Ineffective ventilation during exercise in patients with chronic congestive heart failure. The pathophysiologic mechanisms causing exertional breathlessness in patients with chronic congestive heart failure (CHF) are not fully understood. Therefore, we have studied whether the ventilation in such patients is ineffective during exercise. Thirteen patients with treated chronic CHF (New York Heart Association class II-IV) and eight healthy controls underwent a maximal bicycle ergometer test with continuous analysis of expired air and frequent arterial blood sampling for gas and lactate analysis. All subjects were non-smokers and none had any signs of a pulmonary disease. Peak O2 consumption of the patients was 14.9 +/- 5.3 ml min-1 kg-1 and that of controls 33.6 +/- 7.5 ml min-1 kg-1. In patients with CHF the ratio of pulmonary dead space to tidal volume was significantly elevated at peak exercise compared with that of the controls (0.36 +/- 0.08 vs. 0.20 +/- 0.07, P less than 0.05). The ventilatory equivalent for CO2 (VE:VCO2) was also significantly higher in patients than in controls during exercise (P less than 0.05). Furthermore, both the ventilatory equivalents for CO2 and O2 (VE:VO2) had a significant inverse correlation with peak O2 consumption (P less than 0.001 for VE:VCO2 and P less than 0.05 for VE:VO2), O2 consumption at anaerobic threshold (P less than 0.01) and O2-pulse (P less than 0.001) among the patients. During exercise the arterial PO2 and PCO2 remained normal in patients and controls. These data indicate that in patients with chronic CHF wasted ventilation is pathologically increased during exercise, and this is related to the severity of the disease. Chronic CHF is not associated with decreased ventilatory reserve, hypoxaemia or alveolar hyperventilation. The ineffectiveness of ventilation is probably an important cause of exertional breathlessness in patients with CHF.


Effects of sulphur hexafluoride on psychomotor performance. The narcotic influence of sulphur hexafluoride on mental and psychomotor performance has been studied in 9 subjects at normal atmospheric pressure. Control experiments were performed with air and with nitrous oxide. Psychomotor, perceptual and cognitive abilities were assessed using a computerized test battery. Subjects were exposed to air and six different normoxic gas mixtures: 13, 26, and 39% N2O, and 39, 59, and 79% SF6. Significant performance impairments were found with 13% N2O and gradual further impairment with 26, and 39% N2O. During exposure to 39, 59, and 79% SF6 over-all performance was impaired by 5, 10, and 18%, respectively. Impairment was significant with 59 and 79% SF6. The results indicate that the relative narcotic potency of SF6: N2O is about 1:4 in humans. It is concluded that a normoxic SF6-O2 mixture can be inhaled for lung function studies without any harmful effects and that the short-lasting narcotic effect, although detectable with a test battery, would not impair the ability of the subject to perform simple breathing procedures.


The creatine kinase system in the serum of runners following a doubling of training mileage. This study examined the response of the serum creatine kinase (CK) isoenzyme/isoform system following the stress of successive weeks of increased training. Four highly-trained male long-distance runners doubled their training mileage [45.0 (SD 3.5) to 81.2 (4.7) miles] for 3 weeks. Venous blood samples were obtained prior to the start of the increased training period and at the end of each week, days 7, 14, and 21, 12 h after a training run. All runners experienced a significant increase in training perception difficulty, which correlated with the significant increase in training mileage. While total CK activities did not become significantly elevated until day 14, the tissue isoform CK-MM3, as well as the ratio of CK-MM3 to MM1 (final CK-MM degradation isoform) became significantly elevated at day 7 and remained elevated throughout day 21. These findings demonstrate that an increase in training mileage caused a significant and continuous release of tissue CK activity from skeletal muscle into the circulation.


Redistribution of skin blood flow during leg dependency in peripheral arterial occlusive disease. A disturbed autoregulation of cutaneous blood flow in legs with peripheral arterial occlusive disease (PAOD) has previously been demonstrated for circumscribed skin areas. In the present study, posturally-induced changes of skin perfusion distribution along ischaemic limbs were investigated topographically in 35 PAOD patients by means of fluorescein perfusography. Among the 68 legs studied, 7 had patent arteries and 61 could be assigned to FONTAINE stages I to IV. Limbs with peripheral skin lesions (stage IV) were further differentiated according to either healing (stage IV+) or non-healing (stage IV-) on conservative treatment. Sitting-up always led to prolonged calf as well as foot fluorescein appearance times (AT) except for legs in stage III or IV- disease. In the latter two groups, decreased sitting as compared to supine AT foot-to-calf ratios indicated a relative shift of dye delivery from proximal towards distal skin regions during posture. In contrast, this measure of blood flow redistribution did not change in the other groups. The redirection of fluorescein influx was significantly correlated with the systolic arterial pressure ankle-to-arm ratios. In conclusion, besides small perfusion pressure increases or passive microvessel distension, a shift of the peripheral resistance ratios may contribute to the improved blood supply of ischaemic skin regions during leg dependency. An arteriolar vasoparalysis does not regularly exist in limbs with skin lesions not primarily originating from ischaemia (stage IV+).


Sham-feeding decreases cardiac output in normal subjects. The cardiovascular effect of sham-feeding was measured in seven healthy non-obese human subjects by the Fick principle using the carbon dioxide rebreathing method. The subjects were resting in the sitting position and were exposed to the sight and smell but not the taste of a breakfast meal. Cardiac output decreased significantly from a mean value of 4.0 1 min-1 to 3.5 1 min-1 during sham-feeding (Friedman, P = 0.004). The cardiac output returned to basal values in all seven subjects when the sensory stimulus was removed. The decrease in cardiac output was due to a decreased stroke volume, whereas heart rate and blood pressure did not change. The mechanism of the decrease in cardiac output during sham-feeding remains to be established.


Longitudinal systolic shortening of the left ventricle: an echocardiographic study in subjects with and without preserved global function. The atrioventricular (AV) plane displacement was studied by echocardiography in 79 subjects (45 healthy subjects and 34 patients with acute myocardial infarction or chronic congestive heart failure). From apical 4- and 2-chamber views the displacement of the AV plane towards the apex in systole was recorded at 4 sites in the left ventricle (LV) corresponding to the septal, anterior, lateral, and posterior walls and the mean value from the above 4 sites (AV-mean) was calculated. In addition, in healthy subjects, the AV plane displacement at right ventricular free wall was also recorded. The AV-mean correlated well with the echocardiographic ejection fraction determined by biplane area-length method (r = 0.96, P less than 0.001). The correlation was also high when the percentage of the left ventricular shortening along the long axis was used (r = 0.97, P less than 0.001). The correlation between ejection fraction and AV-mean was also good when separate analysis was made for the subjects with preserved ejection fraction (r = 0.86, P less than 0.001) and decreased ejection fraction (r = 0.82, P less than 0.001). The right ventricle had a significantly higher AV plane displacement (P less than 0.001) than the LV. The study also includes determination of the muscular excursions of the septal and posterior walls along the short axis of the left ventricle from the parasternal long axis view. The AV plane displacement of the respective walls was relatively greater (P less than 0.001) compared to concentric contractions. The septal and posterior wall excursions along the short axis correlated poorly with the AV plane displacement of the respective walls (r = 0.55, P less than 0.01 and r = 42, P less than 0.05).


Subtraction of extra-renal background in 99mTc-DTPA renography: comparison of various regions of interest. Quantitative evaluation of renal function in 99mTc-DTPA isotope renography is hampered by high background activity. This study compares various background regions of interest (ROIs) to obtain the most accurate estimate of the extra-renal background, taking both total counts (integral value) and change by time (slope) into account. Gamma camera renography was performed in 21 patients with a single kidney. Time-activity histograms obtained from 8 different background ROIs were compared in the time interval corresponding to the uptake phase of the renogram with the histogram obtained from a ROI over the empty kidney area. A significant difference could be demonstrated between the slope values of the histograms of the right and left empty kidney ROIs, but not for the integral values. Backgrounds taken over the heart, liver, between the kidneys, and under the kidneys had significantly different characteristics than the one in the empty kidney area. Only background ROIs surrounding each kidney area gave integral and slope values with close resemblance to those recorded over the empty kidney area. The results emphasize the necessity for an individual background ROI for each kidney and the need to separate extra- and intra-renal background activities before subtraction.


Testing arterial baroreflex function in acutely unwell patients. Cardiovascular function is deranged in acute illnesses but specific details of this pathophysiological phenomenon are poorly understood. With advances in intensive care it is now necessary to define these changes. Existing tests of cardiovascular reflex function are ill-suited to the study of acutely unwell patients. The arterial baroreflex is the principal cardiovascular homeostatic reflex. We have modified the neck suction test of baroreflex function such that it can be performed in 30 min using portable equipment. The protocol was validated on control subjects. Testing of injured patients showed that this test and protocol could be used sequentially, beginning within 2 h of injury, to demonstrate acute changes in baroreflex function and to follow these changes through the disease process. Patient tolerance of the test was excellent. Subsequently, further modification developed an even shorter protocol whereby similar information could be obtained within 15 min. The cardiac response to deep respiration can be measured with minimal patient upset or compliance and is ideal for repetitive testing in critically ill patients. This is not a specific test of baroreflex function but responses to it show interesting parallels with changes in baroreflex function which merit further study.


Does diffuse coronary atherosclerosis affect the relation between coronary stenoses and uptake of thallium-201 after exercise? It has been proposed that diffuse coronary atherosclerosis influences the myocardial perfusion. We performed a study of 94 young men with previous myocardial infarction in order to find out whether the presence and extent of diffuse coronary atherosclerosis affected the relation between maximal stenosis and myocardial perfusion in areas remote from the infarction. The patients were examined by planar-imaging thallium-201 scintigraphy, following exercise, and coronary angiography within 6 months after myocardial infarction. The maximal distinct stenosis and diffuse coronary atherosclerosis, comprising both plaque size and extent, were semiquantitatively assessed. The correlation coefficients between maximal stenosis within the LAD, RCA, and LCX vascular territories and the corresponding initial uptake of thallium were 0.52 (P = 0.0001), 0.30 (P = 0.04), and 0.46 (P = 0.02), respectively. No change of the correlations was found, except for a slight increase of the r-value from 0.30 to 0.37 in regions corresponding to RCA, after controlling for the diffuse atherosclerosis score in a multiple stepwise regression analysis. These findings indicate no impact of diffuse coronary atherosclerosis on regional myocardial perfusion in areas remote from the infarction.


Is the high lactate release during arm exercise due to a low training status? To determine whether arm lactate release during arm exercise is related to the training status of the arms, seven arm-trained athletes were studied during 30 min of continuous arm exercise (AE) or leg exercise (LE) of increasing intensities corresponding to 30%, 50%, and 80% of peak VO2 during AE and LE respectively. Blood vessels were catheterized for determination of regional blood flows and substrate exchanges. The respiratory exchange ratio was higher during AE than LE (P less than 0.01). The arteriovenous oxygen difference, [(A-V)O2], for the leg during LE was 11-19% higher than the (A-V)O2 for the arm during AE (P less than 0.01). At the highest intensity the (A-V)O2 was 170 +/- 6 ml O2l-1 during LE, vs. 143 +/- 9 during AE (P less than 0.01). Arm blood flow in relation to limb volume was 56-95% higher during AE (P less than 0.05). Arterial lactate concentrations were 27-60% higher during AE (P less than 0.01) and lactate release from the exercising limb was 2-4 times higher (P less than 0.05) during AE compared to LE. Adrenaline and noradrenaline rose 6- and 21-fold, respectively, during AE and did not differ from corresponding LE values. During AE the (A-V)O2 difference across the arm, arterial lactate concentration, and arm lactate release were of the same magnitude in arm-trained and relatively less arm-trained subjects. Lactate release in relation to O2 uptake by the exercising limb was 7-37% lower during AE in arm-trained subjects compared to AE in arm-untrained subjects but was 3-6 times higher than the corresponding relation during LE (P less than 0.01). We conclude that AE is associated with a larger lactate release compared to LE. This difference is only to a minor extent influenced by intense training of the arms. The high arm vs. leg lactate release appears to be associated with differences in regional circulatory adaptation by the exercising limb.


Non-invasive assessment of vessel-wall changes in hypertensives and normotensive controls. The aim of this study was to evaluate the feasibility of non-invasive assessment of vessel wall changes in early, untreated hypertension. Measurement of intimal+medial (I-M) thickness in the common carotid artery (CCA) using B-mode ultrasound imaging showed no differences between 12 patients with untreated, newly diagnosed hypertension and 9 age-matched controls (0.63 mm vs 0.63 mm just proximal to the carotid bulb). Echocardiography showed that the hypertensive group had thicker left ventricular walls (LVW) than the normotensive group. Correlation analyses disclosed that I-M thickness was significantly associated with age (r = 0.63; P less than 0.05) for the whole material but not with blood pressure levels, serum lipids, or LVW thickness. These results imply that the arterial I-M layers of the CCA are less responsive to pressure overload than the left ventricle. The feasibility of using I-M thickness as an early marker of structural vessel wall changes in hypertensive patients must await results from large scale prospective studies. In view of the present results, age homogenous materials should be selected for such studies.


[Ketoprofen efficacy and tolerance in simple painful shoulder]. Thirty patients presenting with painful shoulder syndrome were treated with i.m. ketoprofen 100 mg b.d. for 8 days to assess the efficacy and tolerance of the above treatment regime. The patients' condition was monitored by clinical, instrumental and laboratory examinations. Ketoprofen was found to be significantly effective in all cases of non calcific rotator cuff tendinitis while no improvement was noted in calcific tendinitis. The above data confirm the efficacy and tolerance of ketoprofen in the treatment of painful shoulder syndrome as an alternative to local steroid therapy.


[Potassium canrenoate and the combination of potassium canrenoate-butizide in the therapy of light to moderate arterial hypertension]. The aim of the study was to evaluate the antihypertensive effect of K-canrenoate, alone or in combination with butizide, in mild to moderate essential hypertensives. Fifteen patients (supine diastolic blood pressure ranging from 95 to 114 mmHg) received K-canrenoate 50mg/die (step 1). In patients with supine diastolic blood pressure greater than 90 mmHg therapeutic regimen was modified at two-week intervals according to the following design: K-canrenoate 100 mg/die (step 2), K-canrenoate 50 mg + butizide 5 mg/die (step 3), K-canrenoate 100 mg + butizide 10 mg/die (step 4). Blood pressure control was achieved in 2 patients treated with K-canrenoate alone (step 2) and in 8 patients on a combined regimen (step 3), and it was maintained throughout the whole trial period (12 weeks); step 4 did not achieve the goal of therapy in the remaining 5 subjects. A statistically significant increase in triglyceridemia (123.2 +/- 42.1 vs 158.3 +/- 62 mg/dl) and uricemia (4.6 +/- 0.9 vs 5 +/- 0.9 mg/dl) was observed at the end of the follow-up period. Serum potassium levels remained stable in all patients. Therefore, K-canrenoate in combination with butizide is an effective and well tolerated drug in the treatment of mild to moderate essential hypertension.


[The tasks and aims of prevention].

[The tasks and aims of prevention]. The purpose of the above note was to offer an overall view of preventive medicine the fundamental object of which is the safeguard of the state of health before the manifestation of disease. Prevention is therefore closely related to epidemiology which looks for causes and identifies risk factors. These tasks must be performed with constant effort and tenacity on the one hand by the state via the necessary public health organizations (personnel, facilities, programming), and on the other by the community as well as by the individual citizen who, being the user and driving force, must take advantage of the benefits and at the same time work for better results through changes in his own behavior and lifestyle.


[Meteoropathy: a syndrome continuously on the increase]. The authors describe the different kinds of meteoropathies, pointing out how these disorders are becoming ever more frequent in countries belonging to the consumer and welfare society due to the progressive lowering of body resistance and immunologic responses. These "unfavourable meteosyndromes", as meteoropathies should be called, develop when wave disturbances arrive, and are more manifest and persistent in subjects with neurologic disturbances, i.e. in the presence of anxiety, stress, hypertension, coronary artery disease, arthropathy, hyperthyroidism, etc. The different moments in which meteoropathies are more frequent and the possible therapies are also discussed.


[The clinical evaluation of the hypocholesterolemic effects of an inhibitor of cholesterol synthesis: mevalonic acid]. Twenty eight patients with heterozygous familial hypercholesterolemia were treated with mevalonic acid (an inhibitor of cholesterol synthesis) for 45 days. Patients received a daily dose of 750 to 1500 mg mevalonic acid depending on plasma cholesterol levels. Results showed a significant reduction in cholesterol values whereas no significant difference was observed in HDL cholesterol and triglyceride levels.


[Yersiniosis].

[Yersiniosis]. The authors' objective in the above review was to stress the epidemiological importance of Yersinia enterocolitica infections. They therefore detail the clinical and epidemiologic features of acute or primary as well as of secondary forms and complications of Yersinia enterocolitica infections. Further, they dwell on the management of these infections and illustrate the properties, toxic effects and other side effects of the antibiotics commonly used in therapy and for the prevention of complications. Finally, they take stock of the regulations to be applied for the prevention of this complex and multifaceted infection.


Role of keratinocytes in allergic contact dermatitis. Although once thought to play a purely structural role, there is increasing evidence that keratinocytes are actively involved in epidermal immune responses, including allergic contact dermatitis (ACD). In vitro studies demonstrate that both urushiol and nickel sulphate induce cytokine production in cultured keratinocytes including molecules responsible for endothelial cell activation and lymphocyte chemotaxis and adhesion. In vivo, these same molecules are expressed in experimentally induced patch test reactions to a variety of allergens. Furthermore, such expression precedes the onset of the inflammatory phase of ACD. Taken together, these studies suggest a role complementary to that of Langerhans cells for keratinocytes in the initiation and propagation of ACD.


A comparative study of formaldehyde detection using chromotropic acid, acetylacetone and HPLC in cosmetics and household cleaning products. Chromotropic acid and acetylacetone methods for qualitative determination of formaldehyde were tested in parallel on 48 commercial samples, with high-performance liquid chromotography (HPLC) implemented for quantitative measure. In addition, interference with the detection of formaldehyde was investigated by analyzing 12 other aldehydes and ketones, 7 essential oils and 3 polysorbates. Throughout this comparative study, the disadvantages of the chromotropic acid method, of which 2 variants were used, were delineated and we found that the acetylacetone test proved to be a more efficient screening method for formaldehyde detection in a clinical laboratory.


Corticosteroid or steroid allergy?

Corticosteroid or steroid allergy? The aim of this study was to elucidate the role of the C11-OH substituent of the corticosteroid molecule in relation to contact allergy to corticosteroids. This group, which is essential for glucocorticoid activity, is not present in other steroid molecules, such as deoxycortisol, progestagens, testosterone, and estrogen. Skin tests with these substances in hydrocortisone-allergic patients revealed a division between patients for whom the C11-OH group was essential to induce the allergic reaction and patients for whom this group did not seem to be essential. Some of the patients of the latter group also reacted to 17-alpha-OH-progesterone. This may indicate cross-sensitivity between hydrocortisone and 17-alpha-OH-progesterone, which might play an etiological role in autoimmune progesterone dermatitis.


Permeation and destructive effects of disinfectants on protective gloves. In working situations where there is a possibility of acquiring blood-borne infections, the use of disinfectants is important. It is also important to use protective gloves, both to protect the skin against disinfectants and to protect against infections. Changes in the structure of the glove material may, however, interfere with the protective capability of the gloves. The influence of 4 disinfectants on the material structure and protective effect of 6 different brands of protective gloves was studied. The proposed International Organization for Standardization (ISO) standard method for determining the liquid chemical resistance of air-impermeable materials was used for permeation testing. Pieces of latex and vinyl glove were also exposed to isopropanol and ethanol for 10, 30 and 60 min and then viewed in a scanning electron microscope. Isopropanol permeated through latex and vinyl gloves in less than 10 min. The polyethylene (PE) gloves were of quite variable quality, and the breakthrough time ranged from 4 to greater than 240 min. The latex and vinyl gloves were also permeated by ethanol, but at a much lower rate. The disinfectants Blifacid, based on p-chloro-m-cresol, and Cidex, based on glutaraldehyde, did not permeate any of the gloves tested within 60 min. Isopropanol had a destructive effect on the material, which became opaque, stiff and brittle. This change in structure was verified with the scanning electron microscope. The tested gloves of latex, vinyl and PE, gave acceptable protection from contact with Blifacid and Cidex for at least 60 min. The same gloves do not give any total protection from contact with isopropanol and ethanol.


Cutaneous reactivity to allergens at 24-h increases from the antecubital fossa to the wrist: an echographic evaluation by means of a new image analysis system. To establish the existence of regional variations in response to allergens, we performed patch tests with nickel sulfate 5% pet. at 4 different sites on the volar forearm skin in 17 nickel-sensitive women, aged from 18 to 45 years. After a 24-h application, patch tests were removed and evaluated both by clinical scoring and by means of a 20 MHz ultrasound B scanner. Recorded echographic images referring to uninvolved skin and to positive test sites were evaluated by a traditional image analysis method for the determination of skin thickness. Furthermore, they were processed by software which ascribes arbitrary values to the amplitude levels of the echoes and enables quantification of the pixels, (the smallest elements in a visual display with controllable colour and brightness) forming objects reflecting within a selected amplitude band. Thus, we demonstrated an increase in thickness of uninvolved skin at distal sites and a greater reactivity at 24 h to patch tests in skin areas near to the wrist crease, as evidenced by a greater increase in pixel and in thickness values at distal sites. From our data, we have a clear indication for the use of rotating patterns or symmetrical sites in quantitative and comparative investigations concerning the evaluation of contact allergy on volar forearm skin.


Contact and photocontact allergy to oxybenzone. The purpose of this study was to determine the frequency of contact allergy and photocontact allergy to sunscreens. A consecutive series of 54 patients with suspected clinical photosensitivity were assessed. All had the same standardized photobiological investigation from January 1989 to December 1990, including patch tests and photopatch tests with 6 sunscreen agents. Oxybenzone was found to cause 4 cases of allergic contact dermatitis (with photoaggravation in 2), and 3 cases of photocontact dermatitis (13% of patients). This is probably due to the wide distribution of oxybenzone in sunscreens and other cosmetics, 2 patients with polymorphic light eruption and persistent light reactivity, respectively, were regular sunscreen users. Photobiological investigation is necessary to ensure accurate diagnosis, since sunscreen contact or photocontact allergy may simulate other photosensitivity eruptions.


Results of routine patch testing with corticosteroid series in 2073 patients. The patch test results of 61 patients allergic to at least 1 corticosteroid molecule are presented. These contact allergies were detected by testing with several corticosteroids included in our standard patch test series between February 1988 and December 1990. Whenever possible, further investigations were conducted by means of a more complete corticosteroid series. We found corticosteroids to be the 7th most frequent allergen, positive results being obtained in 2.9% of all patients referred to our contact dermatitis unit. In this series, budesonide was the most common allergen and often gave simultaneous reactions with other corticosteroids.


In vitro stimulation of retinal pigment epithelium proliferation by taurine. Taurine is an amino acid that is essential for retinal integrity and function. Although it has been suggested that the ratio of melatonin to taurine in the interphotoreceptor matrix may regulate the phagocytosis of outer segments by retinal pigment epithelial (RPE) cells, the effect of taurine on the RPE has not been studied. Using cultured RPE cells, we found that in vitro taurine specifically stimulated proliferation of human and rabbit RPE, but had only minimal effect on cultured scleral fibroblasts. The RPE proliferation was due to more cells entering into S-phase and thus an increase in DNA synthesis, was not dependent upon cell density, and was most pronounced in the presence of a low concentration of fetal bovine serum.


Morphology and movement of corneal surface cells in humans. We examined the morphology of the corneal surface epithelial cells in 13 eyes of 13 subjects using specular microscopy. We determined cell area, perimeter, and shape comparing the central cornea with the inferior and superior periphery. We found surface epithelial cells are significantly smaller in the central cornea. The cells measured 560 +/- 93 square microns in the central cornea, 850 +/- 135 square microns in the superior cornea and 777 +/- 176 square microns in the inferior cornea (p less than .005). Newly emerged surface cells are smaller and are thought to enlarge with time. We postulate that lid shearing forces are greater in the central cornea and contribute to epithelial cell exfoliation. We further postulate that preferential shearing of central corneal surface cells is an important factor driving the centripetal movement of corneal epithelial cells.


A comparison of intraocular pressure elevating activity of loteprednol etabonate and dexamethasone in rabbits. A "Soft" corticosteroid, loteprednol etabonate I, designed based on the "inactive metabolite" concept can be used as a safe ophthalmic anti-inflammatory drug. By design, the metabolism of I follows a predicted biotransformation pathway, thus unwanted systemic side effects are avoided. Local side effects are also reduced. Accordingly, in a cross-over study I did not elevate the intraocular pressure (IOP) in rabbits, as opposed to dexamethasone.


Microendoscopic observations of the hemodynamics in the rabbit ciliary processes. The in vivo hemodynamics of the ciliary process vasculature in the albino rabbit were studied with an improved technique of intraocular microendoscopy. The spreading pattern and velocity of the dye front has been observed in defined vessel segments following intracarotid injection of Evans Blue. In the anterior portion of the ciliary processes a "thoroughfare channel" (bypass) was found leading from the arteriolar tree directly into the marginal venule bypassing the capillary network of the ciliary processes. This bypass is characterized by a higher blood flow velocity (1.5-3mm/sec) than was found for the capillary network (0.8-1mm/sec). A stoppage of blood flow was observed in the capillary network at 45-50mmHg after step-wise elevation of intraocular pressure (IOP): blood flow was not stopped in the thoroughfare channel until IOP values of 55-60mmHg were reached. Intraarterial administration of vasoconstrictive agents could lead to a complete stoppage of blood flow in the capillary net whereas the marginal route often remained patent.


Stimulation of phospholipase D by phorbol esters and ionomycin in bovine corneal epithelial cells. This study was performed to determine the effects of phorbol esters and ionomycin on phospholipase D (PLD) activity in bovine corneal epithelial cells (BCEC). The cells were prelabeled with [3H]myristic acid and incubated for specific time intervals with various test agents in the presence and absence of ethanol. The PLD activity was assayed by monitoring the formation of labeled phosphatidylethanol ([3H]PEt) in [3H]myristate labeled cells. In the absence of ethanol, 1 microM phorbol 12-myristate 13-acetate (PMA) increased the formation of labeled phosphatidic acid ([3H]PA) with no significant effect on the radioactivity of [3H]PEt. In the presence of 85 mM ethanol, whereas there was only a small further increase in [3H]PA, the formation of [3H]PEt was increased by several-fold, demonstrating activation of PLD by the phorbol ester. The effects of PMA were time- and dose-dependent, and were mimicked by phorbol 12,13-dibutyrate. The inactive phorbol derivatives, 4-alpha-phorbol, 4-alpha-phorbol 12,13-didecanoate, 4-alpha-phorbol 12-myristate 13-acetate and 4-alpha-phorbol 12,13-dibutyrate, were without effect. Short-time (30 min) incubation of BCEC with staurosporine or H-7, or prolonged (20 hours) incubation with PMA rendered the cells less sensitive to subsequent treatment with PMA, suggesting that activation of PLD in the cells is mediated by protein kinase C (PKC). Addition of 20 microM ionomycin in the presence of ethanol also increased the formation of [3H]PA and [3H]PEt in a time- and dose-dependent manner. Co-presence of ionomycin and PMA at submaximal concentrations in the incubation medium resulted in increased formation of [3H]PA and [3H]PEt which was less than their individual effects combined, indicating a lack of synergism between Ca2+ and PMA in activating PLD. Incubation of BCEC with staurosporine resulted in significant inhibition of ionomycin-induced production of [3H]PEt, suggesting that in addition to direct activation of PLD by Ca2+, the enzyme is probably stimulated by sequential activation of PLC (producing diacylglycerol) and PKC following the ionomycin addition. We conclude that BCEC possess PLD which is stimulated by PKC as well as elevated intracellular Ca2+.


The effects of 5-fluorouracil and mitomycin C on the corneal endothelium. 5-Fluorouracil (5-FU) and Mitomycin C (MMC) are used as adjunct chemotherapy during glaucoma filtering surgery to suppress conjunctival fibroblast proliferation. Since part of these agents may gain access to the anterior chamber and cause cytotoxicity to the corneal endothelium we set up an in vitro system to establish a dose-response effect. Cytotoxicity of MMC and 5-FU was quantified using Mosmann's colorimetric assay in a bovine endothelial cell culture system. In this assay the respiratory activity of the cells is used as a marker for cell viability. After incubation for 5 minutes the 3.0 mg/ml concentration of MMC showed endothelial cytotoxicity, whereas no endothelial toxicity of 5-FU was noted in concentrations up to 50 mg/ml. After incubation for 30 minutes endothelial cytotoxicity was demonstrated for 50 mg/ml of 5-FU and 1 mg/ml of MMC. After an exposure-time of 60 minutes the toxicity level remained 50 mg/ml for 5-FU but decreased to 0.5 mg/ml for MMC. We conclude that with respect to the clinically used concentrations and methods of application of 5-FU and MMC in vivo endothelial toxicity is not to be expected. However, in cases of accidental access of MMC to the anterior eye chamber and following a reduction of aqueous turnover rate the safety of MMC is unwarranted.


Cytokines and uveitis, a review.

Cytokines and uveitis, a review. Although the exact pathogenic mechanisms underlying uveitis are unknown, cytokines appear to be involved in this inflammatory disorder. This review describes the studies in which the uveitogenic properties of several cytokines, including tumor necrosis factor (TNF), interleukin 1 (IL-1), IL-6, IL-8 and interferon gamma (IFN-gamma), were investigated and the reports on intraocular expression of cytokines, such as TNF, IL-2, IL-6 and IFN-gamma, during uveitis. The exact contribution of these mediators to uveitis remains to be determined. This may provide new clues in the treatment of uveitis.


Functional morphology of the crop of Drosophila auraria. The crop epithelium of Drosophila auraria consists of a single layer of thin epithelial cells whose apex is covered with cuticle. The epithelial cells contain small amounts of rough endoplasmic reticulum, Golgi complexes and secretory granules. The digestive activities of the crop cavity are probably due to enzymes provided by the salivary glands and midgut cells. The epithelium displays continuous folds, which are more frequent in the upper region. The crop of Drosophila is capable of expanding and shrinking, as indicated by starvation and refeeding experiments. Starvation resulted in extensive epithelial folds and a concomitant decrease in the crop volume, while the refed insects displayed an unfolded crop epithelium and a voluminous crop.


Ultrastructure of the hyphae and conidia of Arthrinium aureum. Electron microscopic observations of structures in Arthrinium aureum, which have not previously been described, are presented and discussed. Considerable attention is given to cytoplasmic inclusions, especially nuclei, mitochondria and Woronin bodies.


The mosquitocidal activity of conidia of Tolypocladium tundrense and Tolypocladium terricola. Tolypocladium tundrense and T. terricola UV-irradiated conidia exhibited acute toxicity to Aedes aegypti larvae in concentrations of 5 x 10(5) and 5 x 10(6) ml-1, respectively. Substances deposited on the surface of conidia following sporulation appear to be responsible for rapid intoxication and killing of mosquito larvae. Treatment of larvae with dried methanolic extract of the spores also induced a high level of mortality accompanied by the same histological changes, including vacuolization and subsequent destruction of mitochondria of the midgut cells. Cyclosporin A was identified as a predominant metabolite forming the spore surface layer.


Puffing activity of the salivary gland chromosomes of Drosophila bicornuta. The puffing activity of the salivary gland chromosomes during late third instar and white prepupal development, as well as after in vitro culture with or without ecdysterone of Drosophila bicornuta, was investigated. D. bicornuta belongs to the montium subgroup of the melanogaster species group, and these results are discussed and compared with those of other species of the montium subgroup.


Ultrastructural changes in Culex pipiens larvae treated with tolypin, the insecticidal metabolite of Tolypocladium inflatum gams (Deuteromycetes). Tolypin, the insecticidal metabolite of the entomopathogenic fungus of the genus Tolypocladium, causes knock-down effect followed by high mortality in treated Culex pipiens molestus larvae. Histopathological changes accompanying the knock-down symptoms were similar in all tissues. Mitochondria, the main target in the cells, were destroyed and consecutively changed into vacuoles with the remains of cristae and lysed internal structures. Despite destruction of the internal content of individual organelles, the membranes of the cell surfaces, the endoplasmic reticulum, the nuclei, and the covering membranes of tissues and organs, were not affected and remained intact until final autolysis of the tissues. Some mitochondria in intoxicated cells were destroyed completely, but others remained intact and apparently structurally unchanged.


A chromosomal survey of four species of gekkonid lizards. The karyotypes of the gekkonids were serially graded from the largest to the smallest in the diploid complement. The majority of the chromosomes were subtelocentric. The diploid number was 2n = 38 in Gekko gecko and 2n = 40 in the three species of the genus Hemidactylus examined. A comparative morphometric analysis of the diploid sets of these four members suggested a cytotaxonomic relationship and a possible mode of speciation in this group of reptiles.


An hypothesis for a contractile protein based on the principles of submicroscopic physiology. The discovery of the polyguanidinium ring complex and its various properties has emphasised the versatility of arginines in functional proteins. In an extension of these studies the possibility of formulating a polypeptide which could be the basis for a contractile element in muscle presented itself. Although hypothetical, the deduced molecular properties, based on the unique chemistry of arginine guanido groups are in keeping with known functional aspects of some muscles, and could form the foundation for a more detailed theory of muscular contraction. The structural requirements and the theoretical principles involved are briefly described in this paper.


Detection of small, single-copy genes on protein-G-banded chromosomes by electron microscopy. A method for the detection by electron microscopy of chromosome banding after in situ hybridization of small, nonradioactive DNA sequences is described. Typical high-resolution G-banding is produced by adding 5-bromodeoxyuridine (BrdU) during the last part of the S-phase and by applying a monoclonal antibody against the BrdU-substituted chromosome segments, followed by the addition of protein G, but no further treatment. A protocol for in situ hybridization of small, single-copy biotinylated DNA sequences and their detection by immunogold tagging on banded chromosomes is also described. This combined approach permits high-resolution mapping of small DNA sequences and should be useful in discriminating between neighboring DNA fragments.


Regional mapping of a liver alpha-subunit gene of phosphorylase kinase (PHKA) to the distal region of human chromosome Xp. X-linked liver glycogenosis (XLG) is a glycogen storage disorder resulting from deficient activity of phosphorylase kinase (PHK). PHK consists of four different subunits: alpha, beta, gamma, and delta. Several genes encoding PHK subunits have been cloned and localized, but only the muscle alpha-subunit (PHKA) gene has been assigned to the X chromosome, in the region Xq12----q13. However, we have previously excluded the muscle PHKA gene as a candidate gene for the XLG mutation, as linkage analysis indicated that the mutation responsible for XLG is located in Xp22 and not in Xq12----q13. We report here the chromosomal localization by in situ hybridization of a liver PHKA gene to the distal region of chromosome Xp. Strong hybridization signals were observed on the distal part of the short arm of a chromosome identified as the X chromosome by cohybridization with an X chromosome-specific centromeric probe. The localization of this gene in the same chromosomal region as the disease gene responsible for XLG suggests that the liver PHKA gene is a highly likely candidate gene for the XLG mutation.


Sublocalization of an invasion-inducing locus and other genes on human chromosome 7. By somatic cell fusion studies between noninvasive mouse T-lymphoma cells and invasive human activated normal T-cells we have previously shown that the genetic information responsible for the induction of invasive and metastatic potential in interspecies T-cell hybrids is located on human chromosome 7. Apparently, genes derived from normal activated T-cells are dominantly expressed in the hybrids and control the invasive and, as a consequence, metastatic potential of these T-lymphoma cells. To sublocalize the invasion-inducing locus on chromosome 7 we have generated hybrids that harbor only specific regions of human chromosome 7 with or without a small fragment of human chromosome 21. Analysis of these hybrids revealed that the invasion-inducing locus maps to 7p12----cen. The human DNA complement of the hybrids was confirmed by Southern blot analysis using a large panel of chromosome 7-specific DNA probes. Several of these genes could be further sublocalized. These included: ARAF2 to 7p12----cen, D7S21 to 7pter----p12, ACTB to 7p15----p12, EGFR to 7p12, MDH2 to 7cen----q22, and PDGFA to 7pter----p15.


The human platelet-derived growth factor alpha chain (PDGFA) gene maps to chromosome 7p22. The human PDGFA gene has been mapped previously to two different sites on chromosome 7 (7p21----p22 and 7q11.2----q21.1). Using in situ hybridization and human x mouse somatic cell hybrid lines we present data which confirm the localization of PDGFA to the terminal short arm of chromosome 7, at 7p22.


Assignment of the aspartylglucosaminidase gene (AGA) to 4q33----q35 based on decreased activity in a girl with a 46,XX,del(4)(q33) karyotype. Aspartylglucosaminuria (AGU) is a recessive autosomally inherited lysosomal storage disorder due to deficiency of the enzyme aspartylglucosaminidase (AGA). The structural gene for this human enzyme (AGA) has been assigned to the region 4q21----qter. We determined the AGA activity in cultured fibroblasts of a girl with a 46,XX,del(4)(q33) karyotype. The results indicate that the girl is a hemizygote for AGA, permitting the assignment of human AGA to the region 4q33----qter.


Somatic cell mapping of the human cyclophilin B gene (PPIB) to chromosome 15. The polymerase chain reaction (PCR) technique was used to generate a unique probe complementary to the hydrophobic 5' end of the human cyclophilin B gene. This unique probe was hybridized to DNAs from human x hamster hybrid somatic cell lines retaining different combinations of human chromosomes. The gene was assigned to chromosome 15.


Germ line-restricted supernumerary (B) chromosomes in Eptatretus okinoseanus. Cytogenetic studies were performed on two types of Japanese hagfish (Eptatretus okinoseanus) that eliminate about 45% (type A) and 55% (type B) of their DNA from presumptive somatic cells during the differentiation of somatic cells. The observations revealed inter- and intraindividual variations in the number of chromosomes in germ cells of both types of hagfishes. Although the modal number of chromosomes in the germ cells was 54 in both types, the percentage of cells with the modal number was rather low (38.6% [51/132] in five specimens of type A and 22.7% [25/110] in eight specimens of type B). In addition, one of seven type B specimens clearly had a modal number of 62 chromosomes. Another specimen of type B had a bimodal distribution of chromosome numbers, with peaks of 54 and 59 chromosomes. The observation of interindividual variations was supported by data on the amount of DNA in germ cells of type B specimens. However, these variations were rarely observed in somatic cells. These results suggest that supernumerary (B) chromosomes are maintained in germ cells and are eliminated together with some other chromosomes and/or chromatin from somatic cells.


Cytogenetics of bisexual/unisexual species of Poecilia. III. The karyotype of Poecilia formosa, a gynogenetic species of hybrid origin. Chromosomes of the Amazon molly, Poecilia formosa, a unisexual species of hybrid origin, were investigated by C-banding, silver staining, and fluorescent staining with DAPI, quinacrine dihydrochloride, and chromomycin A3. Analysis of heterochromatin distribution indicates that chromosomes similar to the W chromosome of P. latipinna are not present in the unisexual species. Therefore, morphologically differentiated sex chromosomes do not form the basis of the unisexuality in P. formosa. The number and location of nucleolar organizer regions vary in P. formosa and do not correlate well with those of the parental species.


Assignment of the NRAS protooncogene to chromosome 12 of Syrian hamster by in situ hybridization. The NRAS protooncogene codes for a GTP binding/GTPase p21 protein which resides on the inner surface of the plasma membrane. Using a human cDNA probe for NRAS, we have assigned the gene to Syrian hamster chromosome 12 with the most likely localization being 12qa5.


Localization of the interferon-alpha gene cluster to rat chromosome bands 5q31----q33 by fluorescence in situ hybridization. The chromosomal location of the rat interferon-alpha (IFNA) gene cluster was determined by fluorescence in situ hybridization. The fluorescent signals were localized to 5q31----q33. A previous report, using somatic cell hybrids, had suggested that the IFNA locus maps at a different region on rat chromosome 5.


The persistence of chromosome translocations in a radiation worker accidentally exposed to tritium. The chromosome translocation frequency in lymphocytes of an individual accidentally exposed to tritium six years previously was measured using chromosome painting. Comparisons with results from cytogenetic studies shortly after the accident indicate that the translocation frequency has remained unaltered in this individual for six years.


A primate transfer RNA gene cluster and the evolution of human chromosome 1. The localisation of tRNA(Asn) gene clusters in the karyotypes of primates has been studied by means of in situ hybridisation. In the human and orangutan (Pongo pygmaeus) karyotypes there are two such gene clusters, one each on the long and short arms of chromosome 1. Old World monkeys, however, contain both gene clusters on their equivalent of the human chromosome 1 short arm, which can be explained by a pericentric inversion which (amongst other chromosome changes) distinguishes the human and Old World monkey chromosomes 1. The capuchin (Cebus appella), however, a New World monkey, has only one tRNA(Asn) gene cluster, at least on the elements equivalent to human chromosome 1. This cluster is located proximal to the centromere on a chromosome that has been tentatively identified (by others) as the equivalent of the long arm of human chromosome 1. Should this prove to be correct, it would indicate that the large primate metacentric came into being in the form found today in the great apes, rather than in the form currently found in Old World monkeys. These data further show that the tRNA(Asn) gene cluster has been split in two since before the Old World monkeys and hominids diverged, i.e., over 30 million years ago, and also that the original transfer of these genes from one arm of chromosome 1 to the other was unlikely to have involved a pericentric inversion but, rather, some form of replicative transposition.


Geographic patterns of chromosomal variation in South American marsh rats, Holochilus brasiliensis and H. vulpinus. Karyotypes were prepared from 146 individuals, representing nine populations evenly spaced along a 2,000-km north-south transect in Paraguay and Argentina, to determine the nature, extent, and pattern of chromosomal variation in Holochilus brasiliensis chacarius and H. vulpinus. Two distinct patterns of chromosomal variation characterized these two species. In H. brasiliensis, the diploid number (2n) ranged from 48 to 56 and the nombre fondamental (NF) from 57 to 63. Four classes of chromosomal variation were found in populations of H. brasiliensis: whole-arm Robertsonian (Rb) translocations, including Rb changes with monobrachial homology, variation in the number and kind of supernumerary (B) chromosomes, centromeric rearrangements (putative pericentric inversions), and variation in the amount of euchromatin. The amount of structural variation was uniformly high in all populations of H. brasiliensis sampled, and all rearrangements appeared to be in Hardy-Weinberg proportions, corroborating the hypothesis that chromosomal rearrangements are not strongly underdominant in this species. In H. vulpinus, 2n ranged from 35 to 39 and NF from 57 to 61. Two classes of variation were found in this species: variation in the number, but not the kind, of supernumerary chromosomes and variation in the amount of euchromatin.


Meiotic studies of Robertsonian polymorphisms in the South American marsh rat, Holichilus brasiliensis. Meiosis was studied in male South American marsh rats (1) to help clarify the mechanisms that allow unusually high levels of Robertsonian (Rb) polymorphisms to be maintained in wild populations of these animals and (2) to test competing assumptions in two distinct models of chromosomal speciation. In both simple Rb heterozygotes and Rb heterozygotes with monobrachial homology, no univalency was observed in prophase I or metaphase I. Rates of nondisjunction were uniformly low (less than 10%) and did not differ significantly among any of the animals studied, regardless of karyotype and in contrast to the frequency of nondisjunction in other mammalian species. Robertsonian heterozygotes exhibited significantly more chiasmata than did homozygotes, largely owing to an increase in the number of terminally located chiasmata. There was a significant bias favoring the transmission of two acrocentrics over the single metacentric for some Rb rearrangements in the heterozygous state. In addition, the frequency of sex-chromosome univalency increased with increasing Rb heterozygosity, although the ratio of X- and Y-bearing secondary spermatocytes did not differ significantly from 1:1, and no secondary spermatocytes were observed that were nullisomic or disomic for an X or Y chromosome.


Chromosomal rearrangements in rock wallabies, Petrogale (Marsupialia: Macropodidae). VI. Determination of the plesiomorphic karyotype: G-banding comparison of Thylogale with Petrogale persephone, P. xanthopus, and P. l. lateralis. G-banding has demonstrated the presence of a conserved (2n = 22) chromosome complement in the macropod genus Thylogale and in some Petrogale species. This plesiomorphic karyotype consists of acrocentric chromosomes 1, 2, 5, 6, 8, 9, and 10; submetacentric chromosomes 3 and 4; and a metacentric chromosome 7. It should now be possible to relate the G-banding patterns of all other Petrogale species to this plesiomorphic complement and thereby determine the number and types of changes that have occurred during the course of chromosome evolution in Petrogale. It is hypothesised that this 2n = 22 complement is plesiomorphic for all macropodids.


Chromosomal rearrangements in rock wallabies, Petrogale (Marsupialia: Macropodidae). VII. G-banding analysis of Petrogale brachyotis and P. concinna: species with dramatically altered karyotypes. G-banded metaphase preparations of cultured fibroblasts were used to construct the karyotypes of Petrogale brachyotis (2n = 18) and P. concinna (2n = 16). The two karyotypes differ significantly from the plesiomorphic karyotype of the genus and from those of all other Petrogale species examined. Petrogale brachyotis and P. concinna are characterised by three synapomorphies: a 1-10 centric fusion, a 3a-6 centric fusion, and a submetacentric chromosome 2 (2s). Both species also possess autapomorphies. Petrogale brachyotis is characterised by submetacentric chromosomes 5 (5s) and 4 (4sm), whereas P. concinna is characterised by a 5-9 centric fusion and a submetacentric chromosome 8 (8m). The 2s, 5s, 4sm, and 8m chromosomes all appear to be derived from their plesiomorphic homologs by centromeric transpositions. Although the rate of chromosome evolution varies considerably in Petrogale, the genus clearly exhibits karyotypic orthoselection, with all the autosomal rearrangements identified being either centric fusions or centromeric transpositions. This study also illustrates the potential for convergent evolution in chromosomally diverse groups and demonstrates the importance of G-banding studies for accurate identification of chromosome rearrangements.


Synapsis, recombination, and meiotic segregation in the mesquite lizard, Sceloporus grammicus, complex. I. Pericentric inversion heteromorphism of the F5 cytotype. Chromosomal pairing and recombination were analyzed in male specimens of Sceloporus grammicus heterozygous for a large pericentric inversion of macrochromosome 4. Analysis of silver-stained synaptonemal complexes (SCs) in surface-spread nuclei revealed that homologously paired inversion loops were not formed. Synapsis of the inverted segments proceeded directly to nonhomologous straight pairing. In some nuclei, this resulted in a configuration that could not be distinguished from homozygous bivalents of similar size. Examination of Giemsa- and silver-stained diakinetic nuclei indicated that crossing-over was limited to the noninverted (homologous) portion of the heteromorphic bivalent. Analysis of secondary spermatocytes (metaphase II configurations) revealed normal disjunction and balanced segregation of the elements of the heteromorphic bivalent. These observations indicate that the inversion heteromorphism does not lead to the production of unbalanced gametes.


Synapsis, recombination, and meiotic segregation in the mesquite lizard, Sceloporus grammicus, complex. II. Fission heteromorphism of the FM2 cytotype and evolution of chromosome 2. Somatic and meiotic chromosomal and synaptonemal complex techniques were used to characterize the chromosomal complement and to study the fission heteromorphism of chromosome 4 in the FM2 cytotype of Sceloporus grammicus. Analysis of silver-stained somatic metaphases revealed that the nucleolar organizer region in this cytotype is located at the distal end of a pair of medium-sized acrocentric chromosomes, rather than on the largest acrocentric chromosomal pair, as previously reported. This condition is hypothesized to be the result of at least two sequential rearrangements. Analysis of surface-spread zygotene and pachytene nuclei indicated that the components of the chromosome 4 trivalent initiated synapsis at their distal telomeric regions. Although synapsis of the fission trivalent was synchronous with that of the homomorphic autosomal pairs, completion of synapsis was delayed in the trivalent. Associations between the fission trivalent and other autosomal or sex-chromosomal elements occurred in approximately one third of the pachytene nuclei examined. Analysis of secondary spermatocytes (metaphase II configurations) revealed low levels of nondisjunction in fission heterozygotes. These analyses indicate that FM2 individuals heterozygous for the fission rearrangement of chromosome 4 suffer no meiotic deficit.


Interstitial hybridization sites of the (TTAGGG)n telomeric sequence on the chromosomes of some North American hylid frogs. Interstitial hybridization sites for the (TTAGGG)n telomeric repeat sequence were present in all seven species of hylid frogs examined and in a triploid hybrid between two of the species. Intra- and interspecific differences and similarities in hybridization sites agreed with what is known about the systematics of these species. Chromosome fusions, fissions, and inversions do not appear to have played a role in the evolution of the interstitial sites for the telomeric repeat in the species examined.


Identification of equine chromosomes in horse x mouse somatic cell hybrids. Giemsa-11 (G-11) staining and in situ hybridization were used to identify the equine chromosome complement of horse x mouse somatic cell hybrids. The presence of horse chromosomes in somatic cell hybrids was determined by differential G-11 staining. The slides were then destained and hybridized with biotinylated total horse (Equus caballus) genomic DNA without suppression. Fluorescence detection permitted rapid confirmation of horse chromosomal DNA in the hybrid cells.


Sperm age, sex ratio, and hyperhaploidy frequency in mice. Physiologically aged and unaged sperm from each of 12 sexually mature B6SJLF1/J mice were used to fertilize oocytes from females of the same strain, with each male serving as its own control. Male genomes in 323 and 307 first-cleavage metaphases obtained by in vivo and in vitro fertilization, respectively, were analyzed cytogenetically, using C-banding for detection of the Y chromosome. The sex (X:Y) ratio among all zygotes resulting from in vivo fertilization was 1.18; in zygotes resulting from in vivo fertilization by aged (14-d mating intervals) sperm, however, the ratio was 1.53, which differed significantly (chi 2 = 6.72, P less than 0.01) from the theoretical value of 1.00. Comparison of the sex ratio in zygotes resulting from in vivo fertilization by unaged sperm (3-d mating intervals), 0.94, with that in zygotes resulting from fertilization by aged sperm (using a 2 x 2 contingency table) showed a significant (chi c2 = 4.19, P less than 0.05) relationship between sex ratio and sperm age. In vitro neither the combined nor the individual 3- and 14-d data deviated significantly from the expected sex ratio of 1.00. The frequency of sperm-derived hyperhaploidy did not differ significantly between the in vivo (3.4%) and in vitro (5.9%) populations, but did between unaged (2.5%) and aged (6.8%) sperm (chi c2 = 5.74, P less than 0.01). All hyperhaploid zygotes had a complement of n + 1 chromosomes, except the 14-d in vitro group, where complements of n + 2 and n + 3 chromosomes were seen. Sperm-derived polyploidy, which was observed only in the in vitro group, was independent of sperm age and occurred in 6.8% of the zygotes. These data provide support for the sperm-aging hypothesis and indicate, for the first time, an influence of sperm aging in the male genital tract on the X:Y ratio of conceptuses resulting from natural matings of chromosomally normal males.


Linkage of two enzyme loci in the fish genus Poecilia (Teleostei:Poeciliidae). The linkage of loci coding for glucose-6-phosphate dehydrogenase (G6PD) and phosphogluconate dehydrogenase (PGD) is described in fish of the genus Poecilia (Teleostei:Poeciliidae) and designated Poecilia linkage group I. These two loci were shown to assort independently from six other informative markers (peptidase S, malate dehydrogenase 2 [soluble], mannose phosphate isomerase, parvalbumin 2, phosphoglucomutase, and glyceraldehyde-3-phosphate dehydrogenase 2) within the limits of the data obtained. Data for the linkage analyses were generated by scoring starch-gel electrophoretic phenotypes of the eight loci in reciprocal backcross hybrids obtained from matings between Poecilia perugiae and P. vittata. The linkage chi 2 for G6PD-PGD locus pairs was significant (P less than 0.001) in all reciprocal backcross hybrid broods (22.7% recombinants in the combined data), indicating linkage in both parental species. The linkage of G6PD and PGD in gene maps of the poeciliid genera Xiphophorus and Poeciliopsis documents homology of this linkage within the family. Linkages in salmonid and centrarchid fishes suggest conservation of this linkage group in most or all teleosts. The six additional indpendently assorting loci have been assigned to independent linkage groups in Xiphophorus; thus, no example of poeciliid linkage group divergence has yet been identified.


Absence of satellite III DNA in the centromere and the proximal long-arm region of human chromosome 14: analysis of a 14p- variant. Cytogenetic methods and molecular probes derived from the centromere and short arm of chromosome 14 were used to investigate the structural properties of a chromosome 14 variant. Results of GTL, CBG, Ag-NOR, and non-banded Giemsa staining of the chromosomes suggested the complete absence of the short arm and possibly a large part of the centromere. Negative in situ hybridisation with an alpha satellite III probe confirmed the absence of the arm; the detection of normal amounts of alpha satellite DNA, however, indicated retention of the centromeric domain. The natural occurrence of a human acrocentric variant lacking a short arm was thus established. Within the detection limits of the methods used, the results demonstrate that satellite III DNA is not essential for normal centromeric activity and allow us to exclude the presence of this satellite DNA within the centromere and proximal long-arm region of human chromosome 14.


In situ hybridisation localises the gene for the major intrinsic protein of eye lens fibre cell membranes to human chromosome 12q14. The gene encoding the major intrinsic protein (MIP) of eye lens fibre cell membranes has been localised to human chromosome 12q14 by in situ hybridisation of a cDNA for rat MIP to G-banded metaphase chromosomes. The human MIP gene maps within a conserved region of synteny with mouse Chromosome 10.


Measuring bilingual children's receptive vocabularies. Receptive vocabulary of Hispanic children in Miami was tested in both English and Spanish with complementary standardized tests, the Peabody Picture Vocabulary Test (PPVT-R) and the Test de Vocabulario en Imágenes Peabody (TVIP-H). 105 bilingual first graders, of middle to high socioeconomic status relative to national norms, were divided according to the language(s) spoken in their homes. Both groups, whether they spoke only Spanish in the home (OSH) or both English and Spanish in the home (ESH), performed near the mean of 100 in Spanish receptive vocabulary (TVIP-H means 97.0 and 96.5); in contrast, ESH group children scored more than 1 SD higher in English than OSH group children (PPVT-R means 88.0 and 69.7, respectively). It appears, therefore, that learning 2 languages at once does not harm receptive language development in the language of origin, while it does lay the groundwork for superior performance in the majority language. Furthermore, an analysis of translation equivalents, items shared by both tests, shows that a statistically significant portion of bilingual children's lexical knowledge does not overlap in their 2 languages and is therefore not reflected in single-language scores.


Influences of witnessed affect on information processing in children. Children between the ages of 5 and 10 years watched a videotape of a child having a routine medical exam. Embedded within the scenes were systematic variations of depicted facial affect shown by doctor and child. Measures were taken of autonomic reactions and information-processing errors in response to positive, neutral, and negative affective cues. For 5-6-year-olds, processing errors were greatest in the negative affect condition. Additionally, peak increases in heart rate (HR) and skin conductance level (SCL) were demonstrated by 5-6-year-olds in response to negative affect shown by the witnessed child; increases in HR were in turn predictive of processing errors. Older children (9-10 years) showed trends reflecting reduced processing errors in response to witnessed negative affect. It was suggested that younger children respond to salient threat cues with a "defensive" response pattern that is relatively adaptive at younger but not older ages.


Intermodal perception of happy and angry expressive behaviors by seven-month-old infants. 2 studies were conducted to examine the roles of facial motion and temporal correspondences in the intermodal perception of happy and angry expressive events. 7-month-old infants saw 2 video facial expressions and heard a single vocal expression characteristic of one of the facial expressions. Infants saw either a normally lighted face (fully illuminated condition) or a moving dot display of a face (point light condition). In Study 1, one woman expressed the affects vocally, another woman expressed the affects facially, and what they said also differed. Infants in the point light condition showed a reliable preference for the affectively concordant displays, while infants in the fully illuminated condition showed no preference for the affectively concordant display. In a second study, the visual and vocal displays were produced by a single individual on one occasion and were presented to infants 5 sec out of synchrony. Infants in both conditions looked longer at the affectively concordant displays. The results of the 2 studies indicate that infants can discriminate happy and angry affective expressions on the basis of motion information, and that the temporal correspondences unifying these affective events may be affect-specific rhythms.


Responses to the negative emotions of others by autistic, mentally retarded, and normal children. Attention, facial affect, and behavioral responses to adults showing distress, fear, and discomfort were compared for autistic, mentally retarded, and normal children. The normal and mentally retarded children were very attentive to adults in all 3 situations. In contrast, many of the autistic children appeared to ignore or not notice the adults showing these negative affects. As a group, the autistic children looked at the adults less and were much more engaged in toy play than the other children during periods when an adult pretended to be hurt. The autistic children were also less attentive to adults showing fear, although their behavior was not different from the normal children. Few of the children in any group showed much facial affect in response to these situations. The results are discussed in terms of the importance of affect in the social learning experiences of the young child.


Maternal responsiveness to infants in three societies: the United States, France, and Japan. This study examines and compares prominent characteristics of maternal responsiveness to infant activity during home-based naturalistic interactions of mother-infant dyads in New York City, Paris, and Tokyo. Both culture-general and culture-specific patterns of responsiveness emerged. For example, in all 3 locales infants behaved similarly, mothers also behaved similarly with respect to a hierarchy of response types, and mothers and infants manifest both specificity and mutual appropriateness in their interactions: Mothers responded to infants' exploration of the environment with encouragement to the environment, to infants' vocalizing nondistress with imitation, and to infants' vocalizing distress with nurturance. Differences in maternal responsiveness among cultures occurred to infant looking rather than to infant vocalizing and in mothers' emphasizing dyadic versus extradyadic loci of interaction. Universals of maternal responsiveness, potential sources of cultural variation, and implications of similarities and differences in responsiveness for child development in different cultural contexts are discussed.


The influence of culturally derived values on Anglo and Puerto Rican mothers' perceptions of attachment behavior. This 2-part investigation examined indigenous concepts of desirable and undesirable attachment behavior among middle- and lower-class Anglo and lower-class Puerto Rican mothers in order to formulate culturally sensitive criteria of normative attachment behavior. Study 1 elicited indigenous concepts of desirable and undesirable attachment behavior using open-ended probes. On the basis of mothers' responses in Study 1, culturally sensitive vignettes of desirable and undesirable attachment behavior were constructed, and culturally relevant descriptors of toddler characteristics were selected. In Study 2, mothers' perceptions of the hypothetical toddlers were compared using the selected descriptors. The findings indicate that, whereas the Anglo mothers focus more on characteristics associated with the presence or absence of individual autonomy, the Puerto Rican mothers place more emphasis on the child's ability to maintain proper demeanor in a public context. These findings were coherent across mothers': (a) open-ended conceptualizations, (b) desirability ratings, and (c) descriptor ratings of the toddlers.


Children's relationships with caregivers: mothers and child care teachers. Infant, toddler, and preschool children's relationships with mothers and teachers were examined in this study. 110 children were observed with their mothers during child care arrivals and reunions. 403 children were observed with their teachers in child care. 3 categories of relationships were derived from these observations. Children in the secure relationship category experienced more teacher involvement than children in the avoidant or ambivalent relationship categories. Children in the ambivalent relationship categories experienced more teacher involvement than children in avoidant relationship categories. A subsample (n = 23) of children were seen with their mothers both during child care arrivals and reunions and in the Strange Situation. Relationship classifications were similar.


Children's relationships with child care teachers: stability and concordance with parental attachments. In order to examine caregiving relationships of children enrolled in childcare, two longitudinal samples of children, n = 72 and n = 106, were followed from infancy through preschool. Maternal attachment as assessed by the Strange Situation, 4-year-old reunion behavior, and by the Attachment Q-Set tended to be stable across time. Children's teacher-child relationship quality, as measured by the Attachment Q-Set, was stable if the teacher remained the same. When the teacher changed, teacher-child relationship quality tended to be unstable until the children were 30 months old. After 30 months, relationship quality with teachers tended to be stable regardless of whether or not the teacher changed. Maternal and teacher relationships were nonconcordant. There were few interactions between adult caregiver relationship quality and age of entry into child care or intensity of child care.


Maternal and paternal disciplinary styles: relations with preschoolers' playground behavioral orientations and peer status. To explore relations among parents' self-reported disciplinary styles, preschoolers' playground behavioral orientations, and peer status, 106 mothers and fathers of preschool-age children (age range = 40-71 months) participated in home disciplinary style interviews. Observations of their children's playground behavior in preschool settings and measures of sociometric status were also obtained. Results indicated that children of more inductive mothers and fathers (i.e., less power assertive) exhibited fewer disruptive playground behaviors. In addition, daughters and older preschoolers of inductive mothers exhibited more prosocial behavior. Children of inductive mothers were also more preferred by peers. Few significant relations were found between paternal discipline and child behavior/peer status. Age-related patterns of behavior also indicated that older preschoolers who engaged in more prosocial and less antisocial and disruptive playground behavior were more preferred by peers. In addition, child behaviors were found to mediate maternal discipline and peer status.


Victimizers and their victims: children's conceptions of the mixed emotional consequences of moral transgressions. 4-8-year-old children's conceptions of the emotional consequences of moral transgressions were assessed in 2 experiments. In Experiment 1, most children expected victimizers to feel positive emotions and victims to feel negative emotions, but 8-year-olds who assessed victims first subsequently attributed less positive emotions to victimizers. Despite efforts to manipulate the salience of victims' losses in Experiment 2, children had similar expectations about the emotional consequences of transgressions. However, a developmental shift emerged: 4-year-olds attributed extremely positive emotions to victimizers due to the material gains produced by victimization, whereas 8-year-olds attributed less positive emotions to victimizers, in part due to the unfairness and harm produced by victimization. Probe questions revealed that older children also attributed additional negative-valence emotions to victimizers, suggesting that victimizers are expected to feel conflicting rather than exclusively positive emotions. Discussion focused on potential cognitive constraints in children's conceptions of moral emotions.


Visual attention to and comprehension of television in attention-deficit hyperactivity disordered and normal boys. This study examined the effects of distracters on the television viewing of diagnosed ADHD (n = 19) and normal (n = 20) boys who ranged in age from 6 to 12 years. Subjects were videotaped watching four 7-min segments of "3-2-1 Contact," once in the presence and once in the absence of highly appealing toys. The results indicated that, while in the presence of toys, ADHD boys spent one-half as much time as control boys attending to the television. However, when toys were absent, there were no significant differences in visual attention between ADHD and normal boys. The effect of the toy manipulation was most dramatic with younger children of both groups. Recall of didactic content by ADHD boys and normal subjects did not differ significantly, even when the attention of ADHD boys was reduced. These findings suggest that ADHD children, like their normal counterparts, are active and strategic viewers of television.


Effects of early and recent maternal employment on children from low-income families. The effects of early maternal employment (employment during the child's first 3 years) and recent maternal employment (employment during the previous 3 years) on 189 second-grade children from low-income families were examined. Maternal employment was related to a number of selection factors. In comparison to mothers who were not employed, employed mothers scored higher on a mental aptitude test and were more highly educated. Both early and recent maternal employment were also associated with measures of the current family functioning: there was less poverty and higher HOME environment scores when mothers were employed. Hierarchical multiple regressions showed that children's math achievement was positively predicted by early maternal employment and children's reading achievement was positively predicted by recent maternal employment, even after controlling for selection effects and current family environment. These results are discussed in terms of possible mechanisms by which maternal employment may affect children's development.


Children's awareness of the biological implications of kinship. Preschoolers' thinking about kinship was explored by means of a simple induction task. A target animal was described as possessing a property, and children were asked whether each of 2 other animals shares the property or not. When no information about kinship was given, children in Experiment 1 based their inductions of biological properties on physical similarity. However, when kinship relations were specified, children judged that dissimilar-looking kin share more biological properties than similar-looking but unrelated members of the same species. In Experiment 2, describing the similar animals as socially related did not change the basic pattern of inductions obtained in the first experiment. Moreover, subjects in Experiment 3 did not induce more acquired physical and psychological properties among families than among unrelated animals. The results of Experiments 1 and 2 illustrate one case where young children favor a nonperceptible relation (kinship) over a perceptible one (similarity) as a basis for judgment. The overall pattern of data suggest that young children distinguish to some extent between the biological and social domains.


Young children's understanding of different types of beliefs. The purpose of this investigation was to see whether children's understandings of different types of beliefs develop concurrently. Children of 3, 4, and 5 years of age were told or shown that child story characters held beliefs different from their own or from one another, not only concerning matters of physical fact ("false beliefs"), but also concerning morality, social convention, value, and ownership of property. In contrast to the older subjects, most 3-year-olds had difficulty in attributing to others deviant beliefs of all types, except perhaps ownership, sometimes even after having been told repeatedly what the other child believed. In addition, intercorrelations among different belief tasks were positive and substantial. It was suggested that an emerging representational conception of the mind is what enables older preschoolers to understand the possibility of belief differences of all these types.


A reading-level design study of phonological skills underlying fourth-grade children's word reading difficulties. A 3-group reading-level design was used to investigate phonological analysis, verbal working memory, and pseudoword reading performance in less skilled fourth-grade readers. Children were given phonological oddity tasks assessing their sensitivity to subsyllabic and phonemic units, together with standardized tests of verbal working memory and pseudoword reading. Less skilled fourth-grade readers performed lower than both chronological age and reading-level controls on the phonological oddity and pseudoword reading tests. Less skilled fourth-grade readers performed at the same level as skilled second-grade readers on a test of verbal working memory. Skilled fourth-grade readers scored higher than both other groups on this test. Correlational analyses were consistent with the view that phonological analysis skills contribute more strongly than verbal working memory skills to children's decoding abilities.


[Pulmonary complications following surgical abdominal interventions. Identification of various risk groups]. Incidence and type of postoperative complications were prospectively analyzed in 2280 patients undergoing gastrointestinal surgery. 6.6% had one or more pulmonary complications requiring therapeutic intervention (2.3% pneumonia, 1.6% drained pleural effusions, 1.2% atelectases). Based on univariate and logistic regression analyses, the following parameters constitute high-risk patients with regard to pulmonary complications: Elective surgery (4.3%, 61/1428): anemia (7.2% pulmonary complications), pathological blood gas analysis (9.8%), preoperative hospitalization greater than 1 week (6.3%), blood loss under operations greater than 1000 ml (10.5%), length of the operation greater than 3 h (9.7%); emergency surgery (10.4%, 89/852): upper gastrointestinal operation (16.2%), age greater than 75 (19.9%), ASA IV/V (28%), anemia (19.6%), chronic bronchitis (19%), pathological blood gas analysis (26.6%), diabetes (16.5%), heart failure (18.2%), blood loss under operation greater than 1000 ml (24.3%), length of the operation greater than 2 h (15.4%). These results allow to distinguish between different levels of pulmonary risk.


[Initial results of minimally invasive lung surgery]. From June 1991-February 1992 we have performed in 10 patients wedge resection of the lung by means of minimally invasive surgery. Indications were: spontaneous pneumothorax (5), tumours (3), suspected systemic disease (2). In all patients the pathological specimen preoperatively diagnosed by x-ray and CT, could be harvested without any problem. Minimally invasive, atypical wedge resection is considered as an effective procedure with low risk and discomfort for the patient.


[Routine drainage following uncomplicated, elective cholecystectomy? A prospective, randomized study]. A prospective randomized and controlled study of prophylactic drainage after simple, elective cholecystectomy was carried out. From March 1988 to June 1991 80 patients received an Easy-Flow drain and 80 did not. Operation and perioperative management were standardized. The endpoint of the study was postoperative morbidity, especially postoperative pyrexia and subhepatic fluid collection. The latter was identified by ultrasonography performed daily on postoperative day 1-4. No patient died. The morbidity including postoperative pyrexia revealed no difference between drained and undrained patients. In 19 of the patients with (23.8%) and in 25 of the patients without drainage (31.3%) a subhepatic fluid collection could be demonstrated by ultrasonography. This difference was not statistically significant either. We conclude that prophylactic drainage after elective, simple cholecystectomy is of no use for the patient. As subhepatic fluid collections can be seen in drained as well as in undrained patients it has to be accepted that drainage does not guarantee the removal of subhepatic fluid. Therefore its indicatory function (bleeding) and the ability to prevent the patient having biliary peritonitis or local abscess has to be put in doubt.


[Complications of diverticuli of the proximal small intestine. 3 case reports and review of the literature]. Three cases of small bowel diverticula are presented. In the first patient perforation of a congenital diverticulum in pars II of the duodenum occurred, the second case is the first description of bezoar in a duodenal diverticulum with bleeding of the diverticulum at the same time and the third patient suffered from ileus due to unusually large jejunal diverticulum. Up to 20% of all autopsied patients present duodenal diverticula. In other parts of small bowel diverticula are not as frequent. Most cases are asymptomatic and require no treatment. As soon as ailments occur, further investigations and probably surgical treatment is necessary. Perforation, bleeding and obstruction are indications for surgical interventions. The symptomatology is unspecific, therefore preoperative diagnosis is difficult. At least during the operation the possibility of small bowel diverticula and their complications should be considered. Till today complications of small bowel diverticula are affected with a mortality of 33-48%. More awareness of their existence could possibly improve this unfavourable outcome.


[Rupture of the Achilles tendon--fibrin gluing or suture?]. The rise of recreational sports activities and the incidence of ruptures of the Achilles tendons has increased simultaneously. Recently the use of fibrin sealing for surgical therapy of ruptured Achilles tendons has emerged as an alternative technique. Between 1982 and 1989 62 consecutive patients were operated for unilateral Achilles tendon rupture. Following causes for ruptures are known: 36 indirect traumas in sport (74%), 9 direct blunt injuries at occupational work (18%), 3 traffic-accidents (11%) and 1 rupture after operation of a Haglund exostosis. 25 patients (56%) were treated by suture technique and 20 patients (44%) with fibrin sealant. The mean long term follow-up of 49 months is known of 49 patients. There were 3 (12%) postoperative infections in the suture group and none in the fibrin group. After suturing the Achilles tendon 3 (12%) reruptures occurred 8-10 weeks after tendon repair and 1 (5%) rerupture after fibrin sealing. All reruptures are caused by a new adequate trauma. The time of return to social and recreational activities was 9 months in the suture group and 7 months in the fibrin group. The functional and cosmetic results after use of fibrin was significant better, and the long-term results were very satisfactory. We prefer fibrin sealing for the treatment of acute ruptures of Achilles tendons.


[Compartment resection as therapy of choice in subfascial soft tissue sarcoma exemplified by the thigh]. Soft-tissue sarcomas tend to have local recurrences after inadequate therapy. So reactions with wide margins are required. If a sarcoma is localized subfascially, such wide margins are often hard to achieve in a "wide resection". Concerning the growth behavior of soft-tissue sarcomas and the intraoperative orientation it makes more sense to resect these tumors with their whole anatomical compartment. This kind of operation is described by the three large compartmental resections of the thigh.


[Causes of maternal death. A 10-year case analysis]. The causes of maternal deaths in our hospital from 1981 to 1989 were analysed. There were 12,819 live births and 6 maternal deaths during this period, a maternal mortality rate of 46.69/per 100,000. The main cause of maternal deaths was acute fatty liver of pregnancy (50%), and next cardiac disease, acute hemorrhagic necrotic pancreatitis and hemorrhage of subarachnoid space (each 16.67%). There was no death due to obstetric hemorrhage, pregnancy induced hypertension syndrome or ectopic pregnancy. It is suggested that needle biopsy of the liver should be done for pregnant women with jaundice of unknown cause. Pregnant women with cardiac disease should be under the care of both obstetrician and internist in collaboration and cesarean section is indicated when the woman's cardiac function remains at grade 3 or 4.


[Fetal umbilical arterial blood flow velocity waveforms as measured in the uterus by pulsed Doppler and B-mode ultrasound]. 3.0 MHz Doppler ultrasound was used to measure the umbilical arterial blood flow velocity waveforms (FVW) in 174 fetuses between 22-42 weeks of gestation. The A/B ratio (systolic/diastolic), resistance index (RI), pulsatility index (PI) and impedance index (ImI) were used as indexes of placental flow resistance. In normal pregnancy (n = 152), 460 measurements were performed. Analysis of these waveforms demonstrated that the placental is an organ of low vascular resistance and that placental resistance to blood flow gradually declines with advancing gestational age. Our results indicated a significant negative correlation between each of the four indexes and gestational age. There was a small but significant decrease in all four indexes, from 22-42 weeks. 56 scans were performed on 22 fetuses with intrauterine growth retardation (IUGR). The sonograms from these IUGR fetuses showed different characteristics which implied a high distal impedance to the blood flow. 16 of these (72.7%) presented an abnormal increase in all four indexes.


[Modified method of determining phosphatidylglycerol in amniotic fluid to assess fetal maturity]. In this study the amniotic fluid of 111 cases were analyzed to assess fetal maturity by a modified method of determining phosphatidylglycerol. The L/S ratio was also determined in the amniotic fluid by thin layer chromatography at the same time. This method was found especially valuable where the L/S ratio was not less than 2.0 and the newborn infant did not have RDS. Here the fetal maturation was characterized by an early appearance of PG. Clinical evaluation showed that the rate of accuracy to assess fetal maturity of PG was 97.3%, significantly higher when compared with the 86.5% by L/S ratio (P less than 0.01). The false negative rate for PG was 5%. PG analysis in amniotic fluid as markers of surfactant seems to be of value as an additional index of prenatal evaluation of lung maturity. The modified method of PG assessment in amniotic fluid is a better method for estimating fetal maturity.


[Preterm delivery and its risk factors]. A case-control study on preterm delivery was conducted in Jianan and Jianhan District, Wuhan City in 1988. 130 singleton preterm infants were included with 260 term infants as control. The results showed that the risk factors in prematurity were edema-proteinuria-hypertension syndrome (OR 1.8), maternal diseases in pregnancy (OR 1.6), hyperemesis gravidarum (OR 5.1), vaginal bleeding during pregnancy (OR 2.4), premature rupture of membranes (OR 3.6), low weight gain and low average weight gain per week during pregnancy, psychosocial stress during pregnancy, inadequate prenatal care, maternal stature less than 158 cm (OR 1.7), menarche before age 12 (OR 4.3), multi-gravida (OR 2.1), previous induced abortion (OR 2.1) and passive cigarette smoking during pregnancy. The author suggests that early treatment of complications of pregnancy and forcing prenatal care should be emphasized in order to reduce the incidence of preterm births.


[Prenatal diagnosis of fetal cardiac disease with echocardiography. National Group for Fetal Echocardiography]. M-mode, 2DE and PDE were performed on 630 fetuses of high risk pregnancies. Fetal gestation ages ranged from 16 to 41 weeks. 21 cases of fetal heart disease were detected during pregnancy. The detected rate of fetal cardiac disease with echocardiography in high-risk pregnancies was 3.3%. In total 21 cases of fetal cardiac disease including 3 cases of atrial septal defect, 5 ventricular septal defect, 3 fetal non-immuno hydrops with pericardial effusion, 2 atrioventricular canal defect, 2 cardiac tumor (one rhabdomyoma, another lipoblastoma), an endocardial fibroelastosis, pulmonary stenosis, a single atrium with single ventricle, a hypoplastic left ventricle with single atrium and pulmonary atresia, a hypoplastic right ventricle with pulmonary atresia and a truncus arteriosus were found. 19 cases of fetal cardiac disease were confirmed at autopsy and other two by auscultation and echocardiography after delivery. The significant high-risk factors were bradycardia in 6 cases, non-immuno hydrops in 5 cases and virus infection at early pregnancy in 3 cases. (1) 2DE and PDE are the most valuable non-invasive technique for detection of fetal structural cardiac abnormalities. (2) Sustained bradycardia, non-immuno hydrops and virus infection at early pregnancy were the significant high-risk factors of fetal heart disease. Fetal non-immuno hydrops may present congestive cardiac failure in the uterus.


[Experiences with bromocriptine treatment of female infertility due to hyperprolactinemia]. From July 1981 to September 1988, 106 infertile patients with hyperprolactinemia treated with bromocriptine were reviewed retrospectively with special attention to the dosage of bromocriptine and the evaluation of infertility before treatment 84 patients (79.2%) became pregnant. The patients were divided into 3 groups according to the following doses of bromocriptine: 7.5, 5.0, and less than 5.0 mg/day. The pregnancy rate was 90.7%, 84.6%, and 66.7% respectively with the highest at 7.5mg/day, which was significantly higher than that at less than 5.0mg/day (P less than 0.02). The average duration from treatment to pregnancy was 3.6, 3.4, and 7.4 months respectively. The duration in the less than 5mg/day group was twice that in the other two groups. 84.5% of the pregnancies occurred within 6 months of treatment. Pretreatment of organic lesions and additional therapy for induction of ovulation were given to 29.8% of patients who later became pregnant. Systematic evaluation of the causes of infertility other than hyperprolactinemia before the use of bromocriptine and an optimal dose of 5-7.5mg/day will give the best results.


[Cisplatin nephrotoxicity: clinical observation and animal experiment]. Animal experiment and clinical observation were carried out to study the nephrotoxicity of cisplatin in order to give protective measures. In animal experiment it had been demonstrated that the nephrotoxicity induced by cisplatin was mainly related to the intraperitoneal concentration of cisplatin. The nephrotoxicity was permanent in rats treated with cumulative cisplatin. The main pathologic lesions were characterized by interstitial hyperemia, degeneration of the tubular cells and formation of tubular casts. In a Clinical study to compare two preventive methods (sodium thiosulfate and hydration) from cisplatin induced nephrotoxicity, the BUN and serum Cr were measured in 28 patients. The results revealed that there was no significant difference between the two groups (P greater than 0.05). The two protective measures had similar effect in reducing the nephrotoxicity of cisplatin. Five of 6 patients treated with cisplatin developed hypo-magnesemia but only one had symptoms.


[Cervical ripening and drug dilatation for birth control operations]. Cervical ripening in induced labor at second trimester of pregnancy was studied in 81 cases. The method consisted of injecting diazepam gel through Foley's catheter, into the extra-amniotic space, and at the level of cervical internal os. The cervix was found to be softened, the time interval between induction and onset of labor shortened and there was no cervical laceration. A comparison between the experimental and control groups showed significant difference. The use of suppositories for cervical dilatation in 719 cases of induced abortion and 34 cases of insertion and/or removal of IUD was also studied. The results were satisfactory. The mechanism of cervical dilatation and ripening with drug had been investigated at different periods of pregnancy and in non-pregnant women as well.


[Effect of 3,4-dihydroxyacetophenone on platelet aggregation in normal pregnancy and pregnancy induced hypertension]. The effect of 3,4-Dihydroxyacetophenone (DHAP) on platelet aggregation in normal pregnancy and pregnancy induced hypertension (PIH) in the third-trimester was studied by optical method. The IC50 values of DHAP in inhibiting ADP-induced platelet aggregation in normal pregnancy and PIH were 1.0 x 10(-3) mol/L and 2.4 x 10(-3) mol/L respectively. A dose-effect relationship of DHAP was also demonstrated (r greater than 0.92). At various time-phases of ADP-induced platelet aggregation, the addition of DHAP to the platelet-rich plasma could rapidly decrease the two-phase aggregation. DHAP of 200-240 mg/d x 3-5 days by i.v. drips given to patients with PIH also inhibited ADP-induced platelet aggregation. The authors conclude that DHAP is a potent antithrombogenic agent both in vitro and in vivo and is therefore a promising drug to improve utero-placenta-fetal circulation.


Gastric acid secretion and gastrin release in the baboon. Significant species differences have been demonstrated in gastric physiology, a factor that limits extrapolation of animal data to man. Primate physiology is thought to be similar to that of man; however, gastric function has not been adequately documented in the primate. In the present study six baboons (body weight 25.5 +/- 1.8 kg) were trained to sit in a chair and gastric acid secretion and gastrin release was studied in conscious animals. Mean basal acid secretion was 1.3 +/- 0.1 mmol (H+)/hr. Maximum output after pentagastrin (12 micrograms/kg/hr) was 9.5 +/- 0.9 mmol (H+)/hr and 11.0 +/- 0.4 mmol (H+)/hr after histamine (40 micrograms/kg/hr). A statistically significant (by cosinor analysis) circadian rhythm was demonstrated for intragastric pH over 24 hr in fasted baboons (P less than 0.001). Mean basal serum gastrin level was 37.7 +/- 8.3 pg/ml. The integrated gastrin response after administration of a protein rich meal was 2.52 +/- 0.07 ng x min/ml and this increased to 5.17 +/- 0.18 ng x min/ml (P less than 0.05) following simultaneous administration of a meal with atropine (0.2 mg/kg) (P less than 0.05). Our results suggest that there is significant basal and stimulated acid secretion in the baboon; the amount of acid secreted is similar to that reported in man. Gastric pH demonstrated a circadian rhythm. Postprandial gastrin release was significantly enhanced by cotreatment with atropine. As the present findings are similar to those previously reported in man, the baboon may be a useful model for further studies in gastric physiology and experimental peptic ulceration.


Effect of hepatic collateral hemodynamics on gastric mucosal blood flow in patients with liver cirrhosis. The dependence of the gastric mucosal change in liver cirrhosis on the extrahepatic collaterals is still unknown. Therefore we studied the influence of these collateral hemodynamics on gastric mucosal blood flow and gastric mucosal lesions. The subjects were 23 cirrhotic patients and were divided into two groups by the findings of percutaneous transhepatic portography. The first group consisted of 14 cases whose extrahepatic collaterals were via esophageal varices (group I). The second group included 9 cases having collaterals other than esophageal varices (group II). Multiple red spots were observed in 13 of 14 cases in group I, and two of nine cases in group II. Gastric mucosal blood flow was 2.0 +/- 0.9 volts (mean +/- SD) in group I, 4.0 +/- 1.2 in group II. A statistically significant difference was observed between groups I and II. Gastric mucosal blood flow was not significantly correlated with portal venous pressure in group I. It is concluded that, in liver cirrhosis, gastric mucosal blood flow is changeable according to the types of the extrahepatic collaterals.