Dream mirrors.

Dream mirrors. The mirror is not so rare a dream element as has been thought; and its appearance may mark a critical point in an analysis. Intact mirrors with clear images are reported when the dreamer has made a creative integration of previously threatening material, while mirrors that are shattered or multiplied or without reflection are accompanied by evidence of terror and a lower level of psychological organization. Study of mirror dreams can further clarify the nature of the dream screen and the role of illusion in early interactions and development.


Early gastric cancer.

Early gastric cancer. Gastric cancer is a common cause of death in the Netherlands. The prognosis is generally poor at the time of diagnosis. The designation early gastric cancer (EGC) refers to a gastric carcinoma which does not infiltrate beyond the submucosa. This definition is not influenced by absence or presence of metastases or by the diameter of the tumour. The 5-year survival of EGC is 90% or more. In the Netherlands too, the diagnosis can regularly be made if--in the case of persistent vague upper abdominal complaints--an optimal radiological examination of the stomach is done. At even the slightest radiological suspicion, or if complaints persist in spite of negative radiological findings, gastroscopic examination and multiple aimed biopsies should follow. Personal observations in ten cases are presented.


Diagnostic significance of the pancreatic displacement with extrapancreatic oval-shaped low activity area on scintigram. To aid in the differential diagnosis of upper abdominal tumors, pancreatic scintigraphy was performed in 62 cases. The findings were rather characteristic for pancreatic cysts; namely, pancreatic displacement and, adjacently, an oval-shaped activity area whose count was lower than background. Pancreatic displacement was observed with comparatively large retroperitoneal masses. Low activity areas were observed in cystic lesions. Both findings were noted in 7 (54%) of 13 pancreatic cyst cases. Among the 12 cases with these findings, 7 (58%) had pancreatic cysts.


Scimitar syndrome and pulmonary sequestration. Pulmonary anomalies with persistent embryonic communications between the pulmonary and the systemic circulation. A few cases of scimitar syndrome and intralobar pulmonary sequestration are presented. The characteristic features of the two syndromes are discussed with reference to similarities and differences. Emphasis is placed on the persistent embryonic communications between the pulmonary and the systemic circulation in both syndromes.


Acute inflammation of epiglottitis and supraglottic structures in adults. Acute epiglottitis, an unusual cause of acute upper airway obstruction in adults, is probably more common than previously recognized. While the history and physical findings are characteristic, the clinical diagnosis is often unsuspected. Radiographic findings include swelling of the epiglottis, aryepiglottic folds, arytenoids, uvulae, and prevertebral soft tissues, with ballooning of the hypopharynx and mesopharynx and obliteration of the valeculae. The epilgottic airway may show a characteristic pencil-thin configuration due to edema.


Varicoid carcinoma of the esophagus.

Varicoid carcinoma of the esophagus. Two cases of varicoid carcinoma of the esophagus are presented and differentiation from the similar findings in esophageal varices is emphasized. Radiographically, distinction must be made on the basis of changeability of the configuration of the wall with positional change and alterations in the respiratory pattern, a characteristic feature of varices. Endoscopically, no change is seen in varicoid carcinoma with the respiratory cycle. The latter may have a pallid white appearance in contrast to the bluish color of varices. An area of ulceration would strongly suggest carcinoma, indicating biopsy.


Gastric bypass for morbid obesity.

Gastric bypass for morbid obesity. Gastric bypass operations have been performed on more than 500 patients at the University of Iowa for the treatment of morbid obesity. With this procedure, almost the entire small intestine remains available for absorption, and the metabolic complications which have been described after jejuno-ileal bypass surgery have not occurred. The results with regard to weight loss are encouraging.


Some application problems and solutions in xeromammography. Experience in the xeromammographic procedure has shown some paradoxical findings in demonstrating breast lesions. A skin halo of 1 -2 mm. is not the only criterion of an adequately exposed xeromammogram. Studies were carried out to assess the optimum exposure conditions. By use of a water-scattering phantom, and some clinical studies, image spacial frequency and image recording latitutde are to be found to be dose dependent. Xeromammographic exposures ideally should be tailored to suit the type of pathology under investigation.


Visualization of the lateral edge of the liver in ascites. Medial displacement of the liver was observed in 35 cases of ascites using plain radiographs, total-body opacification, tomography, radionuclide imaging, peritoneography, and/or ultrasonography. In 16 cases the displaces liver was seen on plain radiographs. Separation of the liver and kidney was seen on ultrasonograms in every case; it was increased by addition of increments of fluid in patients undergoing peritoneal dialysis. Since the liver is surrounded by fluid, an interface between it and the extraperitoneal fat cannot account for the displacement seen on plain radiographs: rather, this is the result of a difference in density between liver and fluid.


Impact of state licensure on selected aspects of radiologic technology: a 1975 survey. A 1975 survey to determine the impact of state licensure on radiologic technology compared three licensure states with three states that had no laws regulating operators of radiographic equipment. The survey showed no significant differences in radiation protection practices, recruitment, availability, or economic status of technologists. However, school regulations in the licensure states did show a positive effect upon the quality of radiologic technology education.


Hepatic occlusion venography with a balloon catheter in portal hypertension. Fifty hepatic occlusive venograms with the Swan-Ganz balloon catheter were obtained in 20 patients with portal hypertension. The venographic patterns of hepatic veins were divided into four categories: (a) hepatic venous system without visible alterations; (b) slight loss of branching and tapering, no major wall irregularities; (c) considerable loss of branching and tapering and/or marked wall irregularities; and (d) severe reduction of venous tree with severe wall irregularities ("defoliated tree"). These correlated with severity of the disease. The portal venous system was simultaneously opacified in 10  patients. Intrahepatic and extrahepatic collaterals were found in 8. Hepatic occlusion venography is a suitable method for evaluating alterations of the liver outflow tract in portal hypertension.


Program accountability survey.

Program accountability survey. The public more and more is demanding accountability from its government agencies, professional bodies, and service areas. To address the accountability of a radiologic technology program in terms of its students, a questionnaire has been developed to send to them a year after they graduate. The responses are valuable in anticipating manpower needs, writing behavioral objectives, adjusting curriculums to meet changing needs, and responding to governamnet and accrediting agencies.


Lymphangioma of the pancreas exhibiting an unusual pattern of calcification. A case of calcified lymphangioma of the pancreas is presented. The pattern of calcification evolved through three distinct phases over a 15-year period, suggesting at first a lymphangioma or hemangioma and later a cystadenoma.


Fusion anomalies of the pancreatic ductal system differentiation from pathologic states. If fusion of the ventral and dorsal pancreatic ducts does not occur during fetal life, endoscopic retrograde cannulation of the papilla of Vater will visualize a small complete ductal system which is confined to the head of the pancreas. This system is characterized by normal arborizations throughout, relatively small duct diameters and the absence of a communication with the minor papilla. In contrast, if fusion has taken place and the ductal system is shortened by disease, pancreatography will demonstrate abrupt proximal termination or proximal tapering without side branches, and may show a significant duct of Santorini. If the ducts have fused, an area of narrowing approximately 3-20 mm in length commonly occurs at the level of fusion. This should not be confused with pathologic ductal stenosis.


The long-term follow-up of 195 patients with renal failure: a preliminary report. Radiographic and bone mineral (BM) data were collected over a three-year period on 195 patients with chronic renal failure. Most women maintained BM on dyalysis, whereas 44% of the men lost BM (p less than 0.05). Following transplantation, 86% of the patients either maintained or restored BM. After parathyroidectomy, only half of the women and 34% of the men gained BM. Normal radiographs may be associated with low BM values, but there is a correlation between decreasing BM and increasing renal osteodystrophy in women (p less than 0.05).


Some important radiological aspects of the kidney in Hippel-Lindau syndrome: the value of prospective study in an affected family. Eighty-three per cent of the affected members of a family with Hippel-Lindau syndrome had hypernephromas and cortical cysts of the kidney. Two of the asymptomatic members proved to have multiple hypernephromas by a prospective study. The carcinomas are frequently multifocal or bilateral. The cortical cysts are usually multiple, bilateral and small, and often contain carcinoma in the wall. The association of multifocal or bilateral hypernephromas with renal cortical cysts represents an important aspect of the Hippel-Lindau syndrome. The value of prospective renal studies in affected families is stressed.


Bilateral parotid enlargement ("iodide mumps") following excretory urography. Parotid swelling ("iodide mumps") is an infrequent manifestation of iodism. Only 6 cases have been reported previously. The authors present a case of parotid swelling which appeared to be a reaction to excretory urography.


Renal lymphoma simulating adult polycystic disease. Multiple cyst-like involvement of the kidney in a patient with lymphocytic lymphoma is presented. Both kidneys demonstrated the swiss-cheese appearance on nephrograms, simulating a typical adult type of polycystic disease. No tumor vessels or strains were noted.


Jumpers' fractures: patterns of thoracolumbar spine injuries associated with vertical plunges. Thirty-eight patients who fractured the dorsolumbar spine by vertical plunges are evaluated. The patterns and classification of fractures in cases is presented as well as their salient clinical features. The role of the radiologist in the care of acute spine injuries is highlighted based on the therapeutic implications of proper fracture classification. The role of body section radiography in evaluating patterns of posterior element fractures is suggested.


Thermographic, radionuclide, and radiographic detection of bone metastases. The sensitivity of thermography to osseous metastases is compared to 99mTc bone scanning using the specificity of radiographic skeletal survey as proof of metastases. Thirty-five patients with suspected disease were selected for study. Bone scans detected 94.4% while thermograms detected 22.2%. Thermography proved quite insensitive to osseous metastases. Radionuclide bone scanning is the method of choice for the present.


Pseudotibiotalar slant: a positioning artifact. Pseudotibiotalar slant is a positioning artifact which duplicates a finding recently reported as a new observation in the ankles of patients with sickel cell anemia and the configuration of tibiotalar slant described in juvenile rheumatoid arthritis, hemophilia, and multiple epiphyseal dysplasia. The configuration was produced on radiographs of the author's ankle by flexion of the knee and external rotation. It is a nonspecific finding which should prompt inquiry into the possibility of ipsilateral knee and/or hip abnormality.


Measurement of pedal venous pressure: a screening procedure in the detection of deep-vein thrombosis and occlusion. A simple screening procedure is needed to fill the gap between the clinical examination and venography in patients suspected of having deep-vein thrombosis of the lower extremities. The author suggests that measurement of the pedal venous pressure (PVP) be used for this purpose. Measurements of PVP in 86 lower extremities and correlation with venography showed that all extremities with a PVP greater than 35 cm saline were shown to be abnormal on venography, indicating that measurement of PVP can be a satisfactory screening procedure.


Pressure dressings and postangiographic care of the femoral puncture site. Consecutive patient records (900) were reviewed to determine the incidence of local complications following the use of pressure dressings for femoral puncture. The authors found an overall complication rate (0.44%) which was less than that found by others (1%). No statistically significant differences were found in local complication rates between hypertensive (0.56%) and normotensive (0.42%) groups. No advantage was found in the postangiographic application of pressure dressings.


The angiographic diagnosis of leiomyosarcoma of the inferior vena cava. Two cases of leiomyosarcoma of the inferior vena cava showed a high degree of obstruction of the inferior cava, enlarged local arteries supplying the lesion, neovascularity, and a marked parenchymal blush. Collateral veins bridge the obstruction.


Persistent primitive sciatic artery.

Persistent primitive sciatic artery. Angiography revealed persistence of the primitive sciatic artery in two cases. In one, the artery supplied a large arteriovenous malformation, and the profunda femoris artery was absent. In the other, there were associated findings of neurofibromatosis, decreased left lower limb lymphatic vessels, a left subinguinal lymphocele, and absent external iliac and femoral arteries.


Angiographic diagnosis of small intestinal intussusception. The outstanding angiographic features of small intestinal intussusception are: (a) abrupt disappearance of mesenteric vessels at the neck of the intussusception with crowding of the vasa recta; (b) appearance of long collateral channels at the neck of intussusception; (c) angulation and retraction of major intestinal branches; (d) reversal of the course and angulation of the invaginated mesenteric vessels; (e) overlapping of the mesentery vessels by branches of the intussuscipiens; (f) abrupt change in the appearance of the vasa rectae of the distended intussuscipiens and the distal nondistended small intestines.


Illusory biplane radiographic images.

Illusory biplane radiographic images. The commonly held belief that radiographs taken at right angles to one another will accurately portray the precise location of a metallic implant within a skeletal structure is erroneous. To the contrary, such biplane radiographs often provide misinformation about the exact location of metallic implants. The explanation for this phenomenon is discussed along with several methods to determine the accurate location of metallic implants when only biplane radiographs are available. Orthopedic surgeons should be particularly aware of this potential problem when biplane radiographs are taken at the time of insertion of multiple pins about the proximal femur.


White and gray matter of the brain differentiated by computed tomography. The white and gray matter of the brain can be clearly differentiated by computed tomography (CT). The differentiation is enhanced by the administration of contrast material. Without contrast material, the mean attenuation number of the white matter was 29 units, of the gray matter, 35 units. The effective low contrast resolving power of CT scanners can be clinically evaluated by comparing their ability to differentiate the white and gray matter of the brain.


Computed tomography in intracranial arteriovenous malformations. 22 patients with proved intracranial arteriovenous malformations (AVM) were studied by computed tomography (CT). Of these, 18 were also studied by CT after intravenous injection of contrast material. The plain scan was normal in 23% of cases. A combination of plain and contrast-enhancement CT proved to be superior to other screening techniques in patients with a possible intracranial AVM.


Ring blush associated with intracerebral hematoma. Seven cases of ring blush following spontaneous and post-traumatic, subacute and chronic intracerebral hematoma are presented. As such a hematoma ages, a ring blush may be seen following contrast-agent enhancement. Serial CT demonstrates disappearance of the ring blush from two to six months after the first scan. The CT appearance of the ring blush is not specific for hematoma, but its peripheral location and lack of mass effect may be considered suggestive of hematoma with appropriate clinical findings. The characteristic serial changes permit correct diagnosis without surgical intervention in most cases.


Basilar artery ectasia demonstrated by computed tomography. Basilar artery eclasia was demonstrated by computed tomography (CT) in 4 cases. The course and diameter of the basilar artery as seen by CT closely approximated those aspects of the artery visualized by angiography. The clinical manifestations of basilar ectasia correlated with what brain stem structures were impinged upon by the ectatic artery.


Dense intracranial epidermoid tumors. Computed tomographic observations. Three extra-axial posterior fossa epidermoid tumors manifested nearly identical CT appearance of large size, sharp margination, apparently homogeneously increased attenuation in the range of 80-120 Hounsfield units, and absence of contrast-agent enhancement. This constellation of findings is distinctly different from that reported previously, and appears to be characteristic for some epidermoid tumors.


Cranial computed tomographic scan appearance of Sturge-Weber disease: unusual presentation. The CT findings in both the typical and atypical presentations of the Sturge-Weber syndrome are characteristic if not pathognomonic in most cases. The typical gyriform cortical calcification and cortical atrophy are well demonstrated whether associated with a small or enlarged hemicranium. Contrast enhancement was demonstrated in both cases where contrast medium infusion was performed.


Carotid-cavernous fistula associated with intracranial fibromuscular dysplasia. Fibromuscular dysplasia (FMD) of the intracranial internal carotid and vertebro-basilar system is extremely rare. A case with diffuse intracranial involvement and an associated carotid-cavernous fistula is presented. The literature is reviewed and the pathogenesis of this complication of FMD is discussed.


Epidural mastoid pneumatocele.

Epidural mastoid pneumatocele. The authors report a case of a gas-filled epidural cyst communicating with the mastoid air cells, causing fluctuating but progressive amaurosis. No prior report of a similar finding could be found in the literature.


Respiratory arrest--a fatal complication of myelography. Respiratory arrest occurred in a patient undergoing cervical myelography in the Trendelenberg position. Autopsy revealed infiltration of the phrenic nerves by metastatic breast cancer resulting in diaphragmatic paralysis. Though this is a very rare complication of myelography, it is suggested that more attention be paid to the respiratory function of patients with neurological conditions prior to myelography.


Quantitative external counting techniques enabling improved diagnostic and therapeutic decisions in patients with well-differentiated thyroid cancer. A quantitative technique is described which allows the physician to predict more accurately whether a recurrent or metastatic well-differentiated thyroid carcinoma is amenable to radioiodine-131 therapy or is better treated by other means. A calibrated uptake probe and scaler system is used to obtain conjugate view (i.e., diametrically opposed) counting rates for both the whole body and for any areas of abnormal uptake (lesion) at 24,48 annd 72 hours following the administration of 2 mCi 131l. Quantitative calculations accounting for patient attenuation, lesion size and geometrical factors then provide a determination of the lesion uptake as well as the effective half-life of 131l in the lesion. The radiation dose which would be delivered to the lesion by a given therapeutic amount of 131l may then be calculated to help determine the desirability of 131l treatment. The results of patient studies indicate the potential benefit of such quantitative evaluation.


Application of delayed lung imaging following radioaerosol inhalation. Lung scintigraphy following radioaerosol inhalation reveals evidence of airway disease and regions of decreased ventilation. In obstructive pulmonary diseases, aerosol deposition can be so excessive that lung parenchyma is not visualized immediately after radioaerosol administration. Most of the tracer which is deposited is cleared within hours, but the aerosol reaching the alveoli is retained with a half-life in excess of 2 weeks. If imaging is repeated 8-24 hours after inhalation, abnormal bronchi will usually be cleared of tracer, and regional ventilation defects can be visualized.


Positive 99mTc-stannous pyrophosphate myocardial image in a patient with carcinoma of the lung. A "false-positive" 99mTc-stannous pyrophosphate (99mTc-PYP) myocardial image was seen in a patient with epidermoid carcinoma of the lung. The location of the increased activity corresponded to an area of direct invasion of the heart by carcinoma with associated multiple microscopic foci of myocardial necrosis. Metastatic carcinoma with myocardial necrosis should therefore be considered as a possible cause of a positive 99mTc-PYP myocardial image.


Cholecystitis and hydrops of the gallbladder in the newborn. Inflammatory gallbladder disease is not usually considered in the evaluation of septic newborn infants. When present, the radiographic findings are thought to be sparse. Three instances were recently encountered with radiographic evidence to indicate right upper quadrant abdominal disease. In one, a negative defect on the bodygram phase film of a high volume contrast study demonstrated gallbladder hydrops. Cholecystitis extended to obstruct the pyloroduodenal area with inflammatory reaction in 2 other patients. In all instances, the radiographic changes prompted surgical intervention at an early age.


Radiological quiz. Familial hyperphosphatasemia. Hyperphosphatasemia is a genetic disorder of intramembranous bone formation which is radiographically similar to Paget's disease. The authors report a case of hyperphosphatasemia complicated by salt-losing congenital adrenal hyperplasia in a Puerto Rican child. Recognition of this condition is important because of the promising results with calcitonin therapy.


Anterior displacement of C2 in children: physiologic or pathologic. Differentiating pseudo-dislocation of the cervical spine from true fracture-dislocation of C2 on C3 is often difficult in children. Normal anterior position of C2 on C3 secondary to normal mobility of this area may be so pronounced that it seems true dislocation is present. A helpful line is presented to aid in the solution of this problem and the anatomy of normal and abnormal (fracture-dislocation) motion at the C2-C3 level will be discussed.


A modeled study for diagnosis of small anechoic masses with ultrasound. Hemispherical holes created in the bases of uniform natural sponges were imaged in water to determine how anechoic masses fill in with echoes at increased gains. The increase in gain, from the threshold for outlining a hole, to the fill-in of the hole with echoes, was obtained for a range of hole diameters and imaging conditions. These gain changes fit on a smooth curve when plotted against the hole diameter divided by the ultrasound beam width. The main sources of fill-in, beam width and multiple reverberations, appear to behave similarly in vivo. Understanding these effects may help reduce diagnostic errors.


Nuclear imaging, tomographic nuclear imaging, and gray scale ultrasound in the evaluation of the porta hepatis. Twenty-six patients with an eqivocal portal defect on conventional nuclear images were evaluated with a multiplane tomographic nuclear scanner and gray scale ultrasound. In most cases the correct determination (normal or abnormal) for an area of decreased uptake could be made from the multiplane tomographic scans. When an abnormality was thus confirmed, further characterization was provided by ultrasound.


A composite curve of ultrasonic biparietal diameters for estimating gestational age. A composite curve of biparietal diameters at various gestational ages was constructed from previous reports from five large centers. Estimates of the mean gestational age using the composite curve compared favorably with other reporting institutions. This suggests that the newly established echography department may employ the composite curve of mean values and need not develop its own biparietal growth curve. The clinical application of these mean values however, should recognize a considerable variance from the mean. These variations represent normal growth differences in the biparietal dimension, errors inherent in the ultrasonic methodology and apparent differences in the populations examined. A method is suggested by which variations from the mean may be identified for each echographic facility.


Ultrasound diagnosis of splenic cysts.

Ultrasound diagnosis of splenic cysts. Ultrasound is an effective modality for the study of splenic cysts because it is able to distinguish between cystic and solid lesions. Three cases of splenic cyst are presented in which definitive diagnosis was made with ultrasound B-scan.


Gray-scale ultrasonography in the diagnosis of polycystic kidney disease. Five patients with polycystic disease of the kidney were examined with gray-scale ultrasonography. It was found that bilateral involvement may be demonstrated by ultrasound even when it cannot be seen on excretory urography. It is suggested that this technique be used in screening families in whom a history of polycystic kidney disease has been shown.


Clinical phase I study of the hypoxic cell radiosensitizer RO-07-0582, a 2-nitroimidazole derivative. RO-07-0582 toxicity studies were performed in 12 patients for a total of 16 assays. Single and multifraction dose schedules were used, and drug concentrations in solid tumor tissue, cerebrospinal fluid, and blood (at 14 to 24 hr.) were established. A severe peripheral neuropathy occurred in 1 patient on the multifraction regimen when the total dosage reached 24 g. Drug absorption and concentration in the blood do not significantly differ from that of metronidazole. Maximum blood levels were reached at from 2 to 4 hr., and several days subsequent to administration had stabilized to levels only slightly above control levels.


Sensitivity of radiographic screens to scattered radiation and its relationship to image contrast. For incident X-ray beams of greater than 60 kVp, intensifying screens of rare earth phosphors produced higher radiographic image contrast in the presence of scattered radiation than did screens of calcium tungstate. This was attributed to fundamental energy absorption interaction differences. X-ray absorption is a function of the position of the k-absorption edge of the screen phosphor relative to the X-ray energy spectra of the primary and scattered X-rays. Spectral measurements of X-ray absorption showed that the ratio of primary absorption to scattered absorption is higher for the rare earth screens, causing lower relative sensitivity to the non-information-containing scattered radiation from the radiographic object.


Wide-field resolution in radiography.

Wide-field resolution in radiography. Multiple star test objects were placed so as to record the entire field covered on a 35 X 43-cm (14 X 17-in.) film and radiographed to determine the apparent shape of the focal spot and the directions in which degradation is maximum and minimum. It was found that geometric unsharpness decreases along lines radiating outward from the center of the anode shadow. The small focal spots used in magnification may be anticipated to behave in a similar fashion. It was also shown experimentally that truly lateral resolution is approximately constant over the field. A theoretical explanation for this finding is offered.


Solid state radiographic image converters: medical applications. Solid state radiographic converter screens have characteristics such as high contrast, high resolution, compact size, light weight, easy handling, moderately high gain, and low price which make them attractive for medical applications. They could be substituted for the image-intensifier tube, the intensifier screen, or the radiographic film. Construction, characteristics, and applications of the radiographic amplifier screen and the radiographic storage screen are discussed along with the advantages of using smaller size film and lower dosages. A promising application for mammography is outlined.


The effects of fast neutrons and X rays on the subependymal layer of the rat brain. Some effects of irradiation of rat brain with single doses of X rays or fast neutrons have been measured. This was done by estimating the total number of cells in the subependymal layer at various times after irradiation. The gross response to X rays and neutrons was somewhat different, and the results suggest that the two histologically distinguishable cell types in the subependymal layer have different values of RBE.


Visualization of the posterolateral elements of the lumbar vertebrae in the anteroposterior projection. A radiographic view in the AP projection for visualization of the laminae and articular processes of the lumbar vertebrae is described. This view may be used for the acutely injured patient. In addition to augmenting standard views, the AP projection will assist, and may supplant the need for tomography in selected cases.


Radiation protection requirements for a whole-body CT scanner. Exposure values for a whole-body CT scanner, obtained from a room protection survey covering one month (119 patients), are reported. It was found that weekly exposures could be expected to be in the range of 350-750 mR/week for a daily load of 12 patients. The h.v.l. of gypsum board, lead, and plate glass at this radiation level was 1.8, 0.020, and 1.3 cm, respectively. The authors suggest that plate glass is not the method of choice for shielding a high-volume body scanner installation unless a large enough lead glass window is not available or cannot be installed in time to meet construction deadlines.


A new simple restraining device for fluoroscopically monitored knee arthrography. A new device which facilitates stressing of the knee to obtain improved visualization of the meniscus is described. This device can be used for the examination of either the medial or lateral meniscus without requiring time-consuming adjustments.


A tissue compensation source-to-skin measurement system. An easy to use, low-cost system for measuring the source-to-skin distance used in determining tissue compensation requirements is described. These measurements can be performed with accuracy and precision for any treatment field size and at any treatment beam angle. The system can be used in conjuction with several different tissue compensation methods.


Maximum flow rates for microcatheters.

Maximum flow rates for microcatheters. Microcatheters are defined as those with outer diameters of 4 French gauge or less. Authors tested five sizes of catheters from 2 to 4 French, inclusive to determine the bursting and maximum safe flow rates with automatic injectors. This communication describes the maximum flow rates for various sizes and lenghts, as well as the feasibility of employing automatic injectors with microcatheters.


A spacer/injector needle for 125I and other radioactive sources in permanent seed implants. A spacer/injector needle for 125I and other radioactive sources is described. Exposure is minimized by speed, distance, and (in the case of 125I) the low energy of the source shielded within the needle. Afterloading can easily be performed using small trocars. A readily attached plunger gives the needle a syringe (injection) action, while a rapid seed loader reduces loading time as well as the number of needles required when loading is carried out in the operating room.


Esophageal obstruction following administration of "aged" barium sulfate tablets--a warning. Esophageal obstruction was encountered in 2 patients following the adminstration of a barium sulfate tablet. The tablets did not disintegrate for over three hours. They had been stored in the radiology department for at least three years. In vitro tests showed that the old tablets did not disintegrate for three hours while fresh tablets disintegrated within 30 minutes.


Influence of endoscopic manipulation and patient position on cholangiographic interpretation in endoscopic retrograde cholangiopancreatography. The authors describe the influence of patient position and distorting forces during endoscopy on endoscopic retrograde cholangiography. For accurate diagnosis, radiographs must be taken after withdrawal of the endoscope and rotation of the patient to the supine position.


A rapid, simple method of delivering 1:10,000 epinephrine. A rapid, simple method of delivering intravenous epinephrine 1:10,000 during anaphylaxis is described. It is injected through a disposable syringe needle designed for intracardiac injection, which is coupled to a butterfly needle and its tubing.


Reuse of disposable catheters and guide wires. Recent government directives and manufacturers' warnings have strongly cautioned against reuse of angiographic catheters and guide wires following cleaning and sterilization. Though it is theoretically possible that complications might result from reuse, actual documentation is lacking. Complete sterility can be achieved by standard procedures even when the devices are intentionally infected. Survey data indicate no increased incidence of mechanical malfunction when these devices are reused.


Criteria of the silhouette sign.

Criteria of the silhouette sign. The silhouette sign is a reliable sign, distinguishing anterior lung lesions from posterior or lower lung lesions. This paper has shown that the mechanism by which this occurs is not based on anatomical contact between intrathoracic structures, but on principles governing radiographic contrast, and the perception of that contrast.


Major thoracic dehiscence: radiographic considerations. Postoperative major thoracic dehiscence is an uncommon but potentially fatal complication which is sometimes difficult to detect clinically. Radiography may provide the initial clue to this abnormality. The wire sutures of sternotomy incisions may break, rotate, or become displaced. Disruption of posterolateral incisions is manifested by an increase in the distance between adjacent ribs. Air-fluid collections may be visible in the soft tissues of the chest wall.


Intrapericardial diaphragmatic hernia.

Intrapericardial diaphragmatic hernia. Hernias involving the pericardial cavity are rare. The author describes such a case involving an 85-year-old man who was asymptomatic except for right-upper-quadrant pain. The radiological appearance consisted of loops of bowel lying beside the heart.


Effect of high concentrations of non-steroidal and steroidal antiinflammatory drugs on prostaglandin-induced contractions of the guinea-pig isolated ileum. In addition to their well-known effect at low concentrations on prostaglandin synthesis or their release and production, 11 non-steroidal antiinflammatory drugs and 4 antiinflammatory steroids exhibit at high concentrations a direct antagonism on certain prostaglandin actions. This is demonstrated on PGE1- and PGF2alpha-induced contractions of guinea-pig isolated ileum when compared to acetylcholine-induced contractions. This inhibitory effect is totally reversible after washing out the drugs from the organ bath.


The effect of 15 (R) 15 methyl prostaglandin E2 on gastric acid secretion in duodenal ulcer patients. The effect of synthetic analogue 15 (R) 15 methyl PGE2 on basal and pentagastrin stimulated maximal acid output in 24 duodenal ulcer patients has been studied. The prostagoandin analogue in a single oral dose of 150 mug reduced both basal and maximum output. Basal acid output fell from a mean control value of 5.9 +/- 1.5 mEq/hr to 2.1 +/- 0.6 mEq/hr (p less than 0.05) and maximum acid output from 32.1 +/- 1.6 mEq/hr to 20.6 mEq/hr (p less than 0.001). The volume of gastric secretion did not alter significantly in the basal state but fell significantly in the maximally stimulated state after prostaglandin administration.


Hydrocortisone and the release of prostaglandins from spleen. An infusion of noradrenaline (1 mug/ml/min) released a PGE-like substance (PGEs) from superfused splenic strips of rabbits and from perfused cat spleen. The release of PGEs from rabbit splenic strips was not inhibited by the treatment of strips with hydrocortisone (40-150 mug/ml), but it was completely abolished in strips obtained from animals pretreated with hydrocortisone (1 mg/kg). The release of PGEs from the perfused cat spleen was reduced by hydrocortisone and abolished by indomethacin. It is concluded that the route of administration of hydrocortisone is essential for an appearance of its inhibitory effect on the PG release.


Cardiac muscle: excitability and passive electrical properties. The field of cellular cardiac electrophysiology has made excellent progress in the last decade in its effort to understand the electrical properties of the heart. It has profited from progress in membrane electrophysiology that has increased our understanding of the basic ionic mechanisms. It has developed quantitative methods for study of these mechanisms, in spite of the geometrical complexity of the heart. Indeed this complexity has added a richness and challenge to this area. We have shared with skeletal muscle the problem of electromechanical coupling. This review has discussed the present state of our knowledge of basic membrane mechanisms of importance in understanding normal and pathological function of heart muscle. It is intended to lay the groundwork for the following articles dealing with special aspects of cardiac electrophysiology. There is a continual interchange of ideas and concepts between applied and basic electrophysiology, and, as a result of this interchange, we can expect both areas to grow greatly in the coming years.


Effect of oxygen and solute on PGE and PGF production by rat kidney slices. Increasing oxygen from 5% to 95% resulted in an increases production of both PGE's and PGF's. The release of prostaglandins from slices of rat kidney cortex and outer and inner medulla was measured. Prostaglandin production was observed predominantly in the inner medulla, was close to the lower limit of detection in the outer medulla, and was undetectable in the cortex. Increasing oxygen concentration resulted in a threefold increase in inner medullary prostaglandin production. Synthesis at 95% O2 was less at 2100 mOsm than at 300 mOsm, while synthesis at 5% O2 was not affected by high solute concentration. The implications of these results with respect to kidney function are discussed.


Changes in systolic arterial blood pressure in normal and spontaneously hypertensive rats produced by acute administration of inhibitors of prostaglandin biosynthesis. Six non-steroidal agents having the property of being able to inhibit prostaglandin (PG) biosynthesis or action were tested for their ability to affect systolic blood pressure in unanesthetized normotensive (WKY) and Spontaneously Hypertensive Rats (SHR). In WKY and pre-hypertensive young SHR, s.c. injection of indomethacin (1.0 mg/kg) had no significant effect on blood pressure measured 30 minutes after injection. In older SHR, indomethacin (15 mg/kg) caused a significant pressor response, while in age-matched WKY, this dose had no significant effect. Indomethacin also showed a pro-hypertensive action in 10-14, 23-38 and 23-27 week old SHR with doses of 1.0 and 3.0 mg/kg, respectively. Tiaramide (5 mg/kg), ETYA (5 mg/kg), tolmetin (25 mg/kg), and meclofanamate (15 mg/kg) caused a significant elevation of blood pressure in mature (7-8 month old) SHR. Age matched WKY showed no significant response to the same doses of these four agents. Fenoprofen (75 mg/kg) caused a significant elevation in pressure in 12-13 weeks old SHR which persisted for at least 2 hours. Tiaramide had no significant effect on pre-hypertensive SHR. The results are consistent with the concept that inhibition of prostaglandin in synthesis may result in a diminished turnover of anti-hypertensive prostaglandins in SHR which are being elaborated in response to the hypertensive state. In normal rats and pre-hypertensive SHR, inhibition of prostaglandin synthesis or function may not result in a hypertensive response since pro-hypertensive factors either are absent, or other antihypertensive substances may still predominate to help maintain normal blood pressure.


Thromboxane B2 transformed from arachidonic acid in carrageenin-induced granuloma. A main product (PI) transformed from arachidonic acid in carrageenin-induced granuloma in rats was structurally analysed. PI was converted to a more polar substance by the reduction with sodium borohydride. On the basis of the data on gas chromatography-mass spectrometry, its structure was identified with the hemiacetal derivative of 8-(1-hydroxy-3-oxopropyl)-9,12-heptadecadienoic acid (Thromboxane B2).


The effect of prostaglandin E2 on the cardiovascular response to angiotensin II in pregnant rabbits. The rise in arterial blood pressure in response to angiotensin II was studied in the last third of pregnancy in rabbits. The response was compared with that of pregnant rabbits during infusion of prostaglandin E2 and F2alpha. Prostaglandin E2 significantly diminished the rise in diastolic pressure in response to angiotensin II. Prostaglandin F2alpha did not alter the response. Intravenous indomethacin elevated the blood pressure and caused an absolute increase in the pressor response. It did not mediate a change in the percentage rise in blood pressure in response to angiotensin II.


Intramuscular prostaglandin (15S)-15-methyl PGF2alpha (THAM) in midtrimester abortion. Elective termination of second trimester pregnancies in 63 patients by means of intramuscular prostaglandin (15S)-15-Methyl PGF2alpha (THAM) is reported. In 44 of 61 cases with a successful outcome the duration of pregnancy calculated from a last normal menstrual period was between 13 and 17 weeks. An overall success rate of 96.8 per cent was achieved; and this agent and method warrant further clinical evaluation.


Prostacyclin (PGX) is the endogenous metabolite responsible for relaxation of coronary arteries induced by arachindonic acid. The actions of prostacyclin (PGX) and several other derivatives of arachidonic acid were examined on spiral-strips of bovine coronary artery. The strips were contracted by PGE2 and thromboxane A2. Although PGH2 usually cause a transient contraction followed by a relaxation, a few strips were only contracted whilst others were only relaxed. Prostacyclin invariably relaxed coronary artery strips. Sodium arachidonate usually relaxed the strips but occasionally had no effect. Indomethacin increased the resting tone and abolished or substantially reduced the relaxation induced by sodium arachidonate. 15-hydroperoxy arachidonic acid (15-HPAA), a specific inhibitor of prostacyclin synthetase, also increased the resting tone, abolished the effects of sodium arachidonate and the relaxation component of the PGH2 response, but did not greatly modify the relaxation induced by exogenous prostacyclin. These results strongly suggest that prostacyclin mediates the relaxation induced by arachidonic acid in bovine coronary artery strips. As PGH2 is avidly converted into prostacyclin by the vascular tissue of several species including man, prostacyclin is probably involved in the local regulation of the coronary vascular bed.


Stimulation by prostaglandin F2alpha of acidic glycosaminoglycan production in cultured fibroblasts. The effect of PGF2alpha on the synthesis of hexosamine-containing substances (acidic glycosaminoglycans and glycoproteins) was studied in cultured fibroblasts derived from a rat carrageenin granuloma. Treatment with PGF2alpha ranging from 0.01 mug/ml to 20 mug/ml resulted in a significant increase of the production of these macromolecules by the cells. The stimulatory effect was found significant even at the low concentration of 10 ng/ml, and could be seen as early as 3h after exposure to PGF2alpha. The hexosamine-containing substances increased by PGF2alpha revealed that 80% of the increase was due to acidic glycosaminoglycans and the rest was due to glycoproteins.


Prostaglandin production by methylcholanthrene-transformed mouse BALB/3T3: effect of oxidative phosphorylation inhibitors. Oligomycin, antimycin, and 2,4-dinitrophenol, compounds that are known to inhibit oxidative phosphorylation by different mechanisms, inhibit the production of prostaglandins by serum-stimulated MC5-5 cells. The prostaglandin production that is stimulated by thrombin and bradykinin is inhibited by 2,4-dinitrophenol. Prostaglandin synthesis by MC5-5 cells from exogeneously-supplied arachidonic acid, however, is not affected by 2,4-dinitrophenol. Antimycin and 2,4-dinitrophenol also inhibit the serum-stimulated release of arachidonic acid from the cellular lipids, suggesting that it is the expression of phospholipase activity, a prerequisite for synthesis of prostaglandins by MC5-5 cells, that is dependent on oxidative phosphorylation.


Inhibition of lymphoma cell proliferation by supernatant from fibrosarcoma cultures: preliminary evidence that the inhibitory material is prostaglandin E. Supernatants obtained from mouse fibrosarcoma cultures 48 hr after the addition of fresh medium contained dialyzable material which inhibited the proliferation of syngeneic lymphoma cells in vitro, as measured by 3H-thymidine incorporation. Three lines of evidence indicate that the supernatant inhibitory material is probably prostaglandin (PG) E. First, the supernatant and dialysis of the supernatant contained a substance with the same characteristics as PGE1 or PGE2 as detected by thin layer chromatography. Second, PGE2-treatment of lymphoma cells mimicked the inhibition of proliferation observed with supernatant inhibitory substance. Third, indomethacin, treatment of fibrosarcoma cultures reduced the amount of supernatant inhibitory substance present.


Prostaglandins in chronic cholecystitis. Prostaglandin-like material was extracted from the mucosa and muscle wall of chronically inflamed human gallbladders. Bioassays showed that "synthesised" levels were 3-5 times corresponding "basal" levels, indicating that both mucosa and muscle wall can synthesise PG-like substances, and that indomethacin (10 mug/ml) inhibited this synthesis. Mucosal PG levels were higher in gallbladders with multiple gallstones than with a solitary stone, and overall the mean PG level in mucosa was 12-13 times higher than in the muscle wall. Chromatography of mucosal extracts showed substances indistinguishable from primary PGE and F compounds together with a PGD2-like component. An attempt has been made to relate these findings to the degree of chronic inflammatory cell infiltration and to radiological visualisation at pre-operative cholecystography.


[Recurrent branch of the anterior cerebral artery: a neuroanatomic study of the extracerebral segment (author's transl)]. The neuroanatomic study of the recurrent branch (a. of Heubner) of the anterior cerebral artery has been performed in 83 adult brains from northeasterner brazilians. In the consulted literature the recurrent artery is described as a branch of the precommunical segment of the anterior cerebral artery. Nevertheless, in this observation the results with regard to origin of the vessel were the following: 1) the Heubner artery was a branch of the postcommunical segment in 17 cases (20.8%) on the right side and in 21 cases (25.6%) on the opposite side; 2) the artery arose at the correspondent level to the rostral margin of the anterior commune left; 3) in 38 cases (45.3%) on the right side and 36 cases (44.2%) on the opposite side, the artery arose at the level between rostral and caudal borders of the anterior communicant; 4) only in 5 cases (6.1%) and in 6 cases (7.3%) to the right and to the left, respectively, the recurrent artery was a typical branch of the precommunical segment of the anterior cerebral artery. The author has observed two patterns with regard to the extracerebral course of the recurrent artery.


[Scanning with Au198 in experimental hepatic trauma (author's transl)]. Scintiscanning of the liver with Au198 was performed in 30 mongrel dogs. In 18 animals the scanning was performed after 3 different types of hepatic trauma: intraparenchymal hematoma, stab wound and lasceration of liver. In 12 days without hepatic trauma the scanning was performed with purpose to establish the pattern of the normal liver scan in the dog. Results indicate that scintiscanning of the liver is a good propaedeutic method in the evaluation of the presence and localization of traumatic hepatic lesion.


[Centrolobular cholestasis: experimental study on the possible mechanism (author's transl)]. In the cholestatic condition of many different aetiologies a common pathologic picture is found. It is characterized by the presence of pigmented "plugs" and cytoplasmatic "masses" in the centrolobular region. Dubin has tried to interpret this on purely hydrostatic ground but this is not a very likely explanation. We tried to comprove this hypothesis studying the interference of a previous, or concomitant, centrolobular alteration in the distribution, morphology and intensity of cholestatic lesions: terminal choledochus ligatures were performed in animals intoxicated with carbon tetrachloride, a substance that damages predominantly the centrolobular region. In 6 dogs, terminal choledochus ligature was associated with carbon tetrachloride intoxication. A histological examination of the liver showed that the degree of centrolobular cholestasis was in the inverse ration of hepatocytic damage intensity. This fact does not conform with Dubin's hypothesis.


[Social consequences of intertrochanteric osteotomy in osteoarthritis of the hip (author's transl)]. Patients suffering from hip osteoarthritis mostly accompanied by long histories of pain, showed encouragingly positive attitudes towards their surgical intervention and hospitalisation, and were satisfied with the results of their operations. In the majority of cases post-surgical treatment was not intensive enough and lacked strict medical supervision. In some cases after-treatment was not administered at all. During medical treatment the patients had experienced the therapeutic value of living carefully, which resulted in the post-surgical use of walking aids and influenced the type of occupational activities and the use of leisure time and holidays. In most cases the rehabilitation phase after intertrochanteric osteotomy was no longer than expected. In comparison with the male, female patients generally had less chances of an optimal rehabilitation outcome owing to the household demands arising immediately after hospital discharge, far longer use of walking aids and less favourable transport situation. The author's optimistic expectations regarding rehabilitation results have not been fulfilled.


[Studies on the socio-medical and psychological situation of persons suffering from osteogenesis imperfecta tarda (author's transl)]. A group of 22 patients suffering from osteogenesis imperfecta tarda were evaluated on their school and vocational education, sport activities as well as personality development with the help of follow-up studies, questionnaires or medical records. 21 patients had at least received elementary school education and had been average or good pupils. Five of six patients who had meanwhile reached adulthood had received higher education and vocational training. Owing to their disease five of six patients had to give up their original jobs or occupational plans. There was only one female patient who had received vocational guidance. Of ten children and six adults five and four respectively carried out sports in their leisure time. To improve the patients' situation it is immediately necessary that (1) the parents be informed of the nature of the disease as well as its heridity, and be advised how to handle these children; (2) the patients and their parents receive educational and vocational guidance.


[Sociopsychological and sociological aspects of rehabilitation (author's transl)]. The concept of a social rehabilitation theory should not focus exclusively upon the one-dimensional aspect of restoring the ability to work, but also embrace the behaviour of the individual in all areas of life. The term rehabilitation as used in a modern highly industrialised society has to take into account the social change which has undergone the term "disease", and should respect scientific findings relating to nature and sociology. This would motivate the social environment of the rehabilitee to cooperative understanding and reduce the manifold conflict situations which the chronically ill encounter in the time following rehabilitation. A therapeutic approach towards social rehabilitation could be constitued by improved preparation of the rehabilitee for the post-rehabilitation time--i.e. therapeutic talks and group therapy designed to develop and stabilise behaviour patterns allowing for new and/or different work assignement, also on the premise of reduced possibilities of role functioning.--The diversified psycho-social problems call for increased psychotherapeutic and sociotherapeutic assistance during rehabilitation.


[Data cross-cut and the field of rehabilitation medicine at a vocational re-training centre (author's transl)]. Identified and evaluated were a number of medical and sociological data, e.g. diagnosis, age, population of the place of residence, financially responsible agencies, on 1399 rehabilitees who were admitted to the Dortmund vocational re-training centre during the first five years of its operation (1971-1975). The primary diagnoses (highly identical with those indicative of vocational rehabilitation) and the overall diagnoses (primary and secondary diagnoses) were classified into disease groups according to the ICD and compared with the frequency distribution in the 1970 microcensus. Significance computations determined yearly deviations of the different data, i.e., a significantly steady increase in emotional disturbances. The classification of diseases and disabilities clearly shows the problem complex of adequate comprehensive therapy and medical care, and marks the role of medicine at a vocational re-training centre.


Anticonvulsant drug antagonism of delta9tetrahydrocannabinol-induced seizures in rabbits. A population of New Zealand White rabbits exhibit behavioral convulsions when given low doses of psychoactive cannabinoids of marijuana. Carbamazepine, diazepam and phenytoin were most effective in blocking these convulsions caused by delta9tetrahydrocannabinol (delta9THC). Phenobarbital and ethosuximide also blocked convulsions but only at toxic doses. Cannabidiol was effective in blocking convulsions when given concurrently with, but not prior to delta9THC.


Trichloroethylene-induced deactivation of cytochrome P-450 and loss of liver glutathione in vivo. Liver microsomal enzyme activities and glutathione (GSH) contents of fasted male rats pretreated with phenobarbital (PBT) or vehicle controls were measured during and after exposure to trichloroethylene (TRI) (1% x 2 hr). TRI caused morphologic liver injury only in the pbt animals. Cytochrome P-450 and b5 contents were diminished by the end of the first hr of TRI exposure and NADH-cytochrome c reduction increased three-fold by eight hr in the PBT animals. The only change in vehicle animals exposed to TRI was a decrease in NADPH-cytochrome c reductase activity by eight hr. Hepatic GSH contents of vehicle animals, constant during TRI exposure, rose with time. In contrast, in PBT animals, hepatic GSH contents decreased during TRI exposure and then rebounded. Decreases in GSH were most profound in the microsomal fraction. When fed animals with approximately two-fold higher hepatic GSH levels than fasted animals were exposed to TRI, they had shorter anesthesia recovery times and less liver injury, although excreting similar or slightly more trichlorinated metabolite into their urine in 24 hr than their fasted counterparts. We suggest that the hepatoxic effects of trichloroethylene are caused by inadequate detoxification of its reactive intermediates.


Identification of drugs, drug metabolites, and other compounds in urine by permethylation and gas-phase analysis. A small aliquot of urine (50-200 mul) is evaporated to dryness, the residue permethylated with the methylsulfinylmethide carbanion and methyl iodide, and the product mixture separated and analyzed by GC and GC-MS. Certain drugs (especially the anticonvulsants), drug metabolites, mono-, di-, and trisaccharides, and organic acids, including fatty acids and glucuronides, can be identified in the mixture. The technique is probably useful mainly as a screening method for the detection of any of these types of compounds in urine.


The effect of maternal alcohol consumption on the viability and visceral development of the newborn rat. The clinical observations that offspring of pregnant alcoholics are prone to congenital defects and abnormal growth and development (fetal alcohol syndrome) have generated interest in studying this problem in a well-controlled experimental model. Accordingly, in this study, we assessed the effects of long-term maternal alcohol intake on offspring viability and growth as well as the DNA, total RNA, protein levels and DNA synthesis in brain, heart, liver, and kidney of 3-day-old newborn rats. Chronic oral intake of alcohol (mean 21 weeks plus 20 days of gestation) resulted in maternal blood alcohol levels of 67 to over 150 mg percent. There was a significant increase of newborn mortality (30%) and a decrease in their body weight at 3 days in alcohol-exposed compared to pair-fed (non-alcohol) control pups (p less than 0.025). Protein concentration was unchanged in heart, liver, and kidney and was slightly elevated in brain of 3-day-old pups exposed to ethanol in utero. DNA synthesis rates were normal in all four organs, while DNA concentration was significantly lower only in the liver of the alcohol-exposed group (p less than 0.05). In the alcohol group the total RNA levels were significantly depressed by about 10-30 percent (p less than 0.05) in all four organs studied. In conclusion, our studies suggest that prolonged maternal alcohol intake has an adverse effect on newborn rat viability and growth as well as the total RNA and to some extent DNA concentration of vital organs.


Paraquat toxicity and pulmonary superoxide dismutase: an enzymic deficiency of lung microsomes. Paraquat stimulates the microsomal generation of superoxide radical, O2-, and hydrogen peroxide, H2O2. The detoxification of these two oxidants is accomplished by superoxide dismutase (SOD) and catalase, respectively. SOD activity could not be detected in lung microsomes but was found in microsomes of both kidney and liver. This deficiency may be involved in the pulmonary specificity of paraquat.


Enhancement of granulocyte phagocytosis by products of PPD stimulated human lymphocytes. The effect of supernatant fluids from cultures of stimulated human lymphocytes on the phagocytic activity of human neutrophilic granulocytes was investigated. It was found that lymphocytes of tuberculin (PPD) positive donors after in vitro stimulation with PPD produced factors that significantly increased granulocyte phagocytosis of latex particles.


Anti leukemia activity (L1210) of 6-mercaptopurine and its metallo complexes in mice. Six-mercaptopurine in the free form and complexed with Pt, Pd, or Bi metals was used at various dosage levels to treat L1210 leukemia in mice. Anticarcinogenic activity was shown by six-mercaptopurine and the Pd and Bi complexes, inactivity by the Pt complex, and toxicity by the highest dosage level of six-mercaptopurine.


The effects of morphine on isolated cutaneous canine vascular smooth muscle. In order to evaluate the direct effects of morphine sulfate (MS) on vascular smooth muscle (VSM), a helical strip preparation of canine cutaneous VSM was prepared from vessels of approximately 150 to 250 mug internal diameter. When evaluated at a variety of muscle lengths from 20% to 60% above unstretched length, in the absence and in the presence of norepinephrine (2 to 10x10(-4) mg/cc), MS (10(-3) to 10(-1) mg/cc) failed to produce any noticeable effect. Thus, the well-known arteriolar dilator effect of MS is not a direct effect of the drug on VSM and it is not secondary to blockade of vascular alpha-adrenergic receptors.


Vasopressin release in the spontaneously hypertensive rat. Vasopressin (antidiuretic hormone, ADH), release in response to hemorrhage was studied in spontaneously hypertensive rats (SHR), Kyoto-Wistar rats (KWR), and Wistar rats (WR). The rats were anesthetized with pentobarbital sodium and ADH concentration was measured before and after three successive hemorrhages at 15 min intervals. The blood samples for radioimmunoassay (RIA) of ADH were collected from the external jugular vein. The ADH release in response to hemorrhage was significantly reduced in debuffered WR (carotid and aortic baroceptors and atrioventricular receptors deafferented), intact KWR and intact SHR when compared to the intact WR.


In vitro uptake of 3-methoxytyramine by rat brain tissue slices. The means by which the brain handles the dopamine (DA) metabolite, 3-methoxytyramine (3-MT), has not been characterized. This study has examined one aspect by utilizing tritiated 3-MT in synaptosomes from rat striatum and slices of both striatum and cerebellum. No accumulation of 3-MT could be demonstrated in synaptosomes but DA (0.1 muM) uptake was inhibited by 3-MT (IC50 = 1.3 X 10(-5)M). Studies in brain tissue slices showed: 1) 3-MT accumulation was greater than could be expected from diffusion at a high concentration (10 muM) of amine; 2) the accumulated amine was easily washed out of the tissue slice; 3) the uptake appeared to be saturable with high estimated values for Km and Vmax; and 4) agents, such as metanephrine, which inhibit peripheral extraneuronal amine uptake had similar effectiveness against 3-MT uptake. It was concluded that: 1) the mechanism for the accumulation of 3-MT is similar in structurally different areas of the brain; 2) 3-MT is accumulated by a mechanism which is not a part of the nerve terminal; and 3) 3-MT accumulation in the brain is similar to the extraneuronal accumulation of amines in the periphery.


The role of dog bladder mucosa in the N-oxidation of arylamines. The in vitro metabolic N-oxidation of 1- and 1-napthylamine, 4-biphenylamine, 2-fluorenylamine and 3-dibenzolfuranylamine has been investigated with intact dog bladder, whole intact bladder mucosa and microsomes prepared from this tissue. Very low levels of metabolic N-oxidation of these carcinogenic amines were detected with these tissue preparations using ferrihemoglobin formation in dog erythrocytes. No N-oxidation by these tissue preparations was observed using gas-liquid chromatography. The concentrations of the N-oxidized metabolites observed in the urine of dogs in vivo exposed to thse amines suggests that N-oxidation takes place predominately in the liver and that the bladder plays, at most, a minor role in the formation of these presumed proximate urinary carcinogens.


Failure of ascrobic acid to inhibit the metabolic N-oxidation of the bladder carcingen 4-biphenylamine. The effect of L-ascorbic acid on the in vivo metabolic N-oxidation of the bladder carcinogen 4-biphenylamine has been investigated in the dog. Gas chromatographic analysis of the urines of dogs receiving concomitant oral doses of L-ascorbic acid and 4-biphyenylamine showed no significant difference in the N-oxidized metabolites when compared to dogs receiving arylamine alone. The results indicate that pretreatment with large doses of L-ascorbic acid has no effect on the metabolic N-oxidation of 4-biphenylamine or on the urinary concentration of these metabolites. The failure of L-ascrobic acid to lower the urinary concentration of these presumed proximate urinary carcinogens casts doubt on its efficacy in bladder tumor prophylaxis.


Mechanisms of dissolution of nickel subsulfide in rat serum. To elucidate the initial steps of carcinogenesis by nickel subsulfide, the mechanisms of dissolution of alpha-Ni3S2 were studied by incubating alpha-Ni3S2 dust in (a) water, (b) rat serum, and (c) rat serum ultrafiltrate. The sediments that remained following incubation of alpha-Ni3S2 in the 3 media for 2 weeks were examined by X-ray diffractometry. The rates of solubilization of 63Ni from alpha-63Ni3S2 during incubation in the 3 media were measured by liquid scintillation counting. These studies showed that solubilization of Ni(II) from alpha-Ni3S2 in rat serum requires the presence of O2 and involves three reactions: [I] 2 alpha-Ni3S2 + O2 + 2H2O leads to 4 beta-NiS + 2Ni(OH)2; [ii] beta-NiS + 202 leads to Ni2+ + SO4(2-); and [III] Ni2+ & Ni(OH)2 + serum ligands [albumin & amino acids] leads to soluble Ni(II)-complexes. The rate of solubilization of 63Ni from alpha-63Ni3S2 was initially more rapid in rat serum than in serum ultrafiltrate and much more rapid than in water. After 2 days of incubation the rates of dissolution of alpha-63Ni3S2 in the 3 media became progressively retarded, probably owing to deposition of insoluble surface coatings of beta-63Nis and 63Ni(OH)2 on the alpha-63Ni3S2 particles.


Studies on the percutaneous absorption of 3H-aescin in pigs. Percutaneous absorption of aescin was measured following application of an aqueous solution of tritiated sodium aescinate to the ventral skin of pigs. Following single or repeated application at various intervals, the concentration of total activity, non-volatile activity and aescin activity following TLC was determined in different organs, tissues, blood and urine. Very high concentrations of aescin were found in skin and muscular tissues underlying the application site. Only low values were measured in internal organs, blood, urine, skin and musculature from other parts of the body. The concentration of non-volatile activity in subcutis is 50-600 and in musculature 10-50 times higher than in blood. Only 0.5 - 1% is excreted in urine within 24 hours of administration. The calculated total elimination (bile + urine) may be 1 - 2.5% of the dose. Barely one half is excreted as native aescin, the rest as volatile activity and different metabolites.


[Macroscopic and micro-morphologic evaluation of viability in extracorporeal perfused pig livers (author's transl)]. Several biochemical reactions are used in evaluating viability of extracorporeal perfused livers. Simple and quick tests of organ function, however, are needed in therapeutic application in man. In 33 homologous porcine liver perfusions we found that accurate observation of the macroscopic aspect gave a good criterion of organ function. The combination with micro-morphologic findings, especially after perfusion with Indian ink, proved to be a reliable base for evaluating the functional state of the livers used.


[The influence of extracellular calcium on volume, enzyme and calcium secretion in the isolated perfused canine pancreas (author's transl)]. 1. The kinetics of Ca++ and enzyme secretion are of corresponding pattern as well at hydrokinetic as at ecbolic stimulation. 2. Physiological respectively pathophysiologically relevant changes of perfusate Ca++ concentrations do not influence pancreatic Ca++ secretion. Extracellular Ca++ concentrations beyond 12 mEq/1 initiate an enzyme independent Ca++ secretion. 3. Hydrokinetic or ecbolic stimulated pancreatic secretion do not distinguish in calcium/protein ratio. 4. Basal and stimulated enzyme secretion of isolated perfused canine pancreas remain unaffected by increments of extracellular Ca++ concentrations even at pharmacological values. 5. The stimulated enzyme- and Ca++ secretion remain constant during hypocalcemic perfusate conditions but decrease to basal values in Ca++ free media, rapidly and completely reversible by recalcification of the perfusate. 6. The secretin stimulated volume secretion remains unchanged either by extremely hypercalcemic or Ca++ depleted perfusate conditions.


[The ultrastructure of the neointima of arterial prostheses made of lyophilized human dura. Long-term results in dogs (author's transl)]. Five arterial prostheses made of lyophilized human dura (LHD) were inserted into dogs and removed after 4, 5 1/2, 13, 43, and 46 months to be studied with the electron microscope. The neointima of all grafts consisted of pseudo-endothelial cells, fibrocytes, and collagen fibrils. Additionally, 43 and 46 months after implantation smooth muscle cells and elastic microfibrils were present. Thus, the composition of the neointima was substantially identical with that of the neointima of synthetic arterial grafts and collagen-fabric ones. The clinical application of arterial prostheses of LHD, however, seems at present too early because of degenerative changes in the walls of those grafts which remained nearly 4 years in the dogs.


[Exocrine pancreatic function in rats after treatment with cyclophosphamide (author's transl)]. After a 3- and 8 day administration of cyclophosphamide to rats an approximately dose-dependent decrease in the pancreatic secretion of protein and enzyme activities was demonstrable in vivo under exogenous stimulation with secretin and pancreozymin. The volume of secretion and the electrolyte outputs were found to be slightly lowered. An impairment in enzyme synthesis resulting from cyclophosphamide administration is suggested as the major cause of the observed changes in secretion.


Experimental studies of neurotoxic activity in blood fractions from acute cases of grass sickness. Plasma, serum and  cells were prepared from blood taken from acute cases of grass sickness, and plasma was fractionated by gel  filtration and salt precipatation. These preparations were all tested for neurotoxic activity by injection into ponies. Plasma and serum were found to produce the neurohistological changes seen in grass sickness, as was a plasma  protein fraction of molecular weight  30,000 or greater. Activity was retained following storage at--75 degrees C for 15 months. Plasma given orally to a pony produced no detectable effect, nor was activity demonstrated following the injection of plasma or the high molecular weight fraction to mice, rats, guinea-pigs or rabbits.


The effect of protein intake on the activities of liver specific enzymes in the plasma of dairy cows. Activities of glutamic dehydrogenase (GLDH), sorbitol dehydrogenase (SDH) and ornithine carbamyl transferase (OCT) were determined in tissues of six cattle after slaughter. The liver contained the highest activities of all three enzymes and the kidney cortex also contained high activities of GLDH and SDH. Activities of OCT were negligible in tissues other than liver. GLDH and OCT activities were determined in plasma of two groups of cows fed different levels of protein during the pre-calving period and up to 14 weeks post calving. In both groups activities of both enzymes increased after calving, reaching three to seven times pre-calving levels between seven and 17 weeks post calving and declining thereafter. Activities of both enzymes reached higher levels in the group fed protein to conform to the recommendations of the ARC (1965) than in the group fed 25 per cent below these recommendations. One--conventional--interpretation of this would be that higher intakes of proteins were associated with pathology of liver cells but other interpretations cannot be ruled out entirely.


Experimental immunologic thrombocytopenia in dogs: a study of thrombocytopenia and megakaryocytopoiesis. Immunologic thrombocytopenia was induced in dogs by intravenous or intraperitoneal injection of rabbit anti-canine platelet serum (APS) or by intraperitoneal injection of the IgG fraction of the APS. In contrast, dogs injected with normal rabbit serum (NRS) or the IgM fraction of  the APS did not develop thrombocytopenia. Marrow samples obtained at 24-96 h after inoculation of the IgG fraction contained megakaryocytes giving a positive reaction with flurescein isothiocyanate or horseradish peroxidase-conjugated anti-rabbit globulin. In contrast, negative results were obtained with megakaryocytes in marrow samples collected before injection of  the IgG fraction or after injection of  the IgM fraction or NRS. The attachment of anti-platelet antibody to the surface of megakaryocytes was associated with appearance of morphologic abnormalities, particularly in mature megakaryocytes. Simultaneously, the number of immature megakaryocytes and acetylcholine esterase (AChE)-positive small cells (presumably megakaryocyte precursors) increased considerably. These changes coincided with the development of thrombocytopenia, and subsided as recovery ensued.


Removal of the lachrymal gland and ligation of the Harderian gland duct in the fowl (Gallus domesticus): procedures and sequelae. Surgical methods are described for removal of the lachrymal gland and ligation of the Harderian gland duct in the fowl. Total or partial cystic degeneration of the Harderian gland and loss of immunoglobulins from lachrymal fluid was evident in three of six adult birds 10 weeks after operation. Functional deletion of these paraocular glands is thus feasible and can be used for investigations of local immunity of the oculonasal region.


Gonadal dosage during hip dysplasia radiography in the dog. Thermoluminescent dosemeters were used to estimate gonadal dosage during hip dysplasia radiography of labrador retriever dogs. The mean radiation dose to the unshielded testes was 100 millirad (mrad) and the estimated dose to the shielded testes was 9 mrad. It was considered unnecessary to shield the ovaries.


The influence of anaesthesia on the concentrations of progesterone and cortisol in peripheral blood plasma of sheep. Levels of progesterone and cortisol were measured in the peripheral plasma of sheep subjected to barbiturate (sodium pentobarbitone) and gaseous (halothane) anaesthesia both alone and in combination. Significant increases were recorded inthe level of cortisol in all experiments and in the levels of progesterone in all experiments except that involving halothane alone. It was also found that the cortisol levels remained elevated for a greater period of time than those of progesterone.


Serum and mucus antibodies in sheep immunised with larval antigens of Haemonchus contortus. Inoculation of sheep with larval antigens in adjuvant stimulated a marked serum and mucus IgG antibody response. However no mucus IgA antibodies were stimulated and no protection against challenge infection was observed.


Serotypes of Pasteurella haemolytica in ovine pasteurellosis. The serotypes of 406 strains of Pasteurella haemolytica were determined. These came from cases of pasteurellosis in sheep of all ages. Serotype A2 was the most frequent and comprised 33 per cent of all strains recovered. Serotypes T3, T4 and T10 comprised 16, 14 and 12 per cent of the total respectively. Serotypes A1 and A6 contributed 5 per cent each, A7, 18, A9, A11 and A12 a total of 8 per cent collectively, serotype A5 was not isolated at all while 6 per cent of strains were serologically untypable. More strains were received during September, October and November than at any other three-month period and in these months the T biotype predominated.


Ovine fascioliasis following reinfection. Sheep were reinfected with matacercariae once. Half were treated with anthelmintic one week before reinfection. Compared with a primary infection, the reinfecting flukes in most seemed to migrate faster through the liver although in one treated sheep migration seemed to be longer and more destructive. Migrations extended into areas little affected by the primary infection thus producing more widespread fibrosis. Although a temporary retardation in fluke growth rate occurred, there was no reduction in the numbers of flukes recovered. Flukes killed by anthelmintic formed large granulomata.


Sequential pathological changes in natural and experimental dermatophilosis in Bunaji cattle. Differences in histopathological changes between experimentally and naturally induced dermatophilosis were slight; natural infections persisted longer as they tended to be complicated by other concurrent dermatoses. Sequential pathological changes in bovine dermatophilosis included congestion, dermal oedema and neutrophilic infiltration of dermal papilae and epidermis by the third day; degenerative changes of cells in the upper portion of the stratum spinosum and invasion of the keratinised layer and hair follicles by the filamentous forms of Dermatophilus congolensis by the fourth day; regenerative processes involving the basal cells and selective cellular destruction in the spinous layer and further hair follicle invasion by D congolensis by the ninth day; and proliferative changes characterised by parakeratosis, hyperkeratosis, acanthosis and dermal sclerosis by the 15th day. It is postulated that cattle with hair follicles parasitised by D congolensis are carriers and are responsible for perpetuation of bovine dermatophilosis from one season to the next.


Dynamics of serum immunoglobulin concentrations in sheep during pregnancy and lactation. Monospecific antisera were used to measure the serum IgM1, IgG2 and IgM concentrations in pregnant an d non-pregnant ewes, rams and lambs over a period of eight months. The decrease of IgG1 and IgM concentrations which took place in ewes' serum at lambing was followed by a long and slow recovery phase (five to six months) during and after lactation, while no significant changes occurred in IgG2 concentrations. Serum immunoglobulin concentrations measured in a similar group of non-pregnant ewes throughout the same period showed no seasonal influence. Lambs' sera at three days after birth contained all three immunoglobulin classes and subclasses measured. There was no evidence of IgG2 deficiency. No sex differences were observed in immunoglobulin concentrations in lambs of all ages. Significant negative correlations were found between growth rate from six to 12 weeks and the IgG1 and IgG2 concentrations at 14 weeks.


Experimental fowl typhoid in chicks impaired immunologically by treatment with cyclophosphamide. Male chicks were injected intramuscularly with 6 mg of cyclophosphamide daily for three consecutive days, the initial dose being given on the day of hatching. This treatment impaired bursal development and lymphopoiesis and no circulating antibodies appeared after such chicks were injected with Salmonella gallinarum antigens at 19 and again at 26 days of age. In impaired chicks which were infected orally when 15 days old with S gallinarum the level of mortality was essentially the same as that in unimpaired animals. Impairment did not affect the lower mortality that accompanies feeding with a nutritionally adequate diet containing meat meal as the sole protein supplement in comparison with fish meal as the supplement. An anaemia was present in chicks examined seven days after infection. This anaemia was microcytic to a degree that either exceeded or approached statistical significance. As antibody-mediated hypersensitivity reactions involving the erythrocytes were absent in  the impaired chicks, the anaemia must have differed in pathogenesis from the macrocytic anaemia of immunopathological orgin reported by others in adult females with acute fowl typhoid. A disturbance of iron metabolism could have accounted for the anaemia in the diseased chicks.


Uterine activty and plasma progesterone levels in pregnant goats. Uterine activity was recorded during the last few weeks of pregnacy in goats, and related to changes in plasma progesterone concentration. In six of the 14 pregnancies, there was little activity until immediately pre-partum, but the remainder showed a progressive increase in uterine motility, particularly during the last seven days of pregnancy. There was a significant correlation between increased uterine activity and decline of peripheral plasma progesterone levels.


Histological and histochemical studies of fetal skin follicles in Border disease of sheep. The structure of the epidermis and dermis, and the distribution of reticulin, glycogen, lipid and sulphydryl groups in the skin have been examined in control and Border disease affected sheep fetuses at 95 and 115 days' gestation. In Border disease, there was a temporary retardation of development of the epidermis and skin follicles at 95 days. There was no  difference in the structure of the dermis between control and experimental fetuses at either age. No evidence was found to suggest that the keratogenous process was abnormal in Border disease, but the sulphydryl zone of the primary fibres of affected fetuses was situated nearer the skin surface than in control fetuses. This may have been a consequence of the larger size of primary follices in Border disease. Glycogen present in the undifferentiated epidermis of both groups at 95 days' gestation was absent from the stratified squamous epithelium of the 115 days's fetuses. Glycogen and lipid droplets were present in the outer root sheath of primary follicles of all fetuses examined, but their significance is unknown.


Epidemiological studies on gastro-intestinal nematode parasites of sheep: the seasonal number of generations and succession of species. Monthly post mortem worm counts were carried out from June to September on grazing lambs, in association with faecal egg counts and pasture larval counts. Similar patterns were recorded by all three methods, and egg counts proved to be a reliable reflection of worm burden over this period. A succession of species was recorded, in particular Ostertagia spp and Nematodirus spp in June; Haemonchus contortus in July; Trichostrogylus virinus in August; T axei, T colubriformis and Cooperia curticei in September. A new explanation for this succession is given, based on the overwintering capabilities and freeliving development time of individual species.


Effects of concurrent drug therapy and of feeding on plasma chloramphenicol levels after oral administration of chloramphenicol in dogs. On separate occasions, five fasted adult greyhounds were dosed orally with 50 mg chloramphenicol/kg, both alone and in conjunction with other drugs. The same five dogs were later given 50 mg chloramphenicol/kg when fed ad lib. Chloramphenicol levels in plasma were determined at intervals after dosing. The intial plasma chloramphenicol levels were higher when the drug was administered concurrently with calcium lactate tablets (50 mg/kg) or a proprietary enteric mixture containing kaolin, pectin, aluminium hydroxide and belladonna extract. Lower plasma levels resulted when the antibiotic was given with dry extract of belladonna (20 mg/dog) or intravenous chlorpromazine (2 mg/kg). There was no significant effect with coated ferrous gluconate tablets (30 mg/kg). Feeding ad lib increased the initial chloramphenicol levels, but produced lower levels subsequently.


Granulomas of the testis and excurrent ducts following vasoligation in the fowl (Gallus domesticus). Ten adult 18-month-old male fowls were vasoligated unilaterally just anterior to the cloaca via an incision made between the base of the tail and the cloacal orifice. Two birds each were killed at two weeks and four weeks post-ligation, and the remaining six birds at 12 weeks post-ligation. Forty per cent of the birds showed severe reactions in the ipsilateral testis, epididymal region and ductus deferens. The remaining birds showed slight gross changes and near normal histology. The contralateral organs in all birds were normal both macroscopically and microscopically.


Spinal mobility in the dog. A study in chondrodystrophoid and non--chondrodystrophoid animals. Spinal mobility in chondrodystrophoid and nonchondrodystrophoid animal has been studied radiographically. Movement at the lumbo-sacral articulation is approximately three times greater than at other levels in the lumbar spine. The L7-L6 articulation is the second most mobile level. Movement at other lumbar segments is approximately equal. The range of motion is closely similar for both skeletal types which suggests that this factor alone is not of crucial importance in the aetiology of intervertebral disc disorder in chondrodystrophoid animals.


[The diagnosis of soft tissue alterations of the knee by means of xeroradiography (author's transl)]. Xeroradiography is a useful screening-method for the evaluation of soft tissue alterations in the region of the poplitea. It proves that recognition of Baker's cysts, aneurysms, and even tumours is possible due to morphological criteria which allow for differentiation to a degree. The conformation of a lesion by means of arthrography or angiography is not to be dispensed with, but xeroradiography permits the objective demonstration of a clinically uncertain alteration. This method has demonstrated its usefulness especially for the rheumatologist in the evaluation of Baker's cysts.


[Diagnostic problems in a patient with progressive sclerodermia (author's transl)]. 3 characteristic problems of progressive sclerodermia are discussed on the basis of one case: 1. The differential diagnosis of stenosis of the esophagus due either to the disease or to carcinoma, 2. in the presence of a round focus in a lung, the question of its connection with pulmonary fibrosis or bronchial carcinoma, 3. in rapidly increasing interstitial marking the distinction between increasing fibrosis of interstitial superimposed edema.


[Investigations of xerographic pictures in tomography (author's transl)]. Tomograms of a variety of test-objects and of a Alderson phantom skull are compared for their differences between film- and xero-tomograms. Xerography provides tomography with the advantage of correcting the typical loss of contrast and sharpness by an increase at the margins. The disadvantages is that the sharper contours also appear on the blurring figures which renders them more noticeable. The high irradiation-dosage of Xerotomography so far prevents its clinical use in a wilder field.


[X-ray technique and congenital dislocation of hips (author's transl)]. Positioning, Fixation techniques and x-ray protection with methods accessible for every practising radiologist, are discussed on the example of roentgendiagnosis of congenital dislocation of hips (CDH) in young infants. Established radiologic criteria to diagnose CDH are mentioned and their dependence from correct radiologic techniques are stressed. Pitfalls arising from incorrect fixation and positioning of the infant are discussed.


[Clinical and diagnostic problems of the adolescence hip-joint (author's transl)]. The most important hip-joint diseases of the adolescence are discussed with their differential-diagnosis by means of clinical symptoms, characteristics in x-rays and other additional findings. Beside inflammatory and infectious diseases symptoms and treatment of the juvenile slipped epiphysis of the upper femoral end are discussed particularly.


[Radiographic examinations of the colon -- results of 2400 double contrast enemas (author's transl)]. A technique for the double contrast method was described which was used in our radiology institute on 2400 patients. It takes into account economic factors (amount of film used) as well as the lowest possible radiation exposure (mean screening time: 6.4 minutes). Typical lesions from malignant processes in the colon were illustrated. Today, radiographic examination of the colon should be conducted only with the double contrast method. This rule need not be followed in acute cases, e.g., an ileus produced by a tumor. The examining techniques must be adapted to the individual case. Today, the single contrast technique should be used only in such special cases.


[Critical evaluation of the possibilities for using xeroradiography in serial arteriography of the extremities (author's transl)]. The use of xeroradiography and of low concentrate contrast medium in 55 extremity arteriographs were reported. The advantages and disadvantages of the technique were discussed.


[Rare late complications following thorotrast arteriographs (author's transl)]. Hematemesis in a thorotrastosis patient with severe liver dystrophy led to a tentative diagnosis of portal hypertension. The possibility of portal hypertension was eliminated via angiography. The cause of the hematoemesis was multiple bleeding stomach ulcers. In spite of severe damage to the liver parenchyma, portal hypertension with thorotrastosis does not usually occur. This has been confirmed in the literature and by histologic investigations. In second thorotrastosis patient, the cause of pain and swelling was a sterile abscess formation in the area of the thorotrastoma.


[More safety in catheter cerebral angiography (author's transl)]. Hazards and difficulties of catheter carotid and vertebral angiography are reported. Our experience is based on 257 persons who had undergone 338 carotid and 33 vertebral arteriographies. In 31 patients, bilateral carotid as well as aortic arch and abdominal aortic, iliac and lower limb arteriography were carried out in one session. Our material consists of consecutive cases. The characteristics of the "sidewinder-technique" are emphasized. Several safety measures considered necessary during the examination are described.


[The effects of mechanical disturbances caused by additional body section roentgenographic equipment on the tomogram (author's transl)]. Attention was called to the false images which can appear if additional body section roentgenographic equipment is improperly operated. In practice, the alterations on the tomogram, however, are usually so slight that they are barely noticeable and, for this reason, the disturbances can be overlooked. Additional body section roentgenographic equipment should, therefore, be constructed in such a way that operational errors are basically impossible.


[Exposure doses of the patient and the medical staff during urological x-ray examens (author's transl)]. During 32 intravenous urografies and 48 angiografies of the kidney and the suprarenal glands the x-ray doses at the patient's skin and gonades were determined. During the angiografies the doses were measured at the hands, the gonades and the front (eyes) of the medical staff. The results are discusses. Because the x-ray doses are realtively high, the number of the pictures and the exposure time is to be reduced to the minimum. Clinical experience (sufficient training) and special knowledge is the best x-ray protection.


[Double contrast examination of the colon with glucagon. Method and results]. A standardized clinical technique for double contrast examination of the colon was presented. The focussing and examining technique as well as problems involved with the preparation of and carrying out of this method were discussed in detail. The examining technique and the  results of the hypotonic double contrast examination of the colon with glucagon were discussed and the results of 125 double contrast studies of the colon were given in a table.


Value of systolic time intervals in the estimation of heart failure secondary to acute myocardial infarction. Serial measurements of left ventricular systolic time intervals (STI) were carried out in 44 patients with acute myocardial infarction (AMI) in the first 5 days after onset, by indirect methods. The patients with heart failure showed significant decreases of ejection time (ET) (p less than 0.001) and of the ejection time index (p less than 0.005) and increases of Wiessler's ratio (PEP/ET) (p less than 0.001). The pre-ejection period (PEP), the isovolumetric contraction time and the total electromechanical systole were unsignificantly changed. Ejection time was shorter than 250 msec in the patients with acute pulmonary edema or congestive heart failure, in most of the patients with flutter or atrial fibrillation and in 16 of the 17 patients who died. Ejection time may have a prognostic significance and may be useful in the early detection of heart failure in AMI. The changes of STI after administration of lanatosid C show the positive inotropic effect of this drug in patients with AMI.


The effect of intravenous potassium canrenoate in patients with severe heart failure and digitalis toxicity. In 16 patients with critical condition due to severe heart failure associated with digitalis toxicity, the effects of potassium canrenoate (AldactoneR) administered intravenously were studied. Rhythm and conduction disturbances disappeared or improved in all instances. This effect was well correlated with an increase of serum potassium concentration. In 13 patients, after 1-2 days of Aldactone therapy, heart failure improved, which could be explained by a diuretic effect and by a possible inotropic action of aldactone. It is concluded that intravenous Aldactone is useful in patients with severe heart failure and digitalis toxicity in whom diuretics are often ineffective and even dangerous.


Study of the incidence and prevalence of children bronchial asthma in a Romanian town. The incidence of bronchial asthma was investigated in a population of 4,486 schoolchildren aged 6 to 14 years from Rîmnicu Vîlcea, a Romanian town in the meridional sub-Carpathian zone of the country. The incidence of "probable asthma" was found to be 2.45% and that of confirmed asthma 1.62%. These percentages are among the highest ever encountered in Romania, in both children and adults. A family history of atopy was observed in 42.3% of the children and of asthma in 28.7%. Such big figures have never been found in adults in Romania.


Hypoxemia in chronic bronchitis and pulmonary emphysema. The measurement of arterial blood oxygen tension (PaO2) in 54 patients with chronic nonspecific lung disease with a FEV1.0 of 1.51 or less, in a stable clinical state, at rest, indicated subnormal results to be more frequent among "bronchitics" (79 per cent with hypoxemia) than than among "emphysematous" patients (63 per cent with hypoxemia). The patients were classified according to a mixed clinical-roentgenologic-biological "score" (Nash et al., 1965). A significant correlation was found between PaO2 and the "emphysema score" (r=0.36; p less than 0.01). The average PaO2 was significantly (p less than 0.02) lower in "bronchitics" (65.5 +/- 8.8 mmHg; n = 14) as compared to the "emphysema" group (71.8 +/- 5.7; n = 19), in agreement with the data of the literature.


Relationships between lymphography and the histologic nodal and splenic types in Hodgkin's disease. Considerations on clinical evolution. Trying to establish the eventual interrelations of the initial histologic nodal type and the splenic one, the general lymphographic picture, the histologic nodal type and spleen involvement, lymphographic and histologic examinations were carried out in 151 patients with Hodgkin's disease. Lympographies were performed in 139 cases, and splenectomy (followed by splenic, hepatic and abdominal lymph node biopsies) in 32. Lymphocyte depletion was found in 72.7% of the patients with lymph node obstruction diagnosed lymphographically. Splenic involvement was more frequent in cases with pathologic lymphographic picture and histologic aspects of lymphocyte predominance or nodular sclerosis. In patients with initial nodal histologic types of nodular sclerosis or lymphocyte depletion, the splenic histopathologic types were the same, but they got more severe in cases with lymphocyte predominance or mixed cellularity. Splenic biopsy might be unconclusive after protracted cytostatic treatment or splenic X-ray therapy. In the authors' opinion, early routine splenectomy is rather more advisable than differentiated splenectomy.


Lymphocyte lysosomal acid phosphatase in patients with carcinoma of the larynx. The activity of lysosomal acid phosphatase in the peripheral blood lymphocytes was determined by using the method of Barka and Anderson in 20 men with carcinoma of the larynx, untreated. The results were compared with those in 20 healthy subjects. In the patients a statistically significant decrease of the lymphocyte count exhibiting enzyme-positive lysosomal granules was noted but the number of the lymphocytes with granular and diffuse or only diffuse type of cytochemical reaction was significantly increased. The lack of significant differences in the total lymphocyte count between patients and controls suggests the possibility of lysosome disruption and subsequent release of enzymes into the cytoplasm in the patients studied. The anomalies of the enzyme-positive lymphocyte lysosomal equipment are discussed in the light of the data on immunologic alterations in cancer patients, and of those suggesting that acid phosphatase may serve as marker of T cells.


Sickle-cell disease. Two cases in a Romanian family. Hemoglobin S is rarely found in Caucasians, especially in its homozygous expression. The authors report two cases of homozygotes for Hb S diagnosed in a Romanian family. Ten subjects were investigated, belonging to three generations of the same family, and the following results were obtained: two cases of homozygotes for Hb S; five cases of heterozygotes; three normal subjects. One of the two subjects homozygous for Hb S, a girl aged six, had a severe clinical evolution, typical for homozygous drepanocytosis. The second case, a sister of the first aged two, had a less severe evolution, without splenomegaly and thrombotic accidents. The heterozygote subjects showed no clinical symptoms. The two cases of homozygous Hb S reported are the first cases of sickle-cell disease described in Romania.