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The effects of a single 400 R whole-body dose of X-irradiation on the regional 5HT content of the gastrointestinal (G. I.) tract were studied from four hours to 40 days after irradiation. The total 5HT content of various G.I. tissues was determined and 5HT was also determined per unit of body weight, wet weight of tissue and tissue protein. Irradiation caused an immediate decrease of the amine content of various G.I. regions in adult rats. This was followed by recovery, the degree of which varied in different regions. Some minor morphological changes were seen in enterochromaffin cells one and two days after irradiation but not later. The effects of irradiation on the G.I. tissues were stronger in young rats, in whom no complete recovery of 5HT occurred within 45 days. The present results support the view that irradiation exerts a direct damaging effect on the gastrointestinal 5HT storage, which is associated with liberation of 5HT from amine-containing cells. The duration of the effect varies with age and intestinal segment concerned.

An increase of the radiosensitivity can be obtained by means of microwave use in combination with sparsely ionizing radiation. Comparing the therapeutic effect on the model of an euoxic tumor (mice testicles) with a tumor that contains important parts of hypoxic cells (solid tumor of Ehrlich) it appears that the sensitization evidentely is seen in the hypoxic tumor first of all. No sensitization can be obtained on the euoxic profileration tissue on the testicles. The temperature enhancement ratio (equal TER) does not increase linearly with increasing temperature, but is the greatest within the scope of 41 degrees C. The mere heat effect appears in the foreground with high temperatures (43 degrees C and more). The high frequency application lets hope a solution of the oxygen problem in radiotherapy and could substitute the use of heavy particles (high LET) in the combination with sparsely ionizing radiation as far as a concentration of high frequency and heat on the tumor succeeds in.

Monolayer tissue culture cells from benign nodular hyperplasia of the prostate transferred at 1-2 weeks intervals were examined under the electron microscope after the 3rd, 9th, and 10th transfers. Changes seen after 9 to 10 transfers were interpreted as an "aging process" and consisted of the presence of lysosomes of various types and variations in the mitochondria profile. These changes were described in detail and illustrated and compared to the ultrastructural appearance of monolayer cell cultures in the early transfer stage.

Enzymuria, urinary cell excretion and proteinuria were simultaneously determined in renal diseases of female Wistar rats in order to investigate the diagnostic value of urinary enzymes. Investigations were carried out on rats with E. coli-pyelonephritis facilitated by oestradiolundecylate, aminonucleoside nephrosis, aminoglycoside induced renal lesions and pyelonephritic animals treated with therapeutic and toxic doses of tobramycin. --From the results of these studies it was concluded that the main diagnostic value of urinary enzymes is detection of drug induced tubular lesions in individuals with preexisting renal diseases.

Isozymes of urinary lactic dehydrogenase (LDH) were studied in 55 subjects, including 17 patients with bladder tumors. Normal clear urine from healthy persons showed little activity of LDH5, but in 11 out of 17 patients with bladder tumors LDH5 was increased sufficiently to invert the ratio of LDH5/LDH1, although the urine was not contaminated appreciably with leucocytes. Studies on tissue LDH isozymes in 16 tumors specimens strongly suggested that increased LDH5 in the urine of patients with bladder tumors originated from the tumors themselves. beta-Glucuronidase (B-G) isozymes were studied in urine specimens from 10 normal subjects, and 10 patients with bladder tumors and in 5 specimens of normal epithelium and 5 of tumor tissue. Two or three distinct bands of beta-G were separated from specimens of urine and tumor tissue from patients with bladder tumors, but only a single band was found in specimens from normal subjects.

Upper urinary tract and renal deterioration in the child with congenital neuropathy is due to high intravesical pressure associated with urinary retention. Preservation of kidney function often can be achieved when bladder emptying is improved by lowering the urethral resistance, when reflux is cured, and when infection is controlled. Since incontinence is most often of the overflow type, complete bladder evacuation can allow the child to remain dry for a socially acceptable period of time between voidings. Success depends greatly on the child's motivation and on his cooperation in a bladder training regimen. Diversion is sometimes unavoidable but should be considered only when conservational methods have failed.

Forty female patients suffering for long periods from frequency, urgency, and dysuria without any definite organic cause received nortriptyline chloride for three weeks. In 75 percent there was either considerable improvement or total disappearance of urinary complaints. At the same time the in vitro effects of the drug were tested using the isometric muscle contraction technique. Nortriptyline was found to have anticholinergic properties. The importance of this effect in the clinical study and the possible mode of action of the drug are discussed.

We review our experience with the Boari flap to correct distal ureteral injuries. Satisfactory results were obtained in 15 of 21 patients. We believe this procedure should be considered as an alternative to transureteroureterostomy, autotransplantation, and ileal interposition for short or long distal ureteral defects.

Two cases are reported of functionally significant bladder neck obstruction following urethral valve fulguration which resulted in inability to void. Both patients responded to the administration of phenoxybenzamine, an alpha-adrenergic blocking agent. Treatment of patients with suspected bladder neck obstruction with this agent provides a reversible method of decreasing urethral resistance without the potentially harmful effects of surgical bladder neck revision.

Experimental studies designed to evaluate the anterior bladder tube as a method of maintaining continence in the neurologically deprived bladded achieved a 50 to 60 per cent success rate. This success rate is not sufficient to warrant its clinical use.

The effect of muscle length on adrenergic stimulation of canine detrusor was studied in an vitro muscle bath. The commonly reported response of muscle relaxation with norepinephrine stimulation was seen in muscle strips at or near the resting length. When the muscle strips were stretched, however, an alpha receptor mediated contraction was noted. Length, rather than norepinephrine dose or tension, was the predominant factor determining whether a given strip would respond in an alpha or beta fashion. Sympathetic stimulation may enhance accommodation (beta effect) during bladder filling at low muscle length and potentiate bladder emptying (alpha effect) at increased muscle length.

A fifty-five-year-old man was seen with anuria. Retrograde pyelograms demonstrated bilateral ureteral obstruction subsequently shown to have resulted from sloughed renal papillae. A twenty-year history of phenacetin was obtained. Treatment included bilateral ureteral intubation, then ureterotomy on one side.

Total unilateral renal destruction has been observed in a patient who previously received irradiation for Hodgkin's disease. The clinical features, after a six-year asymptomatic interval, included recurrent calculi and infection in what was subsequently demonstrated radiographically to be a nonfunctioning kidney. The gross and microscopic characteristics of the nephrectomy specimen have been described and correlated with the magnitude of irradiation and the clinical course.

A case is reported in which the patient had classic findings of an abdominal aortic aneurysm, including a pulsatile abdominal mass, curvilinear aortic calcification, and anterolateral deviation of the left ureter. These findings were subsequently demonstrated at surgery to be due to metastatic nodes from prostatic carcinoma. Data presented indicate that further diagnostic studies may be in order in unusual cases in which patients are suspected of having abdominal aortic aneurysm. This is especially true if the patient is known to have another condition such as carcinoma which may mimic aneurysm with metastatic periaortic lymph nodes. Aortography and/or lymphangiography occasionally have their place in selected patients, and this is discussed.

Using flexible gastrointestinal endoscopes, we have examined the urinary intestinal conduits of 15 patients. We have found this to be a reliable, easily performed endoscopic procedure that allows ureteral catheterization when needed. The instrument, technique, and results are described.

Estramustine phosphate administered orally at 900 mg. daily depressed plasma testosterone levels in 10 consecutive patients who had previously been treated with estrogen hormones and/or orchiectomy and who were all in relapse from carcinoma of the prostate. Approximately one half of the patients responded to the treatment clinically. The decrease in plasma testosterone did not correlate with the clinical response. The clinical effect of estramustine phosphate may be due to decreased plasma testosterone levels, inhibiton of 5-alpha reductase activity, and a local cytotoxic effect.

A technique for sequential, unilateral, extraperitoneal pelvic lymphadenectomy is described. The procedure is advocated for staging patients with localized prostatic carcinoma in whom all laboratory test results for metastases are negative and in whom definitive radiation therapy or radical prostatectomy is contemplated. This procedure allows complete excision of the regional lymphatic drainage of the prostate with minimal surgical morbidity.

This study sought to determine whether or not transitional carcinoma cells can adhere and progressively grow on normal or inflamed bladder urothelium. Inflammation was produced by intravesical N-methyl-N-nitrosourea. Tumor cell implantation occurred in only 13 per cent of mice with normal bladder, whereas in the presence of an altered urothelial surface ther was a 60 per cent incidence of tumors. This study not only has clinical implications but also offers a model to investigate modalities to prevent tumor cell implantation.

A case of testicular malakoplakia is described in which cells other than histiocytes were involved in the tissue response. The abundant cell junctions, some closely related to mitochondria, and the peripheral displacement of rough endoplasmic reticulum by abundant phagolysosomes, suggest involvement of Sertoli cells, in addition to histiocytes. It is suggested that, perhaps, some forms of granulomatous orchitis and malakoplakia represent a single disease process observed at a different stage in its evolution.

Three cases of dairy herds affected by production disease (infertility, calf scours and low milk yield) were carried out. The value of blood analysis in establishing a diagnosis and a dietary supplement of molasses in correcting the production problems is illustrated.

Red, sika, fallow, roe and muntjac deer adapted to captivity in experimental units designed for working with foot-and-mouth disease. The red, sika and fallow deer readily accepted rolled oats and hay as their staple diet. This diet was replaced for the roe and muntjac deer with flaked maize, calf starter pellets and green browse. Etorphine/acepromazine ans xylazine were found to be suitable sedatives for detailed examination of the tongue and oral cavity of the various species of deer and gave adequate analgesia for the inoculation and collection of virus samples.

The snouts of 2701 pork, bacon and heavy pigs killed at five abattoirs in England and Scotland during March to July 1974 were examined for evidence of atrophic rhinitis. Lesions were graded 1 to 5 according to severity. Suspicious lesions were present in 75-7 per cent of the sample. There was obvious atrophy of the turbinates in 44-7 per cent (grade 2 to 5) and severe atrophy in 17-5 per cent (grades 3 to 5). Foreign bodies were found in or between the posterior cheek teeth of 5-3 per cent of the sample. There was frequently an associated gingivitis. Other lesions seen included black discolouration of the teeth, severe tooth wear and osteoarthrosis of the temporomandibular joint. It was concluded that the incidence of atrophic rhinitis could have increased markedly since the last survey of the United Kingdom was undertaken in 1956/57 and some form of disease-monitoring service was urgently needed.

An immune agglutination procedure is described in which red cells are coated with antigen and agglutination is observed after a short incubation with antibody in reagent serum. Conversely, the cells may be coated with antibody and used to test for the presence of antigen. Treatment of the reagent serum with cobra venom factor results in inhibition, and there is a marked lo-s of sensitivity with cells pretreated with formalin or chromic chloride, suggesting that C3 and some type of reactive sites on the cells are required. The distinctive features of the new procedure are that incubation time is very short, sensitivity is several orders of magnitude higher than with other related tests, and, within some limitations, bovine (steer) red cells with bovine serum can be used as an alternative to human red cells with human serum. It is necessary to remove an inhibitor from the reagent serum, human or steer. While the mechanism of the procedure needs further elucidation, the findings reported here suggest that it ought to be sufficiently sensitive to detect hepatitus B antigen if present in virtually any blood sample. With appropriate modifications it should be useful for blood donor screening, diagnosis, and for studying many other antigen-antibody systems.

A Negro woman of the Xhosa tribe of Port Elizabeth in the Eastern Cape was found to be S--s--U--with anti-U in her serum. She had two S--s--U-- children, and her husband, father and other children all had single doses of S or s antigen. Three furhter S--s--U-- Negroes were found in a random sample of 1,000 Negro antenatal patients at Port Elizabeth.

A method is described in which the factor VIII (AHF) activity of 40 individual cryoprecipitates can be determined within 4 h. The reagents employed do not require plasma congenitally deficient in factor VIII. The preparation of cryoprecipitates with known biological activity should result in a more rational use of this type of factor VIII concentrate.

The mortality rate due to heroin overdosage in San Francisco has increased dramatically since 1968 and now stands as one of the highest in the United States. While the numbers of heroin fatalities in many eastern United States cities have declined substantially in the past few years, the figures for San Francisco and the other West Coast areas continue to increase. The group of heroin overdose victims from the 1970 through 1973 period is more predominantly Caucasian and younger than from the 1963 through 1965 period. In nearly all of the victims, the presence of morphine (a heroin metabolite) was noted in bile or urine, and in about half the results of blood alcohol tests were positive. Measurement of blood morphine concentrations in the victims showed no significant difference from the concentrations noted in a control group of heroin addicts dying from causes other than overdosage.

Over a one-year period, 167 patients with cancer were seen in a total of 1,931 clinic visits. Of these patients, 59 percent responded to therapy, with 20 percent achieving a complete response. The median duration of response was eight months (12+ months for complete responders, 7 months for partial responders), with only a two-month average survival for nonresponders. Seventy-seven deaths in clinic patients occurred for a death rate of 46 percent. Hospital tumor registry referrals rose 46 percent. The effect of early referrals, sources of referral, metastatic sites, chemotherapeutic drugs used, morbidity and type of therapy are also reviewed.

Survival studies were done on 36 children with cystic fibrosis and heart failure. Thirty percent did not survive the first four weeks, and the median survival for the group was between two and three months. By the end of the first year from the onset of failure, 74 percent had died and at 30 months, 87 percent had died.

This paper reports sporadic occurrence of the Pfeiffer syndrome with Kleeblattschädel (KS) in a male infant who died at 6 months of pneumonia with signs of increased intracranial pressure and who was found to have hydrocephalus, polymicrogyria, cerebellar herniation, bicuspid aortic valve, a common mesentery, absence of lesser omentum, hypoplasia of gallbladder, a single umbilical artery, and multiple eye defects. This case is presumed to represent a new mutation: in other families the Pfeiffer syndrome has been dominantly inherited. The Pfeiffer syndrome is a form of acrocephalosyndactyly and impresses clinically as a mild form of the Apert syndrome. The Kleeblattschädel is an etiologically non-specific developmental field defect (DFC); about two fifths of 51 known cases have apparent thanatophoric dwarfism and about one fifth are probable or possible examples of the Pfeiffer syndrome. The KS-DFC has also been seen in the syndromes of Carpenter, Apert and Crouzon.

The question of "myopathia rachitica" was pursued in a disease progress study using rachitic rats. The length of the study was 18 weeks. During this time a discrete dystrophic myopathy formed. The morphometric examination showed muscle fibre diameters 8--24 mu less than those of healthy control rats in correlation with the degree of rachitis. The absence of fiber growth in the C fibres was conspicuous. The question of the relation of these findings to the inactivity, osteomalacia and changes in metabolism in rachitis was discussed. The myopathic changes can not be solely interpreted as a result of inactivity, but the cause of myopathia rachitica remains unclear.

In 36 children with cystic fibrosis (CF) the isoenzymes of alkaline phosphatase (AP) were determined microelectrophoretically in polyacrylamide- and starch-gel. The study was done to evaluate the clinical significance of these additional data for the diagnosis of liver involvement in DF. The results led to the following conclusions: 1. Serum activity of total AP is comparatively unsensitive "masking" alterations in the isoenzyme pattern contributing to the AP serum activity. 2. In 17 children resp. 47% bile-duct phosphatase was increased indicating a secretostasis while other marker enzymes of cholestasis were normal in part. 3. The activity of bone phosphatase in the serum showed a significant correlation to the degree of growth retardation in these patients. 4. Intestinal phosphatase was present in the serum of only one child with cirrhosis of the liver being an indicator for liver insufficiency. 5. Determination of AP isoenzymes in the serum may provide additional information about the organs involved for the physician in handling CF patients.

A series of cyclic peptides of sarcosine with the general formula c-Sar-n, n=2-8, has been synthesized and conformational studies carried out both in solution and in the solid. The rings are conformationally very homogeneous and contain both cis and trans amide bonds. Their barriers to ring inversion are high; in the smaller rings this is attributed to steric hindrance, caused by the N-methyl-groups, whilst in the larger rings the folding of the chain in helical segments plays an important role.

The crystal structure of D,L-(2-hydroxyphenyl)-alanine has been determined by X-ray methods using 1971 observed reflections. The crystals are monoclinic, space group P2-1, with four molecules in the unit cell of dimensions a=6.32-5 A; b=26.48-9 A; c=5.36-7 A, and beta=98.1-8 degrees. The structure was solved by direct methods and refined to a conventional R-factor of 0.048; estimated standard deviations in bond lengths not involving hydrogen are 0.002-0.004 A and in angles 0.1-0.2 degrees. Bond lengths and angles are in accordance with those found in tyrosine. Owing to an intra-molecular hydrogen bond between the ammonium group and the ring hydroxyl oxygen atom, however, the conformational angles differ from those found in several other phenylalanine derivatives. There are non-crystallographic centres of symmetry between pairs of enantiomeric molecules.

The crystal structure of (--)-adrenaline has been determined by X-ray methods, using 831 observed reflections collected by counter methods. The crystals are monoclinic, space group P2-1 with a=7.873(2), b=6.790(2), c=8.638(2) A and beta=98.01(2) degrees. Least-squares refinements yielded a conventional R-factor of 0.053. Standard deviations in bond lengths are 0.005-0.006 A and in bond lengths aree 0.005-0.006 A and in bond angles 0.4 degrees. The adrenaline molecules were found to exist as zwitterions in the crystals. The conformation of the adrenaline molecule corresponds closely to that usually encountered among the salts of the sympathomimetic amines. The crystals consist of molecular double layers parallel to (100). The molecules within a layer are linked through hydrogen bonds of the types N--H...O and O--H...O, whereas the layers are connected by van der Waals interactions.

In order to investigate the importance of different inspiratory gas flow patterns in respirator treatment, eight intensive care patients were studied with breathing mechanics and five patients also with gas exchange studies. Three different inspiratory gas flow patterns were tested in randomized sequences namely, accelerating, constant and decelerating flow. All three flow patterns were generated by the same respirator. No end-inspiratory pause was used. The results point to a favourable effect on breathing mechanics of a decelerating and a constant flow when compared with an accelerating flow type. However, when the total effects on gas distribution and lung perfusion were evaluated in the gas exchange studies, no significant differences were seen between the three flow patterns.

Thirteen patients submitted to total hip replacement surgery by the Charnley technique were studied. Operations were performed under epidural analgesia with the patients awake and breathing air. During the surgical procedure, the magnitude of tissue-thromboplastic activity, the amount of fat globules, the presence of bone marrow cells and the concentrations of acrylic monomers were determined in the pulmonary arterial blood. Simultaneously, arterial blood gases and blood pressure were monitored. Marked reductions of the arterial blood pressure and arterial oxygen tension occurred after impaction of the femoral prosthesis, and minor depressions appeared after insertion of the acetabular prosthesis. A significant correlation was found between the release of tissue-thromboplastic products into the pulmonary circulation, i.e., products that initiate intravascular coagulation and the circulatory and respiratory reactions. The pulmonary fat droplets, per se, seem to be of minor importance, and the release of acrylic monomers is probably of no importance for these reactions.

The systolic time intervals were studied in 16 surgical patients without heart disease between 29 and 75 years of age by a non-invasive technique before and after an induction dose of enibomal (Narcodorm). The pre-injection period/left ventricular ejection time-ratio (PEP/LVET-ratio) increased between 8 and 60% and (1/PEP-2) decreased between 3 and 50%, indicating a reduction of myocardial contractility under the influence of enibomal. Factors responsible for circulatory depression during barbiturate anaesthesia are discussed.

Catecholamine output and circulation were observed in connection with pulmonary surgery in one group of ten patients who were anaesthetized with halothane-N20-02-d-tubocurarine and who breathed spontaneously after operation. In another group of four patients who received a modified neurolept anaesthesia with phenoperidine-N2O-O2-d-tubocurarine and who were mechanically ventilated also after operation, catecholamine output and temperature were observed. In both patient groups, catecholamine output was normal during iperation. Adrenaline output increased by 400% the first postoperative hours, while noradrenaline output remained normal. Thereafter, noradrenaline output increased, while adrenaline output started to decrease. A subnormal body temperature was seen at the end of the operation. In two patients from the neurolept group, adrenaline output and temperature were recorded hour by hour; maximal adrenaline output concided with maximal temperature rise. In the patients from the halothane group, the pstoperative change in foot, calf and forearm blood flow correlated well with the change in catecholamine output. The central circulatory response to the symptahoadrenal stimulation was, however, found to be less pronounced than is ordinarily seen.

The influence of thiopental (Trapanal) on coronary blood flow (MPF), myocardial oxygen consumption (MVO2), and general haemodynamics was investigated in seven patients without heart disease. Besides measurement of MBF, the amount of substrates (glucose, lactate, pyruvate and free fatty acids (FFA) was also determined in arterial and coronary sinus blood samples. Thiopental was given intravenously in a mean dose of 4 mg/kg b,w, MBF was measured by means of the argon method. After injection of thiopental, all seven patients showed a significant increase of MBF and MVO2, a fact which can essentially be explained by the increase of heart rate. The effects of thiopental on arterial concentrations, arterior-coronary substrate differences, myocardial uptake, and O2-extraction ratio of the different substrates are discussed.

The effect of intravenous administration of dihydroergotamine (DHE) on regional blood flow in the forearm and calf after pharmacological nerve blockade of the lower body induced by epidural anaesthesia has been studied in 13 subjects. After anaesthesia, DHE induced a significant increase in blood flow in the forearm with intact innervation and a significant decrease in blood flow in the nerve-blocked calf. On the average, the arterial blood pressure increased slightly. The calculated local vascular resistance increased in the nerve-blocked calf, probably due to a direct myogenic constrictive effect of DHE. In the intact forearm, local vascular resistance decreased. The results indicate that DHE exerts a complex effect on resistance vessels in addition to its well-known effect on the capacitance vessels.

Ten patients without known cardiac or respiratory disease were investigated with breathing mechanics and gas exchange studies during anaesthesia and artifical ventilation. The effects of three different inspiratory gas flow patterns, namely, accelerating, constant and decelerating flows were studied. A decelerating flow resulted in an increase of total compliance when compared to an accelerating or a constant flow. However, at the same time, there was an increase in physiological dead space and a decrease in alveolar ventilation with a decelerating flow compared to an accelerating flow. These results seem to indicate an improved gas distribution in the greater airways with a decelerating flow pattern, but when the total effects of gas exchange were judged, the greatest benefits were with an accelerating flow.

The arteriovenous concentration difference of bupivacaine in plasma after epidural injection in man and after intramuscular injection in dog was studied. In man, arterial concentration was higher than peripheral venous ocncentration during an initial period of about 30 min, after which time period venous and arterial concentrations became fairly similar. Comparable results were obtained in the animal experiments. In addition, the experiments in dog indicated that the concentration of bupivacaine was fairly similar in central venous plasma and arterial plasma, but higher than the peripheral venous plasma concentration. These factors have to be taken into consideration when toxicological studies of local anaesthetic drugs are made.

Hospital records of 79 patients treated with tracheostomy or long-term intubation from 1969 to 1971 were reviewed, and the 43 surviving patients were examined by laryngoscopy, x-ray and spirometry for complications subsequent to these treatments. Early complications included one tube occlusion and one case of postextubation stridor in each group, one dislocated tube, one bilateral pneumothorax, and one case of fatal innominate arterial hemorrhage in the tracheostomy group, and two cases of atelectasis in the long-term intubation group. Necropsy findings included necrotic ulcers in the larynx of intubated patients and eroded tracheal mucosa in both groups. Late complications in surviving patients were prolonged hoarseness in six patients treated with prolonged intubation, two of whom had also had tracheostomy. Radiologically verified tracheal stenosis (40-60%), four at the stoma level and one at the cuff level, all occurred in the tracheostomy group.

Effects of halothane anaesthesia on aplanchnic blood flow and cardiac output were studied in six dogs. Blood flows in the hepatic artery, the superior mesenteric artery and the portal vein were measured electromagnetically. Cardiac output was measured by thermodilution. Depth of anaesthesia, ventilation, acid-base state and body temperature were controlled. Cardiac output and blood flows in the hepatic artery, the superior mesenteric artery and the portal vein decreased significantly to 73%, 54%, 59% and 60% of control values, respectively. Total peripheral vascular resistance decreased significantly, while mesenteric and portal resistance remained essentially unchanged and hepatic arterial resistance showed a significant increase. It is suggested that the difference between the various vascular responses may be caused by a differentiated release from baroreceptor inhibition in various parts of the bulbar vasomotor center.

Maternal cardiac output, blood pressure, heart rate, fetal blood pressure, heart rate and respiratory blood gases, and uterine blood flow were measured in six pregnant monkeys during halothane-nitrous oxide and oxygen anesthesia and compared to theses same parameters observed during nitrous oxide and oxygen anesthesia. Halothane 1.5% was associated with a decrease in maternal arterial pressure (54%), heart rate (10%), cardiac output (17%), total peripheral resistance (40%), and uterine blood flow (38%). Mean fetal heart rate decreased 18% and mean fetal blood pressure 22%. These changes in fetal hemodynamics were probably related to a direct depression of the fetal cardiovascular system and its usual compensatory mechanism as well as the fetal asphyxia secondary to the decrease in uterine blood flow.

1. The growth model forumlated for prenatal and postnatal growth up to the middle of the puberty phase seems to be valid for the later postnatal phases as well, including adulthood and senescence. 2. In this model, growth consists of phases with exponential growth (constant specific growth rate) separated by sudden changes in the rate. 3. In the period described here, 7 phases can be distinguished, beginning with puberty (phase IV) and ending with senescence (phase X). 4. In 4 of these phases the growth rate does not differ significantly between the four groups of mice used. In the other 3 phases there are no differences between three of the groups but the fourth, one of the sexes of the CPB-S strain, differs very definitely from the rest. 5. Absence of growth occurred in some phases in one of the groups. 6. Some of the phases do not occur in all individual animals; this holds especially for phase VIII, which occurred in only about 25% of the animals. 7. The 'growth constants' postulated in Part I and now studied in the individual mice, tend to have a value of about 2. A theoretical model is described for the regulation of the mitotic rate giving 'growth constants' of about the same numerical value.

The gall bladder from 6 Psammophis sibilans, 10 Bufo regularis and 10 Albino mice were extracted and prepared for microscopic examination. It was found that the mucosa of Psammophis sibilans consisted of ovoid and polygonal cells which were occasionally binucleated cells with darkly stained nuclei and occasionally pear-shaped cells with vesicular nuclei and fine processes. These cells were arranged in three layers. Apossible explanation for the different types of cells encountered and their arrangement was given. The gall bladder mucosa of Bufo regularis and Albino mouse were thrown into folds covered with simple columnar epithelium. However, the epithelium of the frog was higher than that of the mouse, with the nuclei situated midway between basement membrane and the lumen. Vacuolated cells were detected in the gall bladder mucosa of the mouse. The significance of the mucosal folds was discussed.

Cross-sectional studies of the degree of the cranial base flexion were carried out in infant, juvenile and adult skulls in four genera of nonhuman primates (P. paniscus, H. lar, P. urinus, and M. mullatta). The cephalometric observations of the cranial base included linear and angular measurements of each specimen. The data obtained in this study showed that the anterior portion of the cranial base exhibits a significant shortening trend as the mammalian evolutionary scale ascends. Moreover, the growth pattern of the anterior portion of the skull base follows that of the facial bony structures. The ontogenic growth changes of the posterior portion of the skull base follows the growth pattern of the endocranial cavity. The significant trend of elongation in this area directly contributes to the posterior migration of the foramen magnum. The magnitude of these growth changes decreases as the evolutionary scale ascends. The angular measurements of the cranial flexion showed a less obtuse cranial base angle in young specimens and the ones higher on the mammalian scale. The skull kyphosis was less pronounced in these specimens and the anatomical features of the cranial base were more humanlike, including the balance of the head expressed by the position of the foramen magnum.

Evolution of the mammalian tongue has been characterized by a number of extensive structural adaptations for the highly specialized functions which various tongues perform. Variations in shape, epithelium, muscle arrangement and mechanisms of lingual stiffening are described, and the possible way in which such changes have occurred is discussed. The review also shows that a study of the tongue's structure in conjunction with other anatomical features may serve as a useful indicator of an animal's habits and diet and provide important information for taxonomic purpose.

The possible existence of one-sided dominance in the face, similar to the phenomena of handedness and footedness, has been investigated by studying smiling pattern, movements of the angles of mouth, winking, platysma contraction, raising and everting the upper lip with dilatation of the nostril, and vertical wrinkling of the forehead, on 300 right-handed and 30 left-handed persons. The conclusions are as follows: 1. The large majority of persons investigated do not use the two sides of face equally. 2. Facial ambilaterality is a rare feature. 3. There is no clear-cut correlation between handedness and the dominant side of the face. 4. The greater percentage (58.66%) of right-handed persons show a left-sided smile and find it more convenient to perform almost all exercises with the left side of the face. A still greater percentage (73.33%) of left-handed persons shows a right-sided smile and a better performance of all exercises with the right side of the face. The contralateral relationship of handedness to the dominant side of the face is significant in the right-handed and more so, in the left-handed persons.

On 110 preparations of the kidney in some wild animals (hare, fox, wolf, bear, boar and chamois), the blood vessels and the excretory apparatus were studied by dissection, injection-corrosion and microscope. Only the bear has a markedly split kidney, whereas the kidneys of the other animals are unsplit. In the fox there is an obvious split of the renal artery into anterior and posterior branches which supply the anterior and posterior portion, respectively, of the renal parenchyma, being separated from each other, so that we may speak of an anterior and posterior kidney. In the fox, wolf, hare and chamois the interlobar arteries pass through the renal calices in a loop composed of adipose tissue, invested by the epithelium of the renal calyx. The renculi of the bear kidney show complete autonomy in relation to the blood vessels as well as in relation to the excretory apparatus. The relation of the surface of the excretory apparatus to the whole kidney was studied. Thus we have found the fox to have relatively the largest excretory apparatus, whose surface amounts to 31% of the whole kidney. In the remainder of the animals investigated this percentage is considerably less, ranging from 21.7% (boar) to 26.7% (bear).

The histoenzymic pattern of oxidative enzymes (G-6-PDH, G-PDH, ICDH, SDH, HBDH, NADH-2:tetrazolium dehydrogenase) was investigated in the developing neuroglia of rabbit brains, with special regard to the period of myelinogenesis. The obtained results lead to following conclusions: (1) During the early period of postnatal development there is maximal oxidative enzyme activity in ependymal cells, somewhat less reactive are the undifferentiated matrix cells and the differentiating cells of the mantle layer. No distinction can be made between the response of spongio- and neuroblasts. (2) Distinctly increased oxidoreductase activity, as compared to the early period of postnatal development, is demonstrated by the differentiating cells of myelination gliosis, no prevalence being demonstrable for enzymes of the particular metabolic pathways (pentose shunt, glycolysis or Krebs cycle). (3) G-6-PDH, G-PDH and oxidoreductases acting within the citric acid cycle are demonstrable only in single cells of the interfascicular oligodendroglia of adult rabbit brains, while almost all cells exhibit appreciable activity of HBDH and NADH-2 tetrazolium dehydrogenase.

The pattern of mucin secretion of the gastrointestinal tract of the toad (B. melanostictus) was investigated by histochemical methods. The goblet cells of the oesophagus secreted mainly acid mucins which were sialomucins, while the cells lining the surface of the stomach produced neutral mucins only. Goblet cells of the small intestine and cloaca secreted acid mucins, which were predominently sulphated mucins.

In order to strengthen a hypothesis concerning the occurrence of ectopic granule cells, one of the assumptions made was tested systematically. The reaction of the EGL to partial destruction by various single doses by hydroxyurea at various ages was followed. Under all conditions examined, re-population of the EGL takes place--rapidly after lower doses, slowly after high doses of HU. The phenomena observed are discussed with a view on the hypothesis mentioned. Re-population is beneficial, but may itself be a major pathogenetic factor in certain developmental malformations by upsetting the "time-schedule". The results are also of potential interest for an analysis of the regulation of normal cerebellar morphogenesis.

The case of a child is described who at the age of 2 years showed the first evidence of a developing neurological disease. Within a couple of years, profound mental retardation and severe motor deficit with spastic tetraplegia became established. No seizures and no pigmentation of the retina were observed. The condition remained practically unchanged for some 8 years and the patient died at 12 years of age of terminal bronchopneumonia. At autopsy there was conspicuous diffuse atrophy of the brain. The cerebral cortex was particularly involved. Most of the cortical neurons were destroyed and neuroglia showed abundant proliferation. The few remaining neurons contained inclusion material which was identified as lipofuscin. Noticeable cedifferences from the various types of amaurotic idiocies are noted and similarities to a case of lipidosis recently reported from Finland are suggested.

The lateral vestibular nucleus was studied by light and electron microscopy in normal rats as well as in rats in which the anterior cerebellar vermis was destroyed. Dark neurons were seen in many of the operated rats but were rarely found in normal control animals. The dark neurons were not seen in adjacent nuclei. In additional rats, it was found that anoxia, extra anaesthetic, postmortem rough handling, and sham operations did not increase the frequency of dark neurons. These data indicate that dark neurons might not always be artifactual and that the lateral vestibular nucleus appears to be a focal point for their occurrence.

A case of post-traumatic chronic pan-hypopituitarism in a 22 year old man is reported. Post-mortem examination revealed gliosis of the posterior hypothalamus, sclerosis of the neuro-hypophysis, cellular atrophy of the adenohypophysis, with relative hyperplasia of the basophil cells, atrophy of the endocrine target glands. Clinical and morphological findings are correlated and discussed.

Experimental Wernicke's encephalopathy, induced in rhesus monkeys with a diet lacking thiamine (vitamin B1), is characterized by cavitary necrosis of the striatum as well as a microvacuolar periventricular lesion of the brain stem such as occurs in man. With high resolution light microscopy and electron microscopy, the primary structural alteration in the brain stem lesion, and probably also in the striatum, appears to be that of widespread "blister" formation due to splitting of myelin at the intraperiod line. Microvascular alterations were minimal, even in the most severely affected regions. It is the myelin blisters which give rise to the spongy texture of the neuropil. A similar splitting of myelin has been described in several other experimental encephalopathies, and it is probable that it also occurs in Wernicke's encephalopathy in man.

Large dense core vesicles (LDCV) were found frequently enough in normal guinea pig central white matter, basis pontis and spinal cord posterior columns to be regarded as a normal organelle. A review of studies of LDCV and dense core particles (DCP), which have a different cytological localization and appear to be associated with a variety of diseases, suggests that they are the same, and hence remarkedly ubiquitous. LDCV should no longer be regarded as a type of synaptic vesicle, but as an incompetely defined organelle common to many cell types.

Amniotic fluid lecithin and sphingomyelin were determined quantitatively in 33 samples obtained throughout the last trimester. Each sample was divided into three parts and each part was centrifuged at different relative forces prior to extraction. It is shown that centrifugation always removes considerable amounts of both lecithin and sphingomyelin from the supernatant towards the end of pregnancy, but very little at the beginning of the last trimester. The fatty acid composition of amniotic fluid lecithin, studied by gas liquid chromatography, indicate that surface active lecithin is lost by centrifugation of the fluid prior to extraction.

The incidence of somatic complications in connection with legal termination of pregnancy by vacuum aspiration was analysed in 1,123 hospital patients. Special attention was paid to complication rates in relation to gestational age. It was found that the incidence of major uterine haemorrhage increased with gestational period, being unexpectedly high in the 12th week. When anaesthesia was supplemented with halothane there was a significantly higher incidence of uterine haemorrhage that when this anaesthetic was avoided. The results indicate that strict principles for the operation procedure are mandatory to reduce blood loss and other complications. It is suggested that the end of the 12th week should not be considered as a "magic" time limit for vaccum aspiration but that the policy should aim at early intervention, preferably before the end of the 10th week. In the event of late first trimester abortions or "border line" cases it is of advantage to administer prostaglandin extra-amniotically for pre-operative dilatation of the cervix.

Fibrinogen-fibrin degradation products, FDP, in menstrual blood during the first three days of menstrual blood during the first three days of menstruation have been investigated. Two groups of women were studied, those with normal menstrual blood loss (15 women, mean loss 30 ml, range 8-60 ml) and those with menorrhagia (14 women, mean loss 222 ml, range 107-729 ml). The following results were obtained: 1). The FDP concentrations decreased during menstruation in both groups. 2). The FDP concentrations in the two were compared for each day of the menstrual period. No differences were found between the two groups. A possible explanation of the results is given: there is a higher rate of coagulation and fibrinolysis in the endometrium of women with menorrhagia compared with women with normal blood losses. The hypothesis is supported by results of studies in which tranexamic is supported by results of studies in which tranexamic acid, an inhibitor of fibrinolysis, was given to reduce the menstrual blood loss. 3). The FDP excretion patterns differed from women to women. There were no consistent differences between the menorrhagic and the control group.

Prostaglandin F2alpha was used to induce abortion or labour in 84 women between the 11th and 44th weeks of pregnancy. Three different routes of administration were used, intravenous, extra-amniotic, and intra-amniotic. The extra-amniotic infusion of prostaglandin F2alpha produced a faster response than the other two routes. Less than one-third of the dose used in the intra-amniotic group was required in the extra-amniotic group for a complete evacuation of the uterus. Vomiting and diarrhoea occurred in 40% of the women in the intra- and extra-amniotic group, while the frequency was 88% in the intravenous group. Serum levels of progesterone and oestradiol decreased in accordance with the pattern found during spontaneous deliveries. The effect of prostaglandin F2alpha on the myometrium does not appear to be mediated via changes in the blood levels of progesterone or oestradiol.

Analysis of 340 term breech presentations in primigravidas showed a corrected perinatal mortality of 1.5%; the elective cesarean section rate was 15%. The incidence of complicated labour, defined in the study, was analyzed with regard to different parameters, e.g. X-ray pelvimetry data in all 340 cases. Complicated labour in vaginal deliveries markedly increased with increasing fetal weight (p less than 0.001) and decreasing pelvic capacity (p less than 0.001). In each case the fetal weight and smallest pelvimetry data were given score points and the sum of these was called the Feto Pelvic Breech Index, which was correlated to the incidence of complicated labour. By using this index the mortality and the routine use of elective cesarean section. The prognostic methods available to detect feto-pelvic disproportion are discussed.

A survey has been presented of the author's personal methods to treat urge incontinence in women caused by neurogenic disturbances or by urethritis. Denervation of the bladder by unilateral or bilateral resection of the inferior hypogastric plexus is used for neurogenic disturbances with uninhibited bladder contractions or hypertonic bladders and in cases of interstitial cystitis, if a preoperative blockade with local anaesthesia has given a favourable result. Urethral diverticula are extirpated. Urethritis is treated with careful dilatation of the uretha and massage in combination with local treatment of the mucosa with 1% solution of silver nitrate. In cases with a narrow urethral orifice a meatotomy is made. Women with wide external orifice and recurrent urethritis following intercourse are operated upon. A structure similar to the frenulum of the prepuce in the male is constructed, which closes the orifice at the introduction of the penis.

In 24 patients, who underwent therapeutic abortion for various reasons between the 17th and 26th week of pregnancy, urinary excretion of serotonin, 5-HIAA, total estrogens, and pregnanediol were measured before, during and after the intra-amniotic injection of hypertonic saline. 20% hypertonic saline solution (160-500 ml) was given by transabdominal injection over a period of 5 min. The four hormones or metabolites were measured during six periods: I; 12-24 hrs, and II: 0-12 hrs before saline administration, III: 0-12 hrs after saline administration, IV: 0-12 hrs during aborion, V: 0-12 hrs and VI: 12-24 hrs after abortion. The results point to the active participation of serotonin in the process of fetal expulsion, as serotonin was increased by over 100% (from 20-22 to 43-47 mu-g/12 hrs) during periods III-IV, and its metabolite 5-HIAA, too, increased by nearly 60% (from 2.4-2.5 to 3.3-3.9 mg/12 hrs). They decreased during the post-abortive periods V-VI. On the other hand, total estrogens decreased only slowly, but continuously, during all 6 periods (4.9, 4.3, 3.4, 3.1, 1.8 and 1.4 mg/12 hrs). Pregnanediol, beginning with 12 mg/12 hrs showed a slight increase during periods III-IV (14.5 and 15.6 mg/12 hrs) and a decrease during periods V-VI (8.0 and 5.8 mg/12 hrs). These findings are interpreted as indicating the disruption of feto-placental function affecting estrogens during periods III-VI. They might demonstrate an accelerated hydrogenation of progesterone into pregnanediol during periods III-IV, followed by a sharp decreased in progesterone/pregnanediol production during periods V-VI.

The effects of the selective beta-2-receptor stimulator terbutaline on the activity of gravid, human myometrium were investigated in vitro and in vivo, before and after administration of different beta-receptor blockers. Terbutaline, 0.2-1.0 mu-g/ml, inhibited the spontaneous contractile activity of isolated strips of myometrium. This effect was unaffected by the selective beta-a-receptor blockers practolol, 1 mu-g/ml, and H 93/26, 1 mu-g/ml. However, the non-selective blocker propranolol, 0.1 mu-g/ml, completely inhibited the terbutaline effects. The in vitro effects of terbutaline could be correlated with findings in vivo. Intra-uterine pressure was recorded in 4 pregnant women at term. Infusion of terbutaline, 10-15 mu-g/min, for 20-40 min, effectively inhibited both spontaneous and oxytocin-stimulated uterine activity. There was a moderate increase in maternal heart rate, but no consistent effect on maternal blood pressure. Fetal heart rate was little affected. The uterine effects of terbuline were not influenced by practolol, 5-20 mg i.v., but completely inhibited by propranolol, 1-2 mg i.v. The results suggest that terbutaline inhibits uterine motility by effects on uterine beta-2-receptors and that it can be given in clinically effective doses without adverse circulatory effects on mother or fetus.

The present investigation studied the influence of different types of intra-uterine devices (IUDs) especially that of a copper IUD, on the incorporation of 3-H-thymidine and 5-3-H-uridine into the endometrium of the rabbit. "Inert" IUD. In non-stimulated rabbits, the incorporation of 3-H-thymidine was increased in the copper influenced horn. The incorporation of 3H-thymidine in control and Cu-IUD-containing horns reached a maximum at 48 hours after HCG stimulation, but was significantly lower in the copper-containing horn than in the control horn. On the fifth day of pseudopregnancy, the incorporation of 3-H-thymidine was significantly higher in the copper IUD-containing horn. The total amount of DNA in the endometrium increased during early pseudopregnancy, but this increase was markedly reduced in the presence of copper. The copper IUD had no influence on the rate of incorporation of 5-3-H-uridine in non-stimulated rabbits, whereas it caused a higher incorporation on the fifth day of pseudopregnancy.

An account is given of an oscillatory rotating friction measurement apparatus which can be used for demonstration of boundary lubrication by synovial fluid when rubber and glass are employed as rubbing surfaces. A technical description of the apparatus is given. The greatest importance is placed on getting the apparatus to demonstrate reproducible results when saline and normal bovine synovial fluid are used as lubricant. The greatest variations are caused by differences in the cleaning of the rubber and in its tension. On the basis of bovine synovial fluid from ten different hock joints investigations were made of individual variations and changes occurring during storage at 4 degrees C. The individual variations were found to be of no importance; a decrease in the lubricating effect was observed only after storage for two months. Addition of trypsin confirmed that boundary lubrication by synovial fluid can be related to the protein component. The conclusion is that the apparatus is considered suitable for clinical investigations of boundary lubrication in connection with different joint diseases.

In unilateral coxa plana a shortening of the affected leg can often be found. This shortening affects not only the caput-collum part of the femur but also the other parts of the femur and the tibia. In this study, however, the immobilization of the affected leg seemed to be the main reason for the observed difference in the leg length. Children who had not unloaded their affected leg as carefully as they should proved to have a smaller difference in leg length than those who had unloaded their affected leg according to the instructions. On the other hand compensatory growth of the affected leg was found when both legs were again taking weight. The difference in the leg length was significantly reduced one year after the completion of the treatment.

Use of the Doppler principle with an ultrasound flowmeter provided a method of detecting fat emboli during total hip replacement. A measure of the quantity of fat emboli and when the embolism occurs during the operative procedure is possible with this method. By the use of a suction catheter inserted in the intramedullary canal or the placement of large drill holes in the lateral cortex of the femur the amount of fat released into the venous circulation can be reduced. Although no definite signature could be obtained for the audible "chirps" by energy density spectrum analysis the observer could readily distinguish these chirps from the burbling noise produced by air emboli. Ultrasound is an easy, noninvasive and reliable technique for detecting fat emboli during total hip replacement.

35S was administered to 20 puppies which had been exposed to transplantation of osteochondral apophyseal transplants from the iliac crest to defects of the femoral condyles. Some transplants were implanted into defects within the joint surfaces whereas others were implanted outside the joint surfaces. An autoradiographic study was performed to assess the functional vitality of the transplanted cartilage at varying intervals up to 14 months. This study further necessitated an investigation of the normal pattern of incorporation of 35S in the iliac crest. The studies revealed that the incorporation of 35S within the apophysis of the iliac crest was similar to that seen within pressure epiphyses, being heaviest in the proliferating and hypertrophying cells in the growth plate and around the secondary centre of ossification. The increased turnover of sulphur around the secondary centre of ossification declined, however, when the initial stage of the ossification was passed and when hypertrophy of cartilage cells was no longer seen. Ossification then took place without intensified production of organic sulphur-containing compounds in this region. The study further showed that apophyseal cartilage was still able to incorporate 35S following transplantation to the mentioned defects, except in some basal central areas adjacent to the metaphyseal bone. These findings suggested that the cartilage not only survived, but also preserved its capacity for synthetizing sulphur-containing compounds, probably chondroitin sulphate.

A below-knee amputee is generally known to achieve a close-to-normal performance level, with the patellar-tendon-bearing method of stump fitting. This was confirmed by an ergonomic investigation on ten below-knee amputees, fitted with PTB prostheses. The test group subjects were given two static tests, two dynamic tests and one exercise tolerance test, during which their oxygen consumptions, pulmonary ventilations, energy expenditures and peak heart rates were measured. The performance of the test subjects were compared with that of a control group consisting of sixteen normal, healthy, individuals. The percentage increases in the values of the biomechanical parameters of the test subjects, over those of the control group, were found to be justified and thus natural to the below-knee amputee-PTB prosthesis system. The ergonomic study has not yielded information regarding the biomechanical efficacy of the PTB prosthesis, but it has also shown that the amputees fitted with such prostheses can take up, without any undue extra effort and metabolic cost, industrial occupations of the moderately heavy kind.

In 21 autopsy subjects and 25 anatomical cadavers, both knee joints were dissected extensively to find: a) degenerative changes in the menisci of knee joints, especially horizontal tears and b) associated degenerative changes in the articular surfaces of the knee joint, in order to attempt a correlation between the two lesions. Thirty-nine horizontal tears of the meniscus in 21 patients were found, of which 32 were in the medial meniscus. There was no articular damage visible in three, minimal in eight, moderate in seven and severe in three subjects. The highest incidence was in the seventh and eighth decades with black males showing a slight preponderance. The degenerative meniscus with a horizontal tear is a part of the overall degenerative process in the knee joint and should be treated as such.

Forty-five knees with tibial osteotomy for osteoarthrosis were studied at 5 to 10 years following surgery. Twenty-seven were graded excellent, eight good and ten poor. The best results were found in knees which maintained a Femoro-Tibial angle of 163 degrees--180 degrees whereas the poor results were associated with either under-correction at operation or late recurrence of deformity. The latter was closely related to pain. Provided that the initial deformity is adequately corrected and maintained, tibial osteotomy for osteoarthrosis of the knee gives good results which can last up to 10 years.

A series of 58 children with 75 idiopathic congenital clubfeet is presented. Early soft tissue release was performed in 77 per cent. The main purpose of the study was to clarify the causes of postoperative relapse. The results were poor in 12 feet, 11 (19 per cent) were reoperated. On re-evaluation of the "poor" cases we found severe social problems involved, including parental neglect.

The effect of cortisone and an anabolic steroid on plasma hydroxyproline (HOP) was investigated in young male rabbits, following operative fracture of the radius. The action of these hormones was studied in three groups of animals, a cortisone (hydrocortisone sodium succinate 5mg/kg every day), an anabolic (norandronolone-19-phenylpropionate 5 mg/kg every other day) and a cortisone plus anabolic treated group. A fourth group of animals served as controls. Plasma HOP was found to increase during the fracture healing in control animals, particularly in the first week and during callus remodelling. Cortisone produced elevation of HOP level during the first two weeks followed by a decrease to low normal values. Animals treated with the anabolic did not present the initial rise but a sustained increase during callus remodelling. When both the anabolic and cortisone were administered, a curve similar to that of cortisone-treated animals was obtained. The initial increase of HOP is attributed to bone destruction and to a lesser degree to synchronous bone formation at the site of the fracture. This catabolic process seems to be enhanced by cortisone and inhibited by the anabolic. When, however, the two hormones are given together the protective anticatabolic effect of the anabolic is almost abolished.

Four surgeons participated in a study which aimed to demonstrate the physical work load during operations. Maximal oxygen uptake and maximum heart rate were determined by using the Douglas bag technique and recording the heart rate during the tests. By working at two submaximal work loads, heart rate was recorded and miximal oxygen uptake was determined indirectly. Using telemetry, heart rate was recorded during operation, and the mean oxygen uptake was determined. In 90 per cent of all operations the surgeons were working at a level of 20 to 30 per cent of their maximal aerobic capacity. There was an increase in body temperature and a decrease of body weight after all operations. In long lasting operations a decrease of grip force was noted.

Properties of acrylic bone cements during and after curing were determined for three brands of bone cement. Curing time and consistency were chosen for the characterization of the handling and working behavior of these materials. The performance of bone cements after curing may be related amongst other things to the following properties: water resorption, solubility/disintegration, flexural modulus of elasticity, yield stress, proportional limit, flexural strength and impact strength. Methods to determine these handling and material properties are described. The influence of radiopacifying and antibiotic additives on these properties is evaluated as well as the influence of porosity on flexural strength and impact strength. The results indicate that considerable differences in the handling properties occur. The material properties of the three brands tested do not show marked differences. Radiopacifying and antibiotic additives appear to have a negative effect on material properties; the effect of porosity as it develops during curing under simulated clinical conditions is more pronounced.

The pathological mobility of the metacarpo-phalangeal joints of 100 patients affected by rheumatoid arthritis was studied, and the results were analysed and compared with the results obtained in a control non-rheumatoid group. This report seems to suggest that rheumatoid metacarpo-phalangeal joints become more lax the longer the rheumatoid disease has been present. However, when there is marked local involvement of the joint this hyperlaxity cannot be proven because of pain and/or mechanical blockage.

Seventy-four women were studied at various points in time between 1 month and 12 years after a fracture of the distal end of the radius--Colles' fracture. In 50 cases the maximum loss of bone after fracture was considered to have taken place in that more than 4 months had elapsed since the accident. The bone mineral content was measured in both forearms with gamma absorptiometry. It was demonstrated that the degree of post-traumatic osteoporosis, calculated as the difference between the values obtained for the injured and the uninjured arms, decreased with time. The difference between the arms was greater in peri- and early postmenopausal and in very old women suggesting that these groups had lost more bone and/or been less able to restore lost mineral with time.

In a series of girls with idiopathic structural scoliosis the height, weight and age at menarche were studied. It was found that the girls were on the average taller than a control population and that except for the most severe cases their height was greater even if the trunk shortening caused by the deformity was not accounted for. The girls with scoliosis were also somewhat leaner. They did not deviate in age at menarche from normal girls in Sweden but there was a positive relationship between the age at diagnosis of the deformity and the age at menarche. When assessed together with previous data on the subject of height in children with scoliosis in Sweden it must be concluded that children with this deformity have a growth pattern which deviates significantly from that of the normal population.

The sitting height and its relationship to total height was compared for 164 girls with idiopathic adolescent structural scoliosis and 201 age-matched healthy controls. It was demonstrated that although girls with scoliosis were taller than controls the relationship between trunk and legs was undisturbed.

Dating from 1953, the hips of newborn have been examined routinely all over Sweden. In 1963 more than 99 per cent of all newborns (about 110,000) were delivered at maternity departments, where such examination was recommended. 615 cases of preluxation or dislocation were diagnosed, which means a frequency of 5.6 per thousand. A high frequency reported in some hospitals suggests overdiagnosis. To assess to what extent the examination of newborns has reduced the frequency of late diagnosis dislocation and dysplasia, extracts of the records were obtained concerning all infants born in 1963 and treated for dislocation of the hip in 1963-1966 at orthopaedic departments in Sweden. Twenty-seven reported cases were analysed and the children were reviewed after 4-10 years. Fourteen (52 per cent) of the children were found to have normal or practically normal hips at the review. Eight still had dysplasia with subluxation and 3 had substantially deformed joints, one had moderate deformity and one, untreated, still had luxation. Possible causes of late diagnosis are discussed and it is stressed -- that all physicians who examine newborns should be well versed in examination of the hip joints.--that the hip joints should, when possible, be examined on two occasions during the first weeks of life, especially newborns predisposed to dislocation owing to heredity, breech presentation or different kinds of malformations.--that it should be borne in mind that complete luxation, though rare, may exist already in the neonatal period,--that one should not forget to examine the hips of newborns who, because of prematurity, asphyxia etc., are referred immediately for intense treatment before routine examination of the hips has been carried out,--that a child health centes one should not rely on the results of the examination during the neonatal period, but should always examine the hip joints.

Two rabbits were immunized with a pool of mocoid secretion from glue ears. The ear fluids formed up to three specific protein precipitation lines with the absorbed immune serum. One of these proteins was identified as containing acid and another as containing neutral glycoproteins, the third component remained unidentified. The data bring out new evidence of the active secretory capacity of the middle ear mucosa in secretory otitis media.

Good results of iron therapy obtained in ozena patients with significantly lowered serum iron level encouraged studies on the pathogenesis of the disease. In electron microscopic examinations, special attention was paid to the considerable disintegration of connective-tissue stroma in the mucosa. In some connective-tissue cells ferruginous micelles were found in the mitochondrial matrix. Mitochondrial deposits may be a morphological expression of disturbed iron metabolism at subcellular levels.

The primordial submandibular glands of 12-day-old mouse embryos were studied in tissue culture before and after treatment with trypsin under the electron microscope. In vitro differentiation proceeded normally and reached a high level of differentiation. Following a soak in trypsin for 15 or 30 minutes, considerable changes were noted in the basal lamina and in the mesenchymatous cells. There often occurred bizarre bullous protrusions of the cytoplasm through the apparently weakened basal lamina and the mesenchymatous cells were converted into so-called "ropalocytes". Subsequently the cells regained their normal appearance and the basement lamina was covered by a thick layer of amorphous electron-opaque basement membrane like material. It is concluded that the basal lamina (the basement membrane under the light microscope) might be the keystone in the differentiation of an organ and its maintenance in the adult. The development of innervation has also been studied and it was shown that the developing submandibular galnd is endowed with large bundles of nerve axons surrounded by Schwann cells lying in the epithelial-mesenchymal region. Intra-epithelial nerves were conspicuous and occasional synaptic bars or rings could be seen contributing to thedifferentiation of the secretory cell.

Spontaneous nystagmus and locomotor equilibrium function were repeatedly tested before and after unilateral labyrinthectomy in 12 squirrel monkeys in order to study the effect of physical exercise on the vestibulo-oculomotor and vestibulo-locomotor compensation. Post-operatively, 6 of the monkeys received forced physical exercise in the rotating cage, while the other 6 did not. The provocation of post-operative spontaneous nystagmus was less in the exercise group. The statistical studies showed a certain contribution of physical exercise toward the oculomotor balance compensation and maintenance, probably at the level of the brain stem. Statistical comparison of the locomotor equilibrium performance did not depict a significant difference between the exercise and non-exercise groups; however, there was a possibility that the present testing maneuver which involves physically advanced tasks might have concealed the effect of the physical exercise.

Experimentally and clinically, we observed that the parasympathicomimetic reaction of the nasal mucosa was congruent with higher sensitivity of the nasal mucosa. The opposite is true of the sympathicomimetic reaction. The reason for this difference in reaction is connected with the transmitting agent of the vegetative system. This is shown in the provocation of intradermal reaction of different allergens by these transmitting agents.

Thirty-three patients with acute non-traumatic peripheral facial palsy were studied. In one patient, varicella-zoster virus was isolated from CSF. Antibody against the same virus was present in CSF, and rising titre was demonstrated in serum. In two cases, herpes virus hominis was isolated from the nasopharynx. CF-antibody tests indicated recent viral infection in 7 other cases. One additional patient had clinical signs of herpes zoster oticus. In most of these 11 patients, but also in the majority of the remaining 22 patients, an acute phase reaction was present, and serum and CSF immunoglobulins were increased. Thus, an active or recent infection (probably viral) seemed to precede or coincide with the facial palsy in most cases in both groups.

The authors have carried out an ultrastructural study of the human utricular macula and the vestibular nerve in the internal acoustic meatus of four patients suffering from Meniere's disease. They confirm the presence of degenerative alterations in the utricular sensory epithelium. The nervous fibers situated in the supporting connective tissue of the neuro-epithelium showed modifications in the Schwann cell cytoplasm and in the arrangement of the myelin sheaths. The same alterations appear in the vestibular nerve in the internal acoustic meatus in 2 of our cases. In the other 2, the vestibular nerve was formed by a granular matrix with several myelin figures in the proximity of possible Schwann cell nucleus debris.

Pigeons were subjected to weightlessness caused during parabolic flight in an airplane. Experiments were performed with these birds in their normal state, as well as in conditions with hooded eyes, with the legs bound, and a combination of both handicaps. In all these situations, the flight behaviour of the birds was observed. The results are discussed and comparisons are made with the behaviour of man and fish under similar conditions.

Respiratory and cardiovascular reflexes have been elicited from receptors in the nose and larynx in the anaesthetized dog. Cigarette smoke in the nose causes reflex apnoea, bradycardia and vasoconstriction, probably due to systemic absorption through the nose. Stimulation of laryngeal nerve also results in reflex apnoea, bradycardia, and limb vasoconstriction. When asphyxia supervenes due to apnoea, stimulation of the carotid body chemoreceptors occurs which normally cause, as primary effects, hyperpnoea and bradycardia. However, it has been shown that stimulation of the laryngeal receptors inhibits the carotid body respiratory reflex and facilitates the carotid body cardio-inhibitory reflex, the latter leading to temporary cardiac arrest. The clinical implications of this finding are discussed.

There are two extreme types of middle ear effusion leading to hearing loss (a) a rubber-like effusion seen in secretory otitis media and (b) a water-like effusion seen in serous otitis media. The possibility is considered that the degree of crosslinking in these two extreme cases is the basis of an altered mucus transport rate that leads to an accumulation of effusions and hence impaired hearing. It has been shown (King et al., 1974) that the requisite rheological property for transport activity is not unique to mucus structural macromolecules but is found with other polymeric systems that are loosely crosslinked e.g. guaran, polyacrylamide, gelatin and agarose. Studies on one of these systems guaran, indicate that the transport rate is dependent on the degree of crosslinking with a maximum rate found close to the gel point, i.e. in a region where there are very few crosslinks per macromolecule. The finding that mucus from different mucociliary epithelial sources involves a chemically similar structural glycoprotein suggests that differences observed in transport rate between various mucus samples are more likely due to differences observed in transport rate between various mucus samples are more likely due to differences in crosslinking than chemical variations of the glycoprotein units.

Experiments were performed in 18 patients with peripheral facial palsy (Bell's palsy) including unilateral stapedius muscle paralysis. After exposure to narrow band noise centered at 0.5 kHz temporary threshold shift at 0.75 kHz was significantly higher in the ear with paralysis than in the normal ear. After exposure to 2.0 kHz narrow band noise there was no difference in TTS at 3.0 kHz between affected and non-affected ear. It was concluded that the stapedius reflex has a protective function against low frequency sound exposure and suggested that this protection might be extended to higher frequencies only when high frequency noise also contains low frequency components.

A 32-year-old woman, patient of chronic glomerulonephritis whose total clinical course was 3 years. During this period intensive peritoneal and hemodialyses were performed. Autopsy revealed deposition of calcium oxalate in the kidneys and the other main organs as well as chronic glomerulonephritis. And it was thought that the patient was accompanied by secondary hyperoxaluria.

Processes of the formation of cuprizone-induced megamitochondria in mouse liver have been studied in detail by electron microscopy. The earliest change observed was the presence of large intramitochondrial granules. The next stage was the formation of myelin figures by which mitochondria were apparently connected. The third stage was characterized by megamitochondria connected with each other by their outer membranes. Continuity of mitochondria were further examined by serial sections, and megamitochondria were proved to be connected to each other far more frequentlythan expected on one plane of section. A model for the mechanism of megamitochondrial formation is proposed based on electron microscopic evidences, involving the fusion of mitochondrial membranes. Possibility is also discussed that cuprizone-induced megamitochondria may fuse to one single branching mitochondrion.

We examined 340 normal ears and cases of sensorineural deafness with electrocochleography using click stimuli (duration: 0.5 standard deviation of a population; repetition rate: plus or minus 10/sec; N=1 000, alternately positive and negative; analysis time: 31 standard deviation of a population). The latency of N-1 is a function of the sound pressure level and of the age of the subject. The intensity of N-1 (in mu-v) is a function of hearing level and is influenced by the presence of recruitment. The pure-tone audiogram is a function of the ECOG threshold and of the shape of the reaction obtained at maximal stimulation intensity.

Protein constituents of the concentrated urine prepared from 131 patients with various renal diseases were analysed by the use of electrophoretic and immunochemical methods, referring to histopathological findings of the kidney obtained from biopsy or autopsy. Excretion of macromolecular serum proteins in the urine would be promoted not only by the lesion in glomerular filtration but also by the damage in tubular structure due to severe inflammatory change. From the evaluation of levels of immunoglobulins and various autoantibodies in the blood and urine, there could be found that their increase in the urine was mostly associated with chronic persistent inflammatory reactions followed by destructive changes in parenchymal tissue of the kidney. Investigation of the features of urinary protein and activities of autoantibodies in the urine is likely to be advantageous for the differentiation or renal disease and the decision of condition in individual patient. However, it must be noted that variation of the urinary patterns is caused by more complicated pathologic changes in whole kidney rather than the disturbance of glomerular filtrating mechanism.

Adaptation of VIII nerve compound action potentials in response to trains of broad frequency spectrum clicks and high frequency filtered clicks is studied at various intensities in normal guinea pig under normal conditions, while masking with white noise and under pathological conditions after ototoxic antibiotic treatment. The results are discussed with respect to the clinical electro-cochleographic adaptation studies in man and the so-called two populations of receptors and nerve fibres in the cochlea.