of word discrimination material would yield maximum discrimination for normal and sensorineural hearing loss subjects. The results of the study indicated that normally hearing listeners do obtain maximum discrimination at MCL, while presentation of word discrimination material at MCL to sensorineural hearing loss listeners does not yield maximum discrimination. Further examination of the results would also contraindicate the use of any other method which incorporates single or dual presentation levels as a means of determining maximum discrimination for the sensorineural hearing loss listener.


Pre- and postflight systolic time intervals during LBNP: the second manned Skylab mission. After space flight of 59 d, Skylab 3 astronauts were stressed with lower body negative pressure (LBNP). During this stress procedure vectorcardiograms, pneumograms, phonocardiograms, and carotid pulse tracings were monitored and recorded onto analog tape. Accepted techniques were used to measure the intervals of systole. The postflight results were compared to multiple preflight tests and each of the three crewmen served as his own control. Immediately postflight, there were elevations in heart rate and blood pressure in response to a fixed level (-50 mm Hg) of LBNP. Total electromechanical systole, (Q-S2) I, was unchanged. Ejection time index (ETI) was depressed at rest and during stress, while pre-ejection period was elevated compared with preflight values. Systolic time intervals (STI) were within preflight limits after 1 month on earth in all crewmen. Resting STI returned sooner than did stressed STI. The magnitude and direction of STI in the postflight period were similar to those obtained from patients with moderate heart disease, although signs and symptoms were absent in the astronauts. However, the abnormality of the stressed STI persisted after both blood volume repletion and lowered afterload. These findings suggest a compromise in cardiac function, peripheral circulatory integrity, or both after exposure to long-duration space flight, and are consistent with findings reported after 3 weeks of absolute bedrest.


Speech intelligibility and the use of hearing protectors. On theoretical grounds, it is usually assumed that the use of hearing protectors in a noisy working environment has no influence upon speech intelligibility - in fact, may even increase it. In practice, however, people often do not wear hearing protectors, since these are widely believed to reduce speech intelligibility. In the present article, a description is given of an investigation, carried out among 537 subjects, into the influence of hearing protectors upon the speech intelligibility of people suffering from noise-induced hearing loss. From this analysis, it has become clear that the use of ear-muffs only leads to an improvement in speech intelligibility in persons who, according to their pure-tone audiogram, suffer from relatively small hearing losses. In general, it may be said that an increase in the severity of hearing losses will result in a reduced speech intelligibility.


Determination of cardiac size following space missions of different durations: the second manned Skylab mission. A simple method to estimate cardiac size from single frontal plane chest roentgenograms has been described. Pre- and postflight chest X-rays from Apollo 17, and Skylab 2 and 3 have been analyzed for changes in the cardiac silhouette size. The data obtained from the computed cardiothoracic areal ratios compared well with the clinical cardiothoracic diametral ratios (r = .86). Though an overall postflight decrease in cardiac size is evident, the mean difference was not statistically significant (n = 8). The individual decreases in the cardiac silhouette size postflight are thought to be due to decrements in intracardiac chamber volumes rather than in myocardial muscle mass.


Exercise cardiac output following Skylab missions: the second manned Skylab mission. Cardiac output was measured during preflight and postflight exercise-stress tests on the Skylab astronauts. In the postflight tests immediately following the 28-, 59-, and 84-d earth orbital missions, the astronauts exhibited an approximate 30% decrease in cardiac output coupled with an approximate 50% decrease in cardiac stroke volume during exercise. These changes were accompanied by elevated heart rates and significant (p less than 0.01) increases in total systemic peripheral vascular resistance. Mean arterial pressure was unchanged. The hemodynamic alterations were transient in that all parameters returned to normal preflight values within 30 d of the end of the orbital period. Duration of the zero-G exposure did not appear to influence either the magnitude of the hemodynamic changes or the time-course of their return to normal. These results are discussed in relation to other cardiovascular findings and possible mechanisms responsible for the observations are outlined.


Hematology and immunology studies: the second manned Skylab mission. The hematologic and immunologic functions of the Skylab 3 (second manned mission) astronauts were examined during the preflight, inflight, and postflight phases of the 59-d mission in order to evaluate the response to and/or the influence of the space flight environment. Most changes observed were subtle and did not represent a threat to the health and safety of the crewmen during orbital flight. Even the most significant change observed, a reduction in the circulating red cell mass, did not have a detrimental influence on the astronaut cardiovascular or exercise responses as evaluated by other experiment protocols. Considering the facts that the data were not collected under ideally controlled conditions and that the astronauts were in excellent physical condition, the results of these studies would seem to indicate that man can function quite well in the space flight environment of the Skylab orbiting workshop for extended periods of time.


Mineral and nitrogen balance study observations: the second manned Skylab mission. A metabolic study of the effects of space flight on various chemical elements, particularly those with special revelance to the musculoskeletal system, was carried out on the three astronauts of the SL-3 mission for 21 d preflight, during the 60 d flight phase, and for 17 d postflight. The study required of the cooperating crewmen quite constant dietary intake, continuous 24-hour urine collections and total fecal collections. Urinary calcium was significantly increased during flight in all three crewmen with man-to-man variation in pattern and amount; the degree of calcium loss was, in general, similar to that in the prior study of the 28-d Skylab flight (SL-2). The similarity to bedrest immobilization in the pattern of urinary calcium increases and of total calcium shifts suggested that calcium losses would continue for a very long time. Significant losses of nitrogen and phosphorus occurred that were associated with observed reduction in muscle tissue. Both mineral and muscle losses occurred despite vigorous exercise regimens during flight. It was concluded that these studies give warning that capable musculoskeletal function may be significantly impaired during prolonged space flights lasting 1.5 to 3 years unless protective measures are developed.


Bone mineral changes: the second manned Skylab mission. The mineral content of the central os calcis, and distal radius and ulna was measured by the monoenergetic photon absorptiometric technique pre- and postflight on the the SL-3 crewmen. No significant changes were observed in the radius and ulna. Only the SPT showed a loss in calcaneal mineral which slowly returned to preflight levels by the 87th postflight day.


Measurement of a single tendon reflex in conjunction with a myogram: the second manned Skylab mission. A generalized hyperreflexia was observed in Skylab 2 crewmembers during the immediate postflight clinical evaluations. Unfortunately, no provisions had been made to quantitate the observed phenomenon. The cause of the hyperreflexia was not readily apparent at the time of the observation. Reflex changes have been noted in several of the Russian cosmonauts after extended spaceflight. Prior to the launch of Skylab 3, it was decided to measure and record a single tendon reflex and, if possible, the associated muscle potential. Duration of the Achilles reflex immediately postflight showed a significant (p greater than 0.01) shortening for all three crewmen. The reflex duration exhibited further significant shortening from preflight values on the fourth day after recovery. At the 16th day measurement, there was a signficant lengthening of the reflex for crewmenber 2 and 3 while crewmember 1 showed some lengthening which was not significant. By 29 d postrecovery, the reflex time of crewmember 1 had returned to his preflight value while the other two crewmen continued to show a significant lengthening of the reflex, although both were showing trends toward their preflight values. The muscle potential intervals were shortened immediately postflight and remained shortened during the 29 d of postflight evaluation. Currently, work is in progress to correlate these findings with other observed anatomical, physical, and biochemical changes. Final conclusions and an in-depth statistical analysis will be presented at a later date.


Biostereometric analysis of body form: the second manned Skylab mission. Biostereometrics is the measurement and the mathematical description of the three-dimensional form of biological objects. Stereophotogrammetry was used to derive the Cartesian coordinates of numerous points on the body surface of the Skylab crewmen, both before and after flight, on all three Skylab missions. Mathematical analysis of the coordinate description allows the computation of surface area and volume of the body, as well as the volume of body segments, and the area and shape of cross sections. Loss of body weight in the first two Skylab flight crews was accompanied by comparable loss of volume and little change in density. Volume loss wad divided about equally between the trunk and the legs; however, because the volume of the legs is less than that of the trunk, this finding represented a greater proportional volume loss in the legs. Comparison of cross-sectional areas suggests that the calf undergoes shrinkage to a greater extent than does the thigh. The suggested interpretation of these changes is that, during flight, a reduction in bulk of many of the body tissues occurs. This reduction is probably caused, at least in part, by disuse atrophy of skeletal muscles in the absence of gravity. The atrophy is lessened to some extent by the in-flight exercise program. The stereoscopic images of the crewmen from a permanent archival record of body form on which more detailed measurements may be made in the future.


Crew health status and monitoring summary: the second manned Skylab mission. We have attempted to show that objective data used to assess crew health comes to the responsible physicians from the laboratories of the experimenters in sporadic and overwhelming amounts, but rarely in the real-time or near real-time frame which is preferred. The crew surgeon generates little hard data by his own efforts. Because of these factors, whenever an over-all clinical assessment of a particular crewman's fitness to continue a mission is an immediate necessity, it must too often be given on what the clinician would consider less than adequate data. Beginning on MD 28, weekly conferences were held with senior NASA management to make a "Go" or "No-Go" recommendation to continue or terminate the mission. In the absence of absolute indications of an unacceptable declining crew health, a clinical judgment was required. To tighten the criteria for decision-making, the authors selected factors that seemed indicative of overall health and plotted them both as real-time and percentage changes from preflight means. Other plots of the most readily available real-time and near real-time data were also developed for this purpose. The major success of this effort was the initiation of a method which indicated interesting and worthwhile possibilities if continued, refined, and computerized for more rapid availability. Correlation of actual post-flight findings with results anticipated from this method was gratifying but not statistically defensible. Whether or not this method would have forewarned of a serious decrement in crewmen's health cannot be known because, in fact, they were healthy and remain healthy.


Laboratory investigation of "biorhythms". Three subjects were tested on an information processing task on a daily basis for a period of 70 d. Performance measurement included reaction time, movement time, and information processing rate. The data set obtained was subjected to Fast Fourier Transforms (FFT) in an attempt to identify periodicities in performance. Twelve significant harmonics were identified and nine were found to be within 1 d of at least one of the cycles hypothesized by the theory of "biorhythms." The probability of this occurring by chance is remote (p less than 0.05), assuming a uniform distribution of significant amplitude. The results were interpreted as suggesting the possibility of a biorhythmic influence in the performance of the task.


Review of the effects of infrasound on man. Claims that infrasound adversely affects human performance, makes people "drunk," and directly elicits nystagmus, have not been clearly demonstrated in any experimental study. The effects obtained at low intensity levels of 105 to 120 dB, if they can be substantiated at all, have been exaggerated. Recent well-designed studies conducted at higher intensity levels have found no adverse effects of infrasound on reaction time or human equilibrium. The levels at which infrasound becomes a hazard to man are still unknown. However, the hazardous levels are certain to be much higher than have been suggested in some of the literature. The preliminary exposure limits which were proposed several years ago for use in the U.S.A. are still considered safe and adequate based on present knowledge. Caution is necessary in future research because artifacts produced by faulty experimental procedures can suggest genuine psychological or physiological effects.


Braking saccade--a new fast eye movement. A new type of fast eye movement (FEM) is described whose main function is to stop a runaway slow eye movement (SEM). It conforms to the velocity-amplitude relationship characteristic of other types of saccades. The identification of this FEM is the result of examination of the many waveforms manifested by subjects with congenital nystagmus. It is a common, repeatable phenomenon present in all subjects with any of six different types of nystagmus waveform. The fact that braking saccades reset SEM to zero velocity, whereas no other type of saccade interacts with SEM, indicates a developmental mechanism in such subjects.


Visual accommodation variations during trans-atlantic cockpit duties. Twenty airline pilots measured their near point of accommodation employing a modified Princes' Rule. Measurements were performed periodically travelling east- and west-bound. Five clerical control subjects performed the same measurements over 2 consecutive days. The ranges of variability of the nearpoint of accommodation were compared between the two groups, directions and days. No statistically significant differences in the variability of accommodation were found in the comparisons.


ECG monitoring of heart failure and pilot load/overload by the Vesla seat pad. Heart failure has caused sudden incapacitation of pilots in command of commerical airliners. These fatal episodes have occurred in connection with takeoffs and landings, and have resulted in incidents as well as major accidents in which more than 300 people have been killed. Coronary attack may be verified later at autopsy. Sudden cardiac arrest or serious episodes, such as ventricular tachycardia, usually cannot be detected at autopsy. A number of accidents due to unknown reasons or to "pilot error" can be due to, and some probably are, cardiac breakdown. It is today possible, with the Vesla Seat Pad, to monitor the pilot's ECG. The Vesla Seat Pad is a device for biomedical monitoring of ECG signals from human subjects without attachment to the subjects of any leads or sensor devices. The Vesla pad on which a human subject may rest, requires no power source. It is capable of obtaining appropriate ECG signals, transmitted to the pad through the medium of the subject's perspiration, for monitoring the subject's heart action. ECG signals, together with other data, can be electronically processed and used to warn the co-pilot and tower of impending hazard. The "dead man's button" with an OVERLOAD warning system could greatly, when taken into use, improve flying safety.


Simulated aircraft disaster instructional exercise at Baltimore-Washington International Airport. A major, simulated aircraft disaster exercise was held in September of 1974 at the Baltimore-Washington International Airport in Maryland. The significant aspects of community involvement and specialized airport emergency planning were tested during this simulation. This paper presents an evaluation of the experience of the various elements in this exercise. The critical matter of having a system of runners to substitute for a failure within the mobile command post is stressed. Also, the importance of adequate telephone facilities for communication with the fire/rescue stations and community hospitals is highlighted. Many other small and seemingly unimportant items are found to be of considerable significance during the handling of disasters. A strong case is made for periodic disaster simulations to maintain an efficient broadly-based apparatus for handling such disasters, should they occur.


Economical oxygen-delivery system.

Economical oxygen-delivery system. The conservation of aircraft oxygen supplies is becoming of considerable interest to the Air Force. Onboard oxygen-generating systems are being developed which could support an aircrew if oxygen produced by these systems were used conservatively. These experiments studied the conservation potential of a rebreather bag placed in a vented container near the regulator in an oxygen-delivery system. The bag's volume was close to that of the subject's physiologic dead space. When the subject exhaled, oxygen in the mouth, trachea, and mask dead space went to the rebreather bag, to be rebreathed with the next breath. The CO2-contaminated oxygen from the alveoli was vented to the cabin. The dead-space oxygen could be separated from contaminated oxygen because dead-space air is exhaled first with each breath. When the rebreather-bag volume matched the subject's physiologic dead space so that no CO2 accumulated, a 30% oxygen savings was realized. When the bag was large enough to realize a 50% savings, CO2 accumulation was only 2%.