Diagnostic sign of hyperglycemia: persistent movement of neutrophil granules. This study describes a functional marker in the blood of diabetics: the motility of neutrophil granules in vitro. When heparinized blood from patients with diabetes mellitus was kept in capillary tubes for 24 hours, a rapid and intense movement of the granules in the neutrophil leucocytes was regularly seen. In blood from normoglycemic diabetics and normal subjects, no granular motion was seen at 24 hours, but in these cases prolonged motion could be induced by the prior addition of glucose.


Noninvasive diagnosis of acute deep vein thrombosis. A comparison between thermography, plethysmography and phlebography. Fifty-five patients with clinical signs of acute DVT were investigated with thermography, plethysmography and phlebography. A comparison between phlebography and thermography showed a diagnostic agreement of 84%. Thermography was found, however, to have a low reliability for the localization of acute thrombi and was therefore combined with plethysmography in an attempt to obtain better results in this respect. Compared to the invasive phlebography, the noninvasive combination of thermography and plethysmography adequately located acute DVT in 95% of the cases.


Influence of a myocardial infarction on blood pressure and serum cholesterol. Blood pressure (BP) was measured before and after acute myocardial infarction (MI) in 21 men aged 49--60 years from a random population sample. Men on drugs affecting BP before MI or during follow-up were excluded. Pre- and postinfarction cholesterol levels were analyzed in 49 men not on hyperlipidemic treatment recruited from the same population sample. The mean fall in systolic BP (SBP) was 14 mmHg both five weeks and one year after the acute event, but 10 mmHg after two years. The mean fall in diastolic BP (DBP) was 10 mmHg five weeks after the MI and remained at this level for two years. The decreases in SBP and DBP were significant. There was a positive correlation between the maximum rise in SGOT during the acute phase of MI and the decrease in DBP between preinfarction readings and readings five weeks after the MI. Serum cholesterol was unchanged three months, and one and two years after the MI as compared to the preinfarction level.


Myocardial infarction complicated by heart block--treatment and long-term prognosis. A number of 597 patients with acute myocardial infarction (AMI) were treated with continuous ECG monitoring of the heart rhythm in a coronary care unit for at least three days. We found 84 patients with heart block, 39 with complete, 29 with at most second degree and 16 with at most first degree heart block. The treatment was primarily conservative; 22 of the 39 patients with complete heart block were given isoproterenol and two received temporary pacemakers. Survival was traced over two years in the whole patient group with myocardial infarctions. Heart block implied a worsened prognosis over the two years, but survival was independent of the degree of heart block. Among those with complete heart block, survival did not differ from that of a comparable patient series from Copenhagen, where all patients were given pacemakers. This does not support indiscriminate artificial pacing of patients with AMI and complete heart block. Our results ought to be controlled in a randomized study.


Malignant hypertension--improving prognosis in a rare disease. A follow-up was made of 69 patients diagnosed as having malignant hypertension during 1969--76, essential in 26, secondary in 39 and unclassified in 4. A clear male dominance was seen (41 men, 28 women), particularly in the group with essential hypertension (18 men, 8 women). The mortality in this series was less than in previously published series. Thus, the 5-year survival rate was 75% in the patients with essential and 72% in those with secondary hypertension. In part this was due to haemodialysis and renal transplantation. The importance of renal function at the time of diagnosis was evident in this study. In most patients with essential hypertension and serum creatinine levels below 300 mumol/l, renal function could be maintained or improved when antihypertensive treatment was instituted, whereas progression of the renal damage was seen in those with serum creatinine levels above 300 mumol/l in spite of antihypertensive treatment with 3 or more drugs. The incidence of new cases of malignant hypertension tended to decrease during the observation period, particularly as regards essential hypertension.


Adipose tissue cellularity--metabolic aspects. The population study of women in Göteborg 1974-1975. A representative population sample of middle-aged women was studied in 1974-75. In a subsample, body composition and adipose tissue cellularity variables were determined and individuals with a particular clinical disorder were compared with the total subsample. Women with diabetes mellitus had more body fat and higher fat cell weights and larger fat cell members, whereas these variables did not differ in women with IHD or hypertension compared with the total subsample. Total body fat correlated with arterial BPs, fasting blood glucose, serum lipids and serum uric acid. The correlations were stronger than those reported previously by us between weight index and these variables. In univariate analyses, fat cell weight correlated with systolic BP, serum triglycerides and serum uric acid, and fat cell number with diastolic BP, fasting blood glucose and serum uric acid. In multivariate analyses, when due allowance was made for total body fat, the correlations between these variables and fat cell weight or fat cell number did not reach statistical significance.


Mechanical properties of mallard humeral bone in dependence on the form. The mechanical behaviour of bony material taken from humeral bone of the mallard duck was analysed. Wing-clipping led to a change in the values and distribution of the dynamic shear modulus and damping. The distribution of the values of the modulus shows a specific pattern in which the highest values are found ventrally. This pattern changes when there is a disturbance of the functional forces acting upon the humerus -- in this study induced by wing-clipping. The hypothesis is put forward that in birds the bone with its specific shape will resist any change in this shape. For a specific shape required for other functions than simply resisting load, it is functionally advantageous to respond to a change in required forces by adapting the pattern of moduli. An adaptation according Wolff's law will only occur in extreme cases, but an alteration of the bone shape will be avoided.


Cardiac conducting system of Gallus domesticus with special reference to the atrial bundles. Gross anatomy and histology of the cardiac conducting system of Gallus domesticus has been studied. Detailed histology of the atrium revealed for the first time, in the avian heart, the presence of three atrial bundles which communicate between the sinuatrial node and the atrioventricular node. Purkinje fibres in the subendocardium of the right atrium are observed. An atrioventricular segment comprising of the posterior end of the interatrial septum and the atrioventricular nodal region has been reported in which the three atrial bundles converge. The role of the atrial bundles in the cardiac contraction has been discussed.


Hydrocephalus in the laboratory rat.

Hydrocephalus in the laboratory rat. The state of hydrocephalus is applied to all conditions in which the intracranial volume of cerebrospinal fluid is abnormally large in relation to the volume of the brain. Increase in volume of cerebrospinal fluid raises the pressure and results in brain tissue atrophy and enlargement of the cranial vault. The condition can be hereditary or acquired and commonly arises from congenital malformations, inflammatory processes or expanding lesions such as tumours. The laboratory rat has an incidence of hydrocephalus of about 0.3% but no satisfactory indication of hereditary linkage. A small breeding unit of laboratory rats consisting of 2 males and 3 females produced 32 offspring of which 13 exhibited varying degrees of hydrocephalus. Examination indicated that the hydrocephalus was congenital in type, that 11 of the 13 hydrocephalic rats were proven males, that the remaining 2 were likely to be male, that female young were unaffected and that the incidence of the condition was 40.62%. Craniofacial examination showed that the cranial vault enlarged due to intracranial pressure and that the facial and basal components were mainly unaffected. The olfactory aspect of the frontal bone bulged slightly outwards, medial walls of orbits were laterally displaced, parietal and interparietal showed distention and their related sagittal and coronal sutures unfused and open to 1 mm in places. The basioccipital width showed a significant increase to the normal state. It is postulated that this particular congenital hydrocephalus in the rat is a normal autosome mutation, sex limited to males and one in which both males and females could transmit the trait to male progeny.


Ultrastructural changes of the rat renal glomeruli in the early phase of renovascular hypertension. Electron microscopic studies were carried out on rat kidneys during the early phase of "two-kidney" Goldblatt hypertension. Pathologic ultrastructural changes (confluence of foot processes of the podocytes, formation of intercellular juctions between them, etc.) and an enhanced permeability to ferritin were found in the glomeruli of both the ischaemic and the contralateral kidneys. Signs of activation and exhaustion of the lysosomal system appeared in the glomerular epithelial cells of the untouched kidneys. These signs were absent in the kidneys with constricted arteries. The possible significance and pathogenesis of the alteration are discussed in comparison with other pathological conditions showing a similar ultrastructural picture.


Clinico-morphological and histological studies of the foveola palatina. The occurrence of foeveola palatina was studied in 264 patients. The distance  of the foveola palatina from the papilla incisiva and palatinal raphe was measured. Light and electron microscopic examinations were carried out on specimens obtained from cadavers. It was found that ducts of functioning mucous glands open into the foveolar lumen lined by stratified epithelium.


The effect of ethanol on the distribution of synaptic vesicles in cortical synaptosomes of the rat. Ethanol was shown to cause a redistribution of synaptic vesicles in incubated synaptosomes. While the number of synaptosomes containing synaptic vesicles attached to the presynaptic membrane decreased markedly, an increase in the number of synaptosomes lacking membrane-vesicle associations was observed. The findings support the possibility of a presynaptic action of ethanol and point to the role of membrane-attached vesicles in synaptic transmission.


Mutagenicity of polycyclic hydrocarbons III. Monitoring genetic hazards of benz(a)anthracene. Mutagenicity tests (micronucleus test and chromosome aberrations) have been performed with benz (a) anthracene in spermatogonia and bond marrow cells of Chinese hamsters and in NMRI mice oocytes. Mutagenic effects of the polycyclic hydrocarbon could be demonstrated.


Ultrastructural studies in rheumatoid polyneuropathy. The biopsy material from the sural nerve of 8 patients suffering from rheumatoid arthritis and showing, with one exception, positive serological reactions, were studied by means of electron microscopy. All the patients were displaying sensory and sensomotor neuropathy. Besides hypermyelination the damage of Schwann cells, the destruction on unmyelinated fibres and the proliferation and degeneration of the vascular endothelium were observed. No inflammatory signs were seen around the peri- and endoneurial vessels.


Regeneration of proximal tubules of the rat kidney following sublimate necrosis. A scanning electron microscopic study. Necrosis of the proximal tubules of the rat kidney was induced by low (1.5 mg/kg) doses of sublimate. Epithelial necrosis and regeneration were followed by scanning electron microscopy for 10 days. Regressive and regenerative processes were observed simultaneously. The naked basement membrane is first invaded by flat epithelial cells lacking microvilli. Within a few hours microvilli appear followed by the formation of regular brush-border and interdigitations cells. After 7--10 days the newly formed epithelium cannot be distinguished from the intact one.


Combination chemotherapy (COMP protocol) and radiotherapy of anaplastic supratentorial gliomas. Postoperative survival time and recurrence-free intervals in 116 consecutive patients with supratentorial grade III and IV gliomas (glioblastomas, gliosarcomas, anaplastic astrocytomas, and ependymomas) were compared in unselected groups receiving different forms of treatment. Postoperative high-voltage radiotherapy (31 patients, dosage 4,000--6,000 rads) and combined chemotherapy consisting of CCNU, vincristine, amethopterine, and procarbazine in 15-day circles (COMP protocol) (12 patients) showed the same median survival time of 10.6 months and comparable recurrence-free intervals of 6.8 and 7.0 months, respectively. These results were significantly different from a control group (39 patients) receiving best postoperative supportive (conventional) care (median survival 5.4 months, free interval 3.7 months). Combination of postoperative radiotherapy with simultaneous polychemotherapy (COMP protocol), evaluated in 18 patients, did not significantly change the recurrence-free interval (median 7.0 months), but increased the median survival time to 12.9 months, which was significantly superior to the two other treatment groups. The toxic side effects of COMP therapy were moderate and essentially haematological. In general, simultaneous radiation and chemical treatment was well tolerated after major tumour resection. These preliminary results of postoperative combination of radiation and polychemotherapy for anaplastic supratentorial gliomas appear encouraging, but further trials for optimization of combined therapeutic strategies are warranted.


Primary carcinoma of the choroid plexus with metastatic dissemination within the central nervous system. The authors present a case of primary carcinoma of the choroid plexus in a 26-years-old female, localized in the left lateral ventricle. Four years after total removal plus local radiotherapy, the patient presented with an intraparenchymatous metastasis in the right cerebellar hemisphere and intraspinal metastatic seeding. With this kind of malignant growth, a therapeutic approach consisting of radical removal of the tumour plus radiotherapy to the whole neuraxis is proposed.


Malignant gliomas treated after surgery by combination chemotherapy and delayed irradiation. Part I: Analysis of results. Forty-six patients with gliomas were introduced after surgery into a therapeutic programme of six cycles of combination chemotherapy with VM26 and CCNU, followed by delayed irradiation six months after surgery with an average dose of 5,800 rads. After irradiation the same preradiation chemotherapy was readministered for an average of four cycles. The results were compared to those from another group of 28 patients treated only by the same chemotherapy (CRC and C groups sucessively). Twelve patients (26%) died before irradiation in the CRC group, six patients (13%) had recurrences at the time of irradiation, and 28 patients (61%) had no clinical or radiological signs of recurrence at the time of irradiation. For the total of treated patients the median survival after surgery was 17 months, and 46% of the patients were surviving at 18 months. The percentage of survivors at 18 months was significantly more elevated in the group treated by combination chemotherapy and delayed irradiation than in a control group treated by the same combination chemotherapy alone. This result suggests that in approximately 50% of cases combination chemotherapy after surgery, and delayed irradiation six months after surgery, cumulated their effects on survival time.


Malignant gliomas treated after surgery by combination chemotherapy and delayed radiation therapy. Part II. Tolerance to irradiation after chemotherapy. 34 patients operated on for malignant gliomas were successively treated by combination chemotherapy with VM26 and CCNU and conventional radiation therapy with an average dosage of 5,800 Rads, six months after surgery. The general and haematological tolerance of delayed irradiation after chemotherapy was satisfactory. Twelve patients developed neurological complications during or after irradiation. The complications were early in 10 cases, and delayed in 2. They were probably due to tumour growth in five cases, and secondary to irradiation in seven. In four of the seven cases the preradiation chemotherapy seemed to potentiate the radiation effect on the central nervous system.


The influence of dexamethasone on subarachnoid fibrosis after subarachnoid haemorrhage. Scanning electron microscopic study in the dog. The author used the scanning electron microscope (SEM) to study the influence of dexamethasone on subarachnoid fibrosis after experimental subarachnoid haemorrhage (SAH). In the subchronic group of dogs, which were sacrificed three weeks after SAH, an average of 2.82 mg/kg intrathecal dexamethasone seemed to delay the fibrosis somewhat, but statistically showed no significant difference from the control group. In the chronic group, sacrificed three months after SAH, an average of 0.95 mg/kg intrathecal dexamethasone did not prevent the fibrosis, and no significant difference was found from the untreated dogs. The author considers that steroid therapy only delays and does not diminish the inflammatory process. This may also apply to other types of arachnoiditis.


Arachnoid villi affected by subarachnoid pressure and haemorrhage. Scanning electron microscopic study in the dog. The arachnoid villi of 18 dogs were studied. The authors confirmed the pressure gradient changes of the morphology of arachnoid villi of dogs with the scanning electron microscope (SEM). A subarachnoid infusion with 5--10 times higher pressure gradient than the physiological one, tore the superficial endothelial layer from the villi, and the inner part could also be observed stereoscopically. On the surface of the arachnoid villi, the authors observed microvilli, openings of vacuoles and intercellular gaps, but did not find openings of performed channels. After subarachnoid haemorrhage (SAH) generally the villi were blocked but the authors have observed a red blood cell escaping from a villus intercellularly.


Enlargement of intracerebral haematomas following surgical removal of epidural haematomas. Postoperative follow-up computerized tomographic (CT) scans were performed in 16 cases of acute epidural haematomas to assess the efficacy of surgical treatment. Particular attention was paid to postoperative intracerebral haematomas that were detected in four cases on the preoperative CT scans. The intracerebral haematomas were found to have enlarged in all four cases on CT scans performed immediately after removal of the epidural haematomas. In the other 12 patients in whom no apparent abnormalities other than epidural haematomas were detected on preoperative CT scans, postoperative CT scans did not show development of intracerebral bleeding. The results indicate that bleeding may be encouraged in areas of intracerebral haemorrhage when coexisting epidural haematomas are evacuated. The possible pathophysiology of enlargement of intracerebral haematomas after decompression is discussed.


Unusual evolution of a post-traumatic subdural haematoma. Case report. The authors describe a case of a post-traumatic subdural haematoma with an unusual evolution in two phases, one slow, the other very rapid. The rapidity of the evolution was caused by the rupture of a cortical dural artery, shown angiographically.


[Mitotic activity of the pigment epithelium during embryonic and postembryonic development]. The purpose of the present study was to examine the mitotic activity of the normal pigment epithelium of the retina (RPE), the ciliary body and the iris of different animals during gestation and after birth by blocking the metaphase with colchicine and by marking the pigment epithelial nuclei with tritium-labeled thymidine. The colchicine examinations were made on 54 albino rabbits and 56 albino rats, the 3H-thymidine studies with 78 albino mice. In the rabbit the peak of mitotic activity (respectively the end) is found in the RPE at the beginning of the 2nd third of gestation (respectively at the 9th postnatal day), but in the pigment epithelium of the ciliary body and in the iris during the last third of gestation (respectively in the 2nd month of life and the 3rd postnatal week). In the rat the highest mitotic activity is reached in the RPE at the beginning of the 2nd half of gestation (respectively at the 13th postnatal day), in the ciliary body at the 3rd day of life (respectively the 24th postnatal day) and in the iris at the end of the gestational period (respectively the 17th postnatal day). In the mouse the highest rates of mitotic activity are found in the RPE from the 16th gestational day to the 8th day of life (respectively the 20th day of life), in the ciliary body from the 1st to the 4th day of life (respectively from the 12th to the 20th postnatal day) and in the iris on the 9th day of life (respectively the 12th to the 20th postnatal day). The present observations have also demonstrated that with maturation of all areas of the pigment epithelium, the mitotic activity stops. The cells of the pigment epithelium do not have an epithelial cell turnover but they are reversible postmitotic cells. Despite the enormous proliferative properties the pigment epithelium shows no regeneration by mitosis after severe damage.


[Early diagnosis of motorial and mental disturbances during a dispensary consulting-hour for children at risk (author's transl)]. During a dispensary consultating-hour for children at risk and prematureley born children a pediatrist, an orthopaedist, an ophthalmologist, a psychologist and a special educationalist judged the motorial and mental disturbances of 600 children at risk. 21 children with manifested cerebral motorial disturbances are confronted to 89 children with mental peculiarities. Concepts pertaining to a necessary special pedagogical as well as a psycho-therapeutical assistance are discussed.


[Relations between some measures of the human body and menarcheal age (author's transl)]. It is considered which relations may exist between certain measures of the body (KM) and the moment of menarche (MZ). Statistical evaluations are based on the results of interrogations and anthropometry of Karl-Marx-Stadt school-girls, registered in 1974 under the main-topic "Fluoridation of drinking-water (TWF) and its possible effects on the physical process of growth and puberty of children and teen-agers". Considered measurements (height, weight, width of shoulders and pelvis, neck circumference as well as the Rohrer-index show higher means in menstruated individuals (M) than at non-menstruated ones (NM). The same comes true to girls of the same age and - concerning the width of shoulders and pelvis and neck circumference - also to girls of the same height. Advantage in development of M against NM individuals is 1-3 years, depending respectively on the considered dimensions of the body. Girls with an early MZ have also higher measurements of the body in their later physical development.


[The median of menarche in Hungary and its relation to meteorological data (author's transl)]. Statistics of menarcheal age in 16 towns and villages of Hungary are analysed for their relation to 14 meteorological factors. There is a strong correlation of the median of menarche to the sum of hours with sunshine or to the mean temperature in the year. No correlation was found to the maximal height of snow and other characteristics of winter.


[Juvenile rapists].

[Juvenile rapists]. In comparision with the literature of the last 15 years causes and circumstances of juvenile delinquency of rape are examined by 46 cases. It strikes the great portion of disorders of behaviour and personality, disturbances of social conditions and hereditary taint with psychic disorders. Especially oligophrenia of brothers and sisters and abuse of alcohol of the father, moreover a high effect of alcohol for the offences.


[Announcing of suicidal intentions in childhood and puberty]. This study reports experiences from the treatment of youngsters under 16 whose suicidal attempts were without fatal consequences concerning the advertisement of suicidal activities. The author points of the aspects in therapy and prophylaxis of suicidal acts among young people.


[Mother-child-relations from the anthropological point of view (author's transl)]. Some aspects of the ontogenetical process in the field of the mother-child-relations are discussed; the available answers to pertinent questions according to the actual level of knowledge are reviewed. The fact, that in torrid biotopes the increase of the body weight of the fetus towards the end of the fetal time is insignificant in proportion to comparison-values from the temporate zone is traced back predominantly to the effect of social factors (deficiencies in nourishment of the pregnant women). Also with regard to the regional and temporal differences in the conceptive frequency it is necessary for explanation to quote social factors besides climatic ones. Against the increasing radiant exposition of certain population groups objections are advanced in view of a potential damage to embryos and foetes. The teratogenetic effect of certain chemical factors and of the deficiency or shortage of nourishment of pregnant women are illustrated by means of examples. The problematic subject of the variability with age and gender of the colour of eyes and hair is delineated, the implementation of new comprehensive family inquiries is called for.


[Mother and child--interrelations seen by the anthropologist. Their importance in social work and public health (author's transl)]. Working groups in Prague are interested in two problems: First: Anthropology of motherhood; analysing somatic modification of the female body during and after pregnancy and the newborn as modified by biological and social circumstances influencing his mother. Some features of motherhood may have their roots in early phylogenetic events--this is a topic of "anthropology of motherhood" too. Secondly: Survey of growth and development of children and youth in the CSSR from ten to ten years (1951; 1961; 1971 and 1981, now prepared): Special problems within this anthropological task are: correlation of height of the children to parents height, correlation to education and profession of parents (especially of the mother). Author deals with some results of those special investigations.


[Working capacity and social adaptation in childhood and youth (author's transl)]. Some problems and results of investigation about physical and mental working capacity and social adaptation during childhood and youth are summarized out of literature of passed 20 years. Within those three, dialectically and mutually efficient parts of total human productivity social adaptability wins actually importance. Difficulties of social adaptation process are mostly reasoned by scientific and technical development and political change of life and work conditions. The author proposes to coordinate the numerous researches of various investigation groups in order to get adequate investigation methods and as a further result standards for infancy and youth capacities.


[On social adaptation in adolescence (author's transl)]. In adolescence problems of social adaptation are characterized by a particular urgency because the adolescent is taking on new social roles which involve various new social demands. A feature of maladaptation seems to be the reported growing number of ill apprentices who are absent of work. This work-absentism is seen in connection with research into social and psychosocial factors found to occur close in time to the onset of illness in man. By making use of the Social Readjustment Rating Scale (developed by Holmes and Rahe) the paper gives an impression how to measure juvenile social adaptation. The paper is finished with general recommendations to promote juvenile social adaptability.


[Some factors influencing performance at school of Czech children (author's transl)]. In the 1971 survey 29,682 boys and 30,464 girls in the Czech region of CSSR had been measured and investigated otherwise. The average of their school marks is taken as a measure of performance (success) at school. Interrelations between this value and the education resp. profession of the parents, number of inhabitants in their residence, number of siblings, laterality a. s. o. are analyzed. It seems, that children were as better successfull in the school, as better had been the education of their parents, and as fewer are their siblings. Concerning the quality of the school report, the activity of the mother is more important than the activity of the father.


Toward a dialogue in international consultancy in occupational therapy with Japan as a reference. The customs and cultural attitudes that determine occupational therapy practice cannot be transferred from one culture to another. However, the technology of occupational therapy can be transferred. The international consultant is responsible for such a technological transfer. The consultee is responsible for assimilating technology and creating a culturally appropriate treatment practice. Technological transfer in industry demonstrates that divergent cultural applications of the same technology are possible, that the autonomy of the consultee is of primary importance, and that government support of the consultation effort is crucial. Current practice and expectation in international occupational therapy consultation is examined. The author concludes that fluency in the language of the host country is a questionable expectation, and that short-term workshops by teams of therapists should supplement the traditional individual long-term consultancy. Japan is used as a reference for discussion.


Play diagnosis and play therapy.

Play diagnosis and play therapy. Play therapy used in a family psychiatric unit in England is described, together with an evaluation of its treatment value and its usefulness toward a diagnosis. Individual play techniques are explored, and two case histories are given as examples of how the occupational therapist works with the child, the family, and other practitioners.


Effects of the human dissection experience on subsequent related course work. This pilot study was conducted to determine whether or not it is necessary for an occupational therapy (OT) student to dissect a human cadaver in order to gain the knowledge of human anatomy required for subsequent course work in neuroanatomy, kinesiology, and occupational therapy theory and practice in physical dysfunction. Junior students were permitted to select either an anatomy course in which they dissected human cadavers or one in which prosected models were used. Similarity of the academic ability of students in each of the two groups was assured by comparing cumulative grade point averages at the end of the sophomore year. Final grades in neuroanatomy, kinesiology, and the OT course were used as criteria for comparing the effects of the two anatomy course formats. Results indicate that when students are permitted to select the anatomy class of their choice, there is no significant difference in grades in subsequent related course work.


Simultaneous determination of polar and non-polar solvents in air using a two-phase desorption from charcoal. A gas chromatographic procedure is described which is capable of measuring both polar and non-polar organic solvents present simultaneously in the work environment at concentrations between 1/100 and 1 times the Threshold Limit Values (TLV). Airborne organics are collected on a single activated charcoal tube for periods of 3 to 6 hours and desorbed with a two-phase (water/carbon disulfide) desorption mixture. Organic and aqueous phases are analyzed separately on the same gas chromatographic column packed with Oronite NIW on Carbopack B. Recoveries were determined for fifteen common solvents. Most recoveries were greater than 90% with all coefficients of variation being less than +/- 10%. Breakthrough was observed only when solvents were present at very high concentrations. Examples of field sampling are also presented. This procedure is generally applicable for monitoring complex mixtures of volatile organic compounds in air. Advantages include excellent recoveries for polar solvents such as acetone and ethanol, utilization of common analytical instrumentation under a single set of operating conditions and compatibility with TWA personnel monitoring methodology.


Phorate intoxication at an insecticide formulating plant. The use of phorate requires precautions similar to those taken with other organophosphate pesticides, as demonstrated by the case histories and environmental concentrations found in a formulating plant using phorate. Routine supply of personal protective equipment is not necessarily adequate to prevent poisoning.


Effects of separated flow on cotton dust sampling with a vertical elutriator. The vertical elutriator used for cotton dust sampling was examined theoretically and experimentally to determine airflow patterns and particle transport. The theory of diverging channel flow predicts that a separated eddying flow will occur in the elutriator. This calculation disagrees with the laminar flow assumptions used to predict the size sampling characteristic or cutoff of the elutriator. Smoke injection tests verified random local velocity components and clearly showed that the flow is not uniformly upward and laminar. Particle transport tests indicated that unit density spheres as large as 27 micron can reach the sample on the elutriator filter.


Calibration testing of the jet filter as a respirable sampler. This work was done to determine whether the jet filter can satisfactorily serve as a respirable sampler. Monodisperse polystyrene latex (PSL) spheres, crushed quartz particles, and hot-mix asphalt plant dust were used to calibrate the jet filter. The deposition characteristics for the sampler matched those specified by standards quite well for the PSL and the crushed quartz particles, i.e., those particles with optical and equivalent aerodynamic diameters near the same. The jet filter can meet its original design purpose - respirable sampling of radioactive aerosols. The sampler can also be used in gravimetric determinations by cutting the filter into two parts for weighing - the center portion with the non-respirable and the outer annulus with the respirable fraction.


Gaseous hydrogen sulfide determination by discoloration of lead-stabilized PVC. The discoloration of lead-stabilized PVC resulting from its interaction with H2S gas has been investigated as a potential H2S measurement technique. Color measurements of PVC samples exposed to controlled concentrations of H2S over a range of humidities and temperatures demonstrate that toxic H2S concentrations can be detected in less than five minutes. The technique is thus appropriate for industrial applications such as the pretesting of manhole atmospheres prior to entry. Exposure times of several hours are sufficient to detect the much lower H2S concentrations that may be present ambient air; for example, 15 hour exposures are needed for 10 +/- 3 ppb H2S, a level typical of certain oil field, swamp, and sewage treatment areas. The technique is inexpensive and can be performed by unskilled personnel.


Noise control enclosures for industrial equipment. This paper describes techniques used to fabricate enclosures for reducing employee exposure to noise while attaining little or no operational hindrance. The noise enclosures discussed and shown include screw machines, scrap plastic regrinders and their related pneumatic conveying system, as well as high speed presses while having full view of their operation. Engineering design data and noise attenuation results are evaluated.


Air sampling and analytical procedures for benzidine, 3,3'-dichlorobenzidine and their salts. The purpose of the study was the development of new air-sampling and analytical procedures for benzidine, 3,3'-dichlorobenzidine and their salts. Air is drawn through a glass-fiber filter followed by a bed of silica gel to collect these substances as either particles or vapors. The compounds are extracted from the sampler and analyzed by HPLC with sensitivities in the range of 3 micrograms/m3 for 48-L air samples. The methods were evaluated in the laboratory with test aerosol atomospheres and found to be unaffected by temperature or humidity of the sampled environment. Tests of precision, sample stability and separation from interferants indicate that the method should provide reliable results for personal monitoring procedures.


A new method for in-place testing of tandem HEPA filter installations. A new in-place high-efficiency particulate air (HEPA) filter testing procedure has been developed, based on the use of an intracavity laser particle spectrometer for ultrasensitive detection of challenge particulate concentrations downstream of tandem HEPA filter installations. The feasibility of these measurements had initially been demonstrated on a small-scale laboratory system where overall protection factors of 10(9) were routinely measured. The primary scaling problem for systems up to 20 000 CFM was in producing sufficient challenge aerosol. This was accomplished by the design and construction of a high-volume thermal dioctyl phthalate generator. The results of acceptance testing of 13 tandem HEPA filter systems, performed with both the spectrometer technique and conventional light-scattering photometry, are displayed and problem areas discussed.


Three-month inhalation exposure study with methane sulfonylfluoride. The effects of exposure to methane sulfonylfluoride at concentrations of 20 or 100 ppb for a total of 61 exposures of 7 hours each were studied in male and female rats. The control and exposed groups did not differ in appearance, behavior, weight gain or food consumption. There was no effect on plasma cholinesterase. RBC cholinesterase was significantly depressed in the high-level male and female exposure groups. There was no significant accumulation of fluoride in either the liver or blood at either exposure level.


Embryotoxicity of inhaled benzene in mice and rabbits. The effect of inhaled benzene on embryonal and fetal development was assessed in mice and rabbits. CF-1 mice and New Zealand white rabbits were exposed to 0 or 500 ppm of benzene for 7 hr per day from days 6 through 15 (mice) and 6 through 18 (rabbits) of gestation. Little evidence of maternal toxicity was seen in either species. Although some signs of embryonal toxicity were observed in both mice and rabbits, a teratogenic effect was not discerned in either species inhaling 500 ppm of benzene.


Effect of random airway sizes on aerosol deposition. A previously developed deposition model is used to determine the total and regional deposition of inhaled aerosols in a population of human lungs by taking into account variability in airway dimensions. The results for particle sizes ranging from 0.1 micron to 8 micron aerodynamic diameter agree favorably with experimental data, thus suggesting that observed intersubject deposition variability is caused primarily by difference in airway dimensions.


Glycoprotein synthesis in the mucous cells of the vascularly perfused rat stomach. I. Surface mucous cells. We developed a constant-pressure vascular perfusion system of the isolated rat stomach, utilizing an artificial, fluorocarbon (FC-75)-containing medium. Perfusion could be maintained for at least six hours, as demonstrated by the ultrastructure of the mucosal cells and by the constant incorporation of [3H]-galactose in the surface mucous cells. Moreover all mucous cell types in tissue fixed after six hours of perfusion showed the same histochemical reactions for glycoproteins as in tissue fixed shortly after decapitation of the animal. The surface mucous cells of the antrum incorporated 30% less [3H]-galactose, [3H]-serine and [35S]-sulphate than those of the fundus. The amount of radioactivity incorporated per cell did not decrease during a subsequent 2 hour chase.


Glycoprotein synthesis in the mucous cells of the vascularly perfused rat stomach. II. Differentiating mucous cells. Labeled leucine, serine, galactose, glucosamine and sulphate were administered to rat stomachs in a perfusion system. Sections of the gastric fundus were studied by light microscopic autoradiography. Five categories of mucous cells were distinguished and their glycoprotein synthetic activity was measured in autoradiographs by counting silver grains over each category. During their differentiation, while migrating from the isthmus of the fundic glands to the free luminal surface, the surface mucous cells (SMC) showed an increase in incorporation of all precursors used. Differences between the incorporation patterns of the various precursors, in cells of different ages, suggest that structural development runs ahead of functional activity, and that the latter continues up to the very moment the cell is shed from the surface. Sulphate was incorporated at a considerably lower rate by the SMC of the free surface than by the foveolar SMC, in which by cytochemical staining strongly acidic glycoproteins were shown. Since the mucous neck cells incorporated all precursors at a low rate, these cells apparently do not play an important role in gastric mucus synthesis. They did not incorporate sulphate, which is consistent with histochemical observations.


Effects of colchicine on the morphology and prolactin secretion of rat anterior pituitary cells in monolayer culture. The effects of incubation of rat anterior pituitary cells in monolayer culture with 10(-6) M colchicine have been investigated during time-intervals extending from 1 to 96 hours. Prolactin release, as measured by radioimmunoassay, was rapidly inhibited by colchicine, this inhibition being accompanied by increased cellular prolactin content for up to 24 hours of treatment and followed by decreased values of cellular prolactin concentration at later time-intervals. Immunocytochemical localization showed an increased positive reaction for prolactin up to 24 hours after colchicine treatment, whereas transmission electron microscopy demonstrated, in parallel, an increased number of intracellular prolactin secretory granules during the same interval. Longer periods of treatment (24-96 hours) resulted in the appearance of more lysosomes, autophagic vacuoles and microfilaments in the cells, whereas the number of Golgi elements was decreased. Following four hours of colchicine treatment and at later stages, microtubules could no longer be observed in the sections. Scanning electron microscopic data showed that colchicine treatment induced dramatic changes in the cell surface morphology: at short time intervals (4 and 8 hours), the number of microvilli decreased and the cell surface became folded, whereas, later, "bleb"-like protrusions of variable dimensions partially covered the cell surface and seemed to be released from it. These data show a good correlation between secretory activity of prolactin-producing cells and morphological changes induced by colchicine treatment.


Morphology of the epithelium of the extratesticular rete testis, ductuli efferentes and ductus epididymidis of the adult male rabbit. The fine structure of the epithelium lining the extratesticular rete testis, ductuli efferentes and ductus epididymidis of the rabbit has been investigated. In the ductuli efferentes the epithelium is composed of two cell types, principal cells and ciliated cells. The latter type is distinguished from principal cells by the presence of cilia projecting into the lumen and the position of the nucleus in the apical half of the cell. Principal cells in this segment are characterized by micropinocytotic vesicles on the surface plasma membrane and a variety of small dense bodies scattered throughout the cytoplasm. In the ductus epididymidis basal cells replace ciliated cells as the second cell type, but differences between various segments of the epididymis are related to the fine structure of the principal cells. In the proximal caput epididymidis (Nicander's region 1) the principal cells are tall with long microvilli. They typically contain a small Golgi apparatus and a cluster of dense bodies adjacent to the nucleus. In the distal caput epididymidis (Nicander's regions 2-5) the apical cytoplasm of principal cells is filled with numerous micropinocytotic vesicles and large multivesicular bodies; these features are interpreted as signs of absorptive activity. The multivesicular bodies are absent from the cytoplasm of principal cells in the corpus epididymidis (Nicander's region 6) and, instead, numerous elements of smooth endoplasmic reticulum, a large Golgi apparatus, lipid droplets and dense bodies characterize principal cells in this segment. Towards the proximal cauda epididymidis (Nicander's region 7), the number of dense bodies (lysosomes) in the cytoplasm increases considerably. In the globose cauda (Nicander's region 8), the principal cells are reduced in height, and in addition to the features described in region 7, are characterized by a concentric array of rough endoplasmic reticulum in the basal cytoplasm. These observations are discussed in relation to the role of the epididymis in promoting the maturation and survival of spermatozoa.


Morphogenetic reaggregation and luteinization of mouse preantral follicle cells. Small (60-90 micrometer) and large (100-130 micrometer) preantral follicles were isolated from adult mouse ovaries by a collagenase-dissection technique. These follicles were composed of resting oocytes surrounded either by granulosa cells, only, or by granulosa and undifferentiated theca cells. Further enzymatic dissociation of primary follicles yielded monodisperse cells characterized by abundant rough endoplasmic reticulum, microfilament-rich pseudopodia and only scant lipid droplets. These cells reaggregated, when explanted in stationary culture, forming epithelial cords and structures macroscopically reminiscent of native ovarian follicles. Anticipated association of follicular cells in epithelial-like monolayers was rare (less than or equal to 10% of all cultured cells). Formation and growth of both follicle-like (FLS) and cord-like (CLS) structures occurred within 24 hours of culture, continued for 14 days, and was inhibited by cytochalasin B, but not by neuraminidase. FLS and CLS, as well as cell monolayers, underwent luteinization, as indicated by the presence in the culture medium of radioimmunoassayable progesterone and by frequent cytological features suggestive of active steroidogenesis. The present report indicates that (a) specific cell affinities exist among immature follicular cells which may play a role in folliculogenesis; and (b) follicular cells are endowed, from their early developmental stages with intrinsic steroidogenic capabilities which become phenotypically expressed after escape from the intraovarian environment.


Endoscopic papillotomy: sphincterotomy or sphincteroplasty. An ongoing series of patients who were treated with endoscopic papillotomy (EPT) for retained or recurrent common bile duct gallstones or papillary stenosis was analyzed for safety and efficacy of the procedure and compared with accepted surgical technics, sphincterotomy and sphincteroplasty. To date, endoscopic papillotomy was attempted in 77 patients and successful in 71 (92%). The mean hospital stay is 3.1 days (range one to 12 days), convalescence has been short and morbidity has been low. One death has occurred in the series and no patients have been subjected to surgical intervention. Evaluation of the results achieved after papillotomy were compared with surgical technics and revealed that a sphincteroplasty was achieved in 68% of the patients and sphincterotomy in 32%. The results of EPT, therefore, have been extremely encouraging establishing EPT as a first line treatment modality for common bile duct stones and papillary stenosis. As, however, EPT is the only endoscopic procedure with predictable morbidity and mortality, it should be performed by skilled, experienced endoscopists in centers with cooperating surgeons so that it will remain an accepted modality in the treatment of biliary tract disorders.


Causes of obstruction of prosthetic esophageal tubes and their prevention: a case report and review of the literature. A case of Celestin tube obstruction in a 57-year old patient is presented. Obstruction in this case was secondary to three mechanisms: distal mucosal prolapse, intraluminal suture web and food impaction. Prosthetic intraesophageal devices are subject to a number of complications, obstruction being the most frequent. A review of various types of prosthetic tube obstruction are given with emphasis on food impaction. Correct technic on tube insertion and dietary guidance are the best means of insuring tube patency. Guidelines for treating food impaction before endoscopic retrieval are suggested. Papain solution should be taken orally, first. If this is unsuccessful, nasogastric suction over the obstruction and local instillation of papain solution should be the next step. Finally, endoscopic confirmation of the obstruction is performed followed by gentle pulsion on the obstructing particle with a flexible cytology brush.


Effect of prostaglandin E2 and 15(R)15 methyl prostaglandin E2 on canine gastric parietal cell: an ultrastructural study. The effect of prostaglandin E2 (PGE2) and 15(R)15 methyl prostaglindin E2 (15(R)15 PGE2) on the gastric parietal cell was studied in seven and eight dogs, respectively. Another four dogs were used as controls. Gastric biopsies were examined by the electron microscope and the secretory activity of the parietal cells was assessed by morphometrically estimating the proportion of the parietal cell cytoplasm occupied by tubulovesicles as well as the ratio of extramitochondrial cytoplasm:mitochondria. Both 15(R)15 PGE2 and PGE2 increased the latter one hour after administration but only 15(R)15 PGE2 increased the proportion of tubulovesicles. The data suggest that secretory activity of parietal cells is impaired, especially after treatment with 15(R)15 GE2.


Effects of ibuprofen, tolmetin and placebo on the gastric mucosa of aspirin-sensitive volunteers. Patients who have demonstrated a gastric mucosal sensitivity to aspirin often react to other nonsteroidal, anti-inflammatory drugs to a similar or lesser degree. In a single-blind crossover study, five healthy volunteers who had previously developed erosive gastritis secondary to one week of aspirin therapy were randomly assigned to seven-day courses of treatment with ibuprofen, tolmetin and placebo. Treatment schedules were separated by washout periods to eliminate residual drug effects. Ibuprofen produced less gastric mucosal injury than tolmetin and, over all, appeared to be better tolerated. It was also noted that clinical symptoms often do not reflect the severity of gastroscopic findings, which may explain silent hemorrhaging in patients treated with agents of this type.


Chronic active hepatitis with cholestatic features. I. A clinical and immunological study. Twelve of 43 patients with chronic active hepatitis (CAH) (28%) manifested clinical and laboratory features of cholestasis. The criteria for selection of these patients included at least two of the following: chronic or recurrent pruritus, serum alkaline phosphatase levels of 300 mU./ml. and cholesterol of 300 mg./dl. or more. When compared with 31 control cases these patients were found to have a preponderance of Ashkenazi Jews of Roumanian origin, a higher prevalence of joint and thyroid involvement and higher serum Ig-M Levels. Mortality was similar in both groups but patients with cholestatic features tended to die earlier in the course of the disease. Retrospectively, it was found that they had been treated more intensively, attained complete remissions less frequently and developed cirrhosis more readily. There were no significant differences in the frequency of HBsAg and anti-HBs, the mode of onset, the frequency of hepatosplenomegaly and jaundice, the hematologic findings and the prevalence of autoantibodies. Like acute cholangiolitic viral hepatitis, CAH with cholestatic features emerges as a more serious disease than the classical form of CAH.


Chronic active hepatitis with cholestatic features. II. A histopathological study. A review of 25 liver biopsies from 12 patients with chronic active hepatitis (CAH) with cholestatic features (Group 1) and of 30 biopsies from 23 patients without such features (Group 2) revealed that in Group 1 the bile duct epithelium showed significantly more hyperplasis, atypia, swelling, vacuolization and inflammation. When present in patients of Group 2, these parameters, in general seemed to be less severe. The number of bile ducts per portal space was similar in both groups. Thus, on a cumulative basis, a correlation was found between the clinical and biochemical features of cholestasis and the histological signs of bile duct damage.


Cecal perforation in alcoholic pancreatitis. A 51-YEar old male with alcoholic pancreatitis progressed to bowel inflammation and cecal perforation. Colonic complications of pancreatitis include fistula, stenosis, necrosis and perforation. The pathogenesis of these entities is discussed and the literature regarding colonic complications is reviewed. Although it is uncommon, bowel involvement in pancreatitis is potentially lethal and may necessitate surgery in an otherwise medically managed illness.


Squamous cell carcinoma of the ascending colon. A right-sided colon lesion appearing as a typical adenocarcinoma was biopsied and revealed squamous cell carcinoma. The etiologic possibilities include metastatic disease to the gastrointestinal tract (most likely from the lung in this case) and the very uncommon primary squamous cell carcinoma of the colon. The described features of both lesions are reviewed.


Effects of acute and chronic pancreatitis on the stomach patterns of radiographic involvement. The radiographic gastric changes associated with acute and chronic pancreatitis are described. The pertinent literature is reviewed and forms of involvement previously not reported are illustrated and discussed. Intramural and perigastric permeation of extravasated pancreatic enzymes and the secondary inflammatory reaction that follows are responsible for the radiographic changes observed. Generalized rugal thickening and particularly a localized spiculated appearance to the posterior wall of the stomach are transitory findings seen in acute pancreatitis. Radiographic abnormalities associated with chronic pancreatitis include patterns mimicking linitis plastica, indurated and nondistensible rugae involving the proximal stomach and a severely distorted gastric configuration induced by perigastric adhesions. The recognition of these patterns of involvement helps in the radiographic diagnosis and avoids confusing or evasive interpretations.


Quantitative evaluation of antibody-dependent lymphocyte-mediated lysis of human red cells. The ability of lymphocytes to lyse human red cells coated with anti-D antibody was assessed by measuring 51 Cr release from labeled red cells incubated with peripheral blood leukocyte suspensions from 12 normal donors. Mixed mononuclear cell suspensions (containing monocytes and lymphocytes) from all donors produced lysis of sensitized red cells. Treatment with carbonyl iron reduced monocyte concentration to less than 1.2% in all donors, as measured by morphologic criteria, esterase staining and ingestion of latex particles. Lysis of red cells following monocyte depletion was markedly reduced in 8 of the 12 donors. Despite depletion of monocytes, unchanged or increased lysis was noticed with the leukocytes of the remaining 4 donors. This lysis was due to lymphocytes, not to residual monocytes. If target red cells were treated with papain or trypsin prior to sensitization, marked lysis occurred with lymphocytes of all donors, including those which did not lyse unmodified red cells. Direct cytolysis of sensitized red cells during contact with small lymphocytes was recorded using microcinematography, which confirmed the role of lymphocytes in mediating lysis. Lymphocyte-mediated lysis of red cells increased with mounting levels of antibody sensitization regardless to prior treatment with papain. Papain increased antibody coating per red cell, yet lysis per molecule of antibody bound was also increased. Lysis was inhibited by IgG1 and IgG3 in the fluid phase but not by IgG2 or IgG4. At an equivalent level of antibody sensitization lysis was augmented by concurrent coating of the red cells with C3b, C3d and/or C4b, though these components could not produce lysis in the absence of antibody coating.


Antisickling agents: effects of carbamyl phosphate or cyanate on survival, erythrocytes, and leucocytes in the mouse. Equal mole doses of the anions of disodium carbamyl phosphate (carbamyl P) or sodium cyanate, antisickling agents, have been compared in C57B1 mice. Using 15 mice per group, two groups were given the equivalent ip dose of carbamyl P or cyanate anion (7 mmoles/kg/day) in a divided dose, in the morning and six hours later, for 17--18 days. The control group received sodium chloride (13.8 mmoles of Na+ or Cl-/kg/day). Surviving mice per group were sodium chloride, 15/15; disodium carbamyl P, 14/15; and sodium cyanate, 0/15, all mice died by day 2. Surviving mice appeared normal throughout the study, and no abnormalities were seen at necropsy. The hematologic measurements were the same for sodium chloride or disodium carbamyl P, including hemoglobin, packed cell volume, erythrocyte counts, leucocyte counts, and differential counts. The mean hemoglobin carbamylation was 1.24 (+/- 0.06 SE) moles of valine hydantoin/mole of hemoglobin tetramer in mice receiving disodium carbamyl P for 18 days, sufficient for antisickling activity. The enzymatic degradation of carbamyl P to NH3, CO2, and Pi was measured in serial blood samples in additional C57B1 and DBA/2J mice following ip injections of carbamyl P or cyanate. Both NH3 and Pi increased immediately after giving carbamyl P, but no increase occurred after cyanate administration. Thus enzymatic degradation of carbamyl P occurs in vivo and appears to be an important detoxification mechanism. When equivalent mole doses of anion are administered, disodium carbamyl P is less toxic than sodium cyanate in mice.


Three new variants of glucose-6-phosphate dehydrogenase associated with chronic nonspherocytic hemolytic anemia: G-6-PD Lincoln Park, G-6-PD Arlington Heights, and G-6-PD West Town. Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency was identified in three children who were evaluated because of chronic nonspherocytic hemolytic anemia. One child is of German extraction, another Puerto Rican, and the third Mexican. In each of the patients the hemolytic process was well compensated, but each had one or more episodes of anemia following exposure to an oxidant drug or with infections. The electrophoretic, functional, and kinetic properties of the mutant enzymes, derived both from the patients' erythrocytes and from cultured fibroblasts, allowed each to be distinguished from G-6-PD variants previously described.


Specification of the directionality of the Stiles-Crawford function. An index to specify the directionality (spread) of Stiles-Crawford function and related retinal photoreceptor directional sensitivity data is proposed. This index, termed the half-sensitivity half-width (or angle) is the displacement in the pupil (or the change of angle of incidence at the retina) which results in a reduction of sensitivity to one-half that at the function maximum (0.3 log unit decrease). The half-sensitivity half-width or angle, unlike other currently used indices of retinal directionality, can be assessed empirically and is not intrinsically dependent upon curve-fitting assumptions or procedures.


Eikonic lens design for minus prescriptions. Designing size lenses for aniseikonia correction usually involves considering only the shape factor of the total spectacle magnification. However, for minus prescriptions, an increase in the shape magnification of a lens does not always result in total lens magnification. As the front curve of a lens is steepened (which increases the shape magnification), the sagittal depth of the lens is increased, which effectively increases the vertex distance. For a minus lens, an increased vertex distance means decreased power magnification; depending upon the lens power, the decrease in power magnification can totally offset the increase in shape magnification. The shape factor-power factor relationship of high minus size lenses is presented, along with general guidelines for proper design of size lenses.


Absolute stereoscopic thresholds as measured by crossed and uncrossed disparities. Stereoscopic tests of 30 subjects by means of diastereo instruments showed a lower threshold for crossed disparities than for uncrossed disparities. These findings support Richards' conclusion that crossed and uncrossed disparity limits are the result of two different mechanisms.


Continuous wearing of Duragel contact lenses by Swedish air force pilots. This is a report of the application of contact lenses for prolonged wear by military pilots. The safety and effectiveness of wearing these non-HEMA hydrophilic lenses in a highly demanding visual environment is described in the case of an individual jet-fighter pilot who has worn these lenses continuously for 3 years without any complications.


Fundus photography in optometric practice. Fundus photography, an established facet of institutional clinic and hospital ocular care, is emerging as a valuable tool for the private practitioner. Ocular photography permits improved patient care with the additional benefit of providing a means for continuing education for the practitioner. The initial investment depends on the type of fundus camera selected and the number of accessories included in the purchase. The type of camera and accessories selected by a practitioner will vary with the mode and scrope of his/her practice. Numerous types of film are available, but Kodachrome 25 (ASA 25) is recommended. The experienced fundus photographer develops a routine of camera preparation and photographic techniques that provides a consistently successful photographic session.


Skeletal maturity in Danish schoolchildren assessed by the TW2 method. Skeletal maturity was assessed from hand-wrist radiographs in a sample of 3,817 Danish schoolchildren aged 7 to 18 years using the new version of the bone-specific Tanner-Whitehouse scoring system, the TW2 method. In most of the age groups in both sexes the distributions of the bone maturity scores displayed marked departures from normality; percentiles for the scores were therefore counted from the raw data. On the average, over the total age range, the differences between the age equivalents (bone ages) for the fiftieth percentile and chronological age were close to zero in both sexes, indicating good agreement with the British standards. However, in the individual age groups, and in particular at adolescence, characteristic divergences from the standards occurred, apparently reflecting the developmental spurt.


Percentage ash content of nonhuman primate long limb bones. Trotter and Hixon ('76) and Vose and Roach ('72) presented conflicting data about percentage ash content of the long limb bones of M. mulatta and M. nemestrina. The suggestion of Trotter and Hixon ('76) that this discrepancy was due to methods of preparing the bone prior to ashing, rather than to species differences, was tested using data collected by Gong ('72) on the volumetric composition of nonhuman primate bone. Masses of the various chemical fractions of bone reported by Gong ('72) were used to compute ash content as a percentage of total dry weight and ash content as a percentage of fat-free dry weight. Good agreement was found between ash content as a percentage of total dry weight and the data of Vose and Roach ('72); good agreement was also found between ash content as a percentage of fat-free dry weight and the data of Trotter and Hixon ('76). This suggests that the data of Vose and Roach ('72) conflict with those of Trotter and Hixon ('76) because Vose and Roach ('72) failed to defat the bones prior to ashing. No actual species differences exist in the ash content of bones of M. mulatta and M. nemestrina. The data of Trotter and Hixon ('76) are most likely a more adequate reflection of both the magnitude and the regional similarity of ash content in nonhuman primate bone.


Lung function in highlander Bods of Ladakh. A cross-sectional sample of 221 male Bods, 11 to 19 years, from Leh, Ladakh, was studied to determine some biological responses to the environment. The higher forced vital capacity and increased association between chest measurements and respiratory function as well as increased chest dimensions of the Bods resemble the findings on highland Peruvians. These differences from lowland Bods and Indians may partially be attributable to low oxygen pressure in higher areas. However, the contributing effect of factors, viz. varying activity levels and genetics, cannot be dismissed.


Absence of triradius d in a three-generation pedigree and other variations of main-line D. An example is reported of a rare dermatoglyphic variant (absence of triradius d) in a woman of mixed European and Cherokee American Indian ancestry. This variant was not present in her parents, her five siblings, four nephews or one niece. Attention is drawn to the continuum from an absent triradius d to a triradius with an abbreviated main-line associated with either an open field in interdigital area IV, or a loop in interdigital area IV or a tented arch at d. This same continuum occurs at c. The absent triradius at d is extremely rare and the tented arch at d is very rare.


Trends and developments in physical anthropology, 1978-1979. Members of the American Association of Physical Anthropologists were asked to supply information about their current programs and their own graduate training in order to compile a training directory and to analyze certain aspects of the discipline. The data indicate that the majority consider their graduate training to have been deficient, mainly in statistics, genetics, chemistry, physiology, and mathematics. The areas though most important for future research in physical anthropology include fields such a genetics, anatomy, ecology, physiology, and paleontology, although a great many individuals are engaged in teaching and research in other areas. A brief analysis of relative growth in the field over the last few decades indicates a serious imbalance between the number of new Ph.D.'s and available employment opportunities.


The depth of the lingual fossa in permanent maxillary incisors of Norwegian Lapps. The depth of the lingual fossa in permanent maxillary incisors of three groups of Norwegian Lapps was measured. No statistically significant sex differences or group differences were found. The assembled weighted estimates for lingual fossa depth of three groups of Norwegian Lapps were for I1 sup: 0.44 mm and I2 sup: 0.30 mm. Mean lingual fossa depths in Norwegian Lapps clearly fall within the Caucasoid range.


Experimental analysis of temporomandibular joint reaction force in macaques. Mandibular bone strain in the region immediately below the temporomandibular ligament was analyzed in adult and sub-adult Macaca fascicularis and Macaca mulatta. Following recovery from the general anesthetic, the monkeys were presented food objects, a wooden rod, or a specially designed bite-force transducer. Bone strain was recorded during incisal biting and mastication of food, and also during isometric biting of the rod and/or the transducer. The bone strain data suggest the following: The macaque TMJ is loaded by a compressive reaction force during the power stroke of mastication and incision of food, and during isometric molar and incisor biting. TMJ reaction forces are larger on the contralateral side during both mastication and isometric molar biting. Patterns of ipsilateral TMJ reaction force in macaques during isometric biting vary markedly in response to the position of the bite point. During biting along the premolars or first two molars a compressive reaction force acts about the ipsilateral TMJ; however, when the bite point is positioned along the M3, the ipsilateral TMJ has either very little compressive stress, no stress, or it is loaded in tension.


Context change and the role of meaning in word recognition. Two experiments were conducted in which the central variable was the addition of verbal context on the test which was not present during study. Neither study showed context to be a relevant variable. Because verbal context effects (when they do occur) are presumed to result from a change of meaning, the broader role of word meaning in recognition was examined. Studies in which homographs were used to produce a change in meaning were reviewed with the conclusion that when appropriate controls are used the effects are too small to support meaning as a major factor underlying recognition. An experiment using homographs verified the general conclusion from previous studies. A review of studies was then undertaken to determine the influence of synonym distractors on recognition scores. If word meaning is critical in word recognition, the use of synonyms of study words as new words on the recognition test should produce large decrements. The evidence available did not support this expectation, and an experiment using both within-subject and between-subject comparisons showed at best only small effects. The general conclusion was that theories of recognition in which word meaning plays a dominant role cannot be supported. It is likely that word meaning is encoded during study of lists of words but is infrequently used in making recognition decisions.


The effect of food and water deprivation and satiation on recognition. Food and water deprived and satiated subjects, as well as control subjects, were shown words presented tachistoscopically for .01 sec until word recognition. Five food-relevant, five water-relevant, and five neutral (animal) words of high string frequency were matched for letter confusability and letter predictability. Analyses of the data, in terms of number of presentations until recognition as well as number of words recognized at selected presentations, revealed that the amount but not the type of deprivation significantly altered word recognition. Moreover, the effect of motivation was significant already on the first slide presentation, while the effects of word characteristics (word category and generated value) occurred only after a number of presentations.


Memory for symmetry: real or artifact.

Memory for symmetry: real or artifact. Subjects recalled nonrandom digit sequences according to either (a) free recall or (b) a serial recall mode in a series of three studies. Sequential structure was varied with specific rules determining higher-order structure of either (a) arithmetic, (b) symmetrical, or (c) haphazard types. In Experiment I, 18 temporal patterns of 12 digits each were presented visually. Although symmetric patterns were easier than the other two pattern types, this superiority was not determined by recall mode. In Experiment II, 6 temporal patterns of 18 digits each were presented visually, with results similar to those of Experiment I. Auditory patterns equivalent to those of Experiment II were presented in Experiment III. In this study, although the free recall mode produced slightly superior recall with symmetrical sequences, this difference was not statistically significant. It was concluded that superior memory for symmetries cannot be wholly accounted for by organizational strategies made possible by a free recall mode.


Hypnotic susceptibility and the perception of afterimages and dot stimuli. Three experiments were conducted to determine the relationship between hypnotic susceptibility level and the susceptibility to several perceptual phenomena. Experiment I required subjects to observe an induced afterimage in a light-proofed environment and to report the frequency of direction and color changes. In addition, subjects reported the persistence of the afterimage. Experiment II involved the observation of a black dot against a white background, with frequency of observed movement being the dependent measure. Experiment III was similar to the second experiment except that the stimulus was encompassed by a frame. In Experiments I and II, subjects judged high in hypnotic susceptibility reported perceiving the strongest effect. This phenomenon was virtually eliminated in the third experiment. These results were interpreted as supporting a process whereby subjects judged high in hypnotic susceptibility are better able to selectively attend to relevant cues in a stimulus array during conditions of perceptual impoverishment.


Temporal parameters of the feature positive effect. Trial duration and intertrial interval duration were parametrically varied between groups of pigeons exposed to a discrimination involving the presence vs. the absence of  a dot. Half the groups received the dot as the positive stimulus (feature positive groups) and half the groups received the dot as the negative stimulus (feature negative groups). Faster learning by the feature positive birds (feature positive effect) was found when the trial duration was short (5 sec) regardless of whether the intertrial interval was short (5 sec) or long (30 sec). No evidence for a feature positive effect was found when the trial duration was long (30 sec) regardless of the length of the intertrial interval (30 sec or 180 sec). The results suggest that short trial duration is a necessary condition for the occurrence of the feature positive effect, and neither intertrial interval nor trial duration/intertrial interval ratio are important for its occurrence. The suggestion that mechanisms underlying the feature positive effect and autoshaping might be similar was not supported by the present experiment since the trial duration/intertrial interval ration parameter appears to play an important role in autoshaping but not the feature positive effect.


Proteinaceous lymphadenopathy with hypergammaglobulinemia. Three cases of a morphologically distinctive "sclerosis" of lymph nodes are presented. Two patients experienced recurring lymph node enlargement with associated mild malaise over an extended period. The first patient had unilateral axillary lymph node enlargement, but was asymptomatic and died of chronic obstructive pulmonary disease 17 years later with no evidence of lymph node enlargement at autopsy. Each patient had at least transient hypergammaglobulinemia, one with elevated IgM and IgA, one with elevated IgM, and one (from 1958) not further analyzed. Lymph node biopsies revealed extensive deposition of eosinophilic material in all three patients. Identical changes in lymph nodes have been described in chronic diseases. The eosinophilic material may be related to amyloid, but differs from it histochemically and ultrastructurally. The relationship of this lesion to the few cases reported as amyloidosis presenting as lymph node enlargement is discussed. Malignant lymphoma with sclerosis is the most important consideration in the differential diagnosis.


The juxtaoral organ of Chievitz.

The juxtaoral organ of Chievitz. Juxtaroral organs were found in 14 of 25 consecutive autopsies in adults who did not have carcinoma or other lesions of the oral mucosa. Nearly all of the epithelium was squamous-like, but an occasional lumen was present, lined with cuboidal cells. Small nerves were intimately associated with the epithelial component. Awareness of this normal structure may be crucial in preventing unnecessarily extensive surgery should it be misinterpreted as perineural invasion by carcinoma.


Leiomyoma of the nipple.

Leiomyoma of the nipple. Three patients with leiomyoma of the nipple are described. The tumors all appeared to have arisen from the muscularis mamillae and aerolae. One lesion recurred 9 years after incomplete excision. Two of the tumors were clinically apparent painful nodules while the third was an asymptomatic, incidental microscopic finding in a mastectomy performed for carcinoma. As in these cases and others described in the literature, patients with leiomyoma of the nipple or areola often present with a painful, ill-defined mass. Complete excision is indicated to prevent recurrence.


Extraskeletal Ewing's sarcoma. Histologic and ultrastructural observations in three cases. The histologic and ultrastructural morphology of three cases of Ewing's sarcoma of soft tissue are described and the fine structural features of extraskeletal Ewing's sarcoma are compared to those of similar round-cell tumors that are considered in the differential diagnosis. By light microscopy, these tumors are indistinguishable from Ewing's sarcoma of bone. Ultrastructurally, the salient features are also comparable to Ewing's sarcoma of bone and include: 1) absence of surface modifications; 2) cell-contact sites in the form of small thickenings of apposed membranes and large desmosome-like specializations; 3) undifferentiated cytoplasm usually containing abundant glycogen and occasionally nonspecific microfilaments; 4) significant variation in shape and irregularity of nuclear profiles. The ultrastructural features of extraskeletal Ewing's sarcoma are sufficiently distinctive to allow separation from from other small-cell malignant neoplasms in the majority of cases.


Gastric carcinoid and gastric carcinoma. Morphologic correlates of survival. The clinical and histologic material of 140 patients with gastric carcinoma resected more than 5 years previously was examined and 10 tumors with a previous diagnosis of adenocarcinoma showed atypical carcinoid differentiation. The clinical extent of tumors in this carcinoid group was similar to that of the ordinary gastric adenocarcinoma. The 5-year survival was 15% in patients with adenocarcinoma and 70% in those with carcinoid (P less than 0.01 by chi 2 test). These findings indicate the need to distinguish atypical carcinoids from ordinary gastric adenocarcinoma. The most commonly encountered histologic feature suggesting carcinoid, and leading to confirmatory histochemical studies, was found to be regular interlacing trabeculae of tumor and fibrovascular stroma.


Müllerian adenosarcoma of the uterus. Clinicopathologic report of five cases. The clinicopathologic features of five cases of müllerian adenosarcoma of the uterus are presented and are compared with those of previously reported cases. Four tumors were localized in the endometrium; in one case, a cervical or endometrial origin was not clear. The ages of the patients ranged from 53 to 79 years. Two died without clinical evidence of recurrence 19 and 18 years after hysterectomy. One was alive and well 10 years postoperatively and one was lost to follow-up 6 months after therapy. In one case, a first abdominal recurrence was resected 5 years and 9 months after hysterectomy; the patient died of a second abdominal recurrence 18 months later. The tumors were bulky polypoid masses producing metrorrhagia. Histologically, a sarcomatous component was intimately associated with benign epithelium of various müllerian types. The neoplasm was typically organized in papillary fronds and periglandular sarcomatous cuffs. Cystic glands were also a constant feature. Mitoses were generally fewer than 10 per 10 high-power fields, except in one case where they were 44 in a more malignant-appearing area. Adenosarcoma must be differentiated from other müllerian tumors, mainly carcinosarcoma whose prognosis is much less favorable.


Studies on end-stage kidneys. V. Unusual epithelial activity or remarkable endothelial metaplasia. Findings in a dialyzed kidney. Tubule-like cells were found lining an artery and several arterioles and within the capillaries of infarcted glomeruli in one block of kidney from one of 54 cases of end-stage/dialysis kidneys. Three other blocks showed tubule-like structures within infarcted glomeruli and adjacent arterioles. Squamous metaplasia of remaining tubule epithelium was found in sections from four blocks of the same kidney. In two of these blocks, infarcted glomeruli had capillaries which were occupied by squamous cells. These findings are discussed as examples of metaplasia of the endothelium or alternatively as epithelial growth and invasion. The use of special stains and multiple blocks for this study seem to have been justified. These changes offer further evidence that the end-stage kidney after dialysis has unique alterations.


Thymoma. A clinicopathologic study of 54 cases. In 54 patients with thymoma, the factors having the greatest bearing on prognosis were presence or absence of gross tumor invasion or an associated clinical syndrome of myasthenia gravis, anemia due to erythrocytic hypoplasia or hypogammaglobulinemia. Of 17 patients with invasive tumors, 14 were either dead of tumor or living with disease, while 34 of 37 patients with encapsulated tumors were either living or dead of other causes without evidence of neoplasm. A clinical syndrome associated with thymoma was present in 15 patients. Thymectomy appeared to have little if any effect on the syndrome; in three instances the syndrome appeared after removal of the thymoma. Analysis of the histological findings, including type of epithelium, degree of lymphocytic infiltration and presence of other patterns such as rosettes, perivascular spaces and germinal centers, showed that there was no consistent relationship between the microscopic appearance of thymomas and their clinical behavior. Knowledge of the striking variations in histopathologic features is necessary in differential diagnosis.


Primary leiomyosarcoma of the aorta.

Primary leiomyosarcoma of the aorta. A case of primary leiomyosarcoma of the abdominal aorta is reported. The tumor replaced the full thickness of the aortic wall with formation of a large saccular aortic aneurysm filled with an admixture of tumor and mural thrombus. Electron microscopy of the surgical biopsy of the tumor revealed neoplastic smooth muscle cells with myofilaments and a discontinuous basal lamina. To our knowledge, leiomyosarcoma of the aorta has never been reported.


Does malignant hibernoma exist?

Does malignant hibernoma exist? The authors present a case of a highly atypical, possibly malignant, hibernoma. It presented as a deep-seated tumor in the retropharynx of a 57-year-old male. A review of possible similar cases is presented. The patient is without recurrence 4 years after complete excision and radiation therapy. The tumor must be differentiated from liposarcoma. The clinical potential must await the accumulation and observation of additional cases.


Convoluted secretory material in thyroid follicular epithelial tumors. Electron microscopy may occasionally be useful, when routine histopathologic methods fail, in the typing of tumors, including those that present as metastases from occult primary sites. We describe a case in which the presence of an uncommon ultrastructural feature aided in establishing the thyroid gland as the source of a skeletal metastatic tumor.


Tubular carcinoma of the breast.

Tubular carcinoma of the breast. Twenty-five patients with tubular carcinoma of the breast were reviewed. All of the lesions were small, averaging 0.9 cm in diameter, and none exceeded 2.0 cm in diameter. Regardless of treatment, the prognosis proved favorable. Only three of the patients manifested axillary lymph nodal metastases, and none died of recurrent or metastatic neoplasm. These neoplasms frequently were associated with intraductal carcinoma and, to a lesser extent, with lobular carcinoma in situ. It is concluded that tubular carcinoma represents a slow-growing expression of invasive mammary carcinoma; nevertheless, it is likely that, if inadequately treated, these lesions will evolve into more common patterns of invasive carcinoma.


"Pseudosarcoma" of the larynx.

"Pseudosarcoma" of the larynx. Polypoid epidermoid carcinoma of the larynx with a cellular, often atypical stroma has also been classified as pseudosarcoma, carcinosarcoma, pleomorphic carcinoma, or spindle cell sarcoma. The nature of the spindle-shaped stromal cells has clinical significance, but pathologists do not agree about the origin and potential of these cells. This paper describes two laryngeal tumors, one with an abundant osseous component in which light-microscopic, ultrastructural, and clinical features suggest the origin of these fusiform cells from reactive pluripotential mesenchyme. In a second case, atypical fusiform cells within the stroma show ultrastructural epithelial characteristics. These findings suggest a varied histogenesis for pseudosarcoma of the larynx and may explain divergent theories expressed in the literature.


Desmoplastic fibroma of bone. An ultrastructural study. The ultrastructure of three cases of desmoplastic fibroma of bone is presented. The lesion is principally characterized by myofibroblasts admixed with lesser numbers of fibroblasts and primitive mesenchymal cells. Thus, the cellular composition is similar to that described in a variety of nonneoplastic proliferative processes of soft tissue. It is postulated that the myofibroblastic proliferation develops in response to unknown factors acting on marrow fibroblasts or primitive mesenchymal cells.


Colorectal carcinoma in the first three decades of life. Sixteen cases of colorectal adenocarcinoma in patients 30 years of age and younger were treated at the University of Virginia Medical Center between 1957 and 1977. Ten patients (63%) were black, and seven patients (44%) were black females. The high incidence of this tumor in young blacks in our patient population appears to be a recent development, becoming clinically manifested since 1965. Pain was the major presenting symptom, and bleeding was a constant finding in the patients with rectosigmoid lesions. Eighty-six percent had metastases at the time of diagnosis despite a short duration of symptoms. Five-year survival in 11 patients with mucinous adenocarcinoma was 18%, while the three patients with well-differentiated glandular carcinoma had a 5-year survival of 33%. Material was unavailable for histologic review in two cases. Fourteen of 16 patients eventually died of their carcinoma, and one patient died of malignant lymphoma. Additional factors which correlated with length of survival were resectability, extent of bowel wall invasion, and the presence of lymph node capsular invasion. Nodal capsular invasion is an especially sensitive marker for short-term survival and has not been previously reported in colonic tumors.


Recurrent and aggressive chondroblastoma of the pelvis with late malignant neoplastic changes. A case of chondroblastoma involving the left ischium, lower wing of left ilium and inferior ramus of left pubis is presented. The tumor showed aggressive features and repeated recurrences over a 30-year period and ultimately developed the cytologic features of a malignant neoplasm. However, no metastases have developed.


A case of osteoblastoma associated with severe systemic toxicity. A case of an osteoblastoma of the proximal femur with a unique local, massive reactive periostitis mimicking osteosarcoma or osteomyelitis and unique systemic manifestations is reported. The severe toxic manifestations included: massive weight loss, chronic fever, anemia, systemic periostosis, and other signs. Due to confusion as to diagnosis, lack of response to numerous antibiotic regimens, and severe cachexia with clinical signs of impending death, an amputation was performed. Pathologic study revealed an osteoblastoma. A thorough review of the case suggests that the signs and symptoms were possibly consequent to an immune response mounted against the tumor rather than to secondary infection, although the latter possibility cannot be completely excluded.


Extradural analgesia in labour. A comparison of 2-chloroprocaine hydrochloride and bupivacaine hydrochloride. Chloroprocaine hydrochloride 2% and bupivacaine hydrochloride 0.375% in 10-ml doses of plain solutions were studied in a randomised blind manner as the agents for continuous lumbar extradural analgesia in labour. Twenty-four patients were assessed for the speed of onset, duration of action, degree of motor blockade, dermatomal spread, arterial hypotension, and the incidence of unblocked segments. Chloroprocaine showed a quicker onset time  and a shorter duration of action than bupivacaine. Chloroprocaine exhibited more marked motor blockade and a lower incidence of unblocked segments. The dermatomal spread and effect on arterial pressure were similar in both groups.


Intra-aortic balloon counterpulsation. Clinical experience. From March 1975 until September 1978, seventy patients  were referred for intra-aortic balloon counterpulsation for cardiogenic shock complicating acute myocardial infarction or for the treatment  of low cardiac output states following cardiopulmonary bypass. Sixty of these received adequate intra-aortic balloon pump assistance; fifty-two  ped successfully off the balloon pump. Twenty-three patients survived to leave hospital.


Clinical effects of nitrous oxide and oxygen mixtures at sea-level and at 1700 metres altitude. The effects of nitrous oxide, at sea-level and at an altitude of 1700 m, were assessed on a subjective and objective basis. Only marginal differences were shown between the effects of the gas at sea-level and 1700 m. Since consciousness was impaired with 60 and 70% nitrous oxide it is suggested that the use of Entonox-oxygen mixtures should be considered for single-handed operators.


The immunology of tetanus.

The immunology of tetanus. The results of measurements made in two cases of tetanus suggest that the level of tetanus antibody in the blood cannot be used as a diagnostic test for the disease. The investigation also indicated that an attack of tetanus does not result in a rise in tetanus antitoxin antibody levels. This confirms the opinion that tetanus is not an immunising disease. In the cases described, the pseudocholinesterase level was not of diagnostic value.


Shy-Drager syndrome. A review and a description of the anaesthetic management. Autonomic failure in patients with the Shy-Drager syndrome may produce cardiovascular instability during anaesthesia and surgery. The syndrome is reviewed and the anaesthetic management of a case is described. The choice between general and regional anaesthesia seems to be less important than adequate cardiovascular monitoring and the maintenance of blood pressure with intravenous fluids. Sympathomimetic drugs, if used at all, should be administered in very dilute solutions to avoid hypertension from denervation hypersensitivity. In the postoperative period, symptoms from orthostatic hypotension may be severe and their control requires prolonged postural training, by elevation of the head of the bed, and therapy with 9-alpha-fludrocortisone.


Subarachnoid injection during extradural analgesia for labour using 2-chloroprocaine. An obstetric patient had a subarachnoid block during attempted extradural analgesia for labour. The sensory block extended to T1 and was accompanied by hypotension. The analgesia lasted 3 hr. after which sensory and motor function recovered quickly. The local anaesthetic agent used was 2% 2-chloroprocaine.


Pseudotetanus.

Pseudotetanus. Pseudotetanus is a syndrome which is produced by a variety of non-Clostridial factors. It is usually not difficult to distinguish from tetanus but is must always be considered in the differential diagnosis. Six cases are reported in which tetanus was considered and in one of them the full treatment for the disease was started. It is hoped that by increasing the awareness of clinicians of this relatively common problem the risk of making an incorrect disagnosis will be reduced.


The Valved-Y-Cardiff Connector (V.Y.C. Con). A disposable Y-connector for use when two infusions are connected to the same channula has been tested. The connector incorporates a valved tap in one limb which prevents retrograde flow into the infusion connected to that limb.


[Circadian rhythm of plasma testosterone levels. III. Determination of the daily serum testosterone maximum]. Testosterone levels in plasma in 50 young males are found on a plateau between 07,00 h and 10,00 h. As this plateau represents the highest level throughout the day, it is necessary to take blood sample only once during this period. Therefore a statement about endocrine testicle function can be given by only one determination of testosterone between 07,00 h and 10,00 h. This faciliates endocrine examination in ambulant patients.


Experimental findings with spermantibodies: condom therapy (a case report). A couple with no demonstrable cause for their infertility, except for a pronounced antisperm activity in the blood serum of the female partner, were instructed to use a condom while our laboratory monitored the wifes antibody titer. The antibody activity declined sufficiently and an artificial husband insemination were performed after seven months of therapy. A precise report of the spermantibody activity over an eleven month period are given by the authors.


Serum sperm antibodies in cases of azoospermia: comparative diagnostic value of separate and combined, agglutination, immoblization and cytotoxic serological tests. To study the diagnostic value of various serological tests in the detection of serum sperm antibodies a group of 50 patients with azoospermia was studied. Cases were divided by testicular biopsy into: 32 obstructive and 16 non obstructive cases. Tests applied included a microagglutination and a macroagglutination test as well as 2 complement dependent tests; a sperm cytotoxic and a sperm immobilization tests. Applied separately the macroagglutination was the most sensitive test but used together, more cases were detected. Because of this and the different value and significance of each test, it is advisable to use more than one test in the investigations of cases of male infertility.


The ultrastructural response of human Leydig cells to exogenous estrogens. The effect of long term treatment with estrogens alone or along with medroxyprogesterone acetate on the Leydig cell ultrastructure was studied in testes from males undergoing surgery for sexual reassignment. The testes were fixed for electron microscopy by a perfusion method to insure uniform preservation. The morphological features were not the same in all the treated testes. Therefore, the cells found in the intertubular region were classified into three groups: (A) Leydig cells very similar to controls; (B) Absence of typical Leydig cells, but with cells having increased microfilaments, abundant smooth endoplasmic reticulum and some lipid droplets; (C) Absence of any cell type possessing abundant smooth endoplasmic reticulum, but having varying amounts of microfilaments and pigmentation. It is suggested that some of the cell types found in the intertubular region are dedifferentiated Leydig cells. This study indicates that the human testis from transsexuals of reproductive age is an appropriate model to study the indirect and direct effects of estrogens on the ultrastructure of cell types found in the human testes.


Response of the rabbit isolated testicular capsule at hypothermic and hyperthermic temperatures to norepinephrine, acetylcholine and prostaglandin F2 alpha. Spontaneous contractions of the adult rabbit isolated testicular capsule were found to be influenced by moderate hyperthermic and hypothermic temperature changes. The decrease in testicular capsular spontaneous contractions resulting from an exposure to 32, 40 and 42 degrees C have been shown to be influenced by the addition of NE, ACh and PGF2 alpha. Of the three neurohumoral agents studied, NE was found to cause the greatest increase and re-initiation of testicular capsular tone during both hypothermia and hyperthermia. These data indicate that endogenous levels of neurohumoral agents may play an important role in the maintenance of testicular capsular tone during exposure to hyperthermic or hypothermic conditions.


Contractile behaviour of rat epididymis after sympathectomy produced by the administration of guanethidine. The effect of guanethidine (a sympatholytic agent) on epididymal contractions was studied in rats, in order to contribute new data on the role of both the adrenergic and cholinergic nerves in the spontaneous motility of the epididymis and also during ejaculation. The first type of activity was increased when adrenergic innervation was damaged, but the amplitude and frequency of contractions reached normal values approximately 3 hours after beginning the records. Since spermatozoa were eliminated after electroejaculation, the second type of contractions was not affected either. As the epididymis and vas deferens were congested with spermatozoa, it is possible to assume that guanethidine caused a functional obstruction in a distal segment of the genital tract. The increase of spontaneous activity could be the response of the epididymal muscle to overcome this obstruction and, therefore, to cause the elimination of spermatozoa into the urethra, which normally occurs in absence of ejaculations. Finally, no pregnancies occurred among female rats mated with treated males, at least up to 150 days after ending treatment.


[Modification of prolactin and stress by masturbation]. Fertility patients are in a stressful situation at the time of clinical examination. That condition of stress influences hormonal levels, especially prolactin levels, in blood plasma and in seminal plasma. After masturbation previously stress-induced hyperprolactinemia levels are reduced. This is probably due to the decrease of stressful tension during the period of clinical consultation and not likely due to the relaxation by masturbation. In conclusion, the stress condition of fertility patients must be taken into account while evaluating hormonal data.