[Neurosurgical emergencies: cranio-cerebral injuries and their diagnosis and therapy (author's transl)]. The neurotraumatological case material of the Neurosurgical Clinic of the University of Pavia, from the August 1st 1972 to July 31st 1975, includes N. 122 patients, submitted to neurological surgery. All data are examined and discussed in relation to age, to the coma level, to the type of endocranial lesion and the results obtained are compared with the data of literature. The incidence of associated lesions, both endocranial and in other regions, is made standing out more clearly. The importance of an early diagnosis, by neuroradiological tests, is made cospicuous in order to get a correct surgical therapy. The survival is discussed in relation to the type of surgical act and of pathology.


[Encephalitis during mycotic dissemination in a patient (clinical and post mortem findings) (author's transl)]. A case of disseminated mycosis with encephalitis unobserved in life is reported. A mycosis infection ought always be taken into consideration every time that a clinical impression of encephalitis, meningitis or cerebral abcess is reached. Criptococcosis, Histoplasmosis and Candidiasis may present as a meningitis, which the Nocardiasis and the Cladosporosis may appear as an intracranial abscess in the absence of significant lesions of other organs. Many deep mycosis prove to have characteristic lesions in other organs before affecting the Central Nervous System. Development therefore of neurological symptoms ought to make one think of a dissemination at CNS level. Finally Candidosis and Aspergillosis ought to be suspected in all cases of progressive general weakeness after an illness especially when treated with antibiotics, citotoxis drugs, or hormonal steroids. In many cases the neurological lesions represant a manifestation of terminal type in a subject with many more lesions than one would suspect at first.


[Experience with percutaneous embolization of renal tumours (author's transl)]. We have repeated first observations of various authors of blocking angiography in 8 patients with renal tumours. Comparing angiographic findings and the surgical specimens, the success of embolization could be assessed. Control angiography 2 months following an inoperable renal tumor showed shrinking of the tumour by about one half and improvement of the general condition of the patient.


[Multiple gastric carcinoid, its diagnosis in gastric polyposis (author's transl)]. Carcinoid of the stomach, hormonally inactive, is diagnosed with MDP, gastroscopy and biopsy. Solitary carcinoids are treated with excision in toto with immediate histology of the edges. Multiple gastric carcinoids require gastrectomy.


[New perspectives in the treatment of occult, non invasive breast cancers by means of non-notilating surgical therapies (author's transl)]. Six cases of occult, non-invasive cancer or cancer lobular "in situ" of the breast are presented which were treated by means of non-mutilating surgical therapies (such as subcutaneous mastectomy or tumorectomy). Control between 1 and 4 years.


[Extrarenal excretion of urographic contrast media in renal failure (author's transl)]. Communications about extrarenal excretion (ERE) of urographic contrast media are not frequent. The contrast medium is secreted via the liver. It can be observed in the gallbladder and the colon. A case of ERE in a 28 years old patient with renal failure is described.


[Percutaneous aspiration biopsy aided by computertomography (author's transl)]. Computer tomography (CT) permits recognition of normal and pathologic structures and renders percutaneous biopsy easy, giving a high degree of diagnostic accuracy with few complications. It is an ideal technique for the biopsy of foci which cannot be reached otherwise.


[Paget-von Schroetter-syndrome (awthor's transl)]. Report on 3 cases of thrombosis of the axillary vein (Paget-von Schroetter-syndrome). In this relatively rare condition phlebography and early thrombolytic treatment are required.


[Myelopathies cervical arthroses. Apropos of 14 personal cases, 12 of which were operated on]. Reviewing fourteen cases, the authors show that cervical myelopathies present by spastic quadriplegia associated in half of the cases with sensory impairment and in a third of cases with radicular signs in the upper limbs. Tomography always shows posterior discal osteophytosis, sometimes gross, which reduces the lumen of the canal more particularly since it is associated (eleven times out of fourteen) with constitutional stenosis, of variable severity. Opaque or gaseous myelography makes it possible to exclude malformation or new formation and will demonstrate cord constriction within the canal. Surgical treatment (eleven laminectomies, 1 discectomy-artrodesis) resulted in 7 improvements, no change in 3 cases and 2 exacerbations. The myelopathies appeared to be due to repeated contusions of the cord and its arteries against the wall of the canal, caused by neck movements.


Function of neutrophils in preleukaemia. The function of blood neutrophil granulocytes was studied in vitro in 17 patients with preleukaemia. 3 patients had a cellular defect of chemotaxis. 2 of them had monosomy-7 in bone marrow karyotype, in 1 associated with the deletion of the long arm of a chromosome 20. The third patient had trisomy-8. In the patient with trisomy-8, the high percentage of band neutrophils was possibly associated with the chemotactic defect. In another patient with trisomy-8 chemotaxis was normal. There was a statisically significant tendency to reduced phagocytosis and impaired ability to kill Staphylococcus aureus. 1 patient with a chemotactic defect and monosomy-7 suffered from repeated infections. The other 2 patients with defective chemotaxis had several febrile episodes most probably of infectious origin, and 1 of them died in sepsis. All of these 3 patients had cutaneous abscesses. It is concluded that defects in neutrophil granulocyte function are not uncommon in preleukaemia and may result in reduced resistance to infection.


The relationship between Normotest and Thrombotest in patients on oral anticoagulant therapy. Normotest (sample volume: 25 micronl) and Thrombotest were performed in parallel on 150 consecutive capillary blood samples from patients on long term oral anticoagulant therapy. The ratio of Normotest to Thrombotest decreased from 2.50 at a Thrombotest level of 5-5.5% to 1.95 at a Thrombotest level of 13-13.5%, indicating that the effects of PIVKA were more pronounced at lower levels of coagulation activity. The influence of varying sensitivity of the thromboplastin reagents to PIVKA is discussed. The therapeutic range of Thrombotest (5-10%) corresponded to a Normotest level of 12-20%.


Evidence of local synthesis of smooth-muscle antibodies in the central nervous system in isolated cases of multiple sclerosis and chronic lymphocytic meningoencephalitis. Paired samples of serum and concentrated cerebrospinal fluid (CSF) from 53 patients with multiple sclerosis (MS) and from 36 patients with other neurological diseases were adjusted to an equal concentration of IgG and examined for occurrence of auto-antibodies. Anti-nuclear antibodies, anti-mitochondrial antibodies, and rheumatoid factor were not detected with increased frequency in the materials studied. Smooth-muscle antibody (SMA) was, however, detected in CSF and serum from three patients with MS and one patient with chronic lymphocytic meningoencephalitis, and in the CSF only from one additional patient with MS. The SMA activities of the CSF were 4 to 16 times higher than in the matching sera, suggesting a local SMA synthesis within the central nervous system. The SMA was associated with electrophoretically restricted fractions of IgG, but an association between SMA and oligoclonal IgG of the CSF could not be demonstrated in the SMA-positive patients by the methods used.


IGE in human urine and milk.

IGE in human urine and milk. IgE was found in urine from healthy adult volunteers at very low levels (approximately 0.003-0.010 IU/ml), corresponding to a 24-h excrection rate of 3-16 IU. IgE was not detected in 36 out of 47 samples of milk and colostrum. In samples from six women the protein was present at low concentration 1-2 days postpartum but was not detected in later samples (usually day 5 or 6). Mammary secretions from four allergic donors were studied, and IgE was detected at low concentrations in samples from the two most severely affected individuals. The levels of IgE observed in both urine and milk suggest that there is no significant synthesis of the protein in either the urinary tract or in mammary tissue.


[Psychodynamic aspects of paraphrenia].

[Psychodynamic aspects of paraphrenia]. Proceeding from Kraeplin's original a brief summary is given of the literature about the extensive interpretations of the term paraphrenia. Our study is based on a catamnestic examination of schizophrenic diseases first acute in 1930-1940 after 30 respectively 40 years (H. Hinterhuber) and a second group of paraphrenics who at the time being have been under our control for five years. By a simplifying scheme our own conception of paraphrenia is then defined and differentiated from the paranoid schizophrenia and the development of paranoia with special reference to the characteristic juxaposition of schizophrenic symptomatic in otherwise intact personality without a noteworthy derangement of the evironmental relations. The intact personality stands in clear contrast to the only "intact outside personality' with schizophrenic derangement of the ego. Thus the paraphrenic has the possibility to withdraw to the core of his sound personality and erect a mostly stable barrier against the partly massive hallucinations on the periphery of his personality. This corresponds to a passive attitude of avoidance in the sense of behaviour psychology. As THEREFORE the paraphrenic, similar to the phobic, tends to confine the borders of his existence by an increasingly passive avoidance attitude, he tries by a systematic desensibilisation to keep the borders of existence just in the area between psychosis and sound personality and thus render the best possible extent of personality development avoiding secondary restrictions.


[Indication for psychiatric hospitalization. Critical retrospective study on 416 admissions to the psychiatric hospital]. The authors have strained themselves to value subsequently the legitimacy of the psychiatric admittances that had been requested during the year 1967 for 368 patients already known by their Department: the out-patient psychiatric clinic of Lausanne. In order to that, every case has been referred to several psychiatrists, and the concordance between the opinions expressed by these psychiatrists, in terms of many variables, like the diagnosis or the reason of the admittance, has been examined.


[The anosognostic psychosyndrome. Studies and reflections on a case of acoustic agnosia]. We analyse structure and dynamics of anosognostic behavior by means of a case with auditory agnosia for both linguistic and non-linguistic material. First we investigate on the observational level the structural interweaving of conditions. Second we make an attempt of a structural dynamic analysis with inclusion of both neurophysiological and psychodynamic aspects within a frame which is orientated towards system theories. By doing this, the anosognostic syndrome which is describable in a phenomenalistic sense as a disturbance of body-scheme, neuropsychologically as a neglect-or extinction-syndrome and psychodynamically as regressive Ego dissolution, appears as disintegration of the transactional coherence between specific and non-specific functional systems. At the time also the relations to the structure of focal brain syndromes and organic psychoses are dealt with.


Metabolically induced focal seizures: hyperosmolar non-ketoacidotic hyperglycemia. Focal epileptic activity with or without further neurological symptoms may be induced by hyperosmolar non-ketoacidotic hyperglycemia. This syndrome may develop in the course of various diseases and cerebral lesions, frequently during therapeutic dehydration. On the other hand, neurological disorders may arise as a secondary consequence of the metabolic disturbance. Based upon literature reports and eight own observations, the neurological aspects of non-ketoacidotic hyperglycemia and its therapy are described.


[Experience in the joint hospitalization of mothers with their children at a psychiatric day center for adults]. The authors describe the joint hospitalisation of 16 mothers with their children in a psychiatric day center for adults. The first part of this article deals with the underlying theoretical considerations and a brief summary of these mothers and their childrens situation. The second part describes the treatment of a chronic depressive woman, admitted to the day center with her daughter. The authors do emphasize the importance of the therapeutical procedures needed for a treatment and the need to work in a close collaboration between the day center and the child guidance service.


Serum lysozyme in sarcoidosis. Evaluation of its usefulness in determination of disease activity. Serum lysozyme (LZM) determinations were done in 84 patients with clinically proven sarcoidosis. All patients were normocalaemic and had a normal renal function. An increased LZM activity was demonstrated in patients with pulmonary stage I and stage II disease, as well as in patients with extrapulmonary lesions. Treatment with corticosteroids rapidly normalized the LZM activity. A normal LZM activity was found in patients with cured sarcoidosis. The serum LZM activity seems  to reflect the total mass of biologically active granulomas and is of great value in determining the activity of the disease. The dosage of corticosteroids can probably be administered according to the actual LZM level. Increasing LZM activity after stopping treatment may indicate progressive and uncured disease. Normal LZM activity in patients with even large pulmonary lesions seems to indicate inactive disease and unresponsiveness to treatment.


Malignant mesothelioma of 17 years' duration with high pleural fluid concentration of hyaluronate. A patient suffering from malignant mesothelioma of funicular (intra-abdominal) origin is described. The disease proved fatal after 17 years' duration, which is the longest ever described without treatment. The analysis of the pleural fluid hyaluronate concentration gave strong evidence of the malignant aetiology, while biopsies taken 17 and 8 years before the pleurisy caused marked difficulties as to interpretation. In malignant mesothelioma a markedly elevated pleural fluid hyaluronate concentration appears to be a characteristic and specific feature.


[Immune mechanisms in hepatitis B. New aspects and consequent practices]. The different types of immune responses occurring during hepatitis B virus infection are reviewed. The responses specific for HBsAg (hepatitis B surface antigen) are important in the pathogenesis of chronic liver disease. The cell-mediated immunity specific for this antigen seems to be responsible for cytolysis occurring when the antigen is located within the hepatocyte (acute and persistent hepatitis). It is also responsible for the subsequent elimination of the virus. Immune complexes in antibody excess probably provoke the lesion of fulminant hepatitis. Complexes in the zone of antigen excess, which are responsible for the extrahepatic lesions of the prodromic phase, may perhaps also play a pathogenetic role in some forms of chronic active hepatitis.


[Follow-up of 52 patients with chronic aggressive hepatitis]. 52 patients with histologically proven chronic aggressive hepatitis have been followed up for a mean period of 31 months by regular clinical visits, laboratory controls and liver biopsies. Only patients already with a decompensated liver cirrhosis at the time of the first biopsy had a deteriorating course of the disease. According to our criteria of activity of the disease, only 6 cases needed treatment. 6 patients died during the period of follow-up, 5 of them from malignant tumors.


[Does cholestyramine impair the bioavailability of prednisolone?]. Measurements of plasma prednisolone concentrations in two patients who received orally 37.5 and 75 mg of the drug respectively showed no differences when 8 g of cholestyramine was given with the corticosteroid. Thus, no influence of cholestyramine on the bioavailability of orally administered prednisolone could be demonstrated.


[Surgery in 100 patients with acute sigmoiditis]. Report on surgery in 100 patients with acute sigmoiditis (54 females, 46 males). The overall average age was 65.5 years; that of females was 68.5 years and of males 61.5 years. Of the total of 100 cases, one third had one or more attacks prior to hospitalization. One third of cases were treated by conservative methods and did not undergo surgery. Surgery (resection or simply derivation) was performed in 63 patients. Eleven patients died: from rupture of anastomosis in 1 case and from general causes or superinfection in 10. The surgical indications and type of surgery are discussed. As far as possible, the affected segment of sigmoid must be resected, with or without establishment of continuity. Terminal colostomy is imperative.


[Early diagnosis of hepatic duct carcinoma]. 8 patients with carcinoma of the hepatic duct are presented. Despite symptoms during the long anicteric period (2-13 months, x 15 months) the diagnosis was never established until the patients became jaundiced. Early in the course of the diseases all of them reported upper abdominal pain and intermittend diarrhea, and the test for occult blood in the stool was positive. Initially there may be no biochemical evidence of cholestasis. Liver biopsy may at an early stage reveal pseudoxanthoma cells as an index of long-lived, local mechanical cholestasis.


[Characterization of gastric emptying by determination of transit time]. Gastric emptying of a solid test meal labelled with 99mTc-sulphur colloid has been studied in 18 healthy men using a gamma camera with on-line computer. Mean transit time (MTT) was determined by fitting the time-activity histogram to a gamma variate, and the half-time of emptying (T1/2) was calculated by exponential fitting of the down-slope of the C(t) curve. Mean transit times showed a smaller coefficient of variance than T1/2, and this difference was statistically significant (p less than 0.005). This result suggests that MTT may be a more suitable parameter for definition of normal values and for the separation of normal from pathological patterns of emptying.


[Radioimmunoassay for secretin].

[Radioimmunoassay for secretin]. A simple direct radioimmunoassay for human secretin has been developed by immunizing rabbits with synthetic human secretin. After 1-2 injections antisera with titers up to 1:52000 could be induced. In a dysequilibrium system secretin levels in plasma can be measured down to a concentration of 25 pg/ml plasma. Extraction methods gave unreproducible recoveries. Direct estimation in plasma provides only relative values because of a "non-specific" effect of secretin free plasma which is difficult to control. A simple assay based on iodination with chloramin-T and charcoal dextran separation produces at least reliable relative values, as shown by the pattern of secretin concentrations in response to intraduodenal stimulation with HC1.


[Pathologic anatomy of cor pulmonale. Results of autopsies]. In a Zurich autopsy study comprising 7947 adults (over 20-year-olds), cor pulmonale was diagnosed in 8.9% (709 cases). In more than half of the cases the cor pulmonale was caused by lung diseases associated with chronic bronchitis and emphysema or with fibrosis of the lung. In 7 cases recurrent thromboembolism was the sole cause of cor pulmonale, whereas in 103 cases additional lung diseases were involved. 7 cases could be attributed to primary pulmonary hypertension. Cor pulmonale is, as a rule, the result of multiple lung conditions. The lesions of pulmonary vessels in cor pulmonale are produced either by parenchymatous lung changes (such as pneumoconiosis, sarcoidosis, etc.) or by pulmonary hypertension.


[Cancer mortality in patients of psychiatric hospitals]. Studies on cancer mortality in psychiatric patients, especially schizphrenics, are reviewed. The divergences between these studies may be partially explained by the different statistical methods employed. It is difficult to compare the populations observed, due to the influence of such elements as the method of sampling, the period of observation of psychotic patients, diagnostic methods and criteria etc. On the whole, it is concluded that no major difference could be demonstrated with certainty between a non-selected population of psychotic patients (excluding psychoorganic cases) and the general population. With regard to schizophrenics, the hypothesis of a lower mortality from cancer cannot be ruled out on the grounds of studies carried out at the Lausanne psychiatric clinic. However, reports on cancer incidence have not yet confirmed this hypothesis and further studies are needed to verify it. Various factors are discussed which may modify cancer risk in psychiatric patients in hospital such as tobacco, food, sexual activity, neuropleptics, and biochemical and immunological factors. Lastly, the psychosomatic hypothesis of carcinogenesis is discussed in the framework of this review.


H-y antigen: expression in human subjects with the testicular feminization syndrome. Androgen-insensitive subjects with a 46,XY karotype develop as phenotypic females despite presence of testes. The white blood cells of these females type H-Y antigen-positive indicate that expression of the H-Y cell surface component is androgen-independent.


Degradation and detoxification of canavanine by a specialized seed predator. Larvae of the bruchid beetle Caryedes brasiliensis feed exclusively on seeds of the Neotropical legume Dioclea megacarpa, which contains 13 percent L-canavanine by dry weight. L-Canavanine, a nonprotein amino acid analog of L-arginine, exhibits potent insecticidal properties. Most of the seed nitrogen is sequestered in canavanine, and bruchid beetle larvae do not simply excrete this toxic compound. Instead, these larvae possess extraordinarily high urease activity, which facilitates the conversion of canavanine to ammonia through urea. In this way, canavanine is effectively detoxified and a supply of nitrogen for fixation into organic linkage is ensured.


Adequate response of plasma 1,25-dihydroxyvitamin D to parturition in paretic (milk fever) dairy cows. The concentration of 1,25-dihydroxyvitamin D was measured by means of a radioactive receptor assay in the plasma of cows during the period immediately prior to, during, and following parturition. Nonparetic cows showed initially a slight decrease in plasma 1,25-dihydroxyvitamin D which was followed by a significant increase during parturition and 2 days postpartum. The highest concentration achieved in the control or nonparetic cows was 100 picograms per milliliter. In the paretic animals the plasma 1,25-dihydroxyvitamin D concentration increased sharply during the day preceding calving and reached a maximum of 200 picograms per milliliter at parturition. This level was maintained during the ensuing 2.5 days. These results demonstrate that parturient paresis cannot be the result of insufficient synthesis or secretion of 1,25-dihydroxyvitamin D.


Virus-induced behavioral alteration of mice. Neonatal mice were inoculated intracerebrally with lymphocytic choriomeningitis virus (LCM). These mice developed long-term persistent tolerant infections and when tested at 3.5 to 6.0 months of age they showed significant increases in behavioral latency when subjected to open-field tests, and significant decreases in the current level required to elicit to startle response and in locomotor activity in a running wheel. Comparable results were obtained with mice in which persistent infection was induced at 8 weeks of age and which were tested at 3.5 to 6.0 months of age. It was concluded that mice infected with LCM at birth or as adults exhibited long-lasting behavioral abnormalities.


Geomagnetic disturbance and the orientation of nocturnally migrating birds. Free-flying passerine migrants respond to natural fluctuations in the earth's magnetic field. The variability in flight directions of nocturnal migrants is significantly correlated with increasing geomagnetic disturbance as measured by both the K index and various components of the earth's magnetic field. The results indicate that such disturbances influence the orientation of free-flying migrants, but the evidence is not sufficient to show that geomagnetism is a cue in their orientation system.


Nuclide imaging and computed tomography in cerebral vascular disease. This report presents our experience with computed tomographic and radionuclide scans in 224 patients with ischemic or hemorrhagic infarcts or intracerebral hematomas secondary to cerebral occlusive vascular diseases. The results vary according to the site of vascular occlusion. The radionuclide angiograms and static scintigrams show four distinct patterns in cases of occlusion of the middle cerebral artery. Computed tomographic scans exhibit less variation in appearance and have a higher sensitivity in cases of recent ischemic infarction. The "tentorial confluence sign" is an important finding on static scintigrams in patients with occipital infarction; if this sign is not present, this diagnosis should be suspect. Earlier reports have established the value of computed tomography and radionuclide scans in the evaluation of cerebral infarction. In individual cases, however, each of these modalities may render nondiagnostic or false negative findings; combining both both types of examinations and comparing results yield a greater likelihood of an accurate diagnosis of cerebrovascular disease. Computed tomography is clearly more valuable than radionuclide scans in the diagnosis and follow-up of hemorrhagic infarcts or parenchymal hematomas.


The aetiology, diagnosis and treatment of constipation and diarrhoea in geriatric patients. Constipation and, to a lesser extent, diarrhoea, are not uncommon in the elderly and are frequently due to nonorganic causes. Despite this, disturbances in bowel habit always warrant the consideration of possible organic causes. Carcinoma of the colon and endocrine causes are frequently overlooked and rectal examination is mandatory in all patients to exclude rectal carcinoma and faecal impaction. Rectal bleeding, of course, is as alarming a symptom in the elderly as it is in younger people.


Confusion in the aged.

Confusion in the aged. A brief review of the common causes of states of mental confusion in the aged is presented. The emphasis is on the early and accurate recognition of causes, and practical ways of dealing with the condition.


The role of the voluntary welfare agency in the care of the aged. This article summarizes the various facilities available to the aged living in the community and some of the problems associated with providing accommodation for the elderly, and for the mentally frail person in particular. The importance of closer co-operation between the medical profession and voluntary welfare organizations is emphasized.


Geriatrics in twestern Europe.

Geriatrics in twestern Europe. Visits to homes for the aged and congresses on the aged in Western European countries offered informative insights into the amenities available to the aged and the principles employed in providing such amenities. The identity and dignity of the aged are the concern of medical practitioners who have specialized in this field. I was impressed by their insight and dedication to the problem.


Medical research in the Republic of South Africa. A brief overview of the policies and research priorities of the South African Medical Research Council is given. Some of the unique medical problems of South Africa on which research is being done are indicated.


Attitudes of medical students to a family attachment scheme. A family attachment scheme is described, in which a few fourth-year students followed-up the babies they delivered during their obstetric training until the final year of study. Fifth-year students visited families of a normal newborn infant or a child who had presented with an illness or abnormality until the end of their final year. Some students felt that the project had been worth while, while others thought that it was pointless. Families visited by the students thought the scheme had been beneficial, mainly because the student was somebody they could talk to about their problems.


Tumour metastasis to the thyroid gland.

Tumour metastasis to the thyroid gland. Ten cases of tumour metastasis to the thyroid gland are reviewed. Thyroid involvement implies disseminated malignant disease, but metastatic tumours may simulate a primary thyroid tumour. It is suggested that thyroid involvement by metastasis is more common than previously assumed. Needle biopsy of the thyroid gland permits accurate histopathological diagnosis.


Microsporum magellanicum and Cunninghamella antarctica, new species isolated from Australic and Antarctic soil of chile. Keratinophilic fungi were isolated from samples of soil collected in the extremity of Chile, in Southern Shetland and Antarctic continent. Two new species, Microsporum magellanicum and Cunninghamella antarctica are described. Microsporum magellanicum is characterized by verrucose or verruculose clavate macroconidia predominantly uniseptate, 4-87-2micronx14-4-21-6micron. Cunninghamella antarctica has conidiophores usually verticillately, pseudoverticillately and sympodially branched; and globose conidia with evident spines, 12-8-16micron in diameter.


Gastrobronchial fistula diagnosed and treated four years after a shooting accident. A case report. A case of gastrobronchial fistula complicating thoraco-abdominal trauma is presented. Possible pathogenesis is discussed and a further cause for failure of a fistula to close is suggested.


Freeze-etching observations of Trichophyton Violaceum. Trichophyton violaceum was cultured on a Sabouraud's dextrose agar slants for freeze-fracture replication. It was cryoprotected with glycerol and sucrose. The surface structure of the cell wall showed a rodlet pattern. Invagination-like craters were observed in the plasmalemma. The nuclear envelope with pores, mitochondria, and vacuoles were clearly shown. Three-dimensional views of the fine structure were presented.


Blunt abdominal trauma in childhood.

Blunt abdominal trauma in childhood. Blunt abdominal trauma in childhood is a common clinical occurrence. Accurate assessment requires an understanding of patterns of injury and the response of the child. Repetitive examinations in a comforting environment will yield superior clinical judgment. Renal trauma is frequent, requires thorough radiologic evaluation, and may be associated with an underlying anomaly. The goal of management is salvage of functioning nephrons. Definitive indications should exist prior to operative intervention. The goal of management of splenic injury should not be the justification of splenectomy. The operative decision should be based on clinical indications. Judgment should include a knowledge of the risks and alternatives.


Nonpenetrating thoracic injuries.

Nonpenetrating thoracic injuries. In patients with nonpenetrating thoracic trauma, the rib fractures and other chest wall lesions may distract the physician from dangerous internal injuries in the chest or abdomen which may not be noted unless looked for very carefully. Early vigorous correction of any ventilatory problem is essential, particularly if there is any evidence of impaired tissue perfusion. Shock is frequently due to extrathoracic injuries, particularly intraabdominal bleeding. The flail associated with multiple rib fractures may seem mild initially, but severe underlying pulponary contusion and/or associated extrathoracic injuries make early ventilatory assistance extremely important. Rupture of the thoracic aorta should be suspected in rapid deceleration injuries, but is often not considered unless there is widening of the superior mediastinum on hte chest x-ray. Aortography to confirm the aortic tear should be done if time permits, and early repair of the injury provides the best results.


Phenylmercuric acetate intoxication in mink. Mink died following an incidental phenylmercuric acetate (PMA) intoxication. Mortality was restricted to the older animals (31% in the females and 40% in the males). Of all organs the kidneys were most seriously damaged (tubulonephrosis) and contained the highest residual levels of mercury. No lesions were observed in the central nervous system. Twenty-one weeks after exposure mercury residues had declined to normal levels. The half-time of disappearance of mercury was 10 days in skeletal muscle, 22 days in kidneys, 27 days in brain and 36 days in liver. The reproductivity of the surviving mink was not affected by the PMA-intoxication.


Changes of hypophysio-ovarian endocrinological function by aging in woman. Serum estradiol, progesterone, LH and FSH were concomitantly measured by radioimmunoassay in pre- and post-menopausal women in an attempt to study hormonal changes occurring in menopause. The level of serum estradiol in post-menopausal women was maintained at the same level as in pre-menopausal stage within one year after menopause and thereafter began to decrease to the senile minimal level. On the other hand, the mean serum levels of FSH and LH were elevated gradually after menopause. At the conclusion of this study, it was suggested that the key point of the mechanism of menopause may exist not only in the depletion of ovarian function but in the change of the regulatory mechanism of LH and FSH secretion by aging.


Parotid saliva tests in patients with pancreatic diseases before and after surgery. Two patients with pancreatic cyst were treated by cystojejunostomy, two others with pancreaticolithiasis by pancreaticojejunostomy (side to side), and pancreato-duodenectomy was done in one patient with cancer of the duodenal papilla and in one patient with cancer of the intrapancreatic bile duct. All these patients made uneventful recovery. In all these cases, parotid gland function was found depressed. After the operation, four patients showed normal parotid gland function and in one patient it was abnormally elevated. Thus, as previously reported in animal experiments, the parotid gland function was presumed to return to normal or to be elevated in parallel with the improvement of the pancreatic function or lesions.


Triglyceride metabolism in the lung.

Triglyceride metabolism in the lung. Experiments were carried out to examine whether the lung acts as a depot for circulating lipid, especially that absorbed from the intestine. When 0.5 ml of triolein was administered orally to rats, the triglyceride content of the lung increased 2-3 hr later, but its increase in the lungs 2-3 hr later was only of about 1/10 of that in the liver. In the fed state the triglyceride content of the lung was only about 1/8 of that of the liver. When [3H]palmitic acid was administered orally to mice its uptake by the lung 1 and 2 hr later was 1/25-40 of that by the liver. In the lung, it was incorporated into phospholipid more than into triglyceride, but in the liver it was predominatly incorporated into triglyceride. Most of the lipase activity in both the microsomal and soluble fractions of rat lung appeared to be due to lipoprotein lipase. Fasting did not decrease the lipoprotein lipase activity in either fraction. It was concluded that  the lung is not important in removal of triglyceride from the blood, even during fat absorption from the intestine, and that the lung takes up circulating lipid for its own metabolism rather than for storage.


Effects of halothane on coronary and systemic circulations, myocardial metabolism and blood flow distribution within the canine heart. Myocardial metabolism, blood flow distribution within the heart, and coronary and systemic circulations were observed during halothane anesthesia using 15 mongrel dogs. Pao2 and Paco2 were maintained near 100 and 40 torr respectively throughout the study. As arterial halothane content increased, most parameters of systemic circulation were depressed significantly. Coronary blood flow was reduced in parallel with myocardial oxygen consumption (MVo2) (r=+0.89, pless than0.001). Myocardial contractility decreased significantly as anesthesia deepened. MVo2 and myocardial CO2 production were reduced as arterial halothane concentration rose. Arterial-coronary venous difference in blood oxygen content remained unchanged even in deep stage. Lactate and pyruvate were continuously taken up by the myocardium, although the amounts of uptake were reduced as anesthesia progressed. Calculated excess lactate and redox potential did not show any signs of myocardial hypoxia even in deep halothane anesthesia. Among major hemodynamic parameters, left ventricular dp/dt max showed the closest correlation with MVo2. Microsphere injection method was used to observe blood flow distribution within the heart. Halothane did not influence the distribution significantly and I/O ratio of the left ventricular free wall remained near 1.0 during the study.


Toxicity studies on trans-1,2-dichloroethylene. Trans-1,2-dichloroethylene (t-DCE), an industrial solvent, proved to be moderately toxic when studied in small laboratory animals. In adult female rats brief (8 h) and prolonged (8 h daily, on 5 consecutive days a week, for more than 16 weeks) inhalation of 200 ppm--the current TLV/MAC in various countries--produced histological evidence of slight to severe fatty degeneration of the liver lobules and Kupffer cells. In addition marked pulmonary hyperaemia and alveolar septal distention were noted. Fibrous swelling of the cardiac muscle (with striation) just barely maintained) and hyperaemia remained detectable for as long as 14 h post-exposure, but only occurred at 3000 ppm/8 h. A concentration of 1000 ppm/8 h was required to produce a fall in blood albumin, urea nitrogen, alkaline phosphatase activities and erythrocyte count. The cited concentrations failed to produce prenarcotic symptoms of narcosis (central nervous system (CNS) depression). The LD50 was found to be 6.0 ml/kg i.p. and 1.0 ml/kg p.o. for female rats, and 3.2 ml/kg i;p. for female mice. In some of the rats killed in these experiments the organ changes were found to be identical to those observed after inhalation.


Inhalation toxicity studies on cigarette smoke. IV. Expression of the dose of smoke particulate material applied to the lungs of experimental animals. Calculations of total particulate matter (TPM) dose applied to the lungs of animals are made from experimental dosimetry data. TPM dose levels achieved in a number of species following exposure to smoke are related to body weight, lung weight and alveolar surface areas of these animals. The dosage levels achieved in animals are compared with estimate of TPM dose retained by a smoker. Cigarette dosage equivalents to which animals are subjected can be calculated on the basis of these comparisons. The validity of making such extrapolations from animal dosimetry data to the human exposure situation is discussed.


Semichronic oral toxicity of cadmium. I. Studies on rats. Cadmium (in the form of CdCl2) was fed to groups of 20 male and 20 female rats each over a period of 3 months in concentrations of 0, 1, 3, 10 and 30 ppm. Appearance, behaviour, food consumption, growth and mortality of the treated rats of all groups were not affected during the 3-month period. The cadmium concentrations did not cause blood, liver or kidney damage. The systolic blood pressure of the treated animals was not increased. Autopsies and histopathological investigation of the animals showed no sign of any alterations. Cadmium accumulated dose-dependently in the kerated by rats over a period of 3 months without harm.


[Epidemiology of non-Hodgkin's lymphoma]. Main sources of information on the epidemiology of malignant tumors are the statistical data on mortality and incidence and the studies on the distribution of frequencies. The mortality from non-Hodgkin's lymphomas ranges between 0.1 and 6 cases per 100 000 per year. Statistics upon incidence are based on cancer registers of the general population. The figures of incidence range between 1 and 10 cases per 100 000 per year ("Cancer Incidence in Five Continents"). Men are affected with non-Hodgkin's lymphoma twice as frequently as women. Burkitt's lymphoma and the lymphoma of small intestine are particularly interesting, showing a peculiar geographical and age distribution.


[Reversible and irreversible azoospermia after irradiation of the malign tumor of the testicle (author's transl)]. Of the patients who had received radiotherapy for malignant testicular tumors between May 1957 and December 1975, 100 were alive without recurrence and without previous chemotherapy at the time of this study. An evaluable ejaculate could be examined in 52 of these patients. The patients were divided into eight groups according to the radiation fields employed. In this manner a direct correlation between the radiation field distribution, which determined the field size, and the development of azoospermia could be made. The appearance of azoospermia was also temporally related to the onset of radiotherapy. This is not the result of a tumor induced hormonal alteration. It is caused by destruction of the spermatogonia, the precursor cells of spermatozoa, and a resulting failure of spermatogenesis. This azoospermia is dependent on the irradiation received by the healthy testicle and may therefore be partially or totaly reversible or irreversible.


Welding light.

Welding light. Two types of electric welding, welding with gas-shielded arcs and welding with coated electrodes, are considered in this paper. The possible radiation injuries to the eye are described, and the measures for protection discussed.


[Characterization of radiation within the optical region (author's transl)]. The notions which are used for the characterization of radiation within the optical region of the spectrum (quantities, units) and their temporal and geometric relations have been arranged synoptically. Quantities of the international system (SI-System) are stressed.


Tooth allografts in children matched for HLA. Ninety allogeneic transplants of partially developed teeth were performed in children matched for HLA antigens. Significantly better results were obtained in the group of 74 cases where 0 to 2 incompatibilities between donor and recipient were present, in comparison to 16 cases where donors differed from the recipients in 3 or 4 antigens. It is concluded that HLA match gives a clinically relevant benefit to the tooth graft recipient. The peculiarities of tooth transplantation and the difficulties with the evaluation of tooth graft survival are discussed in detail.


Complete HLA and Bf typing in families. II. Bf and the structure of the HLA region. In two families with HLA-A,B cross-overs, the Bf locus followed the segregation of HLA-A rather than HLA-B as expected. These data, when analyzed together with those in the literature suggest that two different sequences of HLA genes exist in the population: one with Bf close to HLA-D and another with Bf in the HLA-A region.


Visual evoked responses and EEG's of 16 divers breathing air at 7 ATA. This study is an assessment of individual differences in electrophysiological response under diving conditions normally conducive to nitrogen narcosis. A group of 16 men made two dives each to approximately 200 ft in a pressure chamber while breathing air. The visual evoked response of the men at depth revealed several decrements; in the response to a slow rate of stimulation, there was a highly significant reduction in a component around 160 ms, and in the response to a rapid rate of stimulation, marked losses in amplitude and increases in variability were found. The latter changes were related to diving experience while the former were not. No significant changes were found in alpha or theta activity in the EEG.


Serum ferritin and dysbaric osteonecrosis. Bone and marrow necrosis has been produced in rabbits. Changes in serum ferritin levels have been measured (with appropriate controls). Results suggest that marrow death is followed by a significant rise in serum ferritin levels. The possiblitiy that this may be of value in the early diagnosis of dysbaric osteonecrosis is discussed.


Joint crepitation after chamber air dives to 188 fsw. Joint crepitation after chamber air dives to 188 fsw. Undersea Biomed. Res. 4(1):89-94.-Joint crepitation was observed in all subjects (8) who were decompressed from 188 fsw (gauge) dry chamber air dives with a bottom time of 45 min. Crepitation was elicited by bending a joint as far as comfortably possible, and intensity of the sound was rated on a scale of 0 to +4. Fingers, wrists, and shoulders of both arms were examined immediately postdive, 1-4, 6- 10, and 20-24 hours postdive. Typically, the intensity and/or the number of joints affected increased during the 1-4 hour postdive period and then disappeared over the next 6-24 hours. The typical "squishy" sound heard in these joints may be due to bubble formation, although radiographic evidence was inconclusive. Closer examination for crepitance in future dives and the reporting of its occurrence may help to elucidate the mechanisms responsible for these joint sounds.


Renal artery thrombosis due to high voltage electricity. A case of traumatic renal arterial artery thrombosis resulting from contact with high voltage electricity (30,000 volts) is described. The literature in respect of closed traumatic renal thrombosis is discussed and the mechanism responsible for thrombosis of the renal artery is described. Diagnosis and treatment of this condition is critically discussed. The importance of early diagnosis and operative intervention is stressed.


The transpubic approach for strictures of the posterior urethra superior to the urogenital diaphragm. For strictures of the posterior urethra lying superior to the urogenital diaphragm, a transpubic approach with resection of the pubic symphysis has been employed. This has permitted primary excision of the scar with reanastomosis of the urethra, thus correcting the defect in a single operation without the introduction of hair-bearing skin and with preservation of the external urethral sphincter. The results in five cases have been most gratifying.


Evaluation of the immunocompetance of patients with transitional cell carcinoma of the bladder. The cellular immunocompetence was examined by means of the quantitative DNCB hypersensitivity reaction in 152 patients with transitional cell carcinomas of the bladder of Broders grades 1-4. Against a control group of 367 normal controls of both sexes, 85 patients with transitional cell carcinomas of grades 1 and 2 showed a normal DNCB reactivity, irrespective of the frequency of tumour recurrence. In 9 patients of this group, an increase of malignancy from grade 2 to grade 3 was observed; the simultaneous deterioration of immunocompetence, however, was not statistically significant. On the other hand, with transitional cell carcinomas of grades 3 and 4, significant impairment of immunocompetence correlating with the tumour stage was noted.


[Epididymal tumors (author's transl)].

[Epididymal tumors (author's transl)]. Six cases of benign primary epididymal tumor have been investigated in our patients. The tumor size fluctuated between 3 and 35 mm in diameter. Frequency, histology and medical development are described. The majority of epididymal tumors (53%) is comprised of so-called adenomatoid tumors of benign nature and their histogenesis is being discussed. The difficulties of differential diagnosis are pointed out. Since malignity exists in 26% of the cases, the surgical exposure and diagnosis by frozen section is being postulated, when suspicion of epididymal tumor becomes evident.


The bulbocavernosusreflex (BCR). Its clinical application and technique. Observations as to the frequency of positive reflex response in the patient with normal neurological status (author's transl). The clinical application and technique of the BCR are described in detail. The reflex was checked in 100 urological patients with normal neurologic status employing the Bors method and the catheter method (i.e. by pulling suddenly on the indwelling catheter). A significant discrepancy in the reflex response was noted. With the first method a high percentage of false-negative results was obtained in comparison with the catheter method. This latter technique is therefore to be preferred for neurologic-urologic examination. The possibillty of a special form of lower neuron lesion, caused by microangiopathic degeneration of the neuron, is discussed.


[Urothelial carcinoma in the prostate (author's transl)]. Some 3% of the prostatic carcinomas in the prostatic cancer register at Homburg are urothelial or transitional cell carcinomas. Based on morphologic and clinical findings, 102 cases are divided into two groups: 50 cases with and 52 cases without involvement of the urinary bladder. In each group there is a subgroup where common prostatic carcinoma is combined with a urothelial carcinoma. Adenocarcinoma can precede the urothelial carcinoma by years. The urothelial carcinoma at first grows predominantly intraductally, is resistent to hormone therapy and carries a bad prognosis. Of the 102 cases, 61 died within 2 years.


[Successful intra-arterial embolization of bleeding carcinoma of the prostate (author's transl)]. The very first case of successful therapeutic embolization for hematuria from carcinoma of the prostate is presented. In a 76-year-old patient with necrotic carcinoma of the prostate, stage D transurethral operations showed no success. By selective intra-arterial embolization via the internal iliac arteries (using Gelfoam), hematuria could be stopped definitely and did not occur any more. Follow-up study showed no complications or necrosis in this procedure.


Penetrating high-velocity genitourinary injuries. Part I. Statistics mechanisms, and renal wounds. As a consequence of missile-tissue energy exchange, high-velocity missile wounds necessitate wide surgical debridement because of severe tissue contusion distant from the wound tract. A missile tract mentally projected by the physician through the urologic tract demands appropriate investigation. The approach to urologic surgery may be primarily determined by the wound tract since this has to be debrided anyway. Ureteral filling on an intravenous pyelogram will save valuable time at surgery. High-velocity penetrating renal injury demands an aggressive surgical approach  to obviate later complications.


Treatment of urethral condyloma acuminatum with 5-fluorouracil cream. Total eradication of intraurethral condyloma acuminatum was accomplished in 10 of 11 patients by intraurethral administration of 5 percent 5 fluorouracil cream.


Clomiphene citrate: pharmacologic treatment of hypofertile male. Thirty-two males were treated with clomiphene citrate for a minimum of six months, a maximum of twelve months, or until pregnancy occurred. Among these patients, thirteen pregnancies occurred. Climiphene citrate appears a reasonable pharmaceutical method for management of idiopathic oligospermia.


Chyluria.

Chyluria. A twenty-four-year-old black female presented through the outpatient department complaining of "white urine". Pertinent history, physical examination, and diagnostic studies are reviewed with special emphasis on lymphangiography. The literature is reviewed particularly with regard to laterilization of the fistula, thoracic duct obstruction, and methods of therapy.


Gray scale ultrasonography, computerized tomography, and nephrotomography in evaluation of polycystic kidney and liver disease. A comparison of gray scale ultrasonography and computerized axial tomography in adults with known adult-type polycystic disease and of ultrasonography and high-dose nephrotomography in their progeny is being conducted. Although all three modalities have proved capable of demonstrating cysts of the kidney and liver, ultrasound has been the most consistent in identifying these lesions. Ultrasound is valuable in diagnosing polycystic disease in adult with large, poorly functioning kidneys; in addition, since cysts could be identified by ultrasound in children who had normal nephrotograms, it provides a safe and useful method of obtaining information for genetic counseling.


Epidermoid cysts of testis: rationale for conservative management. The literature on epidermoid cyst of the testis is reviewed, and 2 additional cases are presented. Etiology and pathology of the disease are discussed. Our review revealed that 85 per cent of patients have undergone orchiectomy for this benign disease. Diagnostic characteristics of this lesion are emphasized so that in selected cases enucleation of the pidermoid cyst may be considered without violating the principles of cancer surgery.


Adenocarcinoma of rete testis.

Adenocarcinoma of rete testis. Adenocarcinoma of the rete testis is a very rare malignant neoplasm originating in the epithelium of the rete testis. Histologically, it appears as a papillary adenocarcinoma. The first case was reported in the literature in 1853 and since that time only 16 additional cases have been reported. This report represents the eighteenth case.


Splenic blood pool: occasional hindrance of accurate interpretation of renal dynamic scintigrams. Because of the proximity of the spleen to the left kidney, the splenic blood pool occasionally interferes with the interpretation of the renal flow images. A review of one hundred consecutive renal dynamic studies revealed some interference in 34 per cent of the studies. The distinction between splenic blood pool and the left kidney can be made on the static images, for the renal studies. If doubt persists, a colloid scan will identify the spleen. An illustrative case is presented.


Epidermoid carcinoma of the frontal sinus secondary to cholesteatoma. We report a case of primary epidermoid carcinoma of the frontal sinus associated with cholesteatoma. We postulate that the carcinoma is secondary to malignant degeneration of the cholesteatoma. The literature review revealed 38 cases of cholesteatoma of the frontal sinus. Four were associated with carcinoma. To the best of our knowledge, this is the fifth such case in the world literature.


Macroglossia in the Beckwith-Wiedemann syndrome. An infant with the Beckwith-Wiedemann syndrome is described, with emphasis placed on the occurrence of macroglossia and possible maxillofacial deformities. In addition to placing the syndrome among the clinical entities which result in macroglossia, attention is also brought to concurrent metabolic disorder through hypoglycemia and possible late-occurring visceral malignancy which may produce significant patient compromise.


Delayed tracheal reconstruction.

Delayed tracheal reconstruction. An extended area of stenosis of the upper mediastinal trachea, which normally would require extensive thoracic mobilization for primary anastomosis, was corrected by resection of the manubrium with the creation of a trough. This was closed in several stages utilizing embedded Marlex mesh and regional skin flaps. The development and modifications of this technique are discussed.


Superior laryngeal nerve paralysis an often overlooked entity. The anatomy and physiology of the larynx are discussed. The larynx is a dynamic structure, and motion pictures are helping to document and to clarify its dynamic behavior in the presence of diseases such as paresis and paralysis. The recognizable distinguishing features of unilateral and bilateral superior nerve paralysis are discussed in detail. These lesions often have gone unrecognized in the past and the patients mistakenly have been referred to the speech therapist with an incorrect diagnosis of "functional voice disorder."


[Acute cholecystitis in choledocholithiasis and stricture of the ampulla of Vater]. The work is based on the examination of 106 patients, operated in the clinic for acute cholecystitis associated with choledocholithiasis and strictures of Vater's papilla. The operation of choice is a removal of pathologically changed gallbladder, elimination of the cause of cholestasis with restoration of bile passage in the bowel. The technic of choledochoduodenostomy adopted in the clinic is described. The immediate mortality was observed in 2.8%. Choledochoduodenostomy yielded good results in 81.1%, external drainage -- in 70.6%.


[Controversy in opinions concerning abdominal adhesions]. Many-year observations enabled the author to consider the term "abdominal adhesive disease" to disagree with the very essence of the disease. Its essence is not the development of adhesions, which may not develop at all, but the occurrence of chronic fibrosis of the peritoneum, mesentery and also chronic stenosing mesenterial peri- and endarteriosis. The author suggests his personal classification of the diseases and states his views on the prophylaxis and treatment of the disease.


[Results of preventive examination of women to detect breast diseases]. As a result of prophylactic examination of 2577 working females, aged from 17 to 65 years, pathological changes in the mammary gland were detected in 79. Fibrous mastopathy and fibroadenoma were the most frequent pathology. Mastopathy was frequently noted in females aged from 35 to 50 years, while fibroadenoma - in females under 25. Mammary gland pathology in 25.3% of cases was associated with gynecological lesions.


[Indications for reconstructive surgery following occlusion of the popliteal artery and crural arteries]. Applications of optic systems and microsurgical technic enables one to perform reconstructive operations on arteries of small calibre - 1.5--1,8 mm (crural arteries). Clinically, 42 reconstructive operations (autovenous bypass shunting) were performed on crural arteries in 42 patients. After the surgical intervention the immediate positive effect with patency of the shunt and shunted artery was noted in 24 patients. In 18 patients thrombosis of the shunt developed in early postoperative terms.


[Means of positioning fragments by smoothly controlled stresses]. In fractures or luxations muscles being in the state of retraction or contracture and with lost capacity to spontaneous relaxation and lengthening may relaxe and lengthen as a result of application of relatively small smoothly controlled stresses incessantly lessening along with muscle lengthening. The long-term experience with the use of the elaborated method in the clinic of general surgery and hospitals of the Gorky City proved convincingly great opportunities of nonoperative treatment of fractures and reduction of dislocations.


[Diaphragmatic lesions in closed injury]. Bases on the analysis of 10 clinical observations, it was found that closed injuries of the diaphragm occur mainly in the use of great mechanic force (compression, a fall from great height, an impact of quick-acting object). In the acute period these are frequently not accompanied by diaphragmatic hernia and remain unrecognized. It is the author's opinion that in early diagnosis of acute diaphramatic hernia clinical symptoms play no leading role, but chest roentgenography is of primary importance. The terms of surgical treatment and the choice of the operative access are determined by general patient's state and the character of associated lesions.


[Aspects of the clinical use of methoxyflurane analgesia and of the determination of its concentration and distribution in the body]. As a supplement to local anesthesia in aortography, appendectomies and operations for hernia in 118 patients the authors employed through a mask an inhalation anesthetic methoxyflurane in subnorcotic concentrations. The patients were in the state of consciousness, analgesia was adequate, no complications relative to methoxyflurane inhalation were noted inhalation anesthesia with methoxyflurane proved to be safe and effective in combination with local anesthesia. The method is indicated in aortographies.


[Enzymatic cholecystitis and cholecystopancreatitis]. Taking into consideration the role of pancreatic enzymes in the etiology of cholecystitis and cholecystopancreatits, the authors examined amylase in 92 patients, bile lipase--in 39 patients during cholecystectomy and also amylase in the choledochus bile during external drainage of the duct in 15 patients in the early postoperative period. The investigations inducated different levels of pancreatic enzymes in bile. Their level is found to depend on the occurrence of hypertension in the bile tract both pre- and postoperatively.


[Changes in the  biliary tracts in various phases of the course of peptic ulcer before and after gastric resection]. By means of serial intravenous cholegraphy, oral cholecystography and the combined investigation of the stomach and gallbladder the state of the bile passages was examined in 157 patients with ulcerous diseas before and after gastric resection. Many patients (52.4%) with ulcerous disease showed congenital and acquired deformity of the gallbladder, some patients (7.6%)--adhesive deformity of the common hepatic and common bile ducts. In most patients functional (mainly the decreased concentration capacity and hyperkinetic dyskinesia) changes in the gallbladder were noted.


[Immediate and late result of gastrointestinal plastic repair (an experimental and clinical study)]. According to the author's findings gastric resection with gastro-jejunoduodenoplasty results in a great number of complication in operated patients. These data were obtained in the experiment on 30 dogs and examination of 14 patients clinically. In the early postoperative period there is the danger of occurrence of limited or total necrosis of the transplant, obturation or twisting with the resulting chronic or acute intestinal obstruction. In later terms peptic ulcers, the dumping-syndrome, deformation of the transplant with impairment of the digestive or motor-evacuative function of the stomach would arise.


[Method of intestinal decompression in treating functional intestinal obstruction]. The authors present an analysis of 149 cases of total decompression of the gastrointestinal tract in grave forms of functional intestinal obstruction accompanying peritonitis and acute intestinal obstruction. Special intestinal sounds made of polychlorovinyl were employed, that facilitates considerably the technic of intubation of the bowel as a whole. The authors data evidence that each method of intubation (transnasal, through gastro-or ileostome, etc) has its positive and negative aspects, therefore a selection of the site for introducing the sound should be conditioned by patient's age, the type of pathology and duration of the intubation procedure.


[External postoperative intestinal fistulae in appendicitis]. The author presents an analysis of the data obtained in 8500 patients operated upon for acute appendicitis, in 62 of them the postoperative period was complicated by intestinal fistula. It was found that the main causes of occurrence of intestinal fistulas are as follows: late terms of hospitalization and operative treatment of patients with acute appendicitis, some damage to the bowel due to inadequate access in appendectomy. The author advocates an earlier operative treatment for acute appendicitis and the use of a wide approach (transverse) in appendectomy.


[Radical operation technic in aneurysm of the infrarenal portion of the abdominal aorta]. The report is based on the experience with surgical treatment of 126 patients having aneurysm of the abdominal aorta. The average age of the operated patients was 60. The technic of radical surgery in aneurysm of infrarenal portion of the abdominal aorta is described, as well as the methods employed.


[Study of the changes in kidney function in acute obstruction of the arteries of the extremities]. The kidney function was studied in postischemia period in 80 patients with acute arterial occlusion,using the methods of radioisotope renography and effective renal blood flow. For the purpose of prophylaxis agains renal complications in addition to regional perfusion and venesection the method of regional inhibition of toxic products in the ischemia focus is suggested. In increased myoglobinuiea the stimulation of diuresis, alkalization of the organism would be a necessity. Renal complications were observed in 13 of 80 patients (16.25%). In 6 patients myoglobinuric tubular nephrosis was noted with lethal issues; in the remaining 7 patients due to early establishment of the diagnosis and intensive therapy myoglobinuria showed an abortive character.


[Transvesical intramuscular transplantation of the ureter in vesico-ureteral reflux in children]. The authors describe a modified method of antireflux operation in vesico-ureteral reflux in children. It consists in transvesical mobilization of the distal ureteral portion together with the urethra and placing it in the tunnel, formed in muscular layer of the urinary bladder from the site of physiological ostium obliquely downward and inwardly. Thirty operations after the describe technic were performed in 17 patients. Four operations were accomplished in the left ureter, 14 patients were operated bilaterally, including 11 cases when one-moment bilateral antireflux operations were performed. The immediate results of surgery were good. In none of 11 examined children during 1-3 years postoperative reflux was noted. In one case of marked hydroureter with ureteritis signs after the operation stenosis of the transplanted sotium developed.


[Clinical aspects and treatment of chondrosarcoma in children and adolescents]. The clinical cours and treatment of chondrosarcoma in 9 children, aged from 8 to 16 years, are analysed. Only provisional and not persistant effect was gained after roentgenotherapy. Resection of the bone with tumor removal also failed to provide radical intervention in all patients, but one, and recurrences were noted 3-12 months following the resection. However,  chondrosarcoma in children is continuously observed to be a local process and is characterized by late metastasization, due to that its prognosis is more favourable than in other malignant bone tumors.


Neurologic disease in naturally occurring Salmonella choleraesuis infection in pigs. A granulomatous meningoencephalomyelitis was seen in 17 feeder pigs submitted for diagnostic evaluation from eight farms. Vasculitis and destructive microgranulomas were widespread in both brain and spinal cord. Occasionally there were microabscesses. Salmonella choleraesuis var. kunzendorf was isolated from six of the eight groups, and there were lesions of acute salmonellosis in all animals examined. In three of the affected herds the principal disease manifestation was neurologic.


[Double infection of the brain with Frenkelia species and Toxoplasma gondii in Chinchilla laniger]. Two caged Chinchillas that died with convulsions had a focal necrotic meningoencephalitis of toxoplasmic origin. Independently of and remote from this inflammatory reaction were several lobulated Frenkelia cysts up to 0.6 mm diameter in the brain. Morphologically and in the way they stained they resembled Frenkelia in various Microtus-species and in Ondatra zibethica. Although toxoplasmosis commonly is found in the Chinchilla this is the first report of Frenkelia in this species. Ecological considerations suggest that the Chinchilla might be susceptible to a Frankelia usually occurring in free living other species.


Competitive trail and endurance riding in the UK. A description is given of trail and endurance riding in the UK as controlled by the Endurance Horse and Pony Society. Veterinary involvement and responsibility are described and measures for their satisfactory execution discussed. Opportunities and need for research into the problems arising are mentioned.


Bilateral luxation of the coffin joints in a horse, as a sequel to palmar neurectomy. Complications from neurectomy have been well known for many years. A 16-year-old mare suffered bilateral luxation of the coffin joints following palmar neurectomy and was destroyed. Autopsy showed complete rupture of the deep flexor tendons, and the supporting ligaments of the coffin joints. Arthritis of the coffin joints, with erosion of articular cartilage was evident.


Recent developments in air transportation of farm animals and horses. This paper deals with some recent developments in the air transportation of cattle, sheep, pigs and horses and comments on the factors involved which influence the results.


[Proteolytic enzymes in palatine tonsil lymphocytes]. Homogenates and subcellular lymphycyte fractions of human tonsilla palatina contained proteolytic enzymes operating in slightly acidic (pH 3.6) and slightly alkaline (pH 7.5) media. The enzymes hydrolyzed proteins (hemoglobin, protamine sulphate, kininogen) and syntheitc substrates (N-benz-d,1-arg-p-nitroanilide, N-benz-1-arg ethyl ester, hippuryl-1-lys and bradikinin). Data on localization of the proteolytic enzymes in subcellular lymphocyte fractions of human tonsilla were obtained.


[Highly-sensitive method of studying the toxicity of lipid peroxides]. A highly sensitive and simple method is developed for study of lipid peroxides toxicity with the use of quail developing embryos as a model. Toxicity of linolenic acid hydroperoxides, obtained by the lipoxygenase catalysis, was distinctly higher than the toxicity of the peroxides, produced alter autooxidation (LD50 = 0.12 and 0.38 mc-eq/embryo, respectively). Occurrence of toxic properties was observed in lipids, isolated from tissues of mice subjected to the oxygen stress. The advantages of the method described are discussed as compared with the published data.


[Determination of inorganic phosphate in the presence of phosphocarbohydrates]. The molybdate methods were shown to have limited application for estimation of inorganic phosphate (P1) in the samples containing phosphocarbohydrates. The definite concentrations of phosphosugars caused the formation of blue molybdenic color. The ascertained critical concentration of Pi and the maximal content of phosphocarbohydrates in the solution studied enabled to estimate P1 in the presence of phosphorus esters of carbohydrates with use of the specific, sensitive and simple method.


[Cytologic diagnosis of myxoid liposarcomas of soft tissues]. Myxoid sarcomas are characterized by the presence of branching capillaries in preparations around which lipogenesis is proceeded (unilocular and multilocular). Fat is chemically neutral. The cell content is represented by two basic kinds of cells: 1. stellate lipoblast -- a cambial element of the tumor, and 2. mature lipocyte -- a terminal stage of the differentiation of stellate lipoblast. Moreover, variable intermediate forms demonstrating the stage of lipoge nesis may be encountered. The differential diagnosis between the former and intramuscular myxoma and neurinoma (Antony B type) was made. The work is based on the analysis of 10 cases of myxoid liposarcomas.


[Incorporation of 1-14C-glycine into total protein and subcellular fractions of rat liver at different periods following administration of tetrachlormethane]. Rate of incorporation of 1-14C-glycine in total protein and subcellular fractions of rat liver tissue as well as the activity of alanine- and aspartate aminotransferases in blood serum were studied at various periods after treatment with CCl4. The protein synthesis was distinctly decreased in liver tissue and the alanine aminotransferase activity was markedly increased in blood serum with the first days after CCl4 administration. Dissimilar alterations were observed in the rate of the label incorporation into nuclear and mitochondrial fractions after prolonged administration of CCl4. Hepatocyte nuclei proved to be more sensitive to cytoplasmic alterations caused by tetrachlormethane. Incorporation of 1-14C-glycine into both nuclear and mitochondrial fractions was decreased only at later periods. In blood serum the alanine aminotransferase activity was drastically increased after prolonged administration of CCl4, whereas the aspartate aminotransferase activity was increased as compared with control less markedly.


[Cytological study in the diagnosis of rectal and sigmoid cancer]. In 102 patients with cancer of the rectum and sigmoid a cytologic method was used to support morphologically a primary tumor focus and also to determine the degree of tumor spread. This method proved to be simple and highly reliable (94.6% of coincidence with histological findings).


[Cultivation of human gastric cancer tissue in diffusion chamber]. Under study was the morphology and proliferative activity of stomach cancer tissue from 10 patients under condition of its cultivation in diffusion chambers implanted in mice. Epithelial, fibroblastoid cells and cells of histiocyte type showed an active growth, greater proliferative activity being typical for epithelial cells. The mitotic cycle duration as evidenced by the data of the label dilution was longer than 30 hours. The time of the volume doubling calculated under some assumptions was, in the average, about 60 days for cancer of the stomach in man.


[Activity and isoenzyme composition of the hexokinase and lactate dehydrogenase of different rabbit muscles]. The hexokinase activity (HK) exceeded several times and the lactate dehydrogenase activity (LDH) was lower in soluble fraction of rabbit slow sceletal muscle as compared with fast sceletal muscle. In the soluble fraction of stomach smooth muscle the HK activity was higher and the LDH activity--lower than in slow sceletal muscle. The LDH isozyme spectrum of soduble fraction of smooth muscle was similar to the spectrum of slow muscle (mobile H-forms prevailed). Muscles of pyloric and fundal stomach parts differed in the enzymes activity and their isozyme content.


[Effect of actinomycin D and ethionine on hormonal induction of ribonucleic acid synthesis in the nuclei and cytoplasm of the liver cells of adult male rats]. Ethionine did not affect but actinomycin D inhibited the increase in DNA-like RNA synthesis (precursor of ribosomal RNA in nuclei and rRNA in cytoplasm of liver tissue cells of adult male rats), which was caused by single administration of hydrocortisone or protamine-Zn-insulin and by both hormones. The data obtained suggest that the effect of these hormones on the synthesis of DNA-like RNA was realized at the stage of transcription.


[Detection of 3-OAA containing antigens at early stages of carcinogenesis]. Quantitative and qualitative methods of precipitation rendered it possible to record 3-OAA-antigens and corresponding antibodies in blood and urine preparations from outbred rats receiving hepatocarcinogen DAB.


[Concentration of components of the adenylate system in the liver during cholestasis]. Content of adenyl system components, inorganic phosphate as well as the glucose-6-phosphate dehydrogenase activity were studied in rat liver tissue under extrahepatic cholestasis. Cholestasis was caused by ligation of the general biliary duct. The correlation was observed between the increase in total bilirubin in blood plasma and the decrease in content of inorganic phosphate. The glucose-6-phosphate dehydrogenase activity was unaltered.


[Histogenetic principle in estimation of reactive properties of tumors]. The reactive properties of tumors of epithelial origin (carcinoma RS-1) and connective tissue origin (Jensen sarcoma) are not analogous. Vitamin A inhibits the growth of carcinoma RS-1 and does not change the growth parameters of Jensen sarcoma. Hydrocortisone and proserine increase the growth rate of carcinoma RS-1. Hydrocortisone was found to inhibit the growth of Jensen sarcoma.


[Method of respiratory polygrams in diagnosis of esophageal cancer]. Among numerous methods, employed for determination of esophageal cancer patients' operability, the method of respiratory polygrams may be singled out. This method can be used in all medical institutions due to its being readily available, simple management and high resolving power.


[Comparative clinical and dosimetric analysis of radiotherapy variants in cervical cancer]. The authors estimated comparatively in 200 clinical patients the results of external irradiation of cervical cancer using two variants of gammatherapy: standard, 4--5 fields irradiation and improved one from 2 central contralateral fields in combination with a splitting lead block. The use of the improved variant of distance gammatherapy, compared with the standard one enabled the authors: 1) to reduce irradiation load on the minor pelvis organs and pelvic bones as much as 2--25 times; 2) to gain more even distribution of radiation on the lesion focus; 3) to reduce irradiation load on the organism, as a whole, in adequate focal dosage at point A and B, thus lessening radiation complications; 4) to simplify considerably centring and to shorten the exposure procedure that contributes to better efficiency of a gammatherapy machine; 5) to increase the effectiveness of combined radiotherapy for cancer of the uterine neck.


[Determination of the metabolic clearance and production of estradiol in breast cancer patients at menopause]. A method for the determination of estradiol metabolic clearance rate (MCR) and production rate (PR) in blood, using radioactive isotope dilution techniques, has been described. In a group of 5 normal menopausal females and 10 menopausal patients with disseminated cancer of the breast the values of MCR and PR were not found to differ significantly, but they diminished after oophorectomy.


[Densitometric analysis of the mammograms in benign breast tumors]. Densitometry of roentgenograms was performed in 48 patients with benign tumors of mammary glands (16-cysts, 16-fibroadenomas, 16-phylloid fibroadenomas). The analysis of densitograms indicated that densitometry provides a more objective characteristic of the structure intensity of the shadow and distinctness of the pathological focus contour. Densitometric analysis of the roentgenological picture of cysts, fibroadenomas and phylloid fibroadenomas along with features common to these neoplasms enabled the recognition of a number of symptoms determining differences in their densitometric picture.


Warm IgM anti-IT causing autoimmune haemolytic anaemia. A patient with autoimmune haemolytic anaemia due to an autoagglutinin of anti-IT specificity is reported. The antibody was of the IgM class and bound complement; unexpectedly, it reacted optimally at 37 degrees C. A prozone was noted when testing serial dilutions of the patient's serum against appropriate red cells in saline, but was not found when testing an eluate prepared from the patient's red cells. Investigations suggested that the prozone was due to a blocking antibody of high molecular weight, which appeared to be specific for I and IT.


Effect of fragmentation of tetanus immune globulin (human) on neutralization of tetanus toxin. The effect of fragmentation produced by plasmin digestion of tetanus immune globulin (human) on the neutralization of tetanus toxin was determined. Based on a mouse test, there was a significant reduction in neutralizing potency when fragmentation to 3.5 S material reached or exceeded 20% suggesting a threshold for antibody fragmentation beyond which the resulting decrease in antibody potency would result in serious disease. Because this threshold is not known for man, the use of fragmented globulin for the prevention or treatment of tetanus should be avoided until additional data are available on its neutralizing potency and efficacy.


Processes to increase the yields of normal serum albumin. By heating in the presence of a stabilizer, albumin can be recovered from Cohn fraction IV-4 and also pyrogen-free from pyrogenic albumin.


A monitoring and alarm system for use with a technicon 15-channel blood grouping machine. An alarm system is described for use in monitoring the function of the sampler of a 15-channel BGM and the level of reagents.


A further example of Kp1/Ko exhibiting depression of some Kell group antigens. This paper gives details of a family in which there are numerous examples of the heterozygous Kdegree state. The study was initiated by the presence of anti-Kpb in the serum of the propositus. Reactions with anti-K, anti-Ku, anti-Jsb and anti-K13 confirm that the Kdegree gene in trans with Kpa results in weaker expression of these Kell antigens. One example of anti-K showed some evidence of dosage effect with kKpb/Kdegree cells, but these results were not confirmed by quantitation studies.


Polymer distribution in human serum albumin powders prepared by lyophilization or acetone drying. Various lots of human serum albumin, prepared by the Cohn alcohol procedure, were assayed for polymer distribution after lyophilization or acetone drying of the albumin paste. Sodium dodecyl sulfate polyacrylamide gel electrophoresis revealed that powders obtained by acetone drying of the pastes contained significantly higher amounts of monomeric albumin.


Quantitative determination of albumin dimer in albumin preparations by combined starch-gel electrophoresis and immunoprecipitation. A method is described for albumin dimer determination. The method is based upon an electrophoretic separation of albumin dimer from the monomer in starch gel with a subsequent immunochemical diffusion and precipitation of the albumin components in agarose gel containing antibodies. The precipitation zones are measured and compared iwth those of albumin monomer standards. A factor for converting monomer to dimer has furthermore been established.


The spectrum of extrapulmonary tuberculosis. The incidence of new cases of extrapulmonary tuberculosis has remained constant, despite the decline in new cases of active pulmonary tuberculosis. This might be due to a delay in recognition, and particularly a lack of consideration of tuberculosis when the presenting symptoms are other than respiratory. Extrapulmonary tuberculosis should be considered in the differential diagnosis of bone, joint, genitourinary tract and central nervous system (CNS) diseases. To determine factors that might delay recognition and identification, 62 patients having extrapulmonary tuberculosis during 1969-1972 at the Los Angeles County-University of Southern California Medical Center were studied.Three quarters of these patients had had CNS, skeletal or genitourinary tuberculosis in equal distribution or 25 percent each. CNS involvement was seen frequently in the disseminated form. Presenting symptoms were protean and not specific, such as fever, anorexia, weight loss, cough, lymphadenopathy and neurologic abnormalities. Roentgenograms of the chest were abnormal in most. When a roentgenogram of the chest suggests pulmonary tuberculosis, signs and symptoms in other body systems should suggest extrapulmonary tuberculosis. If no abnormalities are seen on a roentgenogram of the chest, however, this does not preclude the diagnosis of extrapulmonary tuberculosis. Neither does a negative tuberculin skin test exclude the condition. Abnormal laboratory findings are common, especially in disseminated tuberculosis. These include various anemias, bone marrow disorders, hyponatremia due to inappropriate antidiuretic hormone syndrome. Analyses of pleural, peritoneal, pericardial and joint fluid usually show an exudate high in lymphocytes and occasionally low in glucose. Similar findings are seen in spinal fluid. The histological features of caseous or noncaseous granulomas are suggestive of but not specific for tuberculosis. Only culture of mycobacteria from sputum, urine, spinal fluid, pleural and other effusions and tissue biopsy specimens will yield a definitive diagnosis. Physicians must have a high index of suspicion to diagnose extrapulmonary tuberculosis, as it can resemble any disease in any organ system. Immediate therapy in the disseminated variety, sometimes even before a definite diagnosis can be made, may be lifesaving.


Unrecognized causes of platelet transfusion failure in the presence of anti-HL-A antibodies. When in a patient who is receiving random donor platelet infusions there is an inadequate rise in platelet count and anti-human HL-A antibodies are noted in the serum, it is natural to assume that platelet destruction results from an immunologic cause. Nonimmunologic causes of such failure do occur, however. Two of the most common are disseminated intravascular coagulation and splenomegaly.


A system for coding the presenting requests of ambulatory patients. Effective methods developed to review and study the care of patients in hospital have not been applicable to ambulatory care, in which definitive diagnosis is the exception rather than the rule. A reasonable alternative to using diagnosis as the basis for assessing ambulatory care is to use the problems or requests presented by the patients themselves. A system has been developed for classifying and coding this information for flexible computer retrieval. Testing indicates that the system is simple in design, easily mastered by nonphysicians and provides reliable, useful data at a low cost.


[Long-term results after therapeutic starvation (author's transl)]. 19 Persons with gross refractory obesity (7 men and 12 women) were treated by therapeutic starvation. The patients were controlled after 32 months, on average (range: 7 to 58 months), following completion of treatment. The study shows that 8 of the females gained weight, one of these attaining her pretreatment weight and another even exceeding the pretreatment figure. None of the males had regained his pretreatment weight but 4 showed an increase in comparison with the weight at the time of hospital discharge. During starvation the serum lipids showed a marked decrease, which was statistically significant in the case of cholesterol, but not triglycerides. At the time of follow-up examination the serum lipid values were about the same as before treatment. It is concluded that the long-term results of therapeutic starvation are beter in men than in women and yet this method of treatment should be attempted, when indicated according to strict criteria, in refractory cases of extreme obesity.


[Serum lipase activity and evocation test after endoscopic retrograde cholangio-pancreatography (author's transl)]. Serum lipase activity, which is a more specific indicator of pancreatic damage than serum amylase activity, was determined in 51 patients before and immediately after endoscopic retrograde cholangio-pancreatography (ERCP) and 24 hours subsequently. An increase in serum lipase activity without clinical signs of acute pancreatitis was observed immediately after pancreatography in 20 cases. Increased serum lipase activity after 24 hours is largely observed in patients with parenchymography or those displaying increased values already in the fasting state before ERCP. This observation emphasizes the need for caution in the assessment of the indication for ERCP in patients with preexisting increased serum lipase activity in view of the very real risk of acute pancreatitis and the need to avoid parenchymography of the pancreas. According to our experience the addition of a broadspectrum antibiotic such as gentamycin to the contrast medium may, to a large extent, avoid the development of acute pancreatitis. Lipase evocation tests carried out 10 days after the ERCP showed negative results in patients with increased enzyme activity and parenchymography after pancreatography. Hence, it is concluded that ERCP causes symptomless reversible biochemical pancreatic changes, as opposed to irreversible pancreatic damage.


[Severe accidental acrolein intoxication in the home (author's transl)]. In a private household overheated fat-containing food emitted vapours which caused severe intoxication in a previously healthy man. The resulting pulmonary changes presented a grave threat to the patient's life for several days. The origin and properties of the vapours led to the conclusion that acrolein was their major toxic component.


[Plasmapheresis in the elimination of toxic substances with marked plasma protein-binding properties (author's transl)]. Plasmapheresis is a method used to eliminate toxic substances with high plasma protein-binding properties. Poisoning by strongly plasma protein-binding substances cannot be treated by haemodialysis or peritoneal dialysis. Hence, an attempt was made to hasten the elimination of phenylbutazone, a suitable model substance (plasma protein binding affinity 98%), by plasmapheresis. Some of the experiments were performed with oxygen under high pressure (OHP). A singly plasmapheresis of the total blood volume or triple plasmapheresis of half of the blood volume, performed at 20 min intervals accelerated the elimination of phenylbutazone significantly and all animals survived. A single plasmapheresis of the threefold blood volume had the greatest effect in lowering the concentration of phenylbutazone in the blood, but only one of three animals survived. OHP had no influence on the half-life of phenylbutazone and did not increase the survival rate.


[Acute poisoning with tricylic antidepressants and treatment with physostigmine salicylate (author's transl)]. Three cases of self poisoning with tricyclic antidepressants (TAD) are reported, one of them with a potentially lethal dose. All three cases were treated with physostigmine salicylate (PS)  and in two cases there was complete reversal of coma within a few minutes. In striking contrast to the reported high incidence of cardiac arrhythmias no cardiac complications were observed in any of the cases. Therefore we think that the use of PS should be considered when treating cases of TAD poisoning.


[Changes in glucose tolerance, serum insulin and blood lipids during contraceptive medication (oestrogen-gestagen) in metabolically-healthy women (author's transl)]. A low-dosage combination type of contraceptive (oestrogen-gestagen) was given to 19 metabolically- healthy women of normal weight over a period of 6 months. Glucose tolerance, serum insulin and serum lipids were measured 1 month before, during and 2 months after medication. There was a slight decrease in the basal insulin values and an opposite trend in the basal blood glucose values, not exceeding 10 mg% in comparison to pretreatment values. The oral glucose tolerance test with a load of 100 g oligosaccharides did not show any statiscally significant changes during the 9 month observation period. The serum insulin curve, however, showed a delayed increase with a tendency to return to original values after medication had stopped. A slight degree of insulin resistance without change in glucose tolerance can, therefore, be assumed. There was a tendency for triglyceride values to increase over the observation period. A trend towards decreased cholesterol, on the other hand, was statistically insignificant. The observed changes were all within the normal range in all cases.


[Early detection of postoperative deep-vein thrombosis in gynaecological patients by the 125I-Fibrinogen test (author's transl)]. Deep-vein thrombosis was detected by means of the 125I-fibrinogen test in 37.2% of patients undergoing gynaecological surgical procedures within the first six days postoperatively; 50% of the cases occurred within the first 48 hours. There was no difference in the incidence of thrombosis according to whether the abdominal or vaginal approach had been used. Varicose veins proved to be a high-risk factor in the development of deep-vein thrombosis. Prophylactic administration of horse-chestnut extract has to begin preoperatively in order to achieve a beneficial result.


[Central and peripheral actions of an oral contraceptive with reduced oestrogen content (author's transl)]. The action spectrum of an oral contraceptive which contained a reduced amount of the oestrogen component (0.04 mg ethinyl-oestradiol and 2.0 mg lynoestrenol) was investigated in 4 volunteer subjects. Serum levels of LH, 17 beta-oestradiol and progesterone were determined by radioimmunoassay and, in addition, the karyopyknotic index and cervical function were studied daily from the 8th day of the cycle. These parameters were determined in a control cycle, in the cycle during administration of the oral contraceptive and in the subsequent treatment-free cycle. Furthermore, the bleeding patterns were studied in 284 treatment cycles of 26 patients. Results of these studies indicate complete contraceptive protection by inhibition of ovulation and by an efficient cervical barrier action already during the first treatment cycle. Withdrawal bleeding was observed 3 to 4 days after ingestion of the last tablet. Spotting was recorded in 11 subjects during the first treatment cycle but was rarely observed during further treatment. Blood loss and bleeding control is comparable to that of other combined oral contraceptives with reduced oestrogen content.


[Unusual course and site of metastases of a granulosa cell tumour (author's transl)]. The case is reported of a patient in whom a granulosa cell tumour of the right ovary was removed at the age of 47 years. 14 years later the same type of tumour was found in the left ovary, together with an adenocarcinoma of the body of the uterus. 5 years after removal of these neoplasms splenectomy was carried out on account of splenic metastases. The unusual course taken by the disease and site of metastatic involvement are discussed, as well as the therapeutic management.


Variability of polyploid strains of Candida scottii in accumulation of riboflavin in the medium. Polyploid strains of Candida scottii show a higher spontaneous and UV-induced variability in accumulation of riboflavin in the medium than the original haploid strain. UV irradiation affects the formation of variants and induces those which accumulate more riboflavin than any of the most productive variants resulting from spontaneous variability. In the polyploid strains the frequency of plus-variants increases. Therefore, polyploid strains of C. scottii are advantageous for selection processes.


Effect of authentic and natural vitamin C and carotene on amino acid absorption. The effect of vitamin C or carotene either from authentic or natural sources on absorption of lysine, glycine and methionine was evaluated. Results revealed that maximum absorption of these amino acids was reached at different intervals from the orally given dose. Addition of ascorbic acid enhanced amino acid absorption and this effect was maximum in case of methionine. Carotene brought about variable effect to the three amino acids tested. Pepper, parsley, or orange juices did not affect the extent of intestinal lysine absorption. Pepper juice enhanced absorption of methionine in contrast to orange and parsley. Glycine absorption was markedly enhanced by addition of orange juice. Ascorbic acid suppelementation to dietary constituents is recommended for better utilization of proteins.


Serum mineral changes in dithizone-induced diabetes before and after insulin treatment. In this study, diabetes was induced by intravenous injection of dithizone. In dithizonised diabetic animals, the levels of serum zinc, iron, and potassium were found to be higher than normal, while those of serum calcium and sodium were lower. Copper and magnesium levels were unchanged. After treatment with insulin, most of these serum levels approached the normal, except for serum potassium and magnesium.


Serum and urine amino acid pattern under the effect of carbon disulfide intoxication. The effect of carbon disulphide intoxication on amino acid pattern was studied. Five groups of rats were treated with carbon disulphide through intramuscular injection of 0.05 ml CS2 in 0.2 mg olive oil/rat/day. A number of rats were sacrificed after receiving 10, 20, 30, 40, and 50 injections. As a result of intoxication, a state of hypoaminoacidemia and hyperaminoacidurea affected all the amino acids investigated, but to variable extent. Of value to add that stoppage of carbon disulphide leads to improvement of the amino-acid pattern in group six, compared to the other groups.


[Laboratory diagnosis and internal medicine. Introduction]. The development of internal medicine went parallel with the clinico-chemical diagnostics. The increase of the laboratory achievements, also in the field of prevention, is possible by a regional graduation of the laboratories with a centralisation as effective as possible under management of specialists. It is referred to the observation of quality instructions in standardized methods. The improvement of diagnostics by exchange between clinic and laboratory is particularly emphasized.


[Etiology and clinical aspects of liver cirrhosis]. This review deals with the clinically important aspects of etiology and symptoms of cirrhosis. Apart from alcohol and hepatitis, which are the most frequent etiological factors, also rare causes of cirrhosis are described, because their knowledge is important for the differential diagnosis of cryptogenic cirrhosis. Portal hypertension is the root of most symptoms and complications in cirrhosis. Therefore, a description of the haemodynamic changes precedes the extrahepatic syndromes, of which renal failures, ascites and portal encephalopathy are discussed more in detail.


[Pharmacokinetics in liver cirrhosis].

[Pharmacokinetics in liver cirrhosis]. In patients with severe hepatic parenchymal damage drug metabolism is presumably impaired. The reduced detoxification can not be sufficiently described in the postulated multicompartment model by determination of plasma half-life, because it depends on the physicochemical properties of the drugs. An increase of dihydroxybilic acids inhibits drug metabolism. Some drugs and also its metabolites formed in the liver induce hepatic cell injury including necrosis and therefore they are contraindicated in patients suffering from liver disease.