Autoradiographic comparison of neuronal and glial protein metabolism in rat hippocampus after food-motivated or footshock-motivated conditioning. Quantitative autoradiography has shown that initial food-motivated conditioning results in an increase in 3H-phenylalanine incorporation into cytoplasmic proteins of rat hippocampal neurons. After 3 daily conditioning trials, the incorporation returned to an active control (pseudoconditioning) level while after 6 daily trials, the incorporation was decreased. No changes were revealed in the cells of hippocampal perineuronal glia. Four hours after a footshock-motivated passive avoidance trial, incorporation of 3H-phenylalanine was increased both in the neurons and in their perineuronal glia of rat hippocampus. By the time of a consolidation of this conditioning, such increase still remained perineuronal glia. An importance of the emotional background is outlined for a participation of glial cells in learning-induced metabolic changes in the nervous system.


Human serum albumin as a 'silent receptor' for drugs and endogenous substances. Most drugs are bound to human serum albumin (HSA) via a few high affinity binding sites and several sites of much lower affinity. There is now increasing evidence that the actual number of high affinity drug-binding sites of HSA is rather small. Thus, each of these binding sites binds several drugs of very different chemical and pharmacological properties with relative high affinity. On the other hand these drug-binding sites can in some cases be very specific and even stereoselective, as demonstrated by the stereospecific binding of drugs to some of these binding sites. The discrepancy between both observations can be explained by the conformational adaptability of the HSA-binding sites.


Effect of O-(beta-hydroxyethyl)-rutoside on wound healing in the rat. The administration of O-(beta-hydroxyethyl)-rutoside in 11 daily doses of 300--400 mg/kg p.o. stimulates wound healing by granulation in the rat. The preparation may counteract the inhibitory effect of prednisone on the formation of granulation tissue. In five doses of 300--1,000 mg/kg daily p.o. it augments the tensile strength of cicatricial tissue to a statistically significant degree.


Determination of histamine and its metabolic products in the pig gastric mucosa. This paper describes analytical techniques for quantitative and qualitative determination of histamine and its metabolites (N tau-methylhistamine, N alpha-methylhistamine and N alpha, N alpha-dimethylhistamine) in the pig gastric mucosa. These metabolites and N alpha-acetylhistamine, imidazolyl-4-acetic acid and N tau-methylimidazolylacetic acid were synthesized as reference compounds and analyzed by using the dansylation technique. TLC of dansylated mucosal extracts in various solvents (in situ fluorescence measurements) in combination with TLC/IR and TLC/MS transfer technique demonstrated the presence of histamine. The only metabolite was N tau-methylhistamine.


Prostaglandin-sensitive adenylate cyclase in human gastric mucosa. Inhibition by nonsteroid anti-inflammatory agents. The effects of various nonsteroid anti-inflammatory compounds on human gastric mucosal adenylate cyclase were tested. It is shown that fenamates, indomethacin and diclofenac-Na were relatively specific inhibitors of prostaglandin E2 action at the level of the mucosal cyclase activity. The results suggest that inhibition of prostaglandin E2-activated adenylate cyclase might at least in part contribute to the ulcerogenic effects of certain nonsteroid anti-inflammatory drugs.


On the deconvolution of exponential response functions. The deconvolution or unfolding of exponential response functions from experimental data has been examined through the use of a Bayesian based algorithm. The algorithm, which is founded upon the concepts of probability, ensures positivity of solution. This constraint leads to a significant reduction in the growth of statistical noise in deconvolved data when compared with the more common linear unfolding techniques. The algorithm is an iterative procedure which, in the absence of statistical noise, can ultimately result in complete signal recovery. When noise is present one must balance the degree with which the response function is removed against the growth in the noise and, at some point, terminate the iterative process. Criteria for determining the point at which this 'best estimate' is attained are examined and an operationally realisable test is given. Comparison of results is made with the inverse filter solution which, for an exponential response function, is shown to consist of the sum of the observed data and its first derivative.


Dynamic spatial resolution.

Dynamic spatial resolution. The study of the dynamic behaviour of radiopharmaceuticals within a patient using a scintillation camera with data acquisition and processing facilities often presents analytical problems because of the limited data available. In the effort to maintain good spatial resolution sensitivity is often needlessly reduced producing further limitation in the statistical accuracy within regions of interest. It is shown that for a particular dynamic study and scintillation camera combination an optimum design of collimator exists, often of much greater sensitivity and poorer resolution than those used hitherto. A simple method is given for producing data for any system which will provide the basic information necessary to read off optimal collimator design parameters.


A theoretical study of quantitative flow measurements with constant infusion of short-lived isotopes. Recent developments in the technique of constant infusion and in emission computed tomography have provided a new method for quantitative regional flow measurements. This paper re-examines critically the theoretical relationship between flow and radioactivity during constant infusion of short-lived isotopes. Sensitivity analysis is used to assess the accuracy of the method. Criteria for the selection of an appropriate half-life to meet accuracy requirements are also discussed. A method for the determination of the distribution volume of the tracer is proposed.


A simple method for correcting left ventricular equilibrium radionuclide angiography for the effects of arrhythmias. A simple method of correcting equilibrium radionuclide angiographic data for the effects of arrhythmias is proposed. This involves no further acquisition time or inconvenience to the patient. This correction is necessary in patients with marked arrhythmias as the left ventricular time-activity curve (LVTAC) becomes distorted with greater sampling time in the first few frames of the LVTAC than in later frames. This will show on the LVTAC as greater counts in the first few frames and will lead to an overestimation of left ventricular ejection fraction (LVEF) and wall motion. The method proposed normalises each frame to make the contribution from a non-cardiac region constant over the cardiac cycle. Results of the correction are presented and discussed.


The role of water in microwave absorption by biological material with particular reference to microwave hazards. The problem of the absorption of the energy of plane electromagnetic radiation by an aqueous solution of macromolecules is considered. A simplified model for the hydrated molecule is employed, consisting of a spherical shell of bound water surrounding a spherical core. The power deposition per unit volume of the shell is calculated in the frequency range 100 MHz-100 GHz for several bound water relaxation frequencies. In each case the corresponding values are also calculated for free water for comparison. The values obtained for the bound water are shown to be significantly higher than those for the free water up to frequencies of at least 1 GHz. The maximum difference between these two sets of values is of the order of a factor of five and occurs roughly at the bound water relaxation frequency. Because of the strong coupling between the bound water molecules and the macromolecules present in biological material this result could be a significant factor in the explanation of the biological effects of microwaves at a molecular level.


Dielectric properties of brain tissue between 0.01 and 10 GHz. Dielectric permittivity and conductivity are reported for grey and white matter from dog brain tissue between 0.01 and 10 GHz. Between 0.01 and approximately 1 GHz, the permittivity decreases and conductivity increases as a power law of frequency. Above 1 GHz, the conductivity increases quadratically with frequency due to dipolar reorientation of free water molecules in tissue; the apparent rotational relaxation frequency at 37 degrees C is 21--25 GHz, slightly below the 25 GHz characteristic frequency of pure water at that temperature. The microwave data are analysed using the Maxwell mixture theory applicable for a suspension of nonconducting, low permittivity spheres in bulk water. From the increase in conductivity above 1 GHz, and the tissue permittivity at 2--4 GHz, the apparent volume fraction of water is approximately 0.70 and 0.55 for grey and white matter, respectively, about 10--15% lower than respective values from the literature. This discrepancy is apparently due to a small fraction of water which does not contribute to the tissue permittivity above 1 GHz. Empirical equations are given to summarise the dielectric properties of 'average' brain tissue at 37 degrees C for future theoretical studies of microwave absorption in the head.


Temperature distributions obtained with diathermy electrodes implanted into a phantom. Uniform patterns of heating in a homogeneous phantom were obtained by implanting shortwave diathermy electrodes in a particular configuration. The methods of heating and measurement are described. The technique can be considered for applying localized hyperthermia in the treatment of cancer.


Relationships between energy fluence and energy incident on, emitted by or imparted to a body. From knowledge of the energy and angular distribution of the fluence around a body, the energy incident on, emitted by or imparted to a body can be calculated. The calculation is easily performed if the quantity 'vectorial fluence' is used. Examples taken from the literature are used to illustrate the erroneous results obtained by integrating energy fluence over area instead of integrating the scalar product of vectorial energy fluence and vectorial area.


A critique of Katz's 'high LET constraint on low LET survival'. Katz's interpretation of the connexion between RBE and LET is contrasted with a version published previously by Burch. The implications of Katz's model for dose-response relations apply only at ultra-high absorbed doses in Burch's model. In the latter, the shoulder on type-C survival curves for mammalian cells is explained in terms of Haynes' repair model. Under certain conditions the repair model becomes mathematically equivalent to the 'alpha--beta' model; under some other conditions it becomes equivalent to the 'two-component' model. The formulation of a new repair hypothesis, based on the idea of an inducible repair mechanism, is also set out. It is argued that Katz's 'supralinearity index' is appropriate to the induction of (rare) mutations but inappropriate to cell survival, for which an alternative index is proposed. Certain plausible hypotheses of radiobiological action conflict with Katz's 'logical constraint' which, it is contended, is neither logical nor valid. In conclusion, although experimental findings for some radiobiological systems conform to Katz's 'constraint', the frequently observed violations should not necessarily be regarded as artefacts.


A technique for high-sensitivity alpha autoradiography of bronchial epithelium tissue. A technique for low-level alpha-particle autoradiography of bronchial epithelium utilising the plastic track detector, CR-39, is described. This plastic is new to the field of nuclear track detection and is very sensitive to alpha-particles. The recording properties of CR-39 for alpha-particles are described in detail and the technique for autoradiography discussed. This technique includes two methods of background reduction enabling activities as low as 2 alpha-particles cm-2 to be detected. The location of the point of emission of an alpha-particle from the tissue surface can be determined to an accuracy of a few micrometers. Determination of the lower limit to the energy of individual alpha-particles is possible from measurements of their range in the plastic. Examples are given of the determination of the microdistribution of alpha-particle active nuclei in bronchial tissue including the observation of two 'hot-spots' in the epithelium sample which are attributed to the presence of small particles of uranium with its daughter products.


Thin-layer thermoluminescent dosemeters based on high-temperature self-adhesive tape. Dosimetric material was fabricated by coating commercially available self-adhesive tape able to withstand temperatures up to 400 degrees C with thermoluminescent lithium fluoride crystals. Tests were made on dosemeters of about one centimetre diameter cut from the coated tape. High loading and reproducibility was further by spreading the crystalline materials onto heated tape. Reproducibility was further improved when sieved and washed ground crystalline material was used. Dosemeters with various loadings were fabricated and representative batches with loadings of 12.2 mg cm-2 and 5.9 mg cm-2 were tested for reproducibility, matching, sensitivity to light and photon energy dependence. The dosemeters show exceptional reproducibility and matching, are simple and inexpensive to make and are ideal for many applications where thin-layer dosemeters with approximate tissue equivalence are required.


High-level gamma-ray dosimetry using common TLD phosphors. Thermoluminescence of high temperature peaks, ultraviolet radiation (253.7 nm) induced thermoluminescence and phosphorescence, damage effects and optical density changes in a few common TLD phosphors namely CaSO4 : Tm, CaSO4 : Dy, LiF TLD-100 and Li2B4O7 : Mn were studied from the point of view of measuring high level gamma doses (10(2)--10(6) Gy).


Modifications of ouabain inhibition of xenon accumulation in red blood cells. Implications regarding cell water structuring. Ouabain is known to depress uptake of xenon by red blood cells, but it is now found that the depressive effects of phenolsulfonphthalein (PSP) or heavy water are even more marked. Ouabain partly reverses those effects in a manner suggesting it exerts a constant action on xenon exchange regardless of the presence or absence of PSP or D2O. Processes analogous to exchange diffusion between certain anesthetic substances and xenon were also observed. The theoretical consequences of the findings are discussed.


A physical model of nerve axon. II: Action potential and excitation currents. Voltage-clamp studies of chemical driving forces of Na+ and K+ in squid giant axon. An adsorption model of nerve axon has been extended to account for the origin of membrane currents observed under voltage-clamp conditions. Differing from the Hodgkin-Huxley model, which attributes excitation solely to a change of ionic conductances of the membrane, the present model proposes that a layer of axoplasm attached to the membrane (axon cortex) can undergo conformational changes and hence modulate selectivity for mobile ions. To test the model, a two-step voltage-clamp study was made of the chemical driving forces of Na+ and K+ ions in squid giant axon. The forces were measured by determining the instantaneous current-voltage relation when membrane current is carried by Na+ only or K+ only. The data indicate that the chemical driving force varies as a function of time and does not agree with the Nernst relation during the early phase of excitation. Implications of the observations are discussed.


Biological symptoms of depression.

Biological symptoms of depression. Frequency of occurrence of various biological symptoms in relation to intensity of depression and neuroticism was studied in 37 depressed patients. The best indicator of depression severity and neuroticism were, respectively, early waking and excessive dreaming, when the symptoms were studied individually. A group of biological symptoms predicting the severity of depression was found via stepwise multiple regression analysis of variance. No such grouping was found for neuroticism. However, only neuroticism was found for neuroticism. However, only neuroticism was found to be a useful predictor of the biological symptoms when taken as a whole.


Psychological correlates of progression of atherosclerosis in men. Patients who underwent repetitive repetitive coronary angiograms at an average interval of 17 months completed the Jenkins Activity Survey (n = 66) and were given the Rosenman diagnostic interview to measure Type A behavior (n = 45). Significant progression of coronary artery disease was judged to be an increase in occlusion of 25% or more, or progression to total occlusion in any vessel. At subsequent study, 30% of the patients showed evidence of progression. Progression was much more likely in patients with initially more severe disease and was marginally related to cigarette smoking when initial level of disease was controlled. Interview assessment of Type A did not discriminate reliably between the groups in the smaller sample of patients given this measure. There was significant positive association between magnitude of Activity Survey Type A scores and progression of disease, although mean scores on the Type A scale were not reliably different between the Progression and No Progression groups. The pattern of results suggested that extreme Type B subjects (classified by Activity Survey) were unlikely to show progression over this time period.


Conditioned suppression of a thymus-independent antibody response. An illness-induced taste aversion was conditioned in mice by pairing cyclophosphamide, an immunosuppressive drug, with the consumption of saccharin, a novel drinking solution. Two weeks after conditioning, animals were injected with the hapten trinitrophenyl (TNP) coupled to the thymus-independent carrier, lipopolysaccharide. Serum antibodies to TNP were titered 6 days later by passive hemagglutination. Relative to control groups, conditioned animals provided with saccharin at the time of antigenic stimulation and, again, 3 days later showed a significant attenuation of their anti-TNP antibody response. In a second experiment, the conditioned stimulus (CS) consisted of the novel saccharin drinking solution plus the noxious internal effects of an injection of LiCl. Conditioned animals reexposed to the CS again showed the lowest antibody titers, but differed significantly from only one of the control groups. Taken together, the results of these experiments confirm previous reports of conditioned immunosuppression and suggest that the effects of conditioning on a primary humoral antibody response can be observed in response to a T-cell independent antigen in the mouse.


Aspects of visual perception in radiography. The author has presented experimental results to validate the hypothesis that visual search techniques are related to the practice of radiography. A group of radiographers raised their performance on a film-viewing task from 56%-76% as a consequence of visual search practice and it is suggested that this is important to radiographers undertaking quality control, evaluation of imaging systems and pattern recognition. The final part of the paper considers the need to match the visual abilities of prospective students with the job requirements. Two simple tools are described.


Biopsy techniques in the investigation of diseases of the lung, mediastinum, and chest wall. Closed biopsy techniques  are available for the investigation of diseases of the mediastinum, hilus, and chest wall as well as for pulmonary and pleural disease. Biopsy via the bronchoscope is of greatest value in the diagnosis of endobronchial lesions, especially those that are centrally sited, and of diffuse pulmonary disease including opportunistic infections. Fluoroscopically controlled fiberoptic bronchoscopy is beginning to replace the transcatheter biopsy technique. In general, the use of large needles for biopsy should be avoided. Percutaneous fine  needle biopsy is an effective means of sampling lesions of the mediastinum, hilus, and chest wall. However, this mode of biopsy is most widely used as a safe and highly accurate means of diagnosing localized pulmonary disease.


Interventional radiologic procedures in the investigation of lesions of the breast. The interventional radiologist who performs mammography does far more than read films; he examines every patient, punctures cysts, and localizes other breast lesions for precise excisional biopsy. With specimen radiography, he can confirm that suspicious lesions are completely removed by the surgeon and that the tissue in question is selected by the pathologist for examination. Pneumocystography can save the patient the unnecessary, disfiguring surgical removal of benign cysts. Those patients requiring biopsy may be scheduled for the procedure at once, and close cooperation with the surgeon greatly reduces the time the patient must wait to find out whether or not she has breast cancer. Thus, the interventional radiologist can improve the accuracy and speed of diagnosis of breast lesions, establish a definitive diagnosis and expedite the therapeutic management of benign cysts, and save the patient much of the anxiety commonly experienced in waiting for diagnostic results. The end result is better care at a lower cost to the patient and to society.


Technical considerations of interventional radiology. Unit design and coordination of diagnostic pathology services. With close cooperation between the clinician, radiologist, and pathologist, and with exacting attention to detail, the combined techniques of interventional radiology and diagnostic cytopathology can provide a definitive diagnosis in a large variety of clinical situations. Undoubtedly, the increasing interest in utilization of these methods will expand the number of patients who can benefit from these rapid, safe, relatively inexpensive, and highly accurate diagnostic techniques.


Prostaglandin E antagonist activity of 11-deoxy-16,16-trimethyleneprostaglandin E1. 11-Deoxy-16,16-trimethyleneprostaglandin E1 is a potent inhibitor of prostaglandin E-induced contractions of the gerbil colon. The antagonism is directed specifically against the prostaglandin E receptor and is not manifested when contractions are induced by either prostaglandin F2 alpha or acetylcholine.


Variability in rates of urine prostaglandin E excretion. Urine prostaglandin E excretion rates were determined by hepatic receptor assay in three groups of conscious animals. Although 24-hour urine collections gave reproducibly similar levels of prostaglandin E excretion rates, levels obtained with consecutive 20-minute urine collections were extremely variable despite no obvious changes in renal function. Since short urine collection periods are used frequently in physiologic studies, the significance of variations in prostaglandin excretion rates in these studies may have to be re-evaluated.


Preparation and biochemical properties of PGH3. PGH3 was biosynthesised from all-cis-5,8,11,14,17-eicosapentaenoic acid (20:5 omega 3) by an acetone-pentane powder of ram seminal vesicles and its structure was confirmed by GLC-MS after its reduction to PGF 3 alpha. PGH3 was transformed by horse platelet microsomes to TXB3, and by aortic microsomes to delta 17-6-keto-PGF 1 alpha. The structures of these compounds were confirmed by GLC-MS.


The mechanism of prostaglandin action on the early pregnant human uterus. To extend observations in 11 weeks pregnant patients the mechanism of prostaglandin (PG) action has been examined in 6 weeks pregnant women (LMP). In 10 gravidas menstrual induction was attempted with a single slow release vaginal suppository containing 3000 microgram (155)-methyl PGF2 alpha methyl ester (U-36,384). In 10 additional gravidas menstruation was provoked by the intramuscular injection of 500 microgram 16-phenoxy-omega-tetranor PGE2 methyl sulfonylamide (Sulproston) at 4 hour intervals, totalling 1250 +/- 154 microgram. The PGF2 alpha and PGE2-analogues provoked similar changes in hormone levels and uterine function, sequentially measured by radioimmunoassays and the recording of intrauterine pressure. However, the effects of the intramuscular regimen developed earlier. Both treatments successfully terminated early pregnancy with clinical symptoms of menstruation if they irreversible compromised the conceptus within 12 hours. However, while both formulations represent advances in postconceptional therapy, only further modifications may closely approximate the "ideal" method of non-surgical menstrual induction.


Bradykinin-stimulated release of [3H]arachidonic acid from phospholipids of HSDM1C1 cells: comparison of diacyl phospholipids and plasmalogens as sources of prostaglandin precursors. Ethanolamine plasmalogens (1-alk-1'-enyl-2-acyl-sn-glycero-3-phosphoethanolamines) of many tissues contain high levels of arachidonate at their 2-position, and in certain tissues have been implicated as possible donors of arachidonate required in the synthesis of prostaglandins and thromboxanes. In the present study, [3H]arachidonate-labeled phospholipids of HSDM1C1 cells, a cell line derived from a mouse fibrosarcoma, were examined to determine the donor of the arachidonic acid released upon bradykinin stimulation of the synthesis of PGE2. HSDM1C1 cells labeled with [3H]arachidonic acid for 24 hr in serum-free medium were used in most of the experiments and had the following distribution of label among the cellular lipids; phosphatidylcholine (33%), phosphatidylinositol (20%), diacyl-sn-glycero-3-phosphoethanolamine (15%), ethanolamine plasmalogen (15%), and less polar lipids )16%). Bradykinin treatment stimulated a rapid hydrolysis of [3H]arachidonate from the cellular lipids and conversion of the released acid to PGE2, which was secreted into the medium. The label was released predominantly from phosphatidylinositol and possibly from phosphatidylcholine with no detectable change in the labeling of diacyl- or 1-alk-1'-enyl-2-acyl-sn-glycero-3-phosphoethanolamine. The ethanolamine plasmalogens, therefore, do not appear to be involved in the stimulated release of arachidonate in the HSDM1C1 cells. Indomethacin blocked the bradykinin-stimulated synthesis of PGE2 and to a lesser degree inhibited the release of [3H]arachidonate from the cellular lipids into the medium.


Characterization of the stimulatory effects of PGF2alpha on the release of arachidonic acid. Fibroblasts derived from a rat carrageenin granuloma were cultured in the presence of radioactive arachidonic acid, palmitic acid and linoleic acid. More than 90% of each labeled fatty acid was incorporated into a phospholipid fraction by the cells in 18 hrs. Arachidonic acid was evenly incorporated into phosphatidylcholine and phosphatidylethanolamine, while both palmitic acid and linoleic acid were almost entirely incorporated into phosphatidylcholine. The position of phosphatidylcholine where the fatty acids were incorporated was different for each fatty acid. The ratio of the amount of fatty acid incorporated into the 2-position to the amount incorporated into the 1-position of phosphatidylcholine for each fatty acid was greater than 90% for arachidonic acid, 2:1 for palmitic acid and 5:1 for linoleic acid. In the case of phosphatidylethanolamine, most arachidonic acid (greater than 90%) was incorporated into the 2-position. PGF2alpha caused the stimulation of arachidonic acid release but not of palmitic acid and linoleic acid from pre-labeled fibroblasts. The serum in the medium was completely replaceable by bovine serum albumin. The effect of PGF2Alpha increased with an increasing concentration of bovine serum albumin, suggesting that serum only acts as a "trap" for released arachidonic acid. The effect of PGF2Alpha was greater than bradykinin, and no synergistic effect was seen, although an additive effect was observed. The effect of PGF2Alpha depended on the concentration of calcium ions under magnesium-supplemented conditions.


Biological activities of prostaglandin H1 analogs. The influences of epoxymethano and epoxycarbonyl analogs of PGH1 on washed rabbit platelets, isolated smooth muscles and perfused heart preparations were investigated. On washed rabbit platelets, 11,9-epoxymethano and 11,9-epoxycarbonyl PGH1 produced a platelet aggregation whereas 9,11-epoxymethano and 9,11-epoxycarbonyl PGH1 produced an inhibition of arachidonic acid-induced platelet aggregation. On iso-ated rabbit thoracic aorta strips, 9,11-epoxycarbonyl PGH1 showed strong contracting activity (5 times as active as 11,9-epoxymethano PGH2 and 31 times as active as PGH2). All the analogs of PGH1 caused contraction of guinea pig tracheal muscle and caused an increase of perfusion pressure in guinea pig heart, though 11,9-epoxymethano and epoxycarbonyl PGH1 were far more active than 9,11-epoxymethano and epoxycarbonyl PGH1. Differences in biological activities between 11,9-epoxymethano and  epoxycarbonyl PGH1 indicate that the orientation of functional groups at C9 and C11 influences biological activities.


Prostaglandins V (1). Synthesis and pharmacology of (+/-)-11-deoxy-10-hydroxyprostaglandin E1 methyl ester. (+/-)-Deoxy-10-hydroxy-PGE1 methyl ester (Va) has been synthesised via conjugate addition of the cuprate (III) to the 5-tetrahydropyranyloxycyclopentenone (IId). Va was found to be 0.1 times as active as PGE1 as a uterine stimulant in the anaesthetized pregnant rat, 0.25 times as active as PGE1 in causing vasodepression in the anaesthetized cat, and approximately equiactive to PGE1 in inducing bronchoconstriction.


Release and specific binding of prostaglandins in bovine pineal gland. Incubated bovine pineal glands released prostaglandin E-and prostglandin F-like material (304 +/- 20 and 582 +/- 56 pg/mg dry tissue wt/h, respectively) and the release was increased 2.2 2.9-fold by adding 10(-4)-10(-6)M of norepinephrine to the medium. Binding assays revealed the existence of high affinity binding of 3H-prostaglandin E2 (3H-PGE2) and 3H-prostaglandin F1 alpha (3H-PGF2 alpha) in low speed supernatants of pineal homogenates. Binding was increased by increasing Ca++ concentration in medium up to 2 mM, was heat labile and was depressed following incubation with trypsin. In subcellular fractionation studies maximal 3H-PG binding was found in the 27000 x g pellet. Scatchard analysis of 3H-PGE2 binding revealed the presence of a single population of binding sites with a Kd= 1.2 nM and a binding site concentration of 1-2 pmoles/g protein. A single population of binding sites for 3H-PGF2 alpha was also detected with a Kd= 1.7 nM and a similar binding site concentration. Non-radioactive PGE1 and PGE2 were almost equally effective to compete for 3H-PGE1 binding sites (ED50= 5 and 2 nM, respectively). Unlabeled PGF1 was relatively ineffective to compete for 3H-PGE2 binding (ED50 greater than 1000 nM) but displaced effectively 3H-PGF2 alpha binding (ED20=1.2 nM).


Antigen-antibody complexes stimulate the synthesis and release of prostaglandins by mouse peritoneal macrophages. Antigen-antibody complexes (Ag/Ab) formed at equivalence stimulate the release of arachidonic acid and synthesis of prostaglandin E2 and 6-keto-prostaglandin F1 alpha by resident mouse peritoneal macrophages. Prostaglandin synthesis and secretion is stimulated by submicrogram quantities of Ag/Ab which increases in a dose-dependent manner. This release is time-dependent and occurs in the absence of any loss of cell viability as indicated by increased cellular levels of lactate dehydrogenase without concomitant loss of this activity to the media and the continued secretion of a constitutive cellular product, lysozyme. The stimulated synthesis of prostaglandins by Ag/Ab is inhibited by indomethacin and physiological levels of antiinflammatory glucocorticoids.


Formation of 1a, 1b dihomoprostaglandin E2 by rabbit renal intersititial cell cultures. Growing cultures of rabbit renal interstitial cells released 1a, 1b dihomoprostaglandin E2 into the culture medium. The gas chromatography-mass spectrometry data indicate that much larger amounts of PGE2 were released.


Evidence for an extra-renal origin of urinary prostaglandin E2 in healthy men. In order to verify the validity of the assumption that male urinary Prostaglandin (PG) E2 reflects its renal production, PGE2 and PGF2 alpha concentrations were measured by radioimmunoassay in the renal venous plasma (RVP) and urine (U) of 12 male and 4 female healthy volunteers. While women had a similar PGE2/PFG2 alpha ratio in RVP (0.59 +/- 0.18) and U (0.41 + 0.06), men and a significantly (P less than 0.05) higher ratio in U (1.43 +/- 1.72) as compared to RVP (0.54 +/- 0.16). This was largely due to considerably higher and more variable U-PGE1 concentrations (roughly 6 times higher than female values), despite almost identical RVP levels. The possibility of an increased U excretion of a cross-reacting member of the PG-system, as a cause of such apparently high PGE2-like immunoreactivity (LI), was ruled out by TLC characterization of PGE2-LI with three different anti-PGE1 sera. Thus, male U-PGE2 may variably reflect an extra-renal source, such as contamination with trace amounts of seminal fluid. It is concluded that, unless such a contamination can be monitored and corrected for, measurement of male U-PGE1 should be considered of questionable relevance to renal PG-synthesis.


Chemospecific deuteration of prostaglandin silyl ethers. Complete chemical selectivity (i.e., chemospecificity) has been achieved in the homogeneous deuteration of C5-C6 and endocyclic C10-C11 prostaglandin double bonds without arrangement or partial reduction of C13-C14- or C8-C12 double bonds. The homogeneous deuteration reaction utilizes protection of the C13-C14 double bond as the C15O-silyl ether and protection of the carboxyl group as the methyl ester prior to reduction under molecular deuterium with tris(triphenylphosphine)chlorohodium (I) (Wilkinson's catalyst) in 60:40 acetone:benzene at 25 degrees C. The reaction has been used to prepare six specifically deuterated prostaglandin: 5,6-dideuterio-PGE1 alpha 5,6-dideuterio-PGE1, 5,6-dideuterio-PGB1, 3,3,4,4,5,6-hexadeuterio-PGF1 alpha, 5,6,10,11-tetradeuterio-11-deoxy-PGE1, and 10, 11-dideuterio-11-deoxy-PGE1.


The refief of primary dysmenorrhea by ketoprofen and indomethacin. The prostaglandin biosynthesis inhibitors ketoprofen and indomethacin were compared in the treatment of primary dysmenorrhea in a double-blind, cross-over trial involving 23 patients. Each drug was used for 2-4 days during 3 consecutive menstruations in randomized order. Good or moderate overall relief was obtained in 60 of the 68 ketoprofen-treated menstruations (88%). A dysmenorrhea score, based on subjective estimations of 8 symptoms, similarly decreased from a mean (+/- S.E.M.) basal level of 9.6 +/- 0.6 to 3.6 +/- 0.3 during ketoprofen treatment and to 4.0 +/- 0.3 during indomethacin. Both drugs relieved pelvic and lower back pains and eliminated vomiting and diarrhea in 82-97% of the cycles whereas headache, fatigue and nervousness were less frequently alleviated (40-67%). Eighteen of the 23 women (78%) had been unable to work during the first day of menstruation, the rate of working days lost was reduced to 4% with ketoprofen and 9 with indomethacin. Mild side-effects occurred during 12 ketoprofen and 14 indomethacin therapies. Ketoprofen thus seems to be as effective and tolerable as  indomethacin in the treatment of primary dysmenorrhea.


Prostaglandin biosynthesis inhibitors and endometriosis. Prostaglandins (PGs) may be involved in the development of the symptoms of endometriosis. Therefore 18 patients with pelvic endometriosis were treated in placebo controlled double-blind trial with different prostaglandin biosynthesis inhibitors. These drugs were: acetylsalicylic acid (0.5 g x 3) exerting a weak PG-synthetase inhibition, indomethacin (25 mg x 3) inhibiting PG-synthetase, and as a representative of fenamates, tolfenamic acid (200 mg x 3), which both inhibits PG-synthetase and antagonizes PGs at the target level. The therapeutic effect was evaluated using a specific endometriosis score separately during menstruation and in premenstrum. Prostaglandin biosynthesis inhibitors did not alleviate premenstrual complaints better than placebo. During menstruation tolfenamic acid relieved endometriotic symptoms more effectively than placebo while indomethacin and acetylsalicylic acid did not differ from placebo. A drug which inhibit both the synthesis and action of PGs can thus be used in the alleviation of secondary dysmenorrhea due to endometriosis.


The use of oral prostaglandin E2 in the management of intrauterine fetal death. 12 otherwise healthy patients with intrauterine fetal death 1 to 6 weeks earlier were treated with oral prostaglandin E2. 9 of the 12 patients delivered within 48 hours after treatment began. 2 others delivered with 48 hours after unsuccessful treatment ceased. In a third patient the cervix relaxed after treatment, and the uterine contents were removed by curettage. No serious complications, such as hemorrhage occurred. The uterus seemed surprisingly responsive to oral prostaglandin E2 in cases of intrauterine fetal death.


[Free will in emotional and mental disorders]. The much used and popular word 'freedom' is being examined as to its significance and in that context the peculiar expression 'freedom of will' is also brought into the discussion. In the course of this clarification, philosophy, jurisprudence, poetic-literary and our everday language all had to lend a hand. In its application to psychic abnormal and sick persons one finds that in the endogenous psychoses, because of the profound change of existence some patients experience the freedom of being for the very first time; this, however, can in the course of the illness turn into its opposite.


[Emitted cerebral activity and attention processes in a group of schizophrenic methodologic problems]. This is a study of the relationship between cerebral events and visual attentional processes of schizophrenic patients by means of a spectral analysis method described in this paper. With recorded data it is possible to study the EEG, standard visual evoked potential, visual evoked potention with attention and visual 'emitted' potentials when stimuli were expected but absent. Compared with the summation method and unitary analysis, the spectral analysis method appears very interesting, especially for the study of 'emitted' potentials because it avoids the subjectivity of operators and reduces the number of stimulations. The results show the interest of this simple reliable and effective method for the detection and objectivation of evoked activities with only very few (10) stimulations.


[The recovered patient and his psychosis. A confrontation by videotape]. Patients in complete or partial remission were shown a videotape of their acute psychotic illness, if possible in the presence of one of their relatives. The tape was then discussed with the patients and their relatives. The videotape and the discussion were recorded again, thus allowing for an analysis of verbal and nonverbal reactions and attitudes of the participants. The psychologically unique situation of direct confrontation with the acute psychotic state enables certain problems in this area to be more closely examined and indirectly highlights possibilities of different therapeutic approaches. The investigations will be continued.


A comparative study of involutional depressive patients in French Canada and in Hungary. The data dealing with 200 involutional depressive patients who were treated in Quebec City and in Budapest are presented. A questionnaire prepared for this purpose is produced and evaluated. Half of the Canadian and 80% of the Hungarian patients were personally interviewed by the author. Those patients with organic brain syndromes were not included in the population studied. Besides many similarities between the two groups, there were also symptomatological differences observed, e.g. the agitated type of involutional melancholy occurred twice as often in Canada as in Hungary, the apathetic cases were rarer in Canada, and the illness began earlier among Canadian women. Self-blame in Canada was often linked to religious observation. Two typical syndromes in male and female patients are detailed as special disease patterns. The symptomatology of this disorder has become identical in the last few years in both countries, therefore it is improbable that a similar study in the future could point out the differences described here.


[Development of high-sensitivity radio gas chromatography--specific characteristics of a long path internal gas flow proportional counter (author's transl)]. A long path internal gas flow proportional counter was devised was to be used as a high sensitivity detector for radio gas chromatography, and its performance characteristics were investigated. The long path counter tube used for this detector has a sufficiently long passage in comparison with the diameter. The counter tube for general use is made of brass or copper tube 1 cm in diameter, 100 cm in length with a mirror finish on all internal surface, and the center electrode is of tungsten wire 0.05 mm in diameter. For actual use, several of these counter tubes are connected in series in assembly to hold the total volume of a gas sample in the counting system over a desired counting period. Thus this flow detector as an integral type one and gives directly a counting rate. Experiments showed that the dynamic counting efficiencies of tritium and carbon-14 were about 90% and equal to the static counting efficiencies. Furthermore, with this detector, the counting rate does not appear to be affected by minor variations of the effective inner volume of the counter tube and the flow rate of counting gas.


Determination of the dew point and the frost point below 0 degrees C making use of the beta-ray backscattering and the electric conductivity on the narrow surface of insulated layer. It is necessary to distinguish between the dew point and the frost point below 0 degrees C. The freezing of the dew and the melting of the frost are respectively detected by the rapid decrease and the increase of the conduction current on the narrow surface of insulated layer made of epoxy, 0.5 mm in width and 10 mm in length, on which the dew deposits. The dew point -9 degrees C and the frost point -8 degrees C in the humidity 21% at the temperature 13 degrees C are clearly distinguished in this method.


[Diagnostic system for assessment of left ventricular function with 99mTc-albumin (author's transl)]. Diagnostic system is described that obtains a set of serial gated images (SGI) covering the entire cardiac cycles and left ventricular (LV) volume curve (VC) with high temporal resolution (10 msec). The system consists of two functional parts. The one, which is based upon an inexpensive modification of multiformat imaging device, yields SGI. The other, which is based on a minicomputer system, acquires data only from around about LV area and yields LVVC from ECG P wave without the reconstruction of these images. In as little as 5 min result, which is also corrected uniformity of gamma-camera, is given.


[Clinical significance of serum bile acid radioimmunoassay in hepatobiliary diseases--with special reference to the CG/SLCG ratio (author's transl)]. Both serum cholylglycine (CG) and sulfolithocholylglycine (SLCG) levels were radioimmunoassayed by PEG method in 209 samples (204 hepatobiliary diseases, 5 normal controls). 1) The results revealed that serum bile acid levels were excellent indicators for hepatic dysfunction in comparison with the conventional liver function tests. 2) Means of 19.4 +/- 9.3 microgram/dl for CG and 21.7 +/- 6.7 microgram/dl for SLCG were obtained in controls. Most hepatobiliary diseases demonstrated abnormally high bile acid levels, with extremely high CG values in conditions with bile stasis. 3) To differentiate various hepatobiliary diseases more clearly, the ratio of the primary and secondary bile acids (CG/SLCG ratio) was introduced (1.0 +/- 0.6 for controls). In cases of bile stasis, CG/SLCG ratios ranged from 7.8 +/- 4.8 for intrahepatic cholestasis to 34.8 +/- 27.6 for congenital biliary atresia, while other hepatic disorders demonstrated relatively low values. We conclude that the CG/SLCG ratio is a useful index for cholestasis. Diagnosis of the congenital biliary atresia could be possible.


[Behaviors of nitrato complexes of nitrosylruthenium in aqueous solutions (author's transl)]. Nitrato nitrosylruthenium complexes [RuNO(NO3)x(H2O)5-x] (3-x)+ readily dissociate in aqueous solutions with decrease in pH and increase in electrical conductivity of the solutions. This study aimed to elucidate the behaviours of dissociation of the complexes with time. The change in the amount of undissociated complexes was determined with time. The results indicated that the dissociation was a multi-order reaction involving both protolysis and hydrolysis. The protolysis completed in relatively short period within(several tens of minutes), but it depended on the concentration of the complexes in the solution. The completion of the protolysis and the formation of the resulting dissociation products were observed by absorption spectrometry. The dissociation products, which were assumed as aquohydroxy complexes, underwent the successive step-wise dissociation for a prolonged period as revealed by pH measurements. The rate constants involved in the step-wise dissociation, process were obtained. The degree of dissociation and dissociation constant of the complexes were measured by conductometry.


[Formation of indium-111 in alpha and helium-3 bombardment of natural cadmium (author's transl)]. Formation cross sections and thick-target yields were studied in detail for alpha reactions and helium-3 reactions of natural cadmium in the energy range 10-40 MeV in order to determine the optimum condition for the production of medical use 11In. The helium-3 reactions were found to give higher 111In yield; namely, at the optimum helium-3 particle energy of 40 MeV and with the cadmium foil of 280 mg/cm2 thickness the amount of 11In produced was 270 muCi/muA . h. A cooling-time of 54 hours was required for the best radiochemical purity. The extraction of HBr-isopropyl ether followed by the anion exchange method was found to be the best chemical method for the carrier-free indium-111 separation.


[Metabolism of 14C-miloxacin in rats--metabolites in urine, bile and feces (author's transl)]. Isolation and characterization of metabolites of miloxacin, a new antimicrobial agent, were undertaken with rats. 14C-Miloxacin was orally administered to Sprague-Dawley rats at a dose of 50 mg/kg, and urine, bile and feces were collected. The metabolites extracted from the biological samples were isolated by column and thin-layer chromatographies. Characterization of the isolated metabolites was carried out by comparison with the authentic materials in various physicochemical analyses. Eight metabolites together with intact miloxacin were identified; containing the metabolites of N-demethoxy (M-1), catechol (M-3) and 6-methoxy (M-2 and M-4) types and their conjugates with glucuronic acid.


Study on trace impurity elements in highly purified iron and aluminum by neutron activation analysis. Activation analysis was carried out on the purified iron and aluminum to study the behavior of trace impurities on purification process, and to estimate the purity of the purified samples. Thermal neutrons with high Cd ratio through D2O column or graphite column were used for the activation of samples to reduce the interference effects by fast neutrons, the reactions, (n, p) or (n, a), from matrix elements. On the zone refined aluminum, the segregation of impurity elements was cleary observed. In the case of iron, decrease of impurity content was confirmed on superposing the various purification processes.


[Study on decontamination of radioactive ruthenium by steel wool in waste solution (author's transl)]. Tracer experiments were done in order to establish a decontamination process of 106Ru in radioactive waste solution by column method paying special attention on the solution of nitratonitrosyl complex of Ru which is often encountered as a low level radioactive waste solution. It turned out that metallic iron was the most effective decontaminating agent among the several tens of materials tested. The decontamination factor (DF) of 106Ru increased in proportion to the total surface area of iron and it sensitively depended on the oxidation state of the surface as revealed by the batchwise and columnwise tests. Iron samples with high corrosiveness gave a much larger DF than those with low corrosiveness. The decontamination process proceeded as iron was being oxidized via Fe(metal)leads toFe(II)leads toFe(III). As the results, the DF initially increased after initiating the passage of water through the column but it then decreased as the oxidation process became inactive. An excellent durability up to 10000 bed volumes was demonstrated by the column method at a high average DF of 150.


[Clinical significance of urinary CEA measurement as a screening test of bladder cancer (author's transl)]. Non-infected urine samples of twenty six preoperative bladder cancers were examined by urinary CEA radioimmunoassay and exfoliative cytology. There were 65% of urinary CEA positivity and 58% of cytological positivity (class III, IV, V). CEA measurements were positive in 8 of 11 negative cytology cases (class I and II). Exfoliative cytological examination failed to detect most of well differentiated transitional cell carcinomas, while urinary CEA study detected 4 of 6 such cases. Combination of both urinary CEA measurement and cytology resulted in 85% of positivity. Therefore we recommend routine use of this combination as a screening system of bladder cancer.


[The genus Anastrepha (Diptera; Tephritidae) in the principal fruits of Costa Rica and its reduction to human pseudomyiasis]. Three species of Anastrepha are usually found independently in 9 fruits from different regions of Costa Rica. A striata was found in 5, and A. serpentina and A. obliqua in each of 3 different fruits. During the harvest season, these larvae frequently produce intestinal pseudomyiasis, especially in children.


Simultaneous occurrence of Hb C trait and polycythaemia vera. A slow abnormal haemoglobin was found in a 27 year-old Negro man who had polycythaemia vera. Chemical and structural analysis showed it to be Hb C. The oxygen affinity showed a normal P50 value. Clinical and haematological investigations are described and discussed.


[Anatomo-pathological alterations of the lung in hemorrhagic shock studied with lungs fixed by classical method and when expanded (author's transl)]. The authors have studied lungs of 14 dogs that have been submitted to hemorrhagic shock. The right lung was fixed in the ordinary way and the left lung in expansion. They examine preparations of a 11 lobes of both lungs. Vacuolar degeneration of the cells of the terminal bronchioles and the respiratory bronchioles, hypertrophy of the cells of the alveolar sac of mild degree were constant findings. Alveolar edema of some intensity was observed in all preparations. Atelectasias of severe degree were only seen in preparations fixed in the ordinary way.


[Frequency of antibodies to Toxoplasma in pregnant women and their newborn in Sao Paulo City, Brazil (author's transl)]. In 80 apparently healthy pregnant women and their newborns tested for toxoplasmosis through the dye-test (RSF) greater than or equal to 1:16, were found respectively 50% and 38.7% positives. The positive mothers had positive newborns. The major part with the same titers as their mothers or one titer lower. The negative mothers had negative healthy newborns with one exception, considered "false positive reaction". The great majority of positive newborns were found negative at the 8th month, and the other until the 12th month. It's emphazised that the maternal and the newborn serology must be done at the same time. This considerations should be remembered when asymptomatic newborns with positive serology for toxoplasmosis are discussed.


[Effect of saralasin infusion on glomerular filtration rate and sodium excretion in hypertensive patients (author's transl)]. Saralasin (S) infusion, at a dose of 10 micrograms/kg/min IV, decreased Glomerular Filtration Rate (GFR) in 18 hypertensive patients. This effect was more pronounced in those patients with angiotensinogenic hypertension due to the somation of the effects of S upon renal vasculature and systemic arterial pressure. A decrease in urinary sodium excretion was also observed being more intense in those patients whose systemic pressure also decreased during S infusion. In group II (10 hypertensive patients) infusion of S in increasing doses (0.1, 0.5, 1.0, 5.0 and 10.0 micrograms/kg/min) a progressive decrease in GFR was observed only when the arterial pressure also decreased. However urinary sodium excretion decreased progressively as S doses increased. This effect was not related to S effect upon arterial pressure. This observation indicates that S, like angiotensin II, has a direct effect upon the renal tubules evoking an increase of sodium reabsorption.


[Genetics of anapheline populations. III. Electrophoretic analysis of Anopheles aquasalis (Diptera: Culicidae) (author's transl)]. Genetic variation at 26 loci in a natural population of Anopheles aquasalis has been studied by zymogram technique. Average proportion of polymorphic loci is 23% (criterion I) and 34% (criterion II). On the average 8.1% of the genome is in heterozygous condition in each individual. The degree of genetic variability varies from locus to locus. Some enzymes such as AO, alpha-GPDH, 3 loci of HK, 3 loci of LAP, 3 loci of MDH, GOT, 3 loci of ODH and one locus of EST (EST-4), are monomorphic. Of the rest, proportion of heterozygosity varies from the minimum of 0.041 at Xdh-2 to a maximum of 0.493 at Est-2. Similarly, except for the loci Est-2 and Est-3, proportion of heterozygote individuals is extremely low. A. aquasalis has a higher genetic identity with A. evansae (I = 0.625) than with A. argyritarsis (I = 0.543). There seems to be direct correlation between the genetic variability of a species and its capacity to explore diverse ecological nitches.


Influence of clofibrate on plasma lecithin: cholesterol acyltransferase (LCAT) activity in rats. Effects of clofibrate on plasma lecithin: cholesterole acyltransferase (LCAT) activity, plasma lipid levels and hepatic cholesterol content were examined in rats with clofibrate treatment for a short period of time. The results show that the administration of the drug for three weeks produces substantial shifts in hepatic cholesterol fractions and induces changes in the plasma LCAT enzyme. It is suggested that clofibrate increases plasma LCAT activity by induction of the enzyme on the microsomal fraction of the hepatic cell and subsequent secretion by the liver. Presumably clofibrate treatment also produces an increase in the rate of hydrolysis of cholesteryl esters in the rat liver.


[Hematin treatment of acute intermittent porphyria. A case report (author's transl)]. A young woman with acute intermittent porphyria in profound relapse and severe nervous and respiratory involvement was treated by intravenous infusions of hematin, followed by improvement of symptoms. The diet with high carbohydrate and protein content and a B-adrenergic blocking agent, not showed any beneficial effect on acute attack. The infusion of hematin was followed by a lowering effect on urine porphybilinogen and delta-aminolevulinic acid and clinical improvement. The return to normal of porphyrin precursors in the urine was accompanied by almost complete clinical remission. The relationship of remission and repression of delta-aminolevulinic acid, decrease of urinary levels of porphyrin precursors, pulmonaries tests and electromyograms, were discussed.


Oxytalan fibers in the Schistosoma mansoni tegument. In order to elucidate the nature of the fibrous network present in Schistosoma mansoni tegument, adult worms were studied by light and electron microscopy. It was suggested that this network is formed by bundles of tubular microfibrils 10--12 nm in diameter, similar to oxytalan microfibrils present in higher animals.


Electron microscopy of collagen resorption by fibroblasts in wound repair of the albino rat skin. The ultra-structural study of rat skin repair process at 7, 14 and 21 days has shown a greater collagenous resorption activity on the seventh days of the repair process.


[Anatomical findings in 30 cases of acute severe traumatic coma (author's transl)]. A variety of lesions of varying complexity were noted during pathological examinations of the brain in 30 cases of acute severe traumatic coma, of whom 27 survived for less than 10 days. "Diffuse brain damage" were present in all cases and contusions were frequently noted (83 p. 100). The lesions appear immediately after, and are directly related to the injury. Ischemic lesions were present in 66 p. 100 of cases and their mechanisms of production are various and interwoven. The frequency of respiratory difficulties associated with brain injuries is stressed. Two thirds of the cases with brain stem lesions (80 p. 100) were secondary to phenomena related to trans-tentorial herniation. Clinical examinations of these patients with acute severe coma demonstrates the difficulties encountered in assessing prognosis based on clinical findings within the first 48 hours.


[Anatomo-clinical study in severe head injury (author's transl)]. Fourty-one cases have been studied, using the research of 10 brain stem reflexes, leading to define 6 levels of axial disturbances. The anatomical post-mortem findings allowed the authors to assume that primary brain stem damages are scarcely found (4 p. 100), as compared with diffuse brain damage (93 p. 100). The amount of supratentorial diffuse lesions seems to be the most important factor to determine the level of axial disturbance: the larger supra-tentorial lesion the lower brain stem dysfunction level. The authors emphasize the special value of corneo-pterygoidal reflex as a borderline in the rostro-caudal deterioration process of theCNS, following severe head injury.


[EEG in post-traumatic coma. Diagnostic and prognostic value (author's transl)]. This study concerns 1600 post-traumatic acute comas, who underwent combined clinical and EEG examinations. The EEG has been recorded accurately bedside several times a day throughout the acute stage. The obtained EEG patterns, generally considered to be polimorphous and extremely variable, can be classified into five basic groups corresponding to progressive deterioration of the cerebral electrogenesis: borderline, changeable, sleep-like, monotonous and silent. Borderline, sleep-like and changeable patterns, even though they indicate a varying degree of impairment of cerebral electrogenesis, prove nevertheless that the brain is capable of elaborating physiological rhythms and of modifying its activity in a spontaneous or evoked manner. True slow monotonous activity indicates an extreme degree of cerebral impairment; flattening, up to EEG silence, indicates the onset of brain death. Focal slowing and/or flattening, which often lacks surgical significance, is not considered in this classification. Focal or generalized irritative activity in the early stages, however, indicates a more severe condition. EEG has often proved to be an useful means supporting the diagnostic and prognostic value of clinical examination.


[EEG and clinical study of 107 patients with acute severe traumatic comas (author's transl)]. The authors describe the EEG recordings of 107 patients with acute severe cranial trauma and signs of axial lesions. The initial EEG included: sleep patterns, alternating tracings, alpha band tracings which were either nonreactive pseudo-alpha or modulated alpha often reactive, and diffuse slow wave tracings. They found no particular tracing corresponding to a precise level of rostrocaudal destructuration, but some associations were seen more frequently. EEG sleep patterns and alternating tracings were never observed in brain stem lesions, the activity recorded being of low voltage, rigid, and non-reactive. The presence of spontaneous fluctuations (with sleep rhythms in some cases) and reactivity in other levels (mesodiencephalic junction, diencephalic and cortical-subcortical) are good prognostic signs. Focalised EEG signs are seen especially in the more rostral levels.


[Post-traumatic coma from diffuse brain lesions. A correlative study of the levels of dysfunction and the EEG nyctohemeral aspects (author's transl)]. Thirteen EEG and polygraphic recordings were performed during a 24-hour period in 11 patients with post-traumatic coma. Spontaneous fluctuations, reactivity, and the organization of electrical activity were studied throughout the nyctohemeral period. The results were compared with the data obtained from clinical examinations evaluated in terms of the level of neurological dysfunction. The level of impairment of the EEG was usually a valid indication of the level of neurological dysfunction, the EEG results being sometimes more precise than the clinical data. In regard to the prognosis, the disappearance in the EEG of any fluctuations coincided with an unfavourable evolution.


[Hemodynamic and metabolic changes at various levels of cerebral dysfunction during severe traumatic coma (author's transl)]. Cerebral blood flow (DSC) and oxygen consumption were measured in a series of patients in the acute phase of severe brain injury, and the results analyzed as a function of the level of cerebral dysfunction determined clinically. The most frequent modifications were increased cerebral blood flow and reduced oxygen consumption, whatever the degree of dysfunction. Hemodynamic data has no prognostic value whereas oxygen consumption results are more valid. Increased cerebral blood flow is noted constantly in patients at a level of mesencephalic dysfunction. Reduced O2 consumption associated with increased blood flow is the result of a disturbance in the blood flow-metabolism ratio and could be due to cerebral vasodilatation. This great increase in cerebral vasodilatation observed in cerebral dysfunction syndromes is in favour of the existence of a central neurogenic system in the brain stem regulating cerebral blood circulation.


[Correlations between intracranial pressure (I.C.P.) and EEG changes during traumatic coma (author's transl)]. A total of 55 polygraphic recording (ICP, EEG, EMG, EOG, Respiration, and ECG) were made in 20 comatose patients following cranial injuries, during the week after the injury. Whenever the ICP was stable, and without waves, and whatever the mean values were, the EEG tracing was slow, monomorphic, of large amplitude, and nonreactive. Each time that ICP recordings included Lundberg's B waves, the EEG tracings showed alternating bursts of slow waves and periods of rapid activity, with or without typical sleep patterns. The ICP increases each time there is flattening of the tracing and diminishes with the reappearance (spontaneous or provoked) of slow waves. The artificial respiration is not always involved in determining these phenomena.


[Electro-neurological correlations of the early stages of acute traumatic secondary midbrain and bulbar brain syndrome (author's transl)]. One hundred and sixty-five EEGs were analysed from 140 patients in postraumatic coma with secondary traumatic midbrain and bulbar syndrome. The EEG-pattern was related to the stage of midbrain of bulbar syndrome caused by supratentorial brain shift. There was a close relation between EEG-pattern and the grade of rostro-caudal impairment. A decrease in the number of different EEG-patterns was associated with increasing intra-cranial pressure. An unfavourable state of coma was indicated by the disappearance of sleep or sleep-like activities, alternating pattern and loss of reactivity. In deep stages of coma the neurological examination reveals no lateralizing signs at all. The EEG gives the only hint to a local cerebral lesion. EEG-abnormalities due to the herniation itself interferred with the EEG-changes due to secondary circulatory, respiratory and metabolic encephalopathies. In such cases the above mentioned regularities were blurred.


[Correlations between intracranial pressure variations and EEG changes in patients with cranial trauma (author's transl)]. Polygraphic studies were performed over periods of 14 to 76 hours in 30 patients with reccent closed cranial injuries. Correlations between ICP and EEG findings were rarely found (3/16) in cases of cerebral dysfunction of mesodiencephalic or lower levels, where both ICP and EEG were usually stable. Correlations are regularly found in diencephalic or higher (10/14) levels and their presence is of favourable prognostic significance. Generally, delta waves at 1,5-2 cs, high in amplitude (type A) accompany reduced or low ICP levels,while a rapid and low voltage tracing (type B) is associated with raised or high levels of ICP. In the latter cases, a very slow (0.5 cs) and low in amplitude tracing (type C) can progressively replace the type B. The classical periodic or alternating tracing associates alternate sequences of type A and B and is observed simultaneously with type B pressure waves. These correlations are analogous with those observed during the evolution of intracranial tumors or hydrocephalus. The EEG modifications are probably related more to the pathological lesion than to a direct action of fluctuations in ICP.


[EEG sleep patterns in post-traumatic coma (author's transl)]. EEG sleep patterns were observed in 44 cases of cranial injuries examined within 24 hours of the traumatic incident. Young people were involved, as more than half of these cases were noted in patients under 15 years of age. Two main types of tracing were observed: EEG sleep pattern with slow waves were seen mainly in children; but sleep patterns of low amplitude appeared generally in adolescents and adults. There was usually a favourable outcome in this series, as there was only one death the day after the accident, in a pateint with multiple injuries and only two cases of post-traumatic epilepsy.


[Semiologic aspects of traumatic coma (author's transl)]. After studying 85 patients with severe traumatic coma and reviewing the published literature, the authors propose a simple clinical procedure for the diagnostic of such cases. This classification is based on signs without any ambiguity, easily recognized by different physicians, and of pathognomonic significance. These include reaction to pain, testing four reflexes integrated at different levels in the brain stem, pupil morphology, and spontaneous ocular movements. The clinical features corresponding to different levels of dysfunction in the brain are described and their characteristics outlined. The importance of motor reactivity to pain associated to the brain stem reflexes (fronto-orbicular, photomotor, horizontal and vertical oculo-encephalic) is stressed.


[Evoked brain stem potentials in cases of traumatic coma of: value in determining the degree of brain stem dysfunction (author's transl)]. Auditory brainstem potentials were recorded in 22 comatose patients in whom the level of brainstem dysfunction was defined by the clinical assessment of brainstem reflexes and posture. The patients with cortico-subcortical or diencephalic levels showed normal brainstem potentials. The other patients showed a relationship between the abnormalities of the different components of the brainstem potentials and the clinical levels of brainstem dysfunction caused by the rostro-caudal evolution. Alteration of wave V seemed to be related to a midbrain dysfunction, alteration of wave III to a pontine dysfunction and alteration of waves I and II to a lower brainstem dysfunction.


[Severe traumatic coma from diffuse brain lesions (neuropathological aspects) (author's transl)]. From a review of recent literature, and pathological study of more than 100 personal cases, the authors describe the most interesting of these "diffuse" lesions; they only recall the most common types of lesions (contusions, vascular lesions, edema and its consequences - especially on brain stem); but a more detailed description is given of less known lesions of corpus callosum, brain stem and white matter, which have a more complex pathogeny (direct physical injury, anoxia-ischaemia, edema), and which they consider to be factors which worsen or protract the coma. "Biochemical" lesions (basic myelinic protein, liberated "false" neurotransmitters) are also discussed.


[Influence of choline on amnesia in Alzheimer's disease (author's transl)]. Eight patients with Alzheimer's disease presenting whith memory difficulties and no significant intellectual deterioration were treated with 9 grams daily. Choline base orally for 3 weeks. Quantitative testing, which evaluate memory capabilities such as learning and recall after delays of 1 hour and 24 hours, were used before and after the administration of Choline. The results of a global statistical analysis did not show any significant difference in the performances obtained before and after choline. However, in two patients, recall performance improvement was confirmed clinically. Most likely, these two patients were suffering from an mild foorm of Alzheimer's disease.


[Failure of voluntary eyelid closure, motor impersistence and hemispheric functional specialization. A report on 3 cases (author's transl)]. The impossibility of voluntary closing of the eyelids is usually reported in the published literature as being associated with bilateral cerebral lesions. In the three cases reported by the authors, this rare symptom was caused by unilateral lesions of the right hemisphere. The inability to close the eyelids voluntarily is, with these types of lesion, a transient sign which is rapidly replaced by difficulty in maintaining the consign. The physiopathology of motor impersistence (neglect of instructions), and of absence of voluntarily closing of the eyelids may be connected. Two associated mechanisms are discussed : preferential activation of the left hemisphere during a verbal consign and a fault in interhemispheric inhibition.


[Argyll Robertson in a case of malignant lymphoma with ciliary involvement (author's transl)]. The authors report a case malignant lymphoma associated with a pseudotabetic syndrome including ataxia, tendon areflexia and an Argyll Robertson pupil. Blood and CSF serological tests for syphilis were negative. Death occurred after 11 years of evolution. An autopsy revealed a malignant lymphoma with mediastinal and retroperitoneal tumor proliferation as well as infiltration of peripheral nerves, in particular the ciliary nerves and one ciliary ganglion examined. No lesion was found in the mesencephalon. The importance of this case lies in its contribution to the location of the pathological changes in the presence of an Argyll Robertson pupil.


[A case of familial muscle weakness corrected by exercise (author's transl)]. The symptom described as muscle weakness corrected by exercise appears to be part of the recessive form of congenital myotonia, of which it can constitute the dominant clinical manifestation in some cases. This symptom coincides with decrements of the action of potentials to repetitive stimulations in the electromyogram, which may be particularly severe in these same cases. These observations contribute to the modification and precision of the description of the recessive form of Thomsen's disease, but their pathogenicity remains unclear.


[Benign forms of multiple sclerosis : a revaluation (author's transl)]. The authors studied 38 cases of benign forms of MS, defined as those allowing a normal or nearly normal social, occupational, and family life over a "long" period of tens of years, for at least 15 years (mean : 28 years, range : 15 to 68 years).--Forms with rare relapses with long intervals between them (18 cases), and a mean period of 14 years (5 to 30) between the first and second episode.--Recurrent forms (17 cases) with frequent attacks (one or two a year), including 8 cases with no further relapses after an average period of 10 years, and 9 cases with continuation at the same rhythm for 15 to 23 years.--Secondarily progressive forms belonging to both types--8 in the first and 3 in the second--characterized by the late onset (mean : 25 years, range : 15 to 47 years) of a progressive paraplegia.--Slow forms (3 cases) with an early but only slowly evolving progressive phase, which fall into a border line category of benign forms. Independently of the mean age of onset (26 years); the predominence of females (2.2); and the symptomatology of the first attack (40 p. 100 involve the cranial nerves, and 40 p. 100 have pyramidal signs), the two essential characteristics of benign forms are the remarkable regression of relapses (rare of frequent) and the absence of a progressive phase. Once the 10-year point has been passed without permanent disability the prognosis is good, but with the reserve that the disease can become worse at a later stage.


[Amiodaron neuropathy: clinical and pathological study of a new drug induced lipidosis (author's transl)]. The authors report a case of amiodaron-induced neuropathy in a seventy one years old man. First signs appeared seventeen months after the treatment was started with 400 mg/day for one year and continued with 200 mg/day. Examination on the 29th month disclosed a severe sensory and motor deficit of the limbs with distal predominancy. Motor nerve conduction velocity was strongly impaired without modification of distal latencies. Fundi were normal. The patient improved quickly after drug withdrawal. The authors review the rare similar cases reported in the literature and attempt to describe the clinical caracteristics of amiodaron neuropathy. Qualitative and quantitative light and electron microscopical studies of nerve, muscle and skin biopsies, including teased fibers preparations were performed and they disclosed a marked reduction of the number of myelinated fibers. Wallerian degeneration predominated (31 p. 100) other segmental demyalination (25 p. 100). Numerous polymorphous lipid-laden lysosomes were present in Schwann cells, fibrocytes, pericytes, endothelial and muscle cells. These previously undescribed morphological findings are similar to those present in perhexiline maleate intoxications. We believe amiodaron neuropathy is a new neuropathy with drug-induced lipidosis.


[Polymorphism of the continuous muscle fibers activity syndrome. Possible relationship with Morvan's fibrillary chorea (author's transl)]. Two cases presenting the main features of the continuous muscle activity syndrome (neuromyotonia) are reported. The clinical particularities between the two patients are under lined. The second case is special because of its acute and reversible evolution and the possible role of gold salts in its etiology. This latter point suggests Morvan's fibrillary chorea. The possible relationships between the two syndrome are discussed.


[Recurrent familial neuropathy due to compression (author's transl)]. The authors describe a family, of which 13 members had peripheral neuropathy manifesting as episodes of paralysies usually provoked by minor compression of nerve trunks. Nerve and muscle biopsies in two patients, demonstrated many thickenings of the myelin sheath ("tomacula"). Electron microscopy investigations are used as a basis for discussing the origin and place of this affection among other hereditary neuropathies.


[Syphilitic meningo-encephalitis with probable associated arteritis (author's transl)]. A 21-year-old woman was referred for consultation because of sensory and motor disorders of sudden onset but on lung duration. Neurological examination was normal. Lumbar puncture confirmed the presence of a clear liquid meningitis. Arteriography demonstrated segmental arteritis of the anterior cerebral vessels. Systematic serological tests were positive for syphilis. The authors discuss the relation between arteritis and syphilitic meningitis in this young woman taking oral contraceptives.


[Reconstructive surgery of the extrahepatic biliary tract]. In our Service of Gastroenterology (Hospital Colonia) there were 16 patients in whom surgical plastic repair of the biliary tract was done. Out of these, the files of 11 were reviewed; national and international related medical literature is reviewed. In all cases the lesion was related to previous surgery. The main symptoms were: jaundice, acolia, coluria and pain. Laboratory tests were of help in preoperelative diagnosis and postoperative follow up. Operative findings were section and or ligature of the hepatic duct or the common bile duct. In 6 patients and end to end anastomosis was made, in 4 cases a biliary-digestive tract anastomosis and in one case an internal fistula was closed and common bile dilatation performed. In 8 patients results were considered good, in 2 they were bad, and one case was lost. There were complications in 6 patients, these consisted in wound infections and pneumonia. Four patients were reoperated, one because of a residual common bile duct stone one because of stenosis and two because of insuficient treatment at the first operation. Patients were followed from 6 months to 15 years. The tube was left for more than 11 months in 70% of the cases. There was no immediate mortality. One patient died after 4 years of secundary biliary cirrhosis.


[Infections caused by gram negative anaerobic bacteria and other associated bacterial strains]. Between November 1975--December 1977, in the Laboratory of Microbiology, National Institute of Nutrition, Mexico, 156 cultures for anaerobic bacteria were grown on 118 cases with a clinical picture suggestive of anaerobic infection. There were 42 positive cultures (26.9%) from which 18 (42.8%) grew a mixed flora (aerobicanaerobic). Those 42 cultures came from 35 patients (29.6%) and the 18 mixed cultures came from 18 cases (15.25% global and 51.42% of the cases with anaerobic flora). The highest positive marks were obtained from material provenient from the abdominal cavity, and lesser indexes were obtained from lungs, blood, bone and sinovial cavities. The overall mortality was registered in 24 cases (20.33%) but only in 6 cases (5.8% global and 25% of the total cases) a positive anaerobic culture was obtained. In these 6 cases the cause of death was secondary to the principal disease, and only in one case the patient died from septicemia. The diagnosis of anaerobic infection resides mainly in the clinical findings, secondly in a positive gram stain, and thirdly in the identification of the etiologic agent, that will aid in the choice of a more specific therapy, which must include a surgical excision of the affected tissues.


Factors affecting the pharmacokinetics of diclofenac sodium (Voltarol). The blood level curves of diclofenac have been studied following its administration to young and old volunteers, and results of studies performed on olderly patients and those with renal disease are reported. The investigations on young volunteers show that when the enteric-coated tablets are taken there is a delay in the onset of absorption but thereafter absorption and elimination are rapid, with a terminal elimination half-life of 1.2 hours. The relevance of these observations to the patient who is receiving the drug chronically and who is older, ill and often on drugs is discussed. Clearly, all the different factors which may affect the handling of the drug have not yet been evaluated, but the studies carried out so far suggest that the blood level profile obtained is not materially affected by age, renal impairment or chronic administration.


Comparisons of tolerability findings in international clinical trials. This report summarizes tolerability results from over 30 000 patients treated with diclofenac in clinical trials in rheumatic and other indications in 21 countries. Comparative trials indicates that 75-150 mg daily of diclofenac is better tolerated than similar doses of indomethacin and 1.5-5 g daily of aspirin, and at least as well tolerated as 600-1200 mg of ibuprofen and 500 mg daily of naproxen. In general practice populations unwanted effects can be expected in about 18% of patients and will result in discontinuation in about 4%. Gastrointestinal disturbances were the most frequent unwanted effects with diclofenac, occurring in about 8% of patients. Mild CNS effects also occurred infrequently in about 1.5% and dermatological effects in about 1%; cardiovascular effects also occurred in about 1%. As over 80% of unwanted effects and all of the discontinuations for intolerability occurred in the first six months, the tolerability of diclofenac does not decrease with time.


The chemistry of diclofenac sodium (Voltarol). The study of phenylbutazone and of the major anti-inflammatory agents which followed a decade later provided target criteria for a research project aimed at the synthesis of a new anti-inflammatory agent with superior activity and tolerability. Diclofenac fulfils the steric and physicochemical criteria, and the absence of a heterocyclic ring from its chemical structure may have a beneficial influence on its tolerability.


[Aspiration biopsy of the pancreas].

[Aspiration biopsy of the pancreas]. Biopsy of the pancreas frequently is followed by complications, this is why the transoperative aspiration biopsy has been recomended. During the last 2 years we used this procedure in 46 patients; in each case, one or several aspirations were done in the more-representative area of the pancreatic pathology. With the aspirated material a smear was fixed and treated with H-E stain. Biopsy was negative for carcinoma in 30 patients (65.2%), positive in 12 (26.0%), insuficient material results in other 4 (8.6%) we consider that the procedure was useful in the 82.6% of the cases and help to elect more adecuate surgical tecnic. There were no complications and we concluded that this is not a harmful procedure. The correct interpretation of the citology depends on the experience of the pathologyst with this method, to increase the percentage of correct diagnosis.


[Incidence of the parasite Trichostrongylus among the population of the higher altitude areas of Romania]. The population in two higher regions of the country were examined for the presence of Trichostrongylus, finding a proportion of 0.76% of 412 subjects in one area and 0.73% of 527 subjects in the other. There was a reduced density of eggs in the stools. All the subjects investigated were apparently healthy.


[Dynamics of streptococcal infections and prevention of post-streptococcal diseases in children's communities of Timişoara]. An analysis was carried out of the dynamics of circulation of the beta-haemolytic streptococcus in pre-school and in school children in the first two years of primary school. The study was performed simultaneously in two groups of children (an experimental and a control group) and allowed, after confrontation of the results obtained, to evaluate correctly the investigations performed, that is the detection of the acute disease and of healthy carriers by bacteriological examinations and early detection of post-streptococcal complications with the aid of serologic examinations (ASLO). The importance is stressed, of living conditions in the family and at school, as well as of individual factors (hereditary, hormonal, immunologic, etc.) in the development of late complications. Thus the measures proposed by the authors are aimed not only at the medical aspects, but also to the social-organizatoric ones.


[Peliosis hepatis].

[Peliosis hepatis]. A 35 years old female with peliosis hepatis is reported. She came to us complaining of muscular aches. The only positive finding at the physical examination was a normal size liver but palpable in a deep breath; it was hard, no tender, with smooth surface. The laboratory work up was negative except for a mild increase in transaminase values. The liver biopsy disclosed the characteristic lacunar spaces fulfilled with blood. This is an unusual case because it was not associated with any other former or present disease. A review of the pertinent literature was made.


[Effectiveness of radical treatment in infections with antochthonous strains of P. malariae]. The present paper reports on the results obtained in longitudinal serological investigations (indirect immunofluorescence and species homologous antigen) carried out with a review to evaluating the efficiency of the radical treatment in malaria caused by residual autochtonous P. malariae strains. In acute infections the treatment was followed by progressive decrease in the antibody level, tending towards zero in the course of a year; in the latent, asymptomatic infection, antibodies persisted at high levels for several years after the treatment, indicating persistence of the parasite and, hence, inefficiency of the treatment.


[Is it necessary to routinely use nasogastric intubation and subhepatic (Penrose) drainage after an uncomplicated cholecystectomy?]. 140 surgical patients were studied at the Navy Medical Center in Mexico City. All of them had a cholecystectomy performed. In addition, 29 patients were treated for hiatal hernia with troncular vagotomy, pyloroplasty and hiatal repair. 7 of them had a prophylactic appendectomy. Group A was treated with gastric intubation and subhepatic drainage. Group B received neither. Postoperative morbidity and hospitalization time less in Group B. It is suggested by the authors not to be use nasogastric intubation nor subhepatic drainage after elective cholecystectomy, although there are special circumstances where one or both procedures are indicated.


[Prevention of cholelithiasis with ascorbic acid. Experimental study in hamsters]. Cholesterol lithogenesis is the end result of hepatic microsomal enzymatic alterations which determine an increase in cholesterol synthesis (HMG CoA reductase) and a decrease in its transformation into bile salts (7 alpha hydroxylase). Therefore biliary cholesterol excretion is increased while bile salt excretion is diminished. Ascorbic Acid (A.A.) seems capable of reversing those enzymatic derrangements in scorbutic animals. Since hamsters are able to synthesize A.A., we evaluated its effect used in high doses during diet induced lithogenesis. Two groups of 6 weeks old, male hamsters, were fed with a lithogenic diet for 30 days. Group A received the usual amount of A.A. contained in the diet (0.25 mg/day/manster) while group B had supplementary A.A. added to drinking water (5 mg/day/hamster). Thirteen out of twenty of group A (65%) and 5 out of 20 of group B (25%) developed cholesterol calculi (p 0.05). Less stones were found in the gallbladders of hamsters fed with supplementary A.A. It is concluded that A.A. in this model, has an inhibitory effect on lithogenesis. The possible mechanism seems to be related to A.A. influence on the microsomal enzymes involved in lithogenesis. These findings, plus the lack of undesirable secondary effects of supplementary A.A. suggest a potential therapeutic role in human cholelithiasis.


[Rapid method of testing microbiol sensitivity to antibiotics]. The conventional technique for determining the sensitivity of bacteria to antibiotics is slow and a more rapid method becomes mandatory. The authors tested microbial sensitivity to antibiotics by measuring turbidity of the cultures in fluid medium. The method offers an orientation in the choice of an elective antibiotic within at most 4 hours.


[Rheumatoid foot. Practical podiatric problems]. The rheumatoid foot may obtain relief from practical local measures that prevent the excessive use of drug therapy. These include the decrease in inflammatory phenomena thanks to local injections of corticoids (eventually synoviorthesis), the prevention of deformations through the use of various apparatuses, the protection of the skin of the palms and the nails that are fragile and rapidly altered by local hygiene care. The maintaining of sufficient support and normal walking through the use of plantar prostheses or custommade toe prostheses and by wearing shoes of excellent quality, the maintainance and preservation of articular flexibility and muscular trophicity by adapted kinestherapy and ergo therapy. Major deformations that, while they cannot be modified do not require surgery, can be alleviated with "custom-made shoes" which are at the same time light, adapted and good looking. Whatever the treatment used, local measures are the most effective at any given time.


[Prognosis of chronic systemic-type juvenile arthritis (Still's disease). Numerical analysis of 82 cases]. This study deals with 82 cases of systemic-type chronic juvenile arthritis, 27 of which were followed up over a period of more than 7 years, the development of inflammation of the disease, the extnet of destructive bone lesions and the final functional prognosis. Their conclusion is that, contrary to the traditional notion, this condition often continues to develop beyond adolescence and it often brings about deep-set deterioration of the bones (especially at the wrist and the hip), which has a heavy bearing on the functional prognosis.


[Study of circulating fatty globules by filtration of the serum in primary osteonecrosis of the femoral head]. The authors carried out in a group of 21 aseptic osteonecroses of the femoral head, a study of circulating fatty globules using a filtering technique on a millipore filter. 7 of these patients showed a normal lipid count, 10 had isolated increases of the prebetalipoproteins, 2 had a type IV hyperlipemia, 1 a type III hyperlipemia, and 1 a global hypolipemia. In all cases, no fatty globules were found. Decreases in the level of triglycerides and prebetalipoproteins were noted after filtering but the differences were not significant. These observations do not add support to the theory of fatty microembolism of aseptic osteonecrosis of the femoral head.


[The calcaneus in the Fiessinger-Leroy-Reiter syndrome]. The authors report on 43 cases of calcaneitis seen out of 121 cases of Fiessinger-Leroy-Reiter syndrome. They describe the three developmental stages and show that the polymorphism of the radiological aspects realized depend on the very great variability of the speed of development of the pathological process from one case to another. Calcaneitis of the Fiessinger-Leroy-Reiter syndrome always ends in cure.


[Osteoid osteoma of the foot. Apropos of 4 personal cases]. On the basis of four personal cases of osteoid osteomas of the foot, the authors study their frequency, their localization, and their clinical and radiological manifestations. They insist on the special difficulties of diagnosing this condition due to its atypical and uncertain radiological outline, and also on methods of further investigation : arteriography and especially isotopic scintigraphy.


Reliability in the determination of speech reception threshold (SRT). Clinical measurements of the speech reception threshold (SRT) have been made in order to determine the parameter values of a psychometric function. SRT measurements were then simulated in a computer to obtain, among other things, the standard deviation of a number of measurements from one and the same "patient". "Patients" with poor speech discrimination resulted in bad reliability of the SRT and great sensitivity to the hearing level at which the test started. New methods are proposed here, which are both faster and less susceptible to influence from the patient's speech discrimination.


Frequency selectivity and speech discrimination in sensorineural hearing loss. Two supposed measures of auditory frequency selectivity--the critical band (CB) in loudness summation and the psychoacoustic tuning curve (PTC), Both measured at 1 kHz--were compared with the capacity for speech discrimination in patients with various cochlear disorders and a relatively flat audiometric pattern. The CB in loudness summation was correlated neither to the degree of hearing loss nor to the speech discrimination score. In contrast, the PTC changed with increasing hearing loss in the same manner as the electrophysiological tuning curve (FTC), i.e. rapidly deteriorating beyond normal limit values when the hearing loss exceeded 30--40 dB (HL). Nearly the same dependency of the degree of the hearing loss was demonstrated for the speech discrimination score (determined in noise and after filtering of the signal) and a significant correlation was present between this score and cochlear tuning, as expressed by the PTC. It is proposed that the PTC is a more valid measure of auditory frequency selectivity than the CB in loudness summation. If this is accepted the results seem to support the hypothesis of impaired frequency selectivity as a major cause for deteriorated speech discrimination in patients with cochlear disorders.


Further interpretation of the threshold of octave masking (TOM) test. The threshold of octave masking (TOM) test was administered to normal-hearing and sensorineural-impaired listeners at four test frequencies; 500, 1000, 2000 and 4000 Hz. The TOM value was found to be inversely proportional to the degree of hearing loss at the masker frequency. Results indicate that the TOM test is capable of distinguishing subjects with sensorineural involvement from those with normal hearing and of providing a measure of the degree of sensory dysfunction. Examination of the slope of octave masking dysfunction. Examination of the slope of octave masking revealed that once the influence of hearing loss is overcome at higher intensities the sensorineural ear performs essentially the same as the normal ear in a tone-on-tone masking task.


Brain stem electric response audiometry and middle ear effusion. Brain stem electric response audiometry has been performed in a group of 41 difficult-to-test children under the age of 8 years. All ears were examined with the pneumatic otomicroscope prior to determination of response thresholds, and middle ear effusion found in 24 (29.3%). Seven of the 14 children requiring hearing aid amplification had fluid in 12 ears (42.9%). The importance of early recognition and treatment of middle ear pathology in children with sensori-neural hearing loss is stressed, and routine otomicroscopy by the attending otologist is recommended.


Multiple probe frequency acoustic reflex measurements. Acoustic reflex impedance measurements are made on forty-seven normal and two otosclerotic ears using fixed probe frequencies from 220 to 2000 Hz. In general, the reflex increases the middle ear impedance up to 700 Hz probe frequency and decreases it thereafter. It is postulated that this characteristic is related to removal of the cochlear fluid resistance due to stapes decoupling. At one probe frequency in the range 500--900 Hz, the reflex of 50% of the normal ears has either a diphasic pattern or shows no change in the impedance vector length. The accompanying phase change is always monophasic. In the otosclerotic ear the diphasic reflex is present for every probe frequency. These factors should be taken into account when probe frequencies greater than 220 Hz are used for reflex measurement.


Impedance changes elicited by tactile and electrocutaneous stimulation. In each of 24 randomly selected outpatient the size of the impedance changes elicited by touching the skin in the ipsilateral cavum conchae with cotton wool were compared with those elicited by electrical stimulation of the same skin area. Pulse trains of 0.5 s duration, consisting of individual squarewave constant current pulses of frequency 200 Hz and duration 1 ms, were used. In all ears a current of 0.5-1 mA produced impedance change of about the same size as the tactile stimulus. Therefore, in testing the middle ear function observation of impedance changes elicited by tactile as well as electrical stimulation can be used. Electrical stimulation, however, has the following advantages: 1) Artifacts produced by accidently touching the probe tip are avoided. 2) The electrical stimulus is well defined and reproducible.


Comparison of ascending and bracketing methods in pure tone audiometry. A multi-laboratory study. Four laboratories participated in this study to compare ascending and bracketing methods in manual determination of hearing thresholds using attenuators with 5 dB step. In all, 214 ears were measured. No significant difference was found between mean thresholds obtained with the two methods in the frequency range 0.5--6 kHz; the four-laboratory, six-frequency grand mean difference was -0.31 dB. The variability among subjects also remained essentially the same for the two methods. However, the bracketing method required a significantly longer test time than the ascending method.


Variations in plasma protein concentrations in individuals with ulcerative colitis: analytical and biological factors. Eight plasma proteins were determined in specimens taken every second day during a 14 day period from eleven patients with acute ulcerative colitis. The intra-individual variations in the concentrations of albumin, orosomucoid, haptoglobin, IgG, IgA, IgM and complement factors C3 and C4 were larger than expected in normal persons. A two-way analysis of variance was applied to the normalized protein values to estimate to what extent the observed variations could be explained by analytical errors and the influence of biological factors general to all proteins, such as changes in plasma volume and distribution between plasma and extravascular space. In half the non-operated patients the changes in all proteins could be explained by the above mentioned variations. The individual variations seen in the concentrations of haptoglobin, C4 and IgM occurred at random compared to the clinical state of the disease. Only the operated patients showed a more systematic sequence of protein changes.