The conservative management of toxemia: a brief report of effective perinatal concepts. Toxemia remains inscrutable. Modern perinatal medical facilities have, however, been able to reduce perinatal mortality in this and other chronic illnesses affecting mother and baby by the increased ability to assess fetal maturity and monitor continued welfare. Modern advances in neonatal intensive care have aided inestimably in improving the results. A 5-year experience with a conscientious but conservative approach to toxemia is presented, with perinatal mortality identical to that of the overall population at 11/1000 live births. Results are compared to older data on neonatal mortality from toxemia, emphasizing the importance of cooperative efforts by the obstetrician and neonatologist in any successful perinatal program.


Differential diagnostic aspects between optic neurititis and chiasm tumors. Two patients with a pituitary tumor were first considered to have an optic neuritis from the clinical picture. The electrophysiological examination with VECPs gave results which did not offer a definite differentiation between both diseases, whereas perimetry and X-ray examination were decisive.


[Statistical contribution on symptomatic dry eye]. Optical mark page reader forms to establish the case history were statistically evaluated with regard to the question 'Do you often have the feeling of having sand in the eye. Out of a total of 5,833 patients, 684 (11.7%) answered this question with 'yes'. Women stated with 15.1% relatively more often than men with 9.7% this clinical symptom. Of these 684 patients who subjectively complained of feeling of sand, 241 had an ophthalmological examination. In 92 patients (38.2%) the Bengal-Rosa 1% test was specifically performed due to the specific past history and the clinical symptoms stated on questions by the physician; in all cases signs of a keratoconjunctivitis sicca of different degree were found by slit-lamp microscopy, i.e., at least 4.5% keratoconjunctivitis sicca patients on our whole collective can be expected. The result of a thorough examination in these 92 patients (39 men and 53 women) with ophthalmologically confirmed keratoconjunctivitis sicca showed that in 25 (of 53) women there was an imbalance of the sex hormones. Besides degenerative diseases due to age, diseases of the connective tissue and those caused by an auto immune mechansim were found.


Pterygium in Qatar.

Pterygium in Qatar. The incidence of pterygium in Qatar is 6.2%, which is less than expected. Laying stress on the climatic conditions, the etiological factors have been discussed. 450 cases of pterygia were operated on by a modified bare scleral technique followed by beta-irradiation. No recurrence occurred in 90% following the first operation. The final good result (98.8%) is in favour of the adopted surgical technique and post-operative care.


Functional evaluation in central retinitis pigmentosa. Three patients with central retinitis pigmentosa were investigated in a 5-year follow-up study. The psychophysical and electrophysiological data show the involement of both the central and peripheral photoreceptors and their continuous functional deterioration with time. This conclusion could be demonstrated under all conditions of testing indicating the polymorphism of the disease. The results and the lack of genetical involvement make it difficult to relate this condition to the classical pigmentary retinal degeneration. This data emphasizes the importance of clinical reevaluations and serial electrophysiological testing in order to differentiate between the stationary periods and the progressive deterioration in this disease.


Effects of radiation after enucleation without implantation on orbital development of patients with retinoblastoma. Orbital growth of the patients treated with enucleation and radiation in infancy for retinoblastoma was studied by roentgenographic measurements. The patients radiated following enucleation without implantation were found to be many in the present series, and the effects of radiation and the insertion of an implant to the development of the orbit in infancy were discussed. Judging from the results of statistical analysis of roentgenographic measurements of the orbit, growth retardation of the orbit radiated after enucleation was greater than that of the orbit only enucleated. Radiation therapy after enucleation for intraocular malignant tumor in infancy should be avoided as much as possible unless the extrascleral invasion is found at operation.


[Role of the trabecular meshwork in chamber water exchange based on model experiments]. On the basis of our experiments with models, we suppose that the trabecular meshwork possesses a pump mechanism with a sucking and compressing effect, forming a basic hydrodynamic mechanism together with the humour aqueous production and the uveal and episcleral outflow. This mechanism is able - in spite of the changes of certain factors - to keep the aqueous outflow and the intraocular pressure at a standard level in normal physiologic circumstances. Finally, it is possible that this mechanism can be influenced by the neurohormonal system, or in other words, it may be the physical manifestation of the neurohormonal effects.


Choristoma osseum orbitae. A clinicopathological case report. A brief description is given of a congenital bone formation in the orbit lying on the surface of the outer canthus of the left eye, without any connection to the bulb.


Experimental determination of spinal motion segment behavior. The mechanical behavior of the human spine is complex. Most of the studies in the past have predominantly dealt with axial compression. Some attempts have been made to study spinal behavior resulting from the application of other types of loads. However, coupled motions have not been documented. In the present discussion we have attempted to develop a system that makes it possible to determine the complete elastic behavior of the spine and to present some results of three dimensional studies, including the coupling effects. Some of the conclusions are as follows: 1. The mechanical behavior of the spinal motion segments can be documented by application of 12 physiologic loads to the upper vertebra and measuring the resulting six components of the three dimensional motion. 2. Each physiologic load (a force or a moment) produces one main motion and five coupled motions. 3. Seventy-two load displacement curves are required for a complete description of the elastic behavior of a single motion segment.


Effects of preload on load displacement curves of the lumbar spine. Elastic mechanical properties of the spine are a function of the axial preload as well as the physiologic loads. The published literature does not take into account the effect of the preload. In this study we have presented a new technique for applying large preloads together with 12 physiologic loads and for measuring the resulting three dimensional motion. Some of the conclusions regarding the elastic behavior of the lumbar spine are: (1) The application of any one of the 12 physiologic loads produces a three dimensional motion consisting of three translations and three rotations. (2) The main as well as the coupled motion curve is affected by the inclusion of preloads. (3) As represented by the main motion curves, the spine becomes more flexible in the presence of preloads with the physiologic forces directed laterally or anteriorly, or moments producing lateral bending or flexion. (4) The spine becomes less flexible in the presence of preload when it is subjected to axial tension or axial torsion. (5) No appreciable change due to the preloads is noticed in the load displacement curves when axial compression, posteriorly directed force, or extension moment is applied.


A sonic tool for spinal fusion.

A sonic tool for spinal fusion. The application of sonic energy to bone cutting problems is reported. The basic principle of the resonant tool, its adaptation for surgery, the experimental results of its use in animals, and clinical experience are reported. This sonic tool is found to introduce no significant tissue destruction. It does have several desirable characteristics for routine use in orthopedics.


Aging and degeneration in the lumbar intervertebral disc. 1. The maintenance of the nucleus pulposus matrix in the adult human disc is dependent on the functional integrity of the cartilage end plate cells. 2. Cartilage end plate senescence is followed by compensatory cartilaginous metaplasia of annulus fibrosus cells. 3. It is proposed that disc narrowing and collapse are related to metabolic failure of matrix production by end plate and annulus fibrosus cells. 4. Calcium pyrophosphate dihydrate crystal deposits, a visible manifestation of a metabolic abnormality, are found frequently in the annulus fibrosus and cartilage end plates of elderly patients with degenerative disc disease.


Quantitative electromyographic studies of back muscle activity relatated to posture and loading. The myoelectric activity of some of the posterior muscles of the back was studied quantitatively using signal amplitude estimation and power spectrum analysis. Surface electrodes were placed on both sides of the trunk at T4, T8, L1, L3, and L5 levels. Four different angles of forward flexion were studied during external loading of the spine with 200 N. At 30 degrees of forward flexion studies were made when the load was increased from 0 to 300 N. Asymmetric loading was studied with the trunk erect, in lateral flexion, and in rotation. The myoelectric activity increased when the angle of flexion increased and when the external load was increaed at a fixed angle of flexion. During asymmetric loading, comparatively higher activity was found on the contralateral side in the lumbar region and on the ipsilateral side in the thoracic region. The magnitude of the power spectrum changes correlated well with the amplitude of the myoelectric signal. Spectral changes increased when the signal amplitude increased, indicating localized muscle fatigue.


Scanning and transmission electron microscopy of the nasal mucosa. We attempted to study the nasal mucosa of children (both normal and diseased) under light microscopy followed by both scanning and transmission electron microscopy. Combined methods of microscopy are valuable tools in establishing the diagnosis and lead to a better understanding of disease and its management. For this reason we found it necessary to study the ultrastructural details of the cells of the nasal mucosa. Through scanning electron microscopy we studied the functional aspects and the nature of the surface of these cells. Ultrastructural details of these cells were studied with the aid of transmission electron microscopy.


The iso-enzyme of alkaline phosphatase in neutrophils during pregnancy. The alkaline phosphatase from neutrophils of pregnant women and normal males has been extracted, subjected to various inhibitory procedures and to electrophoresis. It is demonstrated that the iso-enzyme obtained from each group is indistinguishable from the skeletal iso-enzyme, in contrast to the serum iso-enzyme of pregnancy which is placental.


Thorotrast-induced bilateral carcinoma of the kidney. A case of transitional cell carcinoma in the left kidney 25 years after urinary tract investigations, and squamous cell carcinoma in the right kidney 6 years later is described. Thorotrast was identified in the kidneys and in the reticulo-endothelial system post mortem and was presumably the contrast material used for the original retrograde pyelogram. When retained in the kidneys after retrograde pyelography Thorotrast produces a characteristic radiological and histological appearance and can be identified by the spectrum of radiation which it emits. The authors believe that this report of bilateral renal carcinomas related to Thorotrast is unique.


Allergy and infection.

Allergy and infection. The majority of infectious asthma in children is of viral etiology. The respiratory syncytial and parainfluenza viruses are the etiologic agents in most young children, whereas rhinovirus primarily initiates asthmatic episodes in older children. Short-term or alternate day maintenance corticosteroid therapy probably does not significantly increase the asthmatic child's susceptibility to infection.


Determination of bile acid concentration in human amniotic fluid for prenatal diagnosis of intestinal obstruction. Bile acid concentration was measured in amniotic fluid obtained for standard indications from 11 healthy pregnant women without polyhydramnios (28 to 42 weeks of gestation) and from 9 patients with polyhydramnios (28 to 38 weeks of gestation). Two of the latter women delivered infants with intestinal obstruction distal to the papilla of Vater, a condition that causes regurgitation of bile into the amniotic fluid. In the women without polyhydramios, the total bile acid concentration ranged from 1.4 to 2.4 micronmol/liter. In the seven patients with polyhydramnios not associated with fetal intestinal obstruction, the bile acid concentration in amniotic fluid was not significantly different (0.9 to 1.9 micronmol/liter). By contrast, the bile acid concentration in amniotic fluid specimens from the two patients with polyhydramnios who gave birth to children with intestinal obstruction was considerably elevated (30.3 to 83.1 micronmol/liter). These findings suggest that determination of bile acid concentration in amniotic fluid permits prenatal diagnosis of intestinal obstruction distal to the papilla of Vater.


The respiratory mechanism of aerosol inhalation in the treatment of partial airway obstruction. There is a sensory system within the mucosa of the nose and supraglottic larynx that appears to be both mechanosensitive and chemosensitive. Our data suggest that the respiratory modification produced by microaerosol inhalation represents a mechanoreceptor rather than chemoreceptor response. Furthermore, the sensitivity of this reflex system appears aged-dependent, the data indicating a more active response early in life. From a clinical perspective, it is postulated that aerosol inhalation reflex alters the pattern of breathing, resulting in improved respiratory flow rates during partial upper airway obstruction. The mechanism of a favorable clinical response to mist inhalation has not been previously appreciated in this context.


Pulmonary edema associated with croup and epiglottitis. Two children, ages 9 and 2 1/2 years, with clinical diagnoses of laryngotracheitis (croup) and epiglottis, respectively, developed florid pulmonary edema without evidence of cardiac enlargement. Both children responded to vigorous therapy, which included endotracheal intubation, mechanical ventilation with high oxygen concentrations and positive end expiratory pressure, diuretics, and support of the intravascular volume with colloid infusions. Swan-Ganz catheterization was performed in the child with epiglottitis to elucidate any hemodynamic malfunction. Pulmonary artery occluded pressure was found to be normal. We postulate that pulmonary edema may be the result of any of three major physiologic alterations: alveolar hypoxia, increased alveolar-capillary transmural pressure gradient, and a catechol-mediated shift of blood volume from the systemic to the pulmonary circulation. These alterations acting in concert would increase the volume of blood presented to the pulmonary capillaries, the pore size in those capillaries, and the hydrostatic pressure gradient promoting transduation. Failure of pulmonary lymphatics to effectively clear this fluid would result in pulmonary edema. Although pulmonary edema associated with acute upper airway obstruction is unusual, physicians should be altered to its possible appearance and the need for early and vigorous therapeutic measures.


Growth, course, and prognosis after surgery for Crohn's disease in children and adolescents. Surgery is often performed because of growth failure when Crohn's disease occurs in children and adolescents, but the long-term responses of such therapy are not known. Thirty-seven children and adolescents were followed from 2 to 26 years after resections for Crohn's disease. Twenty-eight patients had disease that involved both the colon and terminal ileum; disease was limited to the small intestine in eight patients and to the stomach in one. At the time of surgery 16 patients were at or below the third percentile for weight and only 16 had reached puberty (all of these were older than 14.5 years). Fourteen patients (11 prepubertal, 3 pubertal) had severe impairment of linear growth; height and was at or below the third percentile or linear growth was absent for more than a year. At the time of the first operation, seven patients had incomplete resections and have had persistent disease. The remaining 30 patients had complete resections as determined by gross and histological criteria. Of these, 12 have had recurrences and 18 have been free of disease. Of the 11 prepubertal patients with preoperative linear growth failure, only two had catch-up growth after surgery. The remaining nine and all of the pubertal patients have either failed to grow or have maintained their height in their preoperative percentile. Catch-up growth after surgery for Crohn's disease occurs only in those children who are operated on before puberty and in whom there is no early recurrence. The recurrence rate for this group of patients was 30%; most recurrences occurred within two years of the initial resection. Growth failure, therefore, may be considered an important indication for surgery in the prepubertal child with Crohn's disease, but it probably is not an indication after onset of puberty.


Use of the pigmentometer, a new device for measuring skin albedo: relating skin color with a series of physiological measures. Use of the Pigmentometer, a new device for measuring skin albedo: Relating skin color with a series of physiological measures. An apparatus has been described for the indirect measurement of skin albedo in human subjects. This device operates on the principle of the reflectance of light as influenced by the lightness or darkness of the skin. This new equipment was used to examine the relationship between lightness or darkness of the skin and the basal level and responsivity of some autonomic nervous system physiological variables in a series of 46 black and 47 white male and female subjects. It was observed that blacks had significantly lower (darker) skin albedo (PI), a significantly higher skin resistance (SR) and amplitude of the galvanic skin response (GSR), and an insignificant higher basal heart rate (HR). Pearson Product-Movement correlations between all measures from the total population showed significant relationships between PI and SR, SR and GSR and HR and HRR (heart rate response). The further separation of the total population into subgroups of blacks, whites, males, females, and black and white male and female goups, respectively, altered some of these differences and relationships previously observed. These results appeared to support the premise that race is more responsible for influencing the measured physiological responses, particularly SR, than is the lightness or darkness of the skin.


Evaluation of congenital neutropenic disorders by in vitro bone marrow culture. The congenital neutropenias are a heterogenous group of diseases whose etiology and pathogenesis are largely unknown. We studied nine neutropenic patients from seven families. Evaluation included peripheral blood cell and differential cell counts, epinephrine and typhoid vaccine stimulation studies. Rebuck skin windows, and bone marrow aspirations for morphological assessment and for in vitro culture in liquid suspension and in agar plates. Parallel cultures were set up with and without colony-stimulating activity (CSA), and peripheral leukocytes were assayed for cellular production of CSA. Patients were initially classified on the basis of their clinical course: benign, mild, moderately severe, or severe disease. One patient in the moderately severe group had an immunoglobulin disorder. Morphologically normal mature granulocytes were seen in bone marrow aspirates of two patients, and maturational defects of varying degree were seen in the remaining seven. Colony formation in agar was markedly reduced below normal in three of seven, moderately reduced in two of seven, and greater than normal in two patients. Colonies in six of seven patients consisted exclusively of macrophages. Marrow from all but one of the nine patients demonstrated poor neutrophil development in suspension culture, and addition of CSA did not result in augmented granulocytic proliferation or maturation. A scheme of normal neutrophil maturation is proposed, and the nine patients were categorized according to this scheme. Four patterns of congenital neutropenia emerged: type 1 was the most benign form of disease with essentially normal clinical and in vitro parameters, and a defect considered to be due to a small committed stem cell pool, abnormal release, or excessive utilization peripherally; type 2 had mild disease with presumed defective committed stem cell differentiation along the granulocyte line; type 3 included benign to severe clinical expression with an apparent defect at the level of the committed granulocyte precursor more severe than in type 2; type 4 disease had varied clinical expression but evidence for a defect at the level of the pluripotent stem cell.


Maintenance of protection in patients treated for stinging insect hypersensitivity: a booster injection program. A program of annual booster injections of mixed stinging insect whole body extract was given to 133 patients who had previously had three years or more of immunological treatment for systemic reactions of Hymenoptera stings. Two patients who were restung had mild symptoms that were evidenced by a few scattering hives with itching. No patient on a dose of 0.2 ml of 1:10 dilution extract had any reaction when they were restung. It is believed, therefore, that this program merits continuation with that dosage for a period long enough to determine its true effectiveness. There is some indication that this is an improvement over the program which stops treatment after three years. There is further support for the belief that this condition and the treatment are dose related. There is also evidence for my belief that this sensitivity, and the treatment, differ from the usual atopic sensitivity in antibody-antigen response.


Organochlorine compounds in human blood plasma and milk. Organochlorine insecticides and polychlorinated biphenyls (PCB's were assessed in human blood and milk collected from Israeli mothers 2-4 days ater childbirth during 1975. The concentration of total DDT (sigma DDT) was similar in whole plasma and milk (74 ppb versus 72 ppb) and higher in plasma-extracted lipids than in milk-extracted lipids: 15.12 ppm versus 5.77 ppm. Levels of gemma-BHC, dieldrin, and heptachlor epoxide were higher in whole plasma and plasma-extracted lipids than in whole milk or in milk-extracted lipids. PCB's had similar concentrations in extracted lipids of plasma and milk but were significantly higher in whole milk than in whole plasma. Higher percentages of organochlorine insecticides and PCBs were excreted in milk from mothers between 20 and 29 than between 30 and 39, although the younger group had lower levels of these compounds in plasma. Overweight women excreted lower quantities of organochlorine insecticides and PCB's than did women of normal weight


Pesticide and other chemical residues in total diet samples (X). Since 1964 the Food and Drug Administration Total Diet study has reported residues of pesticides and other chemicals ingested in the diet of a young adult male, statisically the Nation's largest eater. During the tenth year of the study, pesticide residues remained at the relatively low levels previously reported. Thirty market baskets were collected in 30 cites which ranged in population from less than 50,000 to 1,000,000 or more. Averages and ranges of residues are reported from August 1973 through July 1974 by food class. Individual items in the dairy and meat composites in four market baskets were analyzed for pesticides; results are included. Data for lead,  cadmium, selenium, mercury, arsenic, and zinc are also included. Results of recovery studies within various classes of residues are also presented.


DDT residues in air in the Mississippi delta, 1975. In a previous publication the authors reported on 88 percent decrease in sigma DDT (DDT plus metabolities) in air between 1972 and 1974 in the Mississippi Delta. This period was the first two years after the use of DDT was banned in the United States. The present report shows an additional 36 percent decrease in sigma DDT levels in air between 1974 and 1975. Thus in the past three years sigma DDT in air has decreased by 92 percent, a much more rapid decrease than had been expected.


[Lcoc-regional sarcoid reaction. Sarcoidosis and malignant tumors]. On the basis of eight cases, the authors consider the relationship between sarcoidosis and malignant tumours. The development of a malignant tumour simultaneously or during the years following the onset of sarcoidosis is a rarely seen phenomenon. Only seven cases out of 580 of sarcoidosis were noted in this series. The absence of comparison with control groups of similar age and sex as well as of prolonged observation in a certain number of sarcoidosis patients cured or lost from sight prevents any valid statistical assessment, but the average age (51 years) of the patients at the time of discovery of the tumour is that of the risk of spontaneous development of carcinoma. Thus the association "sarcoidosis-malignant tumour" would appear to be purely a question of chance. The finding of sarcoid-type histopathological reactions in lymph nodes involved in the spread of a malignant tumour often represents the residual expression or reactivated by the tumour of old sarcoidosis which had gone unnoticed. The development of a malignant tumour is capable of provoking in old sarcoidosis patients a late recurrence of the disease.


[Esophageal localizations of Crohn's disease]. Oesophageal localisations of Crohn's disease are perhaps not as rare as is classically supposed. The chance discovery of an oesophageal localisation of Crohn's disease led the authors to undertake routine study of the oesophagus in their last 18 patients suffering from the disorder. Each patient underwent endoscopic examination of the oesophagus with multiple biopsies. In 3 of them an oesophageal localisation of Crohn's disease could be demonstrated histologically with in addition, evidence of an epithelioid granuloma in 2 patients out of 3. The value of endoscopic biopsy thus appears to be certain in the diagnosis of this localisation, the influence of which on the course of the disease is not precisely known.


Multiple myeloma: uncommon or uncommonly diagnosed? The experience of a solo practitioner suggests that the incidence of multiple myeloma is higher than the widely reported figure of 2.7/100,000. Only by early recognition and treatment will the survival rate be increased. Measurement of the sedimentation rate may be helpful in spotting the disease, for a rapid rate in patients with bone pain and anemia suggests multiple myeloma.


Infectious complications of alcoholism.

Infectious complications of alcoholism. Physicians must remain attuned to the increased incidence of infectious complications in alcoholics as compared with the general population. Prompt diagnosis and vigorous early treatment of pneumonia and spontaneous bacterial peritonitis may reverse and otherwise grave prognosis. Althought many mechanisms of host defenses seem affected by alcohol ingestion, the precise mechanisms of increased bacterial susceptibility in alcoholism remain unclear.


Alcohol and the upper gastrointestinal tract and pancreas. Alcohol relaxes the lower esophageal sphincter, stimulates acid secretion, and reduces the gastric mucosal barrier to hydrogen ion back-diffusion. These actions may result in esophagitis, acute gastritis, and ulcer formation. Although excessive alcohol consumption commonly produces acute and chronic pancreatitis, and pathogenesis is unclear.


Submaximal treadmill exercise testing of patients with coronary artery disease. The submaximal treadmill exercise test is a valuable noninvasive tool for the diagnosis of overt or latent coronary artery disease (CAD). When submaximal heart rates of 80% to 90% of the predicted maximal rates are attained and when ST-segment depression of at least 1 mm is taken as a criterion of ischemia, testing by any of the various exercise protocols with continuous ECG monitoring affords reasonable specificity and sensitivity. The objectives of testing are to (1) diagnose and determine the severity of CAD, (2) assess functional capacity, (3) observe the natural history of disease, (4) evaluate the effects of medical and surgical treatment, and (5) evaluate responses to physical conditioning or to programs directed toward prevention of CAD. Proper precautions and safety standards minimize the risk of exercise testing.


Common ear diseases: recognition and management. External otitis is directly related to patient habit patterns. It is easily treated, but the habits must be changed to effect permanent cure. Serous otitis media is the most common cause of conductive hearing loss, and its presence my predispose to development of purulent otitis media. Removal of middle ear fluid may be advisable in persistent serous otitis and is recommended in acute purulent otitis.


Sedative action of low doses of dopaminergic agents. The activity of rats receiving low doses of dopaminergic agonists and neuroleptics was tested in the "open-field" test. Apomorphine, piribedil, L-DOPA, and nomifensine given at low doses (1-500 mug/ig) depressed the activity of animals. Spiperone and chlorpromazine given at low doses increased the activity, particularly in respect of one of the parameters investigated: the time of walking. Low doses of pimozide, haloperidol, and fluphenazine did not affect measurably the animal behavior. Spiperone counteracted the sedation induced by low doses of apomorphine, piribedil, and nomifensine. Chlorpromazine prevented the sedation produced by apomorphine. In the rats with a lesion of the substantia nigra only nomifensine retained its sedative action, while apomorphine and piribedil ceased to produce it. The reported results further support the hypothesis about the existence and the role of dopaminergic autoreceptors.


Role of angiotensin in thirst.

Role of angiotensin in thirst. Angiotensin is a potent dipsogenic substance and causes elevated water intake in some pathological conditions but as yet no physiological role for angiotensin in normal thirst has been proven. If angiotensin is important in normal drinking, then it should contribute to the drinking which follows water deprivation. The rehydration of bilaterally nephrectomized rats, rats with bilateral ureteric ligation and control rats was compared after 21 hours of water deprivation. The total intake during the 6 hour rehydration was the same in the 3 groups despite the differences in the level of circulating angiotensin. Thus the renal renin-angiotensin system is not essential for deprivation-induced drinking. Another way to test any contribution to drinking by angiotensin is the administration of the competitive angiotensin inhibitor, saralasin acetate. In a control experiment saralasin acetate was found to block the dipsogenic effect of intravenous angiotensin. The infusion of saralasin acetate in a wide range of doses did not, however, affect the drinking following ligation of the inferior vena cava. Thus angiotensin is not essential for drinking following caval ligation. Two possible explanations for these results are that angiotensin is not normally involved in these types of thirst or that there is redundancy in the control of drinking with compensation for blocked mechanisms.


Absence of sodium appetite in cyclophosphamide and DOCA treated house mice. Intraperitoneal administration of cyclophosphamide 100 mg/kg and 200 mg/kg significantly lowered plasma sodium and significantly increased plasma potassium but did not result in saline preference in a strain of wild-derived house mice given a choice between water and saline (0.15M) to drink. Deoxycorticosterone acetate treatment in dosages up to 1.5 mg for four days also failed to increase salt intake, The data suggest a possible absence of a sodium appetite mechanism in this species.


LSD and d-amphetamine effects on fixed interval responding in the rat. Food-deprived rats were trained to press a key which produced a food pellet for the first press after 3 min had elapsed (FI 3 min). Daily sessions consisted of 10 such intervals. Graded doses of LSD (0.04 - 1.28 mg/kg) and a d-amphetamine (0.5 - 2.0 mg/kg) were given 30 min before sessions. LSD produced a decrease in response rate at doses of 0.32 mg/kg and above, but did not disrupt the typical FI pattern of responding except at the highest dose (1.28 mg/kg). Amphetamine did not significantly alter the overall response rate, but caused a dose-related disruption of the FI response pattern, with previously low response rates increased more than higher rates, and occasional decreases in the previously highest rates. The experiment was repeated using the same rats responding on a multiple FIFR schedule. The presence of a 2000 Hz tone signalled FR periods; the tone was absent during FI periods. During the FR components, a pellet was produced after 30 responses had been emitted. The FI components were unchanged. LSD (0.08 - 0.32 mg/kg) again produced decreases in FI rate without altering the pattern, and amphetamine again altered the FI pattern without significantly changing overall rate.


Behavioral and biochemical effects of the carbamate insecticide, MOBAM. Decreases in rat plasma, erythrocyte and brain cholinesterase levels after intraperitoneal injection of 1 to 5 mg/kg of 4-benzothienyl-N-methylcarbamate (MOBAM) were compared with decrements in both spontaneous motor activity and conditioned avoidance performance produced by this compound. Significant effects were observed with all five measured phenomena at dosages producing no obvious clinical signs. In albino rats, a dosage of 2 mg/kg significantly depressed plasma and erythrocyte cholinesterase activity, and decreased motor activity 15 min after injection but only higher dosages (3 and 5 mg/kg) significantly depressed brain cholinesterase activity and avoidance performance. In Long-Evans rats, both brain cholinesterase activity and avoidance performance were significantly reduced by the lower (2 mg/kg) dosage. The avoidance impairments observed after 3 mg/kg could be prevented by prior injection with atropine sulfate. It is suggested that both central and peripheral cholinesterase changes are important in determining the nature of the behavioral effects observed after exposure to this compound.


Effects of three monoamine oxidase inhibitors on ethanol preference in mice. These experiments investigated the effects of pargyline, N-[2-(o-Chlorophenoxy)-ethyl]-cyclopropylamine (Lilly 51641), and nialamide on voluntary ethanol consumption of C57BL/6J mice. Both pargyline and Lilly 51641 reduced ethanol preference; in contrast, nialamide did not affect preference, despite the fact that it inhibited MAO activity by more than 90%. A subsequent experiment determined that both pargyline and Lilly 51641 produced substantially greater elevations in acetaldehyde levels than did nialamide. It is suggested that increased acetaldehyde is the mechanism responsible for the reduction in ethanol preference observed with pargyline and Lilly 51641.


Open field behavior and gross motor development in offspring of nursing rat mothers given penfluridol. Nursing rat mothers were injected with penfluridol, a dopamine receptor blocking agent, at Day 1, 3, 5 and 7 after delivery, and their offspring were investigated at 6-18 days of age for various aspects of motor behavior development, and at 4, 8 and 12 weeks of age for open field behavior. No deficits were found in the development of locomotion, air righting, startle response and eye opening. Open field ambulation decreased from an abnormally high level at 4 weeks of age to an abnormally low level at 8 and 12 weeks of age. The ability to habituate to an open field decreased from a normal level at 4 weeks of age to an abnormally low level after 8 weeks of age. The behavior deficits were related to a decreased functional activity of the mesolimbic dopamine neuron system, and the possible relation to a clinical dysfunction among children - minimal brain dysfunction - was discussed.


A new device for the rapid measurement of impaired motor function in mice. Measurement of the ability of mice to balance on a rotating rod or cone is often used as a measure of impaired motor function. In most of these procedures the mice must be trained prior to the test. In the new screen test described in this paper, untrained mice are used in a 60 sec test which measures the ability of mice to either climb to the top of or cling to the bottom of a horizontal screen. The ED50 values obtained for failure to reach the top of the horizontal screen are similar to those obtained with the rotarod; the values for falling from the screen are somewhat higher. With both of the horizontal screen measures there were fewer control failures than in the rotarod procedure.


Protein synthesis inhibition alters Drosophila mating behavior. Fruit fly Drosophila pseudoobscura virgin AR females mate preferentially with AR males given a choice between AR and or males. However, AR females which mated with or males when young show a significant change in sexual selection in favor of or over AR males in subsequent simultaneous choice tests. Ingestion of food moistened with 4 ml cycloheximide (400 microng/ml) produces 75% protein synthesis inhibition in the female flies. Females exposed to cycloheximide (CXM) immediately after their initial copulation with or males resemble virgin flies in their choice of mates, and mate preferentially with AR males. Females exposed to CXM before their initial copulatory experience with or males resemble or-experienced but untreated (no CXM) flies in their choice of mates, and mate preferentially with or males. The change in sexual preference shown by females with prior copulatory experience resembles learning in that it is subject to disruption by CXM in ways analogous to those reported in the literature.


Effects of apomorphine on self-stimulation behaviour in dorsal and ventral area of lateral hypothalamus in mice. Intraperitoneal injections of low doses of apomorphine, a dopaminergic receptor agonist, depressed briefly, and then enhanced self-stimulation behaviour in the dorsal area of lateral hypothalamus. In contrast, only depressant effects were observed in the ventral area. These differential effects suggest the presence of a dopaminergic componant in the dorsal hypothalamic self-stimulation system.


A determination by an analysis of X-ray attenuation in aluminium of the intesity distribution at its point of origin in a thick  tungsten target of bremsstrahlung excited by constant potentials of 60-140 kV. A recently described, computer aided method of attenuation analysis has been applied to free-air chamber measurements of the attenuation by up to 30mm A1 of the exposure rate of a narrow beam of X-radiation excited  at a thick W target in a Be window tube by constant potentials of 60, 80, 100, 120 and 140 kV.  It has been shown that the general characteristics of the intensity distributions of the bremsstahlung at its point of origin within the target found by an earlier analysis are fully confirmed but that, for radiation excited at potentials appreciably above the K-absorption edge of the tungsten target, the attenuation measurements must first be corrected for the pressure of target characteristic K-fluorescence radiation. A method for doing this from published estimates of the relative amounts of  W K-fluorescence at various filtrations in radiation excited by the same potentials is described, and it is shown that these amounts come into reasonable agreement when translated to the target surface. Curves of the intensity distribution of the bremsstrahlung at its point of origin within the target are presented which are consistent with attenuation data corrected according to these estimates. They show a good general agreement with theoretical expectation.


An analysis of the Z-dependence of photon and electron interactions. A comprehensive analysis has been completed of the dependence of photon and electron interactions upon atomic number. The calculations were specifically biased towards the application of the data to biological tissues and their substitutes. The photon interactions considered in the survey included all the partial attenuation and energy absorption cross-sections. The electron interactions analysed were collision and radiation stopping powers and angular scattering powers. The derived Z-exponents are tabulated for different energies and elemental groupings and indicate the inadequacy of existing Z-exponents. In particular, the continued use of the single exponent 3.94 for photoelectric attenuation (per atom) is put in question.


Three-dimensional imaging in the position camera using Fourier techniques. A mathematical algorithm for three-dimensional reconstructions in the positron camera is described. Fouier techniques have been adapted for use in analysing the data from cameras with limited detector configuration. Noise instabilities from random fluctuations in the data are discussed and treated. The technique is tested on a computer-generated phantom and the results are presented. Ways of incorporating the effects of Compton scattering and detector response into the algorithm are discussed. It is concluded that the method is feasible and practical for obtaining accurate reconstructions.


Imaging 123I with a scintillation camera. A study of detection performance and quality factor concepts. Image quality, resolution and sensitivity of a scintillation camera equipped with various collimators have been investigated using high purity 123I. Pulse height distributions of 123I from a thyroid phantom partly in air and partly immersed in water demonstrate the substantial septa penetration of the 440 and 529 keV gamma rays of 123I with high resolution collimators. Line spread functions recorded first with the line source in air and then in water show that the area under the 'wings' is attributed mainly to septa penetration but with a marked contribution from scattering in water. The modulation transfer function evaluated from the line spread functions shows a sudden drop at low frequencies for high resolution collimators due to their high degree of septa penetration. The two concepts of 'figure of merit' also used are Qb=Sa [MTF]2, where Sa is the plane sensitivity and Qc=S2/(S+2B), where S is the true signal from the object and B is the total background or noise due to septa penetration and scatter. The image reproduction per unit time which is described by Qb is best for a high resolution converging collimator. The statistical accuracy per unit time which is used in dynamic studies is described by Qc and is best for a medium energy collimator.


Measurements of the microscopic structure of cortical bone. A technique is described in which the microstructure of cortical bone is analysed in terms of distributions of possible paths which ionizing particles take as they transverse the soft-tissue cavities and mineralized component. Measurements are restricted to transverse planes in the long bones, but a method is suggested for generating approximate omnidirectional path-length distributions from the measured transverse distributions. Results are presented for some long bones of a 50 year old man,  a 9 year old boy and a young adult beagle, and these suggest that considerable structural differences occur between the two species. Values of some commonly quoted structural parameters are also given. For example, mean transverse cavity path lengths range between 67 and 99 micron in the long bones of the adult man compared with 29 micron in the beagle femur; the corresponding mean path lengths through the mineralized component are 830-1040 and 1500 micron. Finally, the total cavity plus periosteal surface for cortical bone in adult man is estimated to be about 6 m2.


The calculation of the spectral distribution of natural ultraviolet radiation under clear day conditions. Empirical equations based upon experimental measurements of Bener (1972) have been developed which allow the computation of the spectral distribution of global ultraviolet radiation encountered at sea level under clear day conditions for any desired time of day, day of year and geographical latitude.


Ultrasonic backscattering from human tissue: a realistic model. The propagation of ultrasound pulses in inhomogeneous media is described, and it is shown that they are scattered by fluctuations in density and compressibility. It is proposed that some of the echoes recorded by diagnostic pulse echo equipment are produced in this way. The precise form of the acoustic field backscattered from tissues is calculated using realistic approximations about the nature of tissue inhomogeneitics and the form of the pulses used. It is shown that only limited information about tissue structure is contained in these signals, and the restrictions imposed by the use of typical pulses are indicated. The implications of this analysis for methods of tissue characterization and clinical imaging are discussed.


A two-beam acoustic system for tissue analysis. In the 'thermo-acoustic sensing technique' (TAST), a burst of sound, called the 'thermometer' beam is passed through tissue and its transit time is measured. A focused sound field, called the heating field, then warms a small volume in the path of the therometer beam, in proportion to the absorption. Finally, the therometer beam burst is repeated and its transit time subtracted from that of the initial thermometer burst. This difference measures the velocity perturbation in the tissue produced by the heating field. The transit time difference is td = K integral of infinity-infinity IP dchi where K is the instrument constant, I the heating field intensity, and P a perturbation factor which characterizes the tissues. The integration is carried out along the path of the thermometer beam. The perturbation factor is P = (formula: see text) where C is the specific heat, rho the denisty, V the velocity of sound, (formula: see text) the temperature coefficient of velocity and alpha the heating field absorption coefficient which is apparently sensitive to tissue structure and condition. Experiments on a fixed human brain showed an ability to distinguish between various tissue types combined with a spatial resolution of better than 3 mm. Should predictions based on the data and theory prove correct, TAST may become a non-invasive alternative to biopsy.


Monogamy in mammals.

Monogamy in mammals. This review considers the behavioral, ecological, and reproductive characteristics of mammals exhibiting monogamy, i.e., mating exclusivity. From a discussion of the life histories of selected species of monogamous primates, carnivores, rodents and ungulates, several trends emerge. Two forms of monogamy occur, Type I, facultative, and Type II, obligate. The selective pressures leading to these two forms of monogamy may have been different. Facultative monogamy may result when a species exists at very low densities, with males and females being so spaced that only a single member of the opposite sex is available for mating. Obligate monogamy appears to occur when a solitary female cannot rear a litter without aid from conspecifics, but the carrying capacity of the habitat is insufficient to allow more than one female to breed simultaneously within the same home range. Within both types of monogamy, the following traits are typically seen: (1) adults show little sexual dimorphism either physically or behaviorally: (2) the adult male and female exhibit infrequent socio-sexual interactions except during the early stages of pair bond formation. Additional trends specific to mammals exhibiting obligate monogamy are: (1) the young exhibit delayed sexual maturation in the presence of the parents, and thus only the adult pair breeds; (2) the older juveniles aid in rearing young siblings; and (3) the adult male (father) aids in the rearing of young by any or all of the following: carrying, feeding, defending, and socializing offspring.


Critical evaluation of renal masses' angiography. 152 consecutive space occupying renal lesions (54 cancers, 66 single or multiple cysts, 18 pseudotumors, 8 inflammatory lesions, 3 hydronephroses, 3 hehatomas) were studied by selective angiography, considering the signs noted in the three phases: arterial, nephrographic, and venous. The frequency of each of these angiographic signs in the different forms of renal pathology was evaluated. Based on this study, pathognomonic angiographic signs were identified for the various types of pathology. For each angiographic sign the 'diagnostic value' was calculated in order to differentiate malignant from benign space-occupying lesions. Dependent on the angiographic phase they are in, these signs constitute the arterial, nephrographic, and venous 'symptom constellation' characteristic of each lesion. The relationship between angiographic signs and either histologic type or size of tumor were analyzed. The causes of false positives and false negatives were investigated. The value of certain angiographic signs for a correct diagnosis of the cases judged as suspect or misinterpreted was discussed.


A new topometric method of determining the position of the venous angle on cerebral phlebograms. The authors devised their own craniometric method of determining the normal position of the venous angle on the lateral phlebogram. The fundamental principles of the method are as follows: (1) two auxiliary lines; i.e. (a) a horizontal line the nasion - the tuberculum sellae (N-TS); (b)a diagonal line the nasion - the tabula interna (N-Ti); (2) the two auxiliary lines form the angle alpha, which is equal to 20.44+/- 4.2 degree; (3) the proportional position of the venous angle (the point of intersection S on the diagonal N-Ti) is the ratio of the distance N-S to the total length of the diagonal N-Ti,i.e.: (formula: see text). The value is equal to 49.8 +/- 4.6%. The present method takes into consideration both the length and the height of the skull, has a small statistical dispersion and is simpler than the other available methods.


Influence of the route of administration of prostaglandin E1 on rat gastric secretion. Changes in gastric secretion induced by the subcutaneous, intraduodenal or intragastric administration of prostaglandin E 1 (PGE1) were evaluated in pylorus-ligated rats. Subcutaneous and intraduodenal injections produced a dose-related inhibition in both total acid and volume of gastric secretion. Dose-response curves for inhibition obtained by these routes were parallel, although PGE1 was more potent when given subcutaneously. Gastric administration produced a dose-related decrease in acid and an increase in volume. The slope of the dose-response curve for acid inhibition with this route was flatter than with subcutaneous or intraduodenal administrations. The present results suggest that PGE1 inhibits gastric secretion by the same mechanism of action when given subcutaneously or into the duodenum, while the effects observed after gastric administration are consequences of local actions. The difference in potency of PGE1 given subcutaneously and in the duodenum would seem to be due to differences in absorption from the site of administration and/or to a greater metabolism of PGE1 during its absorption from the intestines.


Effects of prostaglandins on baseline pressure and responses to noradrenaline in a perfused rat mesenteric artery preparation. PGE1 as an antagonist of PGE2. Concentrations of PGE1, PGE2, PGA1, PGA2 and PGF2alpha ranging from 10 to 10(5) pg/ml (2.8 x 10(-11) to 2.8 x 10(-7)M) were perfused through a rat mesenteric vascular bed preparation and their effects on baseline pressure and responses to noradrenaline noted. PGs A2 and FEalpha elevated baseline pressure at concentrations of 100 pg/ml and above but the other three PGs had little or no effect. PGs E2, A1 and F2alpha markedly potentiated responses to noradrenaline at all concentrations studied. In contrast PGs E1 and A2 caused a clear potentiation at 10 pg/ml but at higher concentrations the effect disappeared and concentrations of above 10(4) pg/ml were actually inhibitiory. E1 could antagonize the vascular effects of E2. These results offer possible explanations for some of the confusing findings reported in the literature.


Stimulative effect of prostaglandins on production of hexosamine-containing substances by cultured fibroblasts (2) early effect of various prostaglandins at various doses. Early effects of various prostaglandins on the production of hexosamine-containing substances by cultrued fibroblasts, which were derived from a rat carrageenin granuloma, were studied. At hte stationary phase, the cells were exposed for 6 h to one of the prostaglandin A1 (PGA1), A2, B1, B2, D2, F1 alpha, E1, E2 or arachidonic acid in various concentrations ranging from 0.01 to 10 microng/ml for all the stimuli and from 10 pg to 10 microng/ml for PGF2alpha. The activity of the cells in incorporating 3H-glucosamine into hexosamine-containing substances (acidic glycosaminoglycans and glycoproteins) during this period was compared with that of control cells. All the stimuli tested showed more or less stimulative effect on the synthesis of hexosamine-containing substances at their specific concentrations. PGF2alpha was found to be the most potent stimulant and its stimulative effect was found significant even at the low concentration of 100 pg/ml. PGD2, F1alpha and E2 were the next potent stimuli. Their optimum dose were aroung 1 microng/ml but they still had significant stimulation at the concentration of 0.01 microng/ml. Effect of PGE2 was rather mild. Stimulation by PGA1, A2, B1 and B2 or arachidonic acid was seen at high dose, and it seemed to be non-specific. The results suggested that these prostaglandins such as PGF2alpha, D2, F1alpha and E2 play some important role on regulating the production of intercellular ground substances.


Inhibition of prostaglandin synthesis and contractility in the rabbit and rat uterus by ibuprofen. Sixty uterine strips were excised from 8 pregnant and 7 post partum rabbits and stimulated electrically in vitro until they developed maximum isometric tension. The non-steroidal anti-inflammatory agent, Ibuprofen, at concentrations of 125, 250 and 500 microng/ml, significantly reduced tension of the 55 experimental uteri (P less than 0.001) within 7.5 minutes, in comparison with the pretreatment value. Tension in 15 solvent-treated controls remained stable during the same observation period. The reduction in tension was greater in the post partum than the pregnant uteri (P greater than 0.05). Sixteen additional uterine strips, excised from 4 pregnant and 4 post partum rabbits were treated either with 500 microng Ibuprofen or solvent for 7.5 minutes. Radioimmunoassay showed that Ibuprofen significantly reduced the uterine levels of PGF (P less than 0.001) and PGE (P less than 0.001 post partum; P less than 0.05 pregnant) and again the effect was greater in the post partum uteri. These findings suggest that the suppression of uterine function by Ibuprofen is mediated by inhibition of PG-synthesis. In a subsequent study, 36 rats were treated with Ibuprofen on days 20 and 21 of pregnancy, at the ineffective dose level of 4 mg/day and the effective levels of 12, 20 and 30 mg/day. In comparison with the first group, spontaneous labor was significantly delayed in the other three groups (P less than 0.05, P less than 0.01 and P less than 0.001, respectively). In addition, 7 rats were treated with 30 mg/day Ibuprofen and 7 with solvent on days 19 and 20 of pregnancy. On day 21, the Ibuprofen-treated rats showed a significant (P less than 0.001) reduction in the uterine PGF and PGE concentrations, indicating that the prolongation of pregnancy is mediated by an inhibition of uterine PG-synthesis.


The effect of a 10 cm2, 0.5% 15-ME-PGF2alpha methyl ester intravaginal silastic device on abortion and plasma prostaglandin concentration. Intravaginal insertion of a 10 cm2 silastic device with an 0.5% concentration of 15(S)-15-methyl-prostaglandin F2alpha methyl ester alone successfully induced abortion in 27 of 48 patients in the midtrimester and in an additional 11 patients with a concomitant infusion of oxytocin. The mean abortion time for the 38 successful induction was 15.35 hours. In 8 of the 10 patients who failed to abort even with concomitant oxytocin therapy, abortion was induced by serial intramuscular injections of 15-ME-PCF2alpha; the remaining 2 failures underwent surgical evacuation. The plasma levels of 15-ME-PGF2alpha methyl ester in the 11 patients studied varied widely over the first 2 hours after insertion of the device. The maximum mean level was achieved at 2 hours, maintained at 4 hours and then dropped sharply at 8 hours and declined over the abortion period in undelivered patients. Vomiting and diarrhea were the most common side effects and in general well tolerated by the patients. However, there was an adverse reaction in a single patient who experienced almost constant nausea, vomiting and diarrhea. The device was removed 1 hour 50 minutes after insertion and the patient aborted spontaneously 7 hours later. Intravaginal insertion of a silastic device is an effective means of prostaglandin abortion, but further investigation is required to determine the most effective device which would provide a slow, continuous release of the prostaglandin.


The effect of prostaglandin F2alpha on the counter-current transfer of 85krypton in the ovarian pedicle of the sheep. A miniature Geiger-Müller probe was inserted into the corpus luteum in five anesthetized ewes. A similar probe was inserted into either the lumen of the adjacent fallopian tube or the opposite ovary. Overall, 17 infusions of 85Krypton-saline into the uterine vein were carried out in the five subjects. After each two minute infusion into the uterine vein, an increase in radioactivity was registered in the adjacent corpus luteum within 30 - 60 seconds. Maximum radioactivity was registered 1 - 3 minutes after the start of the infusion and within 10 minutes radioactivity had dropped to background [corrected] levels. In two out of three sheep a similar kpattern of 85Krypton transfer was registered in the adjacent fallopian tube. Only a negligible amount of radioactivity above background level was registered in the contralateral control ovary, a result in keeping with the known rapid clearance of 85Krypton from the circulation. There was no indication of any change in pattern of the counter current transfer of 85Krypton during the infusion of PGF2alpha (10 microng/hr) into the ovarian pedicle. These results suggest that the previously observed slow transfer of PGF2alpha itself in the ovarian pedicle may be due to physical rather than pharmacological properties of this prostaglandin.


[Motility of the rat ureter in vitro. Responses to cholinergic drugs (author's transl)]. The motility of the rat ureter has been studied in vitro. Sixteen per cent of isolated rat ureters present spontaneous motility which depends on the electrolytic composition of the nutritious solution employed. It seems that the cholinergic component in organs from animals previously reserpinized acts as stimulator since 56.6% of ureters with spontaneous motility was observed in vitro. The action or nicotine proves the existence of stimulating nicotinic receptors in the ureter wall. Acetylcholine acts as excitator as increases peristaltic frequency. Atropine, likewise, proves the existence of stimulating muscarinic receptors. Urine dilutions of 1:100 have also proves their ability for producing peristaltic motility in vitro.


[Tubular permeability maintained in post-ischemic acute renal failure (author's transl)]. The effect of nearly total renal ischemia during a two hour period on glomerular filtration and urine composition was studied in relation to tubular permeability and tubular obstruction, two mechanisms that could explain renal insuficiency after iscehmia. Studies on creatinine clearance, micropuncture and microinjection of 14C-inulin into the proximal tubules by means of a hydraulic system were performed before and after the period of ischemia. Thirty minutes after the withdrawal of arterial obstruction, the animals exhibited a maintained diuresis, 50 per cent reduction in glomerular filtration in the superficial nephrons and in the total kidney, a reduction in the proximal fractional absorption of water, and also an increase in the urinary elimination of sodium. The glomerular filtrate of cortical nephorns obtained by micropuncture in anterior areas of the proximal tubules did not differ significantly from the one obtained by micropuncture in more distal areas. The inulin injected into the proximal tubules of a kidney was entirely eliminated by it.


Behavioural and electroencephalographic effects of intracerebral microinjections of sodium pentobarbital. The effects of intracerebral microinjections of Nembutal into different brain areas, with the purpose of reproducing the behavioural and EEG signs of barbiturate narcosis, have been studied and analyzed. Cats were implanted for polygraphic study of the sleep-wakefulness cycle and bilateral brain canulae were also placed in strategic brain areas. The most striking results was the controlateral turning after unilateral injections of Nembutal in the nigra, suggesting a loss of balance among the actions of the nigro-striatal-cortical pathways on both sides. The sequence of events produced by intravestibular injections of Nembutal suggests that the drug, when injected intraperitoneally, acts also upon the vestibular system. This data stresses the importance of localized intracerebral microinjections of drugs to determine and differentiate their action mechanisms when injected in an intraperitoneal or intravenous way.


[Spectrofluorometric determination of dopamine in small areas of rat brain (author's transl)]. A method for the extraction and quantification of Dopamine from small areas of rat brain has been developed. The extraction with solvents eliminates the column cromatography separations and allows the simultaneous processing of a good number of samples. Sample retrieval is quite high (70%) and very reproducible. The evaluation was made from areas with a minimal weight of 0.225 g. The quantification of Dopamine was obtained using spectrofluorometric techniques, reading the fluorescence of the trihydroxy indol derivate. The linear relation between the instrument readings and the concentration of Dopamine is from 0 to 0.5 microng/ml. The maximal concentration of Dopamine was found in the decorticated cerebral hemispheres (1.485 microng/g), the next highest values in the diencephalon (1.046 microng/), and the minimal concentration in the cerebellum (0.283 microng/g). The concentration of the whole brain was 0.701 microng/g.


Arterial-venous differences across the lungs in plasma triglyceride concentration. Arterial-venous differences in plasma triglyceride across the lungs were determined in healthy human subjects before, during and following infusion of a soybean oil emulsion into the superior vena cava. Samples were acquired from the pulmonary and brachial arteries. A significantly greater mean concentration of triglyceride in venous as opposed to arterial blood was evident following 12 min of infusion (pless than 0.001), with a tendency for the retained lipid to be released during the postinfusion period. It could be calculated that during infusion the lungs retained about 20% of the available triglyceride, or 3 mmol/min.


Drive and performance of ventilatory system during rebreathing. In eight normal subjects, eight patients with asthma, and six patients with chronic obstructive lung disease, the first derivative of occlusion pressure at FRC during rebreathing has been studied. The maximal dP/dt was always lower in patients. Such a behavior may depend on reduced neuronal discharge as well as on reduced effectiveness of the contraction of the respiratory muscles. Though (dP/dt)max. may provide a reliable measure of the sensitivity of the respiratory center only in a homogeneous group, the results of plotting its value against ventilation and end-tidal Pco2 confirm the failure of the thoracomuscular system to convert the output of respiratory centers into increase of pulmonary pressure and ventilation.


Bronchial inhalation challenge by plethysmography in asthmatic children. A new technique for breath-by-breath controlled bronchial inhalation test is described, using the body plethysmographic method. The values of airway resistance (Raw) and of thoracic gas volume at resting expiratory level (TGV) have been compared to the data of total pulmonary flow resistance (R1), measured with the intraesophageal catheter method, and of functional residual capacity (FRC). The dynamic lung compliance (C1 dyn) was calcualted, too; the mechanical parameters of breathing (R1; Raw; C1 dyn) have been investigated on the same breathing cycles before, during and after respiratory challenges in symptom-free asthmatic children. Regarding the breath-to-breath variation of the parameters, a respiratory challenge is usually considered as positive, if the R1 or Raw values increase 100% or more. Out of 39 assays, "positive" challenges were observed in 14 casis regarding R1 values and in 11 cases regarding Raw values. "Doubtful" tests - i.e. +50% less than or equal to R1 or Raw less than 100% - were observed in 5 assays regarding R1 and in 7 cases regarding Raw. A decrease of more than 40% of C1 dyn was observed in 12 out of the 19 'positive' or 'doubtful-positive' challenges; the largest spontaneous breath-to-breath variation being +/- 25%. Such a decrease of C1 dyn is suggested as a sign of peripheral bronchial obstruction. An increase of more than 25% of TGV was observed in 11 out of 19 assays, considered "positive" or "doubtful-positive". A correlation being observed between C1 dyn decrease and TGV increase this latter parameter is suggested to be an additional sign of bronchial obstruction. Beside the practical problem of the interpretation of a respiratory challenge, these results are discussed from the phatophysiological point of view.


[Anatomo clinical aspects of a case of ischaemic necrosis of the spinal cord in a patient with a dissecting aneurysm of the aorta (author's transl)]. Neurological complications of dissecting aneurysm of the aorta are not frequently described in the literature. A case of infarction of the spinal cord secondary to aortic aneurysm is presented. The ischemic zone extended from D5-D6 to L2-L3, showing the typical double-funnel-like configuration. Such localization is explained by the blood circulation in the spinal cord. The rupture of a dissecting aortic aneurysm in the toracic and abdominal tract, by occluding the segmental branches to the spinal cord, causes a decrease in blood flow which is responsible for the neurological manifestations. In the present case ischemia is mainly due to the involvement of the artery of Adamkiewicz, while the relative sparing found at the inferior lumbar level is justified by the existence of vessels which take origin below the aneurysm and are tributary to the cauda equina. The histological findings are in agreement with previous observations of a selective necrosis of the gray matter.


[Clinical and pathological observations on a case of granulomatous encephalitis (probable criptococcal infection) (author's transl)]. A case of granulomatous encephalitis in a 42 year old woman is reported. During the course of her illness, she showed over a short period of time a left hemiparesis, epileptic seizures and severe impairment of consciousness. Bilateral carotic angiography showed no evidence of an expansive lesion, while brain-scan presented an hyperactive area in the right parasagittal region. The cerebrospinal fluid examination demonstrated an increasing hyperproteinosis and death occurred 45 days after the first symptoms appeared. At post mortem in addition to brain edema, a soft, grey-brown discoloured area, of the size of hazel nut was found in the right limbic convolution. Histologically the abnormal tissue revealed a granulomatous structure formed by thick masses of lymphocytes, plasmacells and epithelioid cells among which vessel neoformation and hemorrhages were noted. Remarkable perivascular infiltrations were seen in the white matter, in the gray matter and in the leptomeninges also far away from the granulomatous focus. Many round yeast-like elements were observed free in the tissue as well as inglobated in large histiocytes. Although morphologically they resembled Cryptococcus neoformans organisms, the specific staining techniques for the mycoses were negative. The authors, after reviewing the various histopathological pictures of cryptococcosis in the nervous system and the modern diagnostic procedures for this mycotic infection during life, discuss the range of so-called primitive granulomatous encephalites.


[Lumbar myelography with metrizamid (author's transl)]. A series of lumbar myelographies -- 105 in 98 patients - was carried out with water-soluble Metrizamid (Amipaque R) in a concentration of 170 mg I/ml and showed side-effects in 32% and a quality of contrast similar to that of other water-soluble contrast media used before. The side effects were mild, of short duration and needed no treatment. There were no epileptic fits, tonic or clonic carried out 1 - 12 months later showed no signs of arachnoiditis. Dangers of more serious complications appeared to increase, the higher the level of injection into the spinal canal. A short survey of contrast media used in myelography and earlier experience of experimental or clinical side effects caused by Medtrizamid in myelography follows.


[Suction-radiography in mammography (author's transl)]. The value of the suction apparatus used in over 500 examinations as a simple addition to mammography has been convincing in our hands. Suction of 30 mm Hg, produced with a test-rubber bulb, achieves distension or stretching of the mamma. This leads to changes of position, shape and density of normal and pathologic structures and gives further information, compared with routine mammography. It is often possible to distinguish between spaces filled with fluid (cysts, hematomata) and solid tumours, pseudotumours and genuine growths, and between benign and malignant tumours. One essential indication is the "small" breast of various types (constitutional, post-operative and in men), because often suction will enable us to do a mammography. Suction radiographs are added in every 10th patient to previously taken compression radiographs with, of course, large and coned radiographs, which will yield a safe diagnosis in one half of the cases or confirm suspected findings.


[Differential diagnosis of space-occupying lesions of kidneys (comparison between IVP, angiography and ultra-sound) (author's transl)]. On 77 IVP's it can be shown that correct assessment of the identity of space-occupying lesions of the kidneys is difficult (correct diagnosis in 39% of cystic and 10% of solid conditions). Improvement can be expected from early tomography of IVP's by improved pictures of the parenchyma, mainly with ultra-sound which separates cystic from solid conditions. Correlation of these techniques appears sufficient for cystic processes. Angiography is indicated for solid tumors and doubtful ultra-sound findings.


[Nontuberculous infectious osteoarthritis in adults (excluding spondylodiscitis) in rheumatology]. Analysis of twenty five personal observations of septic osteoarthritis compared with information from the literature led the authors to the following conclusions: 1) Diagnosis of septic osteo-arthritis must be considered when confronted with a picture of acute or subacute arthritis generally inflamed with variable fever, raised sedimentation rates and frequently polymorph neutrophilia, above all especially if there are particular antecedents (local trauma or intra-articular injection, conditions which favor infections: diabetes, alcoholism, impaired immunity, corticosteroid therapy or various therapeutic immuno-suppresives). 2) It may be established on absolute criteria (isolation of the organism at the site of the lesions) or, in the absence of direct bacteriological evidence, by a body of evidence amongst which 4 arguments are of particular value: identification of a pathogenic organism in one or more blood cultures and/or at the site of a closed infection, postive serology and particularly elevation of the antistaphylolysine titres, rapid-onset radiological changes of destruction and/or reconstruction. plus hypercellularity of the fluid greater than 100,000 cells/mm3. 3) Medical treatment sometimes includes local treatment (joint aspiration, local injection of antibiotics) and in all cases immobilisation during the acute phase and systemic antibiotics. The latter will vary according to the organism responsible and its sensitivity. It seems useful to continue this for twelve weeks at the minimum in the normal form, initially making use of the combination of 2 antibiotics and preferably using continuous perfusion and/or intramuscular routes during the first half of treatment. 4) The consistently good results of such medical treatment seem to limit considerably the place of surgery for which the indications have become rare during the acute phase and even more so at later stages.


Kinetics of small lymphocytes in normal and nude mice after splenectomy. Autoradiography and various quantitations on lymphoid tissues have been used to evaluate the kinetics of small lymphocytes in normal (+/nu or +/+) and congenitally athymic nude (nu/nu) NMRI mice 1 month after splenectomy or sham-splenectomy. The results indicate that splenectomy causes depressed thymic activity and diminished numbers of T lymphocytes in peripheral lymphoid tissues. The total number of cells in these tissues as well as the blast cell activity, were within normal limits. Bone marrow lymphocyte numbers and kinetics as well as blood lymphocyte levels in splenectomized and sham-splenectomized normal animals were comparable. Blood lymphocyte numbers were at normal levels in splenectomized nude mice, in spite of reduced numbers of bone marrow and thoracic duct lymphocytes. It is suggested that increased number of newly-formed lymphocytes, found in lymph nodes and blood of splenectomized mice, are released from the lympho-myeloid organs in compensation for the loss of long-lived, thymus-derived cells.


ADP-induced refractory state of platelets in vitro. II. Functional and ultra studies on gel filtered platelets. Gelfiltered platelets (GFP) in calcium free Tyrode solution containing albumin, glucose and adenosine deaminase were preincubated with 1 micronM 14C-ADP or 0.15 M NaCl (control) at 37 degrees C. The breakdown of extracellular 14C-ADP was markedly inhibited in this medium. No aggregation took place without fibrinogen, but the platelets underwent a disc to sphere transformation with development of refactoriness towards ADP. Presence of 2 mM CaCl2 in the incubation medium did not prevent refractoriness as reported earlier with washed rabbit platelets. When the ADP degrading enzyme, apyrase, was added at 30 min of incubation a partial recovery of the aggregability was observed. Electron microscopic studies showed that the partial restoration of the aggregation response, due to ADP degradation by apyrase, was accompanied by a return of discoidal morphology of the platelets. The ultrastructural studies showed further that spherical form with large number of pseudopods is not by itself a necessary or sufficient indication of platelets in a refractory state. However, the results indicated that spherical platelets are more vulnerable to external factors. It was concluded that refractoriness was mainly caused by a direct effect on the platelets by ADP itself, but the studies also suggested that deteriorating, irreversible, intracellular changes may take place when platelets are in spherical shape. An artificial medium, mechanical stress, incubation at 37 degrees C are factors that probably speed up these changes.


Cytogenetic studies in preleukaemia using the G-banding staining technique. 15 patients with preleukaemia were cytogenetically studied during the preleukaemic state by using the G-banding staining technique. It was found that 9 patients had a completely normal karyotype, while the other 6 showed various chromosomal abnormalities, numerical (trisomies in 5 cases) and structural (deletion in 1 case and a marker chromosome in 1 case). The abnormalities concerned group C in all 6 cases, while group A was involved in 3 cases. G-banding technique revealed that trisomy C affected the chromosomes nos 8 (2 cases) and 9 (3 cases); also a deleted chromosome 11 (11q-) was identified in 1 case and a marker chromosome in 1, the origin of which was established as a translocation between chromosomes 3 and 6. The abnormalities of group A concerned chromosome no 3. The abnormalities found in our cases, using the G-banding technique, were similar to those described in acute leukaemia.


Inverse relationship between splenomegaly and stem cell compartment size in mice treated with nitrogen mustard. Following the administration of similar doses of nitrogen mustard (4 mg/kg) to different strains of mice, wide variations in the subsequent degree of splenomegaly were observed, implying strain differences in the role of the spleen in the compensatory erythropoietic response to haematopoietic stress. This investigation was undertaken to determine whether or not these differences were related to the size of the haematopoietic stem cell compartment size in the various strains of mice. Groups of 4 different strains of mice (Swiss Webster, A/J, C57BL/6J and CS1/ASH) were injected i.v. with nitrogen mustard (4 mg/kg body weight) and autopsied at regular intervals up to 20 d post-injection. At autopsy, the wet weight of the spleen was determined. Subsequently, groups of the same 4 strains of mice were exposed to single doses of wholebody gamma-irradiation in the range of 500-900 rads. 9 d after gamma-irradiation the mice were autopsied, their spleens removed, and the number of endogenous spleen colonies determined. The greatest degree of splenomegaly was observed in the C57BL/6J mice. The Swiss Webster mice showed no splenomegaly during the time period studied. There existed a linear inverse relationship between the maximum degree of splenomegaly observed and the dose of wholebody gamma-irradiation required to completely eliminate endogenous spleen colonies. This data is in accord with the hypothesis that there exists an inverse relationship between the extent of splenomegaly observed following haematopoietic stress and the haematopoietic stem cell compartment size.


The haemostatic effect of 51CR-labelled blood platelets. An experimental study in the rabbit. The haemostatic effect of 51Cr-labelled platelets was studied in 5 rabbits made thrombocytopenic (35,000/micronl blood) by whole body ionizing irradiation. Bleeding times were recorded after standardized cuts on the inner side of the rabbit's ear, a method with an acceptable reproducibility. The animals were then each transfused with concentrates of labelled platelets from 2 healthy donor rabbits. This increased the platelet counts to about 2 x 10(5)/micronl blood. Bleeding time values were markably prolonged before transfusion and became normalized when tested 1 and 4 h after transfusion. In 3 control experiments, where unlabelled platelet rich plasma was transfused to thrombocytopenic recipients, a similar shortening of the bleeding time was observed. It is concluded that 51Cr-labelled platelets retain haemostatic ability comparable to non-labelled platelets, when circulating in a recipient animal.


In vitro detection of cell-mediated immunity to antigens associated with Hodgkin's granulomas. Inhibition of the migration of peripheral blood leucocytes with extracts of homologous spleen granulomas was demonstrated in 2 out of 19 patients with Hodgkin's disease prior to any irradiation or cytostatic therapy. These patients were the only ones in the material classified as stage IA. Furthermore, leucocyte migration was inhibited in 2 out of 3 patients tested shortly after high voltage irradiation against mantle-fields. Based on these findings it is concluded that lymphocytes, which are sensitized specifically against components of the granulomas, might occur in Hodgkin patients with restricted involvement of lymph nodes, and probable patients with more widespread disease might regain their specific cell-mediated immunity after radiotherapy.


Streptokinase resistance in medical patients in Oslo. The streptokinase titrated initial dose (TID) was estimated in 31 2 patients consecutively admitted to a medical department in Oslo. 93% had a TID below 250,000 IU, 97% below 425,000 IU and 98.5% below 650,000 IU. No differences were found between the two sexes. The highest values were found in patients 50--60 years old. Otherwise, no differences were found between different age groups from 10 to 90 years of age. Two patients with extremely high TID values were both anamnestically prone to streptococcal infections. It is concluded that our standard initial dose of 250,000 IU of streptokinase is sufcient for the great majority of our patients. Pre-treatment test for TID is recommended only when recent streptococcal infections are suspected.


Effect of preimmunization with native and methylated carrier on class-specific anti-hapten and anti-carrier antibody response. Effects of priming with bovine serum albumin (BSA) and methylated BSA (MBSA) on the primary anti-2,4-dinitrophenyl (DNP) response were studied in the chicken. A new radioimmunoassay of class-specific antibodies (RIACA) was used to quantitate IgM and IgG antibodies against BSA and DNP. The anti-DNP antibody response after priming with BSA was dose-dependent: large doses of BSA suppressed and the smallest dose augmented it. In contrast, no dose dependence was observed between MBSA and the anti-hapten response. All doses of MBSA enhanced the primary anti-DNP antibody response of both immunoglobulin classes. No corresponding differences in anti-BSA antibodies were observed between BSA- and MBSA-primed groups. This suggests that the anticarrier antibodies as such are not the agent suppressing the anti-hapten response when large doses of native carrier are used for priming. A more probable explanation of this phenomenon is a competition between carrier-specific B cells and hapten-specific B cells for common T cells. A less obvious explanation is the generation of more helper cells or less suppressor cells when priming with MBSA than with BSA.


Kinetics of theta-positive and theta-negative lymphocytes in thymus-deprived and normal mice. An autoradiographic study. Life spans and proliferative kinetics of theta-positive (theta +) and theta-negative (theta -) cells were evaluated in normal, neonatally thymectomized (NeoTx) and sham-thymectomized (ShamTx) Balb/c mice. This was done by exposing cell suspensions, incubated with anti-theta antiserum + complement, to a dye exclusion test followed by fixation and autoradiography. Results from normal mice given [3H]thymidine injections 5 weeks before being killed indicated that long-lived theta + and theta - cells constituted about equal percentages of the respective populations in peripheral lymphoid tissues. Long-lived theta + cells constituted a relatively high percentage of theta + cells in the bone marrow, whereas a minority of the theta - lymphocytes were long-lived. Results from NeoTx and ShamTx mice, given intensive injections of [3H]thymidine, showed that the theta - cells of the mesenteric nodes were renewed at comparable rates in both groups of mice, whereas the theta + cells were more rapidly renewed in NeoTx mice than in sham-operated littermates. In the bone marrow, the majority of both theta - and theta + cells were very rapidly renewed, indicating a production of these cells in the bone marrow of Sham Tx mice and also in NeoTx mice, in which the number of bone-marrow theta + cells was significantly higher than in Sham Tx littermates.


Stimulation of human fetal lymphocytes by lipopolysaccharide B in culture. Cultures of Isopaque-Ficoll-isolated lymphocytes from three human sources were compared with respect to the effect of mitogens. The cell sources were maternal blood immediately after delivery, cord blood, and blood obtained by heart puncture of 10-20-week aborted fetuses. Lipopolysaccharide B (LPS) induced incorporation of tritiated thymidine, blastic transformation, and mitotic activity in cord and fetal, but not maternal, cells. The stimulation reached a maximum on days 4-8 of culture. It was stronger than the spontaneous transformation often displayed by fetal cells. If fetal cells spontaneously occurring in the blood of pregnant women were to react in a similar way, it should be possible to selectively stimulate the fetal cells with LPS. Such transformed fetal cells could then be isolated from cultures of maternal blood samples and used for antenatal diagnosis of fetal disease.


[Significance of brain scintigraphy for the course of clarification of neurologic-neurosurgical patients]. The results of a retrospective study on 835 patients in which brain scan was performed during their ambulant and clinical examination are presented. In 18.6% of the cases the scan gave correct results which highly determined the further diagnostic procedure. In 37.5% of the cases the radioisotope brain scan revealed positive results which besides other findings contributed to the decision on the further diagnostic procedure. In 30.5% of the cases the results of the scan were correct but of low diagnostic value, since the further procedure was determined by other diagnostic methods. In 7.4% of the cases the brain scan gave false positive results indicating a focal brain lesion. In these cases the cerebral scintigraphy gave rise to redundant and riskful neuroradiological investigations. In 1.8% of the cases in which retrospectively a threatening brain lesion could be established, the brain scan gave false negative results. The results of this investigation indicate that brain scanning although being a harmless diagnostic method, can induce redundant and riskful further examination. The application of isotope brain scan as diagnostic procedure requires a precise indication even more so, since computerized transverse axial tomography, a harmless screening method of high resolution is now available.


[Modifications of the pupil in acute subdural hematoma]. This study is based on the observation of 81 operated acute subdural haematoma. The various coordinates concerning the clinical aspects and the evolution are analysed in function of the presence or absence of pre-operatory anisoria. The discussion abords the gravity of this sign and its value in localizing the lesion, as well as the clinical distinction between ipsi-lateral and contra-lateral mydriasis. Possible subdivisions in cases of contra-lateral relative mydriasis, as well as their probable pathophysiological mechanisms and respective clinical and prognostic implications are also examined.


[Is the current legal protection of psychiatric patients sufficient? 179th Decision of the Psychiatric Appeals Commission of the Zurich Canton 1963-74]. 179 decisions of the Psychiatric Commission of Appeals of the Canton of Zurich in the years 1963 to 1974. Only every 200th patient admitted to 6 psychiatric clinics in the Canton of Zurich appealed against hospitalization to a commission of appeals, although 20 to 40% of all patients deny the need for hospitalization at least in the beginning. More detailed information of the patients as to the possibilities to appeal did not increase the number of appeals. Males, skilled workers, schizophrenic and manic patients are overrepresented, females, unskilled labourers, depressed patients or such with brain-damage are underrepresented among the appealers. The appeals were made on repeated admissions rather than on first hospital stays and after some weeks rather than in the early days after after admission. The majority of appeals (142) was settled in two ways: 1) the clinic authorities agreed to discharge the patient; 2) the commission of appeals was not competent for the complaint in question. 37 appeals led to personal examination of the appealer. The appeal was given suit in 3 cases only. Cases of illegal "dumping" were not observed. Patients under guardianship tend to appeal at least as frequently as those not under tutorage. If the commission of appeals were given competence also for those under guardianship - as demands the European Convention on Human Right - this would satisfy the needs of this group of patients. However, an initial control of all hospitalizations by court or other officials is uncalled for. It would only impair the personal rights of the patients, delay their discharge and foster seemingly but not truly voluntary admissions.


Ability of spirometry, flow-volume curves and the nitrogen closing volume test to detect smokers. A population study. Vital capacity, FEV1 and various measurements of forced expiratory flows as well as closing volume (CV), closing capacity (CC), the mean slope of the alveolar plateau (phase III), the maximal amplitude of the cardiogenic oscillations (N2-osc), and other variables obtained from the nitrogen CV-test were measured in random samples of 50- (n = 221) and 60-year-old (n - 410) men in Gothenburg. All the variables were significantly different in smokers consuming 15 g or more tobacco daily compared with asymptomatic non-smokers. Reference values were established from measurements in the non-smokers without respiratory symptoms, and the sensitivities of the measured variables to tobacco smoking were assessed. Phase III revealed the highest sensitivity, being abnormal in about 40-60 % of subjects smoking 15 g or more tobacco daily and in about 30-35 % of subjects smoking less. CV and FEV1 were approximately equally sensitive, being abnormal in about 10-30 % of subjects smoking 15 g or more daily and in about 5-20 % in subjects smoking less. Other measurements of maximal expiratory flow rates gave values below minus two standard deviations for the appropriate reference group in less than 15 % of the smokers. However, when we took the skewed distribution of reference values into account we found a two- to sixfold increase of the sensitivities of these variables in the 50-year-old smokers, in which abnormal values were obtained in about 30-40 % of subjects smoking 15 g or more daily and in about 10-15 % in subjects smoking less. Taking all variables obtained from the CV-test in conjunction, one or more abnormal valves were obtained in 60-70 % of the subjects smoking 15 g or more daily. To the extent that sensitivity to smoking reflects sensitivity to abnormalities in small airways, phase III appeared to be the most efficient single measurement for detection of this condition in the present age groups.


Pregnancy in Swedish teenagers. Perinatal problems and social situation. Teenage pregnancies are considered a major problem, socially and medically, in the USA. In the present study, the scope of the problem in a Swedish population was investigated. Primiparas age 17 or less constituted 2% of all 8945 women delivered of babies at the University Hospital in Linköping, 1969-72. The most common obstetrical complications and operations did not occur more often in this age group. The incidence of deliveries before the 36th gestational week was increased 3-fold but no significant differences in intra-uterine growth retardation, asphyxia or perinatal mortality were found. One to two years after the delivery, 70% of the young mothers lived in ordinary nuclear families. Their economic position was worse than in a control group of women 21-29 years old. Barely 10% reached the median income of the control group. This disadvantageous situation was not thought to be caused by their early pregnancies, but rather considered part of the life pattern of an underprivileged group otherwise characterized by a low occupational status of their own fathers, a low educational level and a high frequency of teenage pregnancy among their own mothers.


Diabetics in school. Knowledge and attitudes of school staff in relation to juvenile diabetics. The purpose of this study was to assess whether the schools satisfy the special requirements of diabetic pupils. Both school staff and parents were of the opinion that diabetic pupils need special consideration at school. However, the results reveal an inadequate knowledge of the basic facts about diabetes and its treatment--a situation which could have dangerous consequences for the child and complicate its schooling in a number of ways. The treatment of juvenile diabetes may also become difficult to manage. Most school staff seemed to lack any source of information about diabetes. The contact between parents and school was not always sufficient and information from the hospital was seldom adequate. At present the school cannot be expected to participate in the treatment of diabetes in the way that could be desired. Improved information of school staff on the subject is recommended, as well as early and repeated contacts between hospital and school. These conclusions are drawn from an investigation in which 308 school staff members and the parents of 61 diabetic pupils answered questiomaires.


Electrocardiographic findings in men and women aged 18 to 65. In an epidemiological study--the REBUS study--about 2500 men and women aged 18 to 65 underwent an electrocardiographic (ECG) examination at rest and a subsample of about 1000 persons also performed an ECG exercise test. The ECG recordings were coded according to the modified Minnesota code (2). At rest, 55% of the population had normal ECGs. In the subsample the figure was 65%, indicating a certain selection. During and/or after the exercise test 80% of the men and 70% of the women had no major ST- and T-wave changes, arrhythmias or ectopic beats. In both men and women the percentage of abnormal changes in the exercise ECG rose with age, for the men from 45 years, and for the women from the age of 35. ST depressions were most common abnormal changes recorded. At rest, 20% of the women and 9% of the men had ST depressions. The corresponding figures (major and minor changes) during and/or after the exercise  test were 78% and 60% for the women and the men respectively. Out of 184 major ST depressions recorded during the exercise test (codes 4.1--4.4) 14 (7%) were not present immediately after the test. During and/or after the exercise test, 8% of the men and 20% of the women, having no ST changes at rest, had ST changes of the major type. Those subjects who had arrhythmias or ectopic beats at rest, had in general no such changes during and/or after the exercise test.


Childhood accidents. Three epidemiological studies on the etiology. Three studies on childhood accidents are presented. The aim was to study the importance of different factors regarding the accidents in question. The following factors have then been taken into consideration: the enviromental hazard, the accident proneness, the supervision and the education. Methodologically the investigations were carried out with an epidemiological technique. One is of a descriptive nature and the other two more analytically oriented. The studies are based on two different 1-year-materials consisting of accidents among children recorded in the emergency departments of Ostersund Hospital and the University Hospital in Uppsala. The results indicate that risk factors in the children's physical milieu played an important role in the occurrence of the accidents: clearly identifiable risk factors in the environment could be connected with 52% of the accidents, whereas some deficiency in supervision was noted in 20%. The investigators could identify a number of specific risk factors. Attempts were made to examine how frequency and type of childhood accidents vary with the population structure and social structure in well-defined housing areas, but the results were hard to evaluate because of methodological problems. The results are presented against the background of a detailed discussion on central methodological problems in epidemiological accident research. It is pointed out in particular that epidemiological methods have clear limitations in attempts at studying the low-frequency events that each individual type of accident in fact comprises. It is of great importance that in future research, side by side with the traditional epidemiological methods, other techniques are tested with the aim of obtaining maximal usable information from a detailed study of individual accidents and their backgrounds.


[Hepatitis B: new aspects, practical implications. Virology and epidemiology]. Although neither A nor B hepatitis virus (HAV, HBV) has been grown in cell or organ cultures, both agents have been identified and characterized. The subsequent ability to diagnose hepatitis A and B has led to the recognition of a third form of viral hepatitis, "non A--non B hepatitis". It has been possible to eliminate HBV from blood used for transfusion and from blood products, and the combined results of hepatitis research have led to a better understanding of the epidemiology and pathogenesis of viral hepatitis. The most important development, though, has been production of a vaccine with the prospect of controlling at least hepatitis B in the near future by active immunization. However, immunization experiments in man should proceed with the utmost caution and one must not underestimate the difficulties which still have to be overcome before vaccination against hepatitis B becomes routine.