Diagnostic value of a chemistry test profile. Serum chemistry test results were correlated with discharge diagnoses of 4,295 persons admitted to an acute care general hospital in a seven-month period. The diagnostic value of the test results, separately and in combinations of up to 12 tests, were calculated at each of ten levels as measured from the mean of normal in standard deviations. All patients had a serum profile consisting of total calcium, inorganic phosphorus, glucose, urea nitrogen, uric acid, cholesterol, total protein, albumin, total bilirubin, alkaline phosphatase, lactic dehydrogenase, and glutamic oxaloacetic transaminase levels. Analysis by manual and computer technics is illustrated. Computerized analysis of a chemistry profile is reported as a list of diagnostic possibilities in ranking order, with the calculated probability for each. In this preliminary report individual diseases are replaced by categories of disease taken from The International Classification of Diseases, Adapted (ICDA).


Polytomography in an otologic practice.

Polytomography in an otologic practice. The polytome should be used as an adjunct to conventional roentgenograms of the temporal bone and not as a substitute. The purpose of this paper is to demonstrate how the polytome has been used to great advantage in a private otologic practice.


Cardiac arrest after edrophonium therapy of supraventricular tachycardia.


An unusual live-birth sex ratio in Ecuador.


Basilic vein to brachial artery fistula: a new access for chronic hemodialysis. A new vascular access for chronic hemodialysis is developed by creating a fistula in the upper arm between the end of the relocated basilic vein and anterior aspect of the brachial artery. The procedure has been used 24 times in 23 patients over the past 15 months (average eight months) with minimal complications and low failure rates. This fistula provides a straight, long, easily accessible conduit with high flows; it has only one vascular anastomosis and maintains the anatomic continuity of its venous end with the axillary vein. It also obviates the need for autologous, prosthetic, or heterografts. The procedure is indicated when suitable vessels in the forearm have been exhausted or are unavailable. However, additional clinical trials and continued long-term follow-up are necessary for more definite conclusions.


Etiologic factors in lead nephropathy.

Etiologic factors in lead nephropathy. The rare occurrence of lead nephropathy in widely differing circumstances has suggested that additional causative factors might be required for its production. Seventeen cases of interstitial nephritis associated with severe chronic lead poisoning were reviewed in an attempt to identify these. Data suggested that alcoholism and preexistent hypertension, and also previous or minor urinary tract disease, may potentiate the injurious effects of lead. We recommend that the diagnosis of lead nephropathy should be a positive one, not one of exclusion, and that stored lead should be removed, particularly in persons with hypertension or previous urinary tract diseases.


Surgical treatment of reflux in completely duplicated ureters. Vesicoureteral reflux occurs in approximately 50% of duplex systems that undergo evaluation and most commonly involves the lower renal segment ureter. The therapeutic approach can be tailored for each case after careful evaluation of the anatomic and functional status of each renal unit. If reparative srugery is indicated and only one ureter is involved, then ureteropyelostomy or ureteroureterostomy have yielded excellent results. If more than one ureter is involved with either relfux or obstruction, then reimplantation of the paired ureters is indicated if the renal units are slavageable.


Tay-Sachs disease: a pilot screening program for the detection of the heterozygote in the Charleston Jewish community. A pilot screening program for the detection of the carrier (heterozygote) of the Tay-Sachs disease (TSD) gene has recently been completed at the Medical University of South Carolina. A fluorometric assay for serum hexosaminidase A and B was performed on the serum of 181 individuals from the Charleston Jewish community. One hundred seventy-six of these individuals were classified as normal based on the percent hexosaminidase A (Hex A) in their serum; five persons were classified as carriers of the Tay-Sachs gene, including a young married couple who were later referred for genetic counseling.


Ovarian pregnancies with Dalkon Shield IUCDs in situ: laparoscopic visualization. Two ovarian pregnancies coexistent with intra-uterine contraceptive devices are described. In one case, the ovary appeared to contain a cyst at laparoscopy and rupture of the cyst and extrusion of the fetus were witnessed. In the second case, a hemorrhagic ovarian cyst bled at laparoscopy and laparotomy resulted in the diagnosis of ovarian pregnancy. These two cases reveal that laparoscopic examination could be misleading and result in inappropriate management if the diagnosis of ovarian pregnancy is not entertained. The cases described add to the growing number of reports of extrauterine pregnancies occurring in patients using intra-uterine contraceptive devices.


Management of patients with modified Hunt pouch esophagojejunostomy after total gastrectomy for carcinoma of stomach. The Hunt pouch and its various modifications have been used as an esophagojujunostomy technic after total gastrectomy or esophagogastrectomy for benign and malignant conditions. This pouch procedure may be particularly useful for palliative gastric resections in which the patient's ability to ingest adequate foodstuffs might be enhanced by a larger reservoir, thereby improving nutritional status and possibly facilitating chemotherapy or radiation therapy or both. Intravenous hyperlimentation has been used to advantage preoperatively and postoperatively to help nutritionally depleted patients better tolerate such an operation and has been useful during treatment of complications related to the procedure. Three recent cases are discussed to illustrate the above propositions.


Superior mesenteric artery (Wilkie's) syndrome: report of three cases and review of the literature. Of the three cases of superior mesenteric artery (Wilkie's) syndrome presented, one was associated with anorexia nervosa; this association has not been reported before. Two patients were treated surgically with a duodenojejunostomy, and one was treated medically. Vascular compression of the duodenum is a controversial subject. The syndrome probably is more common than generally recognized and is underdiagnosed due to its exclusion from the differential diagnosis of small-bowel obstruction. Its recognition is important because early diagnosis of a partial obstruction may allow for medical rather than surgical intervention, as exemplified by our third case.


A new approach to pilonidal sinus excision.


Hypnosis in surgery--why and when.

Hypnosis in surgery--why and when. Hypnosis offers an excellent alternative to conventional anesthesia in certain selected or complicated cases. Ten different patients were selected from a group of 38 and were studied thoroughly. Good surgery and a smooth recovery were possible through hypnosis, alone or with conventional anesthesia.


Bridging: an effective and practical method of preventive skin care for the immobilized person. Various methods have been used in an attempt to decrease prolonged pressure on skin, especially over bony prominences, and thus prevent pressure sores in immobilized patients: turning frames, circle beds, flotation beds, and special mattresses. Bridging is one means of relieving pressure on bony prominences which is both simple and inexpensive. Through the proper positioning of pillows, a patient is supported above the surface of the bed with free space between the bony prominences and the bed surface. Several different positions for pressure relief are possible. Advantages of the technic include its low cost, patient acceptance, lack of mechanical components which can fail, and ease of training personnel or family members to carry it out.


Survey of sudden death in the offices of Atlanta physicians and dentists.


Postoperative infection of lumbar intervertebral disk space. Sixteen cases of postoperative intervertebral disk space infection are reviewed. Most occurred after diskectomy, but one followed an unsuccessful attempt at a spinal anesthetic and two followed diskography. Treatment varied from aggressive surgery, either by a posterior, lateral, or anterior approach, to drain the infected disk space or spaces, to more conservative immobilization. Antibiotics were used in all cases. Needle biopsy is valuable in establishing diagnosis and identifying the organism and its antibiotic sensitivities. In some cases fusion occurred spontaneously from the infection; in others, fusion was a result of surgical fusion preceding or following the infection.


The detection of glass foreign bodies.

The detection of glass foreign bodies. Roentgenography is a reliable method for detecting glass foreign bodies resulting from trauma. The density of glass in comparison to surrounding tissue almost always provides sufficient contrast for roentgenographic differentiation. This method is slightly compromised by the relative size of the foreign body and the body part being examined, but setting the roentgen ray beam for bone technic and having the patient in different positions facilitate detection of such a foreign body.


Pulmonary vein obstruction by bronchogenic carcinoma. Two patients with obstruction of the pulmonary veins by bronchogenic carcinoma, an unusual cause, are presented. These and other cases reported have had features suggestive of mitral stenosis. The differential diagnosis is discussed.


Arthroscopy of the knee joint.

Arthroscopy of the knee joint.


Fracture-dislocation of the dorsal spine. A patient with fracture-dislocation of D9 on D8 had considerable posterolateral displacement. The neurologic injolvement of his left leg proved to be progressive. Treatment consisted of posterior decompression, exploration, open reduction and stabilization by means of Harrington rods, and fusion. All neurologic findings resolved completely. Final evaluation 18 months later showed a good and serviceable spine with no residual neurologic deficits. In my opinion, the treatment used in this case under given circumstances represented a reasonable modality of therapy.


Migrating placenta previa.

Migrating placenta previa. A case of third trimester bleeding from placenta previa is presented in which serial ultrasonograms were obtained from the 30th to the 36th gestational week and confirmed by isotopic scanning. Evidence is presented showing a migration of a placenta previa marginalis away from the cervical os followed by vaginal delivery at term. The concept and mechanism of placental migration are reviewed.


Inflammatory subluxation of the atlantoaxial joint. A case of atlantoaxial subluxation accompanying pharyngitis is reported in a 4-year-old child. Diagnosis was made by examination and roentgenograms of the lateral cervical spine. Treatment consisted of halter traction and bracing. The patient responded well to treatment and is normal in all respects one year later. Atlantoaxial subluxation should be considered when treating pharyngitis, especially if the patient presents with torticollis.


Reye's syndrome in a neonate.

Reye's syndrome in a neonate. This case substantiates the fact that Reye's syndrome can occur in newborns. The clinical features appear to be slightly different in the neonate, in that respiratory distress was the presenting sign in this case and in the one other reported case in a newborn, with no mild preceding illness or vomiting. Thus, Reye's syndrome must be considered when a newborn presents with respiratory distress and evidence of central nervous system and hepatic involvement.


Dumbbell granulomatous abscess of the chest wall following needle biopsy of the pleura. A 38-year-old woman who had a Cope needle biopsy of the pleura was treated for plural tuberculosis on the basis of a positive PPD-S skin test and presence of caseating granulomas in the pleural biopsy. Ten months later she developed a tender, subcutaneous nodule in the area of the previous needle biopsy. Surgical exploration revealed a dumbbell abscess through the chest wall communicating with an area of consolidation in the right middle lobe. En bloc surgical resection of the abscess and peripheral portion of the right middle lobe was curative, although all pathologic and cultural studies of the resected tissue were non-diagnostic.


Multiple myeloma on polycythemia vera following radioactive phosphorus therapy. A 74-year-old white man with established polycythemia vera was treated with radioactive phosphorus after phlebotomies alone failed to control his disease. About 2 3/4 years later he died of multiple myeloma. The mutagenic effect of radioactive phosphorus may have caused or possibly accelerated preexisting myeloma. Basic nonmalignant disease deserves careful consideration before radiation or radiomimetic agents are used. One might consider a probably less mutagenic drug such as hydroxyurea in patients with polycythemia vera when phlebotomy alone does not give good control of red cell mass and thrombocytosis.


Mesenteric thrombosis after penetrating cardiac trauma. Survival of the severely injured trauma victim through aggressive therapy results in new complications. We report the first instance of mesenteric thrombosis in association with penetrating cardiac trauma. Selective visceral angiography should be obtained early in a patient with persistent abdominal pain following a period of prolonged shock; such cases should have a more favorable prognosis if diagnosed early in view of the limited period of cardiac dysfunction and the younger age group.


Dissecting popliteal cyst: an unusual complication of Reiter's syndrome. A case of Reiter's syndrome associated with a dissecting popliteal cyst mimicking deep vein thrombophlebitis is reported. The cyst was diagnosed by arthrography and responded to intra-articular injection of corticosteroids. The diagnosis of a dissecting popliteal cyst should be considered in a patient with arthritis of the knee joint from any cause and who develops signs and symptoms of thrombophlebitis.


Chlorpropamide-induced hyponatremia.

Chlorpropamide-induced hyponatremia.


State psychiatric hospitals: a response.


Manifestations of cystic fibrosis in adults.


Hepatitis B and possibilities for control.


Adverse psychologic reactions to ileal bypass surgery. Of 33 patients who underwent ileal bypass surgery for morbid obesity and were followed up with psychiatric interviews and consultation postsurgery, five appear to have had adverse psychologic sequelae related to the procedure. The emotional problems of these five patients were in part related to or precipitated by their drastic weight loss after ileal bypass. In most cases, the patients generally had depressive symptoms and, in dynamic terms, were dependent individuals with lifelong problems in object relations. The coping styles demonstrated, while not rigorously classified as psychiatric illness, appeared to predispose them for certain difficulties even when weight had been lost. Ileal bypass surgery apparently is not psychologically innocuous as previously thought, and psychiatric follow-up of patients is indicated.


Pneumatosis intestinalis in association with connective tissue disease. Pneumatosis intestinalis in association with connective tissue diseases is an unusual combination whose pathogenesis is not yet understood. Furthermore, steroid medication, often used to treat these diseases, may itself cause pneumatosis. Three cases of scleroderma, systemic lupus erythematosus, and amyloidosis in association with pneumatosis and without prior steroid therapy are presented. The small vessel occlusive pathologic processes in these diseases may cause focal areas of mucosal ischemia resulting in small, perhaps transient ulcerations that allow gas to enter the gut wall from the lumen.


Exophthalmos and epidural hematoma.

Exophthalmos and epidural hematoma. The development of a right exophthalmos in a patient with a left hemispheric epidural hematoma is reported. The parallel development of these two conditions in this unusual case suggests some direct relationship, although it must be recognized that a coincidental relationship is possible. The exact cause of the exophthalmos remains obscure.


Long-term follow-up of hip fractures.

Long-term follow-up of hip fractures. Hip fractures on 117 patients treated surgically and followed up for an average of 10.2 months are reviewed. Among the parameters analyzed were complications, mortality, clinical follow-up by the operating surgeon, and the ability to ambulate after surgery. Postoperative surgical complications occurred in 36% and medical complications in 18% of the patients. Mortality was 25% within the first year after surgery. Sixty-one percent of the patients returned at least once to the surgeon's office for follow-up; only 38% were followed for more than six months. In the surviving patients who were good ambulators before hip fracture, 60% to 70% became good ambulators postoperatively. Only 20% to 30% of the surviving patients who were poor ambulators preoperatively ever walked again.


Induced hypothermia: electrocardiographic abnormalities. Hypothermia was induced intermittently in a patient to combat hyperpyrexia. The electrocardiogram taken during the hypothermic phase displayed typical abnormalities and consisted of: pronounced sinus bradycardia, marked prolongation of the Q-T interval, muscle tremor artifact, and the characteristic "Osborn wave." Spontaneous rewarming resulted in disappearance of the electrocardiographic alterations, underscoring the functional and reversible nature of the abnormalities.


Autoimmune atrophic gastritis with hypergastrinemia. Elevation in fasting serum gastrin levels was found in three patients being evaluated for persistent upper abdominal pain without radiographic evidence of peptic ulcer disease. Fiberoptic endoscopy of the upper gastrointestinal tract in each patient revealed characteristic changes of chronic atrophic gastritis. Gastric biopsies showed diffuse chronic inflammation in the lamina propria, a decrease in the number of parietal cells, and "intestinalization" of gastric mucosa. Total achlorhydria was demonstrated after a maximal histalog stimulus; however, serum levels of vitamin B12 and Schilling test values were normal in all three patients. Parietal cell antibodies were found in the serum in all patients in a dilution of 1:20 to 1:80. These cases represent autoimmune (type A) chronic atrophic gastritis and should be distinguished from chronic simple (type B) gastritis, in which serum gastrin levels are normal and no parietal cell antibodies are found in the serum. Patients with autoimmune gastritis should be observed at frequent intervals for the occurrence of pernicious anemia or gastric carcinoma.


Mediastinal and subcutaneous emphysema in labor. The recent world literature on mediastinal emphysema has been reviewed and two cases added. This condition is relatively benign, and the supportive treatment is discussed. Subsequent pregnancies have been uncomplicated.


Pelvic lipomatosis.

Pelvic lipomatosis. A case report of pelvic lipomatosis in a woman is presented. This condition is a benign, apparently self-limited disease in which mature adipose tissue is deposited in the pelvis. The clinical presentation is discussed.


Complications of total hip replacement.

Complications of total hip replacement. The most common complications of total hip replacement are infection, loosening, dislocation, phlebothrombosis and embolism, neurovascular deficity, periarticular calcification, nonunion of the greater trochanter, malposition of components, fractures, and discrepancy in leg length. The cause, prevention, and treatment of these complications are reviewed.


Sequestration of the lung in children.

Sequestration of the lung in children. Three instances of intralobar pulmonary sequestration are reported to call attention to the occurrence of this lesion in children. In all three patients, the sequestration was diagnosed by arteriography and treated by lobectomy. Extralobar and intralobar sequestrations are described and the differential diagnosis is discussed.


Hair transplant surgery: planning the procedure. Factors important in planning hair transplant surgery are presented. The procedure must be designed for each patient individually. Success with hair transplantation depends upon developing surgical skill and having an appreciation of esthetically pleasing designs.


The diagnosis of subcapsular hematoma of the liver by scintigraphy. The diagnosis of subcapsular hematoma of the liver following blunt abdominal trauma has assumed clinical importance with recent reports of improved mortality with conservative management. There is increasing use of hepatic scintigraphy in evaluation of upper abdominal trauma. Two recently observed cases are used to illustrate the typical findings in this entity.


Psychotherapy as adjunct in treatment of vomiting during pregnancy. Adjunctive psychotherapeutic measures were used to treat ten consecutive pregnant women referred to a psychiatric consultation service because of severe intractable vomiting. In addition to customary medical measures, they received three types of psychotherapy: (1) supportive psychotherapy (establishment of positive relationship, frequent reassuring conversations, and encouragement of expression of thoughts and feelings); (2) hypnotherapy (trance induction and suggestions of comfort in the gastrointestinal tract, desirability of feeling of substance in stomach, and ability to retain and digest food eaten); and (3) behavior modification (positive reinforcement for retaining food and gaining weight, through granting desirable considerations such as visitors, radio, television, and being up in or outside the room). Results were encouraging. Nine patients recovered and completed normal pregnancies, while one improved but later aborted due to other complications. When compared with a control group of routinely treated patients, recovery was more rapid.


Teaching sex education and counseling for the primary physician. Today's family physicians are being confronted by increasing numbers of patients who desire and need sex education and counseling. It is suggested that the family and primary physician can approach the multiple sex-related needs of the family by understanding the family life cycle and by using permission-giving, limited information, and specific suggestions with patients as needed and as appropriate. The experience of the University of Miami's Department of Family Medicine in teaching human sexuality to medical students, residents, and faculty of the medical center is cited to help other residency programs include sex counseling and sex education in the armamentarium of residents.


Case clustering in cancer.

Case clustering in cancer. There is little evidence that time-space clustering is important in the epidemiology of leukemia, lymphoma, Burkitt's tumor, and myeloma. Clustering by interpersonal contact, particularly in Hodgkin's disease, does appear to occur, but more study is needed to warrant the conclusion that such contact is necessary for subsequent illness to develop. Future epidemiologic studies should include the use of laboratory analysis to evaluate the role of viruses, genetics, and environmental factors in cluster studies.


Preparation of tables for medical articles: guidelines for physician-authors. This review of the basic purposes and principles of tables is oriented toward their preparation by physician-authors for use in medical manuscripts. The guidelines suggested are consistent with the general format and style current in scientific and medical writing, with emphasis upon the latter. Style and usage do evolve, though, and even at any given time there may be in existence several acceptable variations of "standard" practices. Therefore, the value of style of the journal to which a manuscript will be submitted is again emphasized.


Occult sclerosing carcinoma of the thyroid. A case of occult sclerosing thyroid carcinoma is reported. The primary requirement for diagnosis is that the cancer is less than 1.5 cm in diameter. In addition, a fibrosing component with varying degrees of sclerosis is present. Lymph node metastases are frequent and may appear as benign thyroid follicles. Occasional direct invasion or vascular invasion may occur. Distant metastases were not reported in the series reviewed. Adequate therapy would seem to be total thyroidectomy of the involved lobe and radical subtotal thyroidectomy of the opposite lobe with excision of all enlarged or involved lymph nodes.


Granular cell myoblastoma (schwannoma) of the carina in a patient with sarcoidosis. The sixth case report of granular cell myoblastoma (schwannoma) of the carina, occurring in a 22-year-old black woman, is presented. Incidental coexistent carcoidosis was present. The various theories of the histogenesis of the lesion are reviewed briefly.


Transient electrocardiographic changes in anaphylaxis.


Thrombophlebitis and pulmonary embolism with surgical intervention in the third trimester. A case of acute deep vein thrombophlebitis and pulmonary embolism in late gestation has been presented with a discussion of diagnostic modalities, therapeutic regimens, and theoretical considerations. It is our belief that aggressive medical management is best accomplished by giving heparin intravenously as the primary anticoagulant. When medical management is best accomplished by giving heparin intravenously as the primary anticoagulant. When medical management is not effective or if embolism occurs, surgical intervention, consisting of vena caval clipping and ovarian vein ligation with scrupulous attention to detail, is indicated. Further, support to prophylaxis of abruptio placenta secondary to the mechanism espoused by Mengert et al is added by the course of this patient.


Serum immunoglobulin levels in White and Black patients with virus-A and-B hepatitis. Serum immunoglobulin G, M and A levels were measured in 106 White patients with acute virus-A (hepatitis-B surface antigen-negative) hepatitis and 27 White patients with acute virus-B (hepatitis-B surface antigen-positive) hepatitis and compared with the values previously obtained in Black patients with these diseases. The mean serum IgM level in the White patients with virus-A hepatitis was significantly higher than that in virus-B hepatitis (p less than 0,001). This difference was much more obvious than that in Black patients, mainly due to a much lower mean serum IgM response in Black patients with virus-A hepatitis. The reason for the blunted IgM response in Black patients with virus-A hepatitis is not known, but it may be related to a difference in the reaction against altered host tissues rather than any difference in antibody production against the virus per se. The mean serum IgG and IgA levels were not significantly different in the White patients with virus-A and virus-B hepatitis and they were lower than the corresponding figures in Blacks.


Laboratory studies on the vector capability of Aedes (neomelaniconion) unidentatus McIntosh and Aedes (Aedimorphus/ dentatus (Theobald) with West Nile and Sindbis viruses. Laboratory tests were made with Aedes (Neomelaniconion) unidentatus McIntosh and Aedes (Aedimorphus) dentatus (Theobald) collected from the Highveld region of the Transvaal, South Africa, to determine their ability of transmit West Nile and Sindbis viruses. Viraemic hamsters or a viraemic chick were exposed to the mosquitoes as infective meals. Infection of mosquitoes was determined by testing mosquitoes individually for the presence of virus 10-26 days later. Transmission of virus, attempted between the 10-20th days by exposing hamsters to groups of mosquitoes, was not achieved. With West Nile virus, the high concentrations of virus required to infect each species led to the conclusion that neither is an important vector of this virus. With Sindbis virus and A. unidentatus the 10 per cent infection threshold was less than 2,6 logs of virus, while with A. dentatus it was about 3,5 logs. This suggests that both species, but more particularly A. unidentatus, could be vectors of this virus.


The feeding pattern of the fruit bat Rousettus aegyptiacus in captivity. An electrical apparatus was designed to record continuously the feeding activity of either a colony of 30 fruit bats (Rousettus aegyptiacus) or single bats in captivity. The endogenous feeding activity rhythm was synchronized by change in the external light-dark cycle. During June to August (winter), the bats consumed an average of 96 g sliced banana, equal to 76 g wet weight/100 g body weight per 24 hours or 15 g dry weight/100 g body weight per 24 hours. The feeding period began shortly after sunset and continued for 10,6 h. Feeding consisted of 6-14 separate small meals. The mean or overall feeding rate was 9,1 g banana/h, and the feeding rate during the first 3 h, 13,1 g/h. The bat regulated its food intake by varying the rate of food consumption and not by changing the duration of  the feeding period. It is suggested that clustering of the bats may influence the caloric intake by reducing the energetic cost of thermoregulation.


GLC determination of paracetamol and d-propoxyphene. d-Propoxyphene and d-norpropoxyphene were determined in rat plasms, rat brain homogenates and human plasma by means of GLC utilizing extracts obtained by micro-phase extraction of the drugs. Paracetamol was determined in the same samples by GLC separation of the O-butyrate derivative using caffeine as internal standard. The problems associated with the GLC determination of d-propoxyphene and d-norpropoxyphene in biological material are discussed and attention is drawn to the particular advantages of the micro-phase extraction procedure for the quantitative determination of these drugs.


Current problems regarding the hygiene of the environment and the international co-operation.


Characteristics, objectives and activities of an institution for the improvement of public health management.


The crisis of the bourgeois conceptions in the field of health protection economy.


The importance of system aspects analysis of disability in industrial medical practice.


The organization and activities of the health statistics system in Hungary.


Efficiency of selected methods in contact flouride prophylaxis combined with dental health education.


Causes of death in men living in urban areas within a period of ten years. 1-st part.


The medical diagnosis as a specific problem of knowledge.


Contribution to the appreciation of the mean values of physical development indices in children and adolescents according to age groups and sex.


The morbidity through heart ischaemia in men in urban areas within a period of ten years. Part II.


The implementation of the new directions in the organization, activity and building of nursing homes in Hungary.


The quantity and quality of social services.


Management by objectives in a hospital social service unit. A Management By Objectives (MBO) system has been installed in the Social Service Department of the University of Minnesota Hospitals. MBO involves administering organizations through establishment and follow-up of goals. In order to accomodate a human service milieu two additions have been made to the usual MBO format: (a) a statement of program philosophy, and (b) a statement of essential program functions. Staff reaction to the system has been mixed, while hospital administration has been uniformly favorable. In the future the MBO system will be integrated with a management information system, and "significant others" will be surveyed to get more outside input inot the formulation of objectives. MBO meets organizational needs for effective planning, management of resources and control, while at the same time maximizing staff input into the overall operation.


The status of graduate-level social workers teaching in medical schools. At present, relatively little national data are available concerning the involvement of social workers in medical education. This article presents the results of a study conducted recently to obtain a comprehensive, up-to-date profile of graduate-level social workers teaching in medical schools and to survey the opinions of medical school deans regarding their present and future status. Continuing research in this area is essential if we are to acquire a greater understanding of the contribution social workers make to contemporary medical education. Only then will we be better equipped to assess social work's potentials for the future and take those steps necessary to bring them to fruition.


The HMOs: new models for practice.

The HMOs: new models for practice. New areas of practice are open to innovative social workers in an existing and expanding comprehensive health care delivery system--the health maintenance organization (HMO). In this article, four health plan models are described that document the experience of social workers in established HMOs. These illustrations demonstrate the necessity and opportunity for expanded social work roles in humanizing and corrdinating patient services in complex multidisciplinary health care delivery systems.


Education for social work in health care organizations. The American health care delivery system stands on the brink of major change and reorganization. There are many opportunities for the social work profession to increase its influence and expand the scale of its activities within health care. These opportunities represent a challenge to the vision, creativity, and flexibility of social work educators. This article discusseses educators' roles within the context of a system conceptualization of the inputs throughputs, and outputs of education for social work in health care organizations.


Social work education for the field of health: a report of findings from a survey of curricula. This paper presents the findings of a survey of programs in schools of social work made with specific reference to content germane to the field of health. The 62 schools responding to this inquiry constituted a representative sample of the 85 members of the Council on Social Work Education in 1972-73 in almost all regions of the United States and Canada. The inquiry included questions regarding; (a) specialization; (b) courses in health care systems; (c) courses in social work practice; (d) field practice; (e) interdisciplinary collaboration; (f) educational innovations; and (g) faculty coordinating the health component in the curriculum. Findings suggest a remarkably modest thrust in the direction of health and specialization at a time when health care is undergoing uncommonly rapid change.


Interdisciplinary education for community health: the case for nursing and social work collaboration. A nurse educator and a social work educator developed an interdisciplinary team-taught course in community health for both social work and nursing students. This account of their experience elaborates the implications of interdisciplinary education for the student learning experience including theory and practice content, socialization, and transition; faculty development; and the larger university community. Although this particular instance is limited to baccalaureate education, the authors underscore the potential of interdisciplinary course work for the enrichment of all levels of nursing and social work education.


Participatory governance: a model for shared decision making. The sharing in departmental decision making is viewed as a responsibility to be borne collaterally with the director by practitioners delivering direct services. While the process is viewed as consonant with professional growth and therefore properly evolutionary, the authors after facilitating premises and structures as well as a delineation of risks and rewards.


Psychosocial factors in low-incidence genetic disease: the case of osteogenesis imperfecta. Osteogenesis imperfecta (OI), a dominant genetic disorder, was examined in an exploratory case study of psychosocial implications. The cross-sectional survey sample consisted of 13 OI-affected adults and 21 families with an OI-affected child who were interviewed. Findings revealed numerous psychosocial concerns and problems in addition to their complex and lifelong medical problems. Specific problem areas differed according to the severity of the disease, type, and mode of genetic inheritance. The results indicate the need for local as well as national policy changes through legislation and extensions of existing services for low-incidence disease groups such as OI-affected persons. Implications for social work practice interventions call for greater involvement with genetic diseases, more aggressive approaches in case identification and service coordination, and performing longer-range monitoring functions than is usually the case.


Nursing home decision makers and the social service needs of residents.


Crisis intervention in a newborn nursery intensive care unit. Premature birth of a defective infant challenges personal and family integrity, and immediate intervention is optimal in reaching a positive outcome. The G. case exemplifies many aspects of crisis theory; worker intervention was built around them. As the G. family struggled with the impact of a severely damaged infant, a broad range of worker techniques, based on the parents' strengths and personal backgrounds, was required. Intervention was significant in effecting a positive resolution. This article details the events endured by the G. family, and the way in which they experienced them during their baby's first 3 weeks of life.


Unmet social service needs in skilled nursing facilities: documentation for action. The skilled nursing facilities in Hennepin County were surveyed to measure 21 specific social services in five general categories of service. Quantitative distribution summaries were made on understanding, performance, and satisfaction for each social service, and the five general categories of service were compared. Cross-tabulations indicate a significant difference in facilities with social work staff. Further study is recommended, and immediate actions to rectify current social service deficiencies are cited.


Social work and liaison psychiatry.

Social work and liaison psychiatry. The Liaison Team of the Department of Psychiatry at Cook County Hospital uses a generic, multidisciplinary, crisis intervention approach to mental health consultation to facilitate humane and comprehensive yet cost-effective care for the medically indigent. Social work functions on the team include diagnosis, short-term individual and group treatment, referral, follow-up, staff development, in-service training, program planning, and interdisciplinary clinical instruction.


Social work in a pediatric primary health care team in a group practice program. The inclusion of a psychiatric social worker as a member of a pediatric team in a prepaid group practice extends the range of pediatric mental health services to children. This paper discusses the collaboration of the social worker with the pediatricians and allied health personnel on the team in dealing with the emotional problems of referred children and their parents. Case examples are included. All cases seen by the social worker during a 6-month period are reviewed. With available psychiatric backup a wide range of emotional problems are identified, and effective mental health care is provided.


The doctor-relative relationship: an exercise in interview techniques in the "relatives' clinic". The importance of the physician's relationship with the patient's relative is discussed, and the content of a series of interviews with relatives is analyzed. Their significance in adding to the doctor's knowledge of the patient is delineated.


Public accountability, quality assurance and social work. The growing demand for public accountability and quality assurance mechanisms affords the social work profession an opportunity to take a more forceful hand in the shaping of the health care delivery system. This paper surveys the impact of public accountability developments on the practice of social work in the health care fields, analyzes what has been done in social work qualtiy assurance, and suggests some strategies for enlarging the scope of social work to include productive new endeavors. Emphasis is placed upon resolution of the conflict between medical and human service treatment models.


Improving the effectiveness of program consultation. In a recent project concerned with the evaluation of consultation, experienced health program consultants demonstrated difficulty in two areas: (a) integrating mutnd (b) setting objectives and specifying criteria by which to measure attainment of those objectives. This paper outlines the purposes of this project, its background and methodology, and discusses in depth the areas of concern. Through an exploration of these issues in program consultation evaluation, health professionals can understand and hopefully improve their skills in this important area of functioning.


Potential partners: attitudes of family practice residents toward collaboration with social workers in their future practices. The study examines attitudes of family practice residents toward social work collaboration in their practices. Residents valued social work services highly, and almost three-fourths want a social worker in practice with them. Residents valued the broad range of services offered by social workers, and over half could see no disadvantages to such collaboration.


Staffing patterns: issues and program implications for health care agencies. Unsolved staffing pattern issues are viewed in the current context of funding pressures, third party payment, and management necessity for program and cost projections. Relevant factors are mustered for consideration with their implications. Use of differentiated skill levels and response as well as development of departmental services mandate are considered. The author also shares his experientially derived thoughts on staff ratio to certain institutional assignments.


Social work fees in medical care: a review of the literature and report of a survey. This paper is based on a study undertaken to determine the advisability of establishing fees for social work service in a Family Practice Residency Program as a way of providing a funding base to assure continuing this professional service in the model Family Practice Unit at the University of Washington; and as a way of providing social worker services in other medical clinics.


Social work and genetic counseling.

Social work and genetic counseling. Genetic counselors often impart anxiety-producing information to the patient and his family. A social worker should be available to help these individuals deal with the emotional impact of the genetic facts given them. Areas of concentration for the social worker in the genetics setting include aid in family planning, identification of psychosocial aspects of genetic disorders, and help in interpreting and understanding the genetic diagnosis and medical recommendations. The individual who discovers he possesses or transmits a defective gene needs help in improving his self-image and in relieving his guilt load. Genetic counselors often impart anxiety-producing information to the patient or his family.  A social worker should be available to help these individuals deal with the emotional impact of the genetic facts given them.  Reactions to such information can be extremely varied.  Areas of concentration for the social worker in the genetics setting include aid in family planning, identification of psychosocial aspects of genetic disorders, and help in interpreting and understanding the genetic diagnosis and medical recommendations.  The individual who discovers he or she possesses or transmits a defective gene needs help in improving his or her self-image and in relieving his or her guilt load.


Group work with emphysema patients.

Group work with emphysema patients. This article describes group work services to ambulatory emphysema patients in a community hospital. The group is viewed as an essential component in the treatment of patients with a chronically disabling illness. These patients experience devastating changes in their lives in the community, in the world of work, and in their families. Physical and respiratory therapy and medication comprise the medical treatment, group work provides the peer support necessary for coping with the disease in a way as to assist with maintaining health and improving the quality of life.


Social science, social work and pharmacy. In an effort to make pharmacy a more patient oriented health profession, pharmacy students at the University of Pittsburgh are required to take a course entitled, Social Sciences in Pharmacy. Besides drawing from the diverse social and behavioral sciences this course also includes material from the field of social work. This article describes the course and the students' reactions to it. It also provides an overview of some of the recent trends in the field and suggests areas where consultation between pharmacist and social worker may be indicated.


Are fluorocarbon emulsions useful blood substitutes.


Studies in patients with metastatic breast carcinoma treated with aminoglutethimide for medical adrenalectomy.


Effect of fine--needle biopsy, incisional biopsy, and palpation on experimental metastasis formation.


Role of polymorphonuclear leukocytes in host defense mechanism against cancer.


Improved survival in endotoxemia with aspirin and indomethacin pretreatment.


L-asparaginase bound to collagen membrane in an extracorporeal device: an intermittent antitumor enzyme therapy delivery system.


Total body hyperthermia and preliminary results in human neoplasms. We believe the hyperthermia is an effective adjunct to current modes of cancer therapy and warrants further study. The method described is safe and effective in achieving controlled total body hyperthermia. Monitoring techniques and life support measure are discussed. Limits of tolerance in humans are defined in this series as 41.8 C for 5 hr and 42 C (108F) for 2 hr, with the heart and liver as the limiting organs.


Isolation regional prefusion: an experimental study.


Immunocompetence measured by antibody--dependent cell--mediated cytotoxicity in surgical patients.


Immunotherapy in treatment of anal condyloma acuminatum.


The ileal loop: a novel approach to study of lymphoid depletion mediated by urine.


Reversal of ischemically induced uncoupled oxidative phosphorylation by restoration of adequate perfusion.


Inhibition of tumor growth by glucan, a nonspecific immunostimulant.


Thiabendazole: a new immunopotentiator effective in therapy of murine fibrosarcoma.


Enhancement of tumor growth by dinitrochlorobenzene (DNCB).


The immunostimulant Corynibacterium parvum and hematopoietic toxicity of chemotherapy.


Effect of various thyroid states on immunity.


Unique features of serially transplanted human pancreatic cancer in nude mice.


Local vs systemic factors in control of tumor inocula.


Adjuvant immunochemotherapy of murine neoplasms.


BCG immunotherapy: effects of dose and route of administration in mice bearing established tumors.


Synergistic lymphocyte stimulation to tumor--specific antigens after immunization with modified tumor cells.


Role of macrophages in would healing.

Role of macrophages in would healing.


Inhibition of tumor growth by metyrapone and desoxycorticosterone.


Increased reliability of cellular immune assays with cryopreserved lymphocytes: studies in humans.


Physiological dead space and arterial oxygenation following pulmonary artery occlusion in patients post trauma.


Influence of heparin and isoproterenol on ventilation and perfusion following pulmonary embolism.


Effect of colloid osmotic pressure and pulmonary capillary wedge pressure on intrapulmonary shunt.


Role of tumor angiogenesis factor in maintenance of tumor-induced vessels.


Effects of hepatic autologous lysosomal enzymes on rat lungs.


Intravascular platelet neutrophil aggregation in staging of posttraumatic pulmonary insufficiency.


A pulse technique for measuring compliance of the lung.


Effect of O2 tension on microbicidal function of leukocytes in wounds and in vitro.


Effect of prostaglandin E-1 on the lung in hemorrhagic shock.


Pulmonary changes of hemorrhagic shock with normotensive cephalic perfusion.


Endobronchial cryotherapy in treatment of tracheal strictures.


Pulmonary vascular response to nitroprusside and dipyridamole.


Prevention of pulmonary insufficiency by prophylactic use of PEEP and rapid respiratory rates.


Fibrinogen 131I scans for detection of experimental absesses.


Acute respiratory insufficiency: mechanisms of improving oxygenation by partial cardiopulmonary bypass.


Acute arterial ulcer detection with radionuclide particles.


Failure of aortic cross-clamping to cause renal cortical blood flow redistribution and increased renin release.


Mismatch of mechanical properties as a cause of arterial prostheses thrombosis.


Correlation of endothelial damage with fibrinogen 125I accumulation in arteries.


Effect of steroids and immunosuppression on anastomotic intimal hyperplasia in femoral arterial bypass grafts.


Effect of hypothermia, hemodilution, and pump oxygenation on organ water content and blood flow.


Fibrinolytic treatment of acute or subacute arterial thrombosis.


Prevention of endotoxin--induced irreversible platelet aggregation in vitro.


Mannitol and intra--aortic balloon pumping as interventions to reduce myocardial infarct size.


Effects of intra-aortic balloon assistance on plasma catecholamines after myocardial infarction.


Methylprednisolone and regional myocardial blood flow during acute coronary occlusion.


Direct vs balloon counterpulsation assistance of the failing myocardium.


Optimal myocardial hypothermia at 10 to 15 c.


Effect of hemodilution and profound hypothermic circulatory arrest on blood flow and oxygen consumption of the brain.


Effects of ischemia on left ventricular regional function in conscious dogs.


Arteriovenous shunting in the canine hindlimb with sepsis.


Myocardial preservation with glucose-insulin-potassium (GIK) and steroids during anoxic arrest.


Intermittent infusion of cardioplegic solution during aortic cross-clamping.


Citrate reperfusion of ischemic heart in cardiopulmonary bypass.


Effects of steroid pretreatment on LV blood flow, compliance, and performance after hypothermic ischemic arrest.


Myocardial ischemia distal to critical coronary stenosis during cardiopulmonary bypass: fibrillating vs beating nonworking heart.


Coronary blood flow and metabolism in dogs without tricuspid valve, with and without right ventricular hypertension.


Effects of increasing pacemaker sensing circuit impedance on R-wave detection.


Radionuclide assessment of left ventricular function following cardiac surgery.


Does potassium-chloride-induced cardiac arrest protect the myocardium during aortic cross-clamping?


Body composition following heart valve replacement.


Neutrophil chemotaxis in surgical patients: effect of cardiopulmonary bypass.


Distribution of renal blood flow after furosemide in critically ill patients.


Dopamine vs epinephrine in patients following cardiac surgery: randomized study.


An experimental evaluation of coronary air embolism.


An experimental model of cardiomyopathy.


Graded venous hypertension as a potentiator of ischemic myocardial injury.


Septic cardiomyopathy: physiology of left ventricular failure.


Effects of cardiopulmonary bypass on neutrophil chemotaxis.


Simplified in vivo measurement of diastolic compliance of the left ventricle.


Effects of glucagon on renal function in protein--deprived rats.


Totally implantable diaphragm pacemaker: experimental studies.


Myocardial contusion: diagnostic value of cardiac scanning and echocardiography.


Physiologic function of transplanted parathyroid glands in man.


Endogenous fuels in experimental shock.

Endogenous fuels in experimental shock.


Isolation and biological characterization of rat histocompatibility antigens.


Depressed cellular immunity in diabetics.


Effects of glucose and alanine on energy metabolism in hemorrhagic shock.


Interference with testicular development by delta 9 tetrahydrocannabinol.


Mechanism of elevated cerebral serotonin concentration associated with acute hepatic ischemia.


Regulation of liver regeneration by the pancreas in dogs.


Pancreas extract and liver regeneration.


Hepatotrophic activity in nonpancreatic, nonduodenal portal blood.


Hepatic blood flow and pancreatic hormones as modifiers of hepatic regeneration.


Wound healing in partially hepatectomized rats and effect of their serum on fibroblast growth in vitro.


Insulinase in liver cirrhosis.

Insulinase in liver cirrhosis.


Nitrogen--sparing in normal man:effect of glycerol and amino acids given peripherally.


Early hemodynamic effects of the distal splenorenal shunt.


Bile acid alterations in patients with cholesterol gallstones.


Effect of portacaval shunt on rat serum lipids, lecithin cholesterol acyltransferase, and lipoproteins.


Response of the distal esophageal sphincter to respiratory and positional maneuvers in humans.


Bicarbonate perfusion and lower esophageal sphincter response to pentagastrin.


Effect of glucose on the nitrogen--sparing effect of amino acids given intravenously.


Vagal stimulation of canine duodenal motor activity.


Prostaglandin E2 prevents aspirin and indomethacin damage to human gastric mucosa.


Effect of the E2 prostaglandins on gastric mucus production in rats.


Normal structure--function relationships in gastric microcirculation and changes in experimental stress ulceration.


Stimulation of gastrin secretion by parathyroid hormone.


Patterns of molecular forms of gastrin in antral mucosa and antral serum.


Chronic hypergastrinemia produces hypertrophy of the liver and intestine in rats.


Effect of bombesin on serum gastrin and cholecystokinin in dogs.


Gastric autoantibody and serum gastrin in achlorhydric states.


Adverse effects of elemental diets on tolerance for fluorouracil (5-fu) toxicity in rats.


Gastrin cell hyperplasia induced by corticosteroids.


Effect of prostaglandin E1 on plasma secretin and pancreatic exocrine function in dogs.


Determination of secretin levels in mucosa by radiommunoassay.


Metabolic significance of skeletal muscle during normal and shock conditions.


Cholecystokinin, a new hypocalcemic agent.


The placenta as a possible source of gut peptide hormones.


Active bicarbonate secretion by mammalian antrum.


Early proliferative activity in the left colon of the rat after partial small--bowel resection.


Effect of bile acids on hepatic cholesterol synthesis in partial ileal bypass in rabbits.


Origin of regeneration factor.

Origin of regeneration factor.


Small--intestinal bypass in nutritionally obese rats receiving choline supplement.


Duodenal reflux into the pancreatic duct in dogs.


Action of insulin inhibitors on exocrine pancreatic secretion of the rat with chronic pancreatic fistula.


Development of an animal model of pancreatic cancer.


Anticoagulation in the treatment of experimental peritonitis.


Delivery of surgical care: inferences based on hospital discharge abstract data.


Microsurgical anatomy of anterior cerebral anterior communicating recurrent artery complex.


Spinal cord deformation velocity, impulse, and energy related to lesion volume in "standardized" trauma.


Dynamics of capillary permeability in cerebral edema.


Time course of brain tissue pressure and compartmental CSF pressure in cerebral edema.


Hemorrhagic pulmonary edema following stereotactic hypothalamic lesions in dogs.


Effect of dexamethasone on the brain edema of cranial impact.


Threshold loaded CO2 response curves: a new method for evaluating breathing in neurosurgical patients.


Experimental selective middle cerebral artery stroke model.


Experimental middle cerebral artery microsurgical embolectomy.


Cerebral effects of barbiturate: shift from "energy" to synthesis metabolism for cellular viability.


Cerebral hemodynamics: effect of mannitol on the cerebral perfusion gradient.


The nitroblue tetrazolium (NBT) test in evaluation of postoperative fever.


Regional cerebral blood flow: intravenous injection technique.


Preliminary observations on the weight-bearing surfaces of the human ankle joint.


Rotational axis of the ankle joint: comparison of normal and pathologic states.


Effects of ligamentous injury on ankle and subtalar joints: a kinematic study.


In vitro strain patterns in "intertrochanteric fractures" internally fixed with nail-plate or compression screw-plate.


Pathologic fractures of femoral shaft: study of internal fixation techniques incorporating methylmethacrylate.


Etiology of fat embolism syndrome: early morphologic lung changes of respiratory distress syndrome produced by triolein.


The biophysical properties of methylmethacrylate: effects of radiation and other parameters.


Patterns of mineralization in forming membrane bone.


Cortical bone atrophy secondary to compression plate fixation: a clinical and pathophysiologic study.


The hypertension of femoral lengthening: a canine experimental model.


Experimental chronic hematogenous osteomyelitis.


Serum, muscle, and bone levels of intravenous, intra-arterial, and regional cephalothin perfusion.


Induction of collagen synthesis in rats by transplantation of allogenic macrophages.


Hearing loss, renal disease, and cochlear strial deposits.


Control characteristics of the normal human in quiet standing.


Alteration of pulmonary function associated with artificial nasal obstruction.


Effect of radiotherapy on aerobic and anaerobic isolates in hemovac lines.


Teratomas of the head and neck.

Teratomas of the head and neck.


Microsurgical anatomy of the optic canal: anatomical relations and exposure of the optic nerve.


Deep ocular socket reconstruction.

Deep ocular socket reconstruction.


Maxillectomy with preservation of orbital function.


Systemic and regional arteriovenous shunting in endotoxic and septic shock in dogs.


A new collagen sponge to dress open wounds.


Calcium-related cutaneous necrosis.

Calcium-related cutaneous necrosis.


The periosteum and craniofacial growth.

The periosteum and craniofacial growth.


Altered polymorphonuclear leukocyte bioenergetics in patients with thermal injury.


Prolonged ischemia in the replanted rat leg: a biochemical and morphologic study with microvascular techniques.


Effects of mobilization on partially lacerated tendons.


Quality of tendon graft healing in silastic pseudosheaths: breaking-strength studies.


Immune "save" of lethally irradiated mice with use of allogeneic spleen cells.


Continuous monitoring of in vivo oxygen tension with a fuel cell.


Dose-related effect of testosterone, dihydrotestosterone, and cyproterone acetate on male organ weights.


Androgenic effects of testosterone and dihydrotestosterone applied topically to the rat phallus.


Renal air embolism: an unrecognized cause of organ failure.


Response to chemically induced prostatic tumors in rats to stilbestrol and orchiectomy.


Spontaneously occurring renal adenocarcinoma in balb c/cr mice: electron microscopic observations.


An in vivo model system of human bladder cancer.


Effect of distention on vesical blood flow.


Bladder adherence to urothelium.

Bladder adherence to urothelium.


High-dose glucose-insulin-potassium in treatment of irreversible hemorrhagic shock.


Prostatic fluid and extract from prostate inhibit macrophages.


Improvement of oxygen--carrying properties of stoma--free hemoglobin solution with acetrizoate sodium.


Pulmonary and systemic capillary permeability to protein following endotoxin.


Antibiotic bowel preparation and burn wound colonization.


Role of branched chain amino acids (BCAA) intake in preventing muscle proteolysis.


Erythropoietin elevation in anemia of thermal injury.


Cholesterol metabolism after portacaval shunt and partial ileal bypass in rabbits.


Jejunoileal bypass, liver morphology, and intestinal microflora in conventional and germfree dogs.


Hyperparathyroidism during pregnancy and neonatal hypocalcemia.


Effect of total portal and intestinal venous diversion of dietary hyperlipidemia.


Functional activity of a gonadotrophin--producing human lung carcinoma after transplantation in nude mice.


Elevated immunoglobulins in bronchial washings of patients with lung cancer.


Safe use of vincristine following partial hepatectomy.


Effect of surgery on antitumor immunity measured by tube leukocyte adherence inhibition assay in breast cancer.


Diagnostic accuracy of thermography in breast cancer screening: effect of examination sequence.


Treatment of breast cancer with danazol.


Immunologic diagnosis of breast cancer.

Immunologic diagnosis of breast cancer.


Estrogen-receptor movement to the nucleus: discussion of a cytoplasmic-exclusion hypothesis.


Investigation of the mechanisms and consequences of steroid hormone action on vitellogenin synthesis in Xenopus laevis.


Light and dark adaptational changes in the accessory eye of the shrimp, Palaemonetes. The fine structure of the accessory eye of the shrimp, Palaemonetes, was studied after light and dark adaptation. Adjacent to the principal compound eye, the accessory eye is a small compound eye composed of about 20 ommatidia which are smaller in structure to the ommatidia of the principal compound eye. During dark adaptation, rhabdomal microvilli increase in length; however, little pigment migration occurs. The implications of these changes in relation to the function of the accessory eye are discussed.


Quantitative changes and ultrastructural alterations of the cornea in response to ultraviolet light. II. Effects of amphibia; elucidation of desmosomal structure and basement membrane synthesis. The effects of far ultraviolet light irradiation upon an amphibian cornea were studied to compare the effects observed both quantitatively and ultrastructurally with data obtained after UV irradiation of mammalian corneas. The ultimate goal of this series of investigations is the elucidation of the alterations and the regeneration mechanisms, which might reflect existing morphological diversities among the species, observed in vertebrate corneas following exposure to UV light. It was found that while the epithelial cells undergo oedema after low dose exposures and are gradually damaged after high doses of UV light, 2-4 days leter a new epithelium has been formed. Intercellular permeability is increased by low dose exposure as was detected by the penetration of Ruthenium Red into the intercellular clefts. Under these conditions desmosomal structure revealed a 21-laminar configuration. The basement membrane of the amphibian, unlike that of the mammal, does not dissolve away upon exposure but shows localized disruptions which are thought to accommodate the passage of leucocytes from stroma to epithelium. That a new basement membrane is subsequently formed is evident by the existence of extracellular and intracellular secretion granules. In comparison to irradiated rabbit corneas, this stroma remains remarkably at the same thickness following a high dose exposure although a noticeable disorganization of collagen arrangement is apparent. Finally, as in the case of the rabbit corneas, a secondary degeneration of endothelium was observed 4 days after a moderate dose exposure.


Quantitative and comparative ultrastructure of the vertebrate cornea. I. Urodele Amphibia. The cornea of the urodele amphibian Triturus c. cristatus was studied ultrastructurally in order to provide the basis for a comparison among corneas throughout the vertebrate phylum. The cornea of this salamander consists of relatively thick epithelium and basement membrane and thin Descemet's membrane, unlike the mammalian corneas. The outermost epithelial cells contain Ruthenium Red stainable extracellular filaments and intracellular vesicles which are thought to play a role in the process of lubricating the corneal surface. Occluding junctions have been observed in the apical region of the superficial epithelial cells and are considered as barriers to the intercellular passage of material. A thin substantia propria (stroma) consists of about 40 collagenous highly organized lamellae. The thicknesses of the basement membrane, Descemet's membrane and the epithelium are believed to represent the primitive situation in the process of corneal evolution.


Fine structure of the spermatozoon of an onychophoran, Peripatopsis. The spermatozoon of the Onychophoran Peripatopsis moseleyi is described. This cell is characterized by the general filiform shape, the absence of an acrosome, the presence of mitochondrial derivatives, of an annulus and of nine accessory tubules and a manchette of microtubules around the axoneme. All of these characters are typical of highly evolved sperm models, like those of insects and mammals, and suggest a long evolutionary history. Only the position of the mitochondria, inserted between nucelus and axoneme, is reminiscent of annelid features.


The morphology of regeneration of skeletal muscles in the rat. Muscle regeneration was studied by light and electron microscopy in soleus muscles of rat. After segmental crushing the number of fibres increased in some muscles within 30 days, indicating that numerical hyperplasia can take place. Locally applied Ringer solution of 60-70 degrees C caused necrosis of myofibres but left satellite cells and blood supply largely intact. Following phagocytosis, four mechanisms of regeneration were seen. (1) Lost fibres were replaced by clusters of myotubes formed by satellite cells within persisting basal lamina tubes. These clusters displaced the surrounding endomysium and looked like longitudinally 'split' fibres. (2) Viable fibre fragments fused with satellite cells. (3) Satellite cells of surviving fibres proliferated and fused to myotubes localized beneath the basal lamina. (4) Thin new fibres occurred in the interstitium. Their origin remained unknown. After 6 months the mean size of the new myofibres was normal, but the scatter of diameters was increased, central nuclei, fibre 'spliting' and branching, and fibrosis were prominent. Staining for acetylcholinesterase revealed that many fibres were short and not innervated. The similarity with dystrophic muscles in man suggested, that the most prominent histological changes in myopathic muscles may be due to attempts of regeneration.


The investigation of vinylcyclohexane dioxide as a polar dehydrant for the improved retention of lipids in the Spurr embedment. The use of vinylcyclohexane dioxide (VCD) as a polar dehydrant with subsequent embedment in Spurr was studied. The utilization of Epon 812 resin (E 812), hydroxyethyl methacrylate (HEM) and hydroxypropyl methacrylate (HPM) as polar dehydrants for Epon embedment were re-examined, and a polar Epon mix was introduced. The most effective dehydration sequence was: first 90%, then 95% VCD in water for 5 min. followed by two 20 min changes of 100% VCD. After 1 hr in equal quantities of VCD and Spurr mix, tissues were infiltrated with Spurr embedment (two 1 hr changes and overnight) and finally embedded in Spurr and polymerized at 60 degrees C for 16 hr. The most utilizable polar Epon mix was determined to be Epon 812 = 50 ml, NMA=42 ml, DMP-30=1-2 ml. It was somewhat brittle but cut well with both glass and diamond knives. All four polar dehydrants were found to retain lipids and carbohydrates equally well in thin section in striated and cardiac muscle, liver, kidney and brain from the rat. The E 812 was the only dehydrant that retained lung multilamellar bodies. The possible carcinogenic effects of VCD were considered and the probably metabolism and excretion of VCD were discussed.


Hyperinsulinemia: effects on body weight, obesity and motivated behaviors. Five experiments were performed to evaluate the physiological and behavioral similarities between lesions of the ventromedial hypothalamus (VMH) and injection-produced hyperinsulinemia. It was found that the rate of weight gain and fat deposition in both adult and weanling rats was essentially the same for both VMH and hyperinsulinemic rats. Measures of activity and taste preference measures yielded no differences between hyperinsulinemic rats and intact rats. Electric shock thresholds revealed a decrease in reactivity for hyperinsulinemic rats compared to intact rats. A hypothesis was suggested in which a combination of hypophysectomy, gonadectomy, and hyperinsulinemia might produce most of the physiological effects seen with VMH lesions. It was also suggested that since these physiological alterations radically modify the organism's internal environment, the behavioral effects of VMH lesions may be the results of the attempts of a brain-damaged animal to maintain new physiological conditions.


'Self-correcting' spherical bioelectrode. Most of the widely used biopotential macroscopic and microscopic bioelectrodes do not enable proper measurements while in contact with 'problematic' tissues, such as myocardial and other muscular tissues, cortical and intracavital tissues. A quantitative spherical electrode was designed as an example in the family of bioelectrodes enabling application in moving or vibrating media. The electrode developed is insensitive to its contact area. Decreasing the contact area to 40% causes 25% increase in measured resistance only. The electrode shows excellent performance in alternating current conditions combined with well-defined direct current characteristics.


Adriamycin plus cyclophosphamide in advanced bronchial carcinoma. Adriamycin (40 mg/m2 i.v., on day 1) plus cyclophosphamide (200 mg/m2 orally, day 1 to 5) were given to 23 patients with advanced lung cancer. Administration cycles were repeated every 3 weeks. No patient had been previously treated with chemotherapy, 5 received prior radiotherapy. Objective improvement was observed in 7 patients, partial remission was observed in 3. The median duration of response was 2 months.


Hysterosalpingography in the sequels of conisation of the uterine cervix. A hysterosalpingographic survey was made of 65 women of reproductive age who had undergone conisation of the uterine cervix for carcinoma in situ or severe dysplasia at least one year before. None of the patients investigated radiologically had undergone uterine surgery before conisation. In a high percentage of cases morphological changes of the cervical canal and, less frequently, the isthmus were found. Most of the changes are attributable to scar retraction, and the hysterosalpingographic findings did not differ appreciably from those following other types of gynecological surgery, namely, segmental or total stenosis and ectasia of the cervical canal and isthmus. A control series of patients with preoperative and postoperative hysterosalpingograms is now under consideration to confirm the radiological findings and to correlate them with clinical data.


Nuclear glycogenosis and virus-like particles in human laryngeal papilloma cells.


Myocardial injury induced by a single dose of adriamycin: an electron microscopic study. Adriamycin cardiomyopathy has been studied under the electron microscope using myocardial ventircular cells of CRF mice, previously treated with 10 mg/kg body weight of the drug given in a single intravenous injection. Within 10 min myocardial cell nucleoli show a nucleolonema fragmentation, and during the following 3 hours they acquire the nucleolar segregation pattern. Fourteen hours after drug injection, nucleolar morphology again becomes normal, while areas of focal degeneration, characterized by damaged mitochondria and enlarged smooth reticulum cisternae, appear in the sarcoplasm. One to 3 days later the degeneration process involves the myofibrillar component, and after 50 days the great majority of myocardial ventricular cells is damaged. The early appearance and the functional significance of nucleolar segregation support the hypothesis that adriamycin cardiotoxicity might be dependent on its ability to bind to myocardial cell DNA. The consequent failure of RNA and protein synthesis, impairing the continuous renewal of myofibrillar and mitochondrial components of the cell, might explain the progressive myocardial damage.


Skin tests in childhood lymphoma and neuroblastoma. Intradermal skin test antigen (Varidase, Mumps, Candidine) and contact sensitization with 2,4-dinitrochlorobenzene (DNCB) were employed in 35 previously untreated children with neuroblastoma and malignant lymphoma, to evaluate delayed cutaneous hypersensitivity. Cutaneous responses were correlated to stage of disease and survival. The limited number of patients prevents any definitive conclusion. It is apparent, however, that in childhood non-Hodgkin's lymphoma anergy to DNCB is correlated to advanced stages with rapid progressive disease. In neuroblastoma and Hodgkin's disease patients skin test sensitization seems to be of questionable clinical value.


The importance of metastic cervical lymph nodes on the prognosis and therapy of malignant neoplasias of the head and neck. The author in a study of 667 patients submitted to unilateral or bilateral radical neck dissection presents a critical analysis of clinical palpatory and histopathological methods in the evaluation of the metastatical lymph nodes in head and neck cancer. The advantages of the last one are pointed out showing the real prognostic value of the histopathological metastases.


Biological properties of cell lines derived from Moloney virus-induced sarcoma. Two cell lines derived from a primary MSV-M-induced tumor in a BALB/c mouse were studied. One line (MS-2) was subject only to continuous tissue culture transfer (tct). After 21 tct, MS-2 cells produced progressive tumors (MS-2 tumors) in syngeneic hosts. The second cell line (MS-2T) was established by cultivation of a MS-2 tumor. The ability to produce progressive tumors decreased with increased number of tct, in both cell lines. The virus content of MS-2 and MS-2T cells was very low, as shown by uridine incorporation and electron microscopy. Immmunofluorescence tests demonstrated that antigens different from the viral MSV-M antigens were present on the cell lines, and that antigenic changes occurred with increased number of tct. Serum of mice bearing progressive MS-2 tumors reacted with MS-2T cells when these cells produced progressive tumors and did not react with MS-2 cells when they produced regressing tumors. MS-2 cells producing regressing tumors reacted with serum from mice in which the MS-2 tumor had regressed and with serum from mice immunized with MS-2T cells at late tct when they were poorly oncogenic. The antigenic changes seemed, therefore, to parallel the decrease of malignancy. A chromosomal analysis carried out on MS-2 and MS-2T cells, when both produced progressive tumors, showed a modal number of 48 and 44, respectively. MS-2T cells showed a large acrocentric chromosome. In contrast, the MS-2 cells at late tct, when they gave regressing tumors, showed a modal number of 60 and a wide range of distribution of chromosome number.


Ultrastructural changes produced in cultured, adriamycin-treated myocardial cells. The ultrastructural evaluation of the early alterations adriamycin-induced on cultured mice heart cells is reported. The major effects are hypertrophy of the sarcoplasmic reticulum and a market increase of the number and total extension of the gap junctions. These findings are discussed in the light of the information available in the literature.


A case of cavernous haemangioma of the spleen.


Modifications of ureteric peristalsis by local anaesthetic. An experimental study in dogs. An in vivo study of the response of the dog ureter to local anaesthetics administered systemically and by ureteric perfusion, revealed that lidocaine, procaine, and mepivacaine, caused hyperperistalsis. The intravenous use of a near toxic dose produced hyperperistalsis of limited duration, whereas, intraureteric administration produced a prolonged and constant response with low dosage. The mode of action of these drugs is unclear as they are generally regarded as being non specific smooth muscle depressants. Continued peristalsis after prolonged exposure to local anaesthetic favours a myogenic rather than neurogenic conduction of the ureteric contraction wave.


Trends in alloplastic replacement of segments of the urinary tract.


ABH secretor status in patients with bladder tumours. The ABO blood groups and secretor status of a group of patients with bladder tumours were investigated and compared with those of a group of patients of a similar age suffering from a variety of genito-urinary diseases. Some of the control patients were known to have been exposed to potential carcinogens, and the findings in this group were analysed separately. No significant differences were found when comparisons of these three groups of patients were made.


Urinary oxalate in summer and winter in normal subjects and in stone-forming patients with idiopathic hypercalciuria, both untreated and treated with thiazide and/or cellulose phosphate. Urinary oxalate excretion has been measured by a specific enzymatic method in normal subjects and stone formers with idiopathic hypercalciuria. In every group studied urinary oxalate was higher in the summer than in the winter. These differences were slight and not significant in normal subjects but were considerable and statistically significant in the stone formers both untreated and when treated with thiazide. Thiazides raise urinary oxalate only very slightly but cellulose phosphate leads to large rises in urinary oxalate both in the summer and the winter. The highest values of urinary oxalate were seen in the summer in patients treated with cellulose phosphate. The mean rise in this group was 70% above normal and this must be viewed with some anxiety.


Lipofuscin pigment over benign and malignant choroidal tumors. This study has shown that lipofuscin pigment may accumulate in RPE cells and macrophages over several types of benign and malignant choroidal tumors. The color of the pigment, however, varies with the nature and color of the underlying lesion. On the surface of deeply pigmented tumors the lipofuscin pigment may produce an orange color, whereas over amelanotic lesions it may appear brown or reddish-brown. On the surface of vascular tumors, such as choroidal hemangiomas, the lipofuscin is almost invisible ophthalmoscopically but may be demonstrated with fluorescein angiography. Although the presence of such pigment accumulation is suggestive of a malignant melanoma, it is not diagnostic and may occur over benign simulating lesions as well.


A comparison of the sensitivity of carotid compression tonography with ophthalmodynamometry in the diagnosis of internal carotid artery occlusive disease. The cases of 100 consecutive patients with arteriographic evidence of carotid occlusive disease were reviewed. All 100 patients had undergone ODMY and CCT prior to carotid arteriography. A comparison of the sensitivity of ODM testing with CCT testing revealed the ODMY pressure differences were reliable in detecting carotid occlusive disease in only 70 of these 100 patients, whereas CCT testing detected decreased blood flow on the involved side in 95 of the 100 patients. The advantages of CCT testing are discussed, comparing certain limitations and contraindications often encountered with ODMY testing. The CCT test is more sensitive than ODMY testing and is easier to perform. In addition, the results of CCT are more objective and provide a permanent record which can be analyzed at any time to check for reproducibility. Overall, the CCT test appears to be a more suitable screening test than ODMY to study carotid occlusive disease.


Clinical experience with presumed hemangioma of the choroid: radioactive phosphorus uptake studies as an aid in differential diagnosis. A total of 27 cases of choroidal hemangioma was evaluated with radioactive phosphorus uptake studies. In each case the diagnosis of malignant melanoma was initially entertained, but the 32P test was unequivocally negative in every instance. Follow-up studies in every case have supported the clinical diagnosis. In 22 patients, the lesion was treated with photocoagulation, and in every treated case the serous macular detachment disappeared. The importance of early and correct clinical diagnosis is stressed, since these are salvageable and potentially useful seeing eyes.


Denervation of the inferior oblique: current status and long-term results.


Iatrogenic breaks in Buuch's membrane in choroidal melanoma. Three patients with choroidal melanoma have been observed to develop subretinal hemorrhages associated with their ocular examinations. One hemorrhage appears to have been caused by transillumination, while two others have occurred during radioactive phosphorus testing. Histopathology confirms defects in Bruch's membrane through which blood or tumor cells have entered the subretinal space.


Radiotherapy of malignant melanoma of the choroid. Twenty-two patients with choroidal melanomas were treated conservatively using radioactive radon rings with a mean follow-up of 43 months. In 14 patients there was successful tumor regression. Eight eyes were enucleated because of inadequate tumor response. Of the patients whose tumors were apparently destroyed, two have subsequently died of metastases and one eye was enucleated due to scleral rupture. Of the eight cases unsuccessfully treated, one has subsequently died of metastases. Radiation therapy is likely to be effective in patients with tumors 7 mm in diameter and 2 mm in elevation or less. Tumors larger than 12 mm in diameter and 3 mm in elevation do not respond adequately to irradiation. Relatively large doses of radiation (at least 8,000 rads to the tumor apex) must be used if the tumor is to be effectively obliterated. We believe that radiation effectively can destroy small choroidal melanomas.


Indirect fundus camera.

Indirect fundus camera.


The pathogenesis and treatment of persistent epithelial defects.


Double simultaneous aspirating-irrigating syringes.


Indirect ophthalmoscopy lens holder.

Indirect ophthalmoscopy lens holder.


Sphincterotomy scissors.

Sphincterotomy scissors.


A lens implant holder.

A lens implant holder.


A micro iris retractor.

A micro iris retractor.


Lacrimal duct probing light.

Lacrimal duct probing light.


Infusion-aspiration control.

Infusion-aspiration control.


Lid eversion clamp.

Lid eversion clamp.


The double-ring support: an instrument to insure safety with scleral buckling after cataract extraction.


The Girard-Storz assistant's microscope: a new accessory for the Zeiss operating microscope system. A bracket has been designed for the Zeiss 1 and Zeiss 6 operating microscopes, enabling the mounting of two accessory microscopes for the surgeon's assistants. These accessory microscopes operate independently of the primary microscope and in many cases may be preferable to beam-splitter systems which drastically reduce illumination to the primary microscope and preclude the use of photographic accessories.


Retinal cryoring: a new instrument for retinal surgery. The retinal cryoring, a doughnut-shaped cryoprobe, has been developed to allow continuous cryocoagulation around retinal holes.


A new phacoliquification cryoprobe.

A new phacoliquification cryoprobe.


An improved method of viewing topical fluorescein.


A new binocular scotometer.

A new binocular scotometer. A new method of binocular scotometry is described based on an intriguing binocular phenomenon and using a new binocular scotometer and a retinoscope with its head reversed. Shortcomings in previous attempts have been corrected by objectively aligning a "blind" eye with the center of a translucent opalescent screen. This was made possible by having the patient rotate the retinoscope to induce conjugate eye movements in cases of manifest eye deviation. The examiner could then observe the "blind" eye directly through a central opening in the screen, by reinforced assistance through dependence on the corneal light reflex and, if necessary, by circumferential plotting.


Variable fixation lid clamp (Bethesda-Gavaris clamp).


A new machine for irrigation-aspiration. This new irrigation-aspiration system (Fig 9) demonstrates application of basic physical principles to a particular medical problem, maintaining the integrity of the anterior chamber during aspiration of cataractous material. This system is readily incorporated into the standard procedure of irrigation-aspiration of soft cataractous material at relatively low cost. The surgical procedure and the operation of this system with irrigation-aspiration and "prevent-collapse" components are under direct control of the physician.


Closed-circuit television magnification of fluorescein angiography.


Fiberoptic conjunctivorhinostomy probe.

Fiberoptic conjunctivorhinostomy probe.


Reduction of nasal orbital fractures and simultaneous dacryocystorhinostomy. A technique for restoration of structure and function in naso-orbital fractures has been described. Three case reports demonstrate a few of the final results. The case reports also indicate that many of these fractures require late definitive surgery in spite of optimal surgical treatment immediately subsequent to injury.


Metastatic adenocarcinoma to the larynx: report of a case.


Hemangiopericytoma of the nasopharynx.

Hemangiopericytoma of the nasopharynx.


Armed Forces Institute of Pathology. American Registry of Pathology.


Treatment of post-cataract bacterial endophthalmitis with periocular and systemic antibiotics and corticosteroids.


Cemento-osteoid tumor of the maxillary sinus.


Traumatic vertebral artery aneurysm.

Traumatic vertebral artery aneurysm.


Meibomian gland carcinoma of the ocular adnexa.


Cytopathological effects of detergents on Paramecium caudatum.


Role of vitamin E in regulating malaria expression.


Natural preservation of corpses of Paramecium aurelia in cultures of a suctorian.


Liposarcoma of the larynx.

Liposarcoma of the larynx.


Striate muscle dysfunction in iron deficiency.


Malignant ameloblastoma of the maxilla.

Malignant ameloblastoma of the maxilla. This case illustrates a rare occurrence of an ameloblastoma arising in the maxilla and metastasizing to the neck and lungs within a three-year period following the initial resection. A discussion of the pathology is presented and the necessity for aggressive initial therapy with close follow-up is emphasized.


The effect of synthetic androgens in hereditary angioneurotic edema: alteration of C1 inhibitor and C4 levels.


Carcinoma in thyroglossal duct cysts--a review.


Plasma 5alpha androstanediol: an androgen marker of hirsuitism in women.


The risks and limitations of the course as providing competent training.


Evidence for reflex coronary artery spasm in patients with ischemic heart disease.


Introduction of missing enzymes into the cytoplasm of cultured mammalian cells by means of fusion-prone liposomes. It is therefore possible to introduce enzyme-laden liposomes into two sites within the cytoplasm of cells previously lacking such enzymes. The first site is gained after enzyme-laden liposomes are phagocytosed into the lysosomal apparatus. Liposomes coated with immunoglobulins engender their own uptake by inducing the Fc receptor of phagocytic cells to launch ingestion of the vector as if it were an opsonized bacteria or virus against which the host had mounted an immune response. As for the second site, described here, involving enzyme deficiencies of the free cytosol, these may be corrected when liposomes have lysolecithin incorporated as a fusogen. The fusogen induces merger of the liposomal membrane with that of the plasma membrane presumably by virtue of the capacity of lysolecithin to engender mixed, fusion-prone micelles. Introjection of enzymes or other sequestered molecules is accomplished without access of these to external solutes, such as calcium. Consequently, uptake of enzyme cannot be due to trivial factors such as pinocytosis induced by lysolecithin or to phagocytosis per se. These two new techniques of cellular engineering now render it possible to introduce either into phagocytic or into non-phagocytic cells, enzymes or macromolecules in which these cells are genetically deficient.


A new look at the metabolism of the arterial wall.


Cholesteatoma of the frontal sinus.

Cholesteatoma of the frontal sinus.


The value of electron microscopy in the diagnosis of fibrosarcoma of the larynx.


A reticulo-epithelial system: cutaneous trap for antigens.


Reduced renal papillary plasma flow in Dahl and Kyoto spontaneous hypertensions.


The need for a postgraduate review committee for these courses.


The case for elective prophylactic neck dissection.


Achieving the educational objectives of a short postgraduate course.


The Association of American Physicians: its first seventy-five years.


Horatius Cocles at the bridge of publication.


The distinguished lecture: Pyrrolic victories.


Management of prostatic fistulas.

Management of prostatic fistulas. Prostatic fistulas communicating with the rectum or perineal skin are unusual complications of a prostatic operation, pelvic trauma, prostatic abscess or other iatrogenic injury. A third of these fistulas may close spontaneously with proper urinary drainage and avoidance of fecal soilage. The many operative procedures described for the repair of these fistulas indicate that no ideal method of repair can be applied to every case. Operative management should be mandated by the size, location and duration of the fistula as well as by the surgeon's experience with the various anatomic approaches.


The role that these courses may have in the future regarding credit hours toward recertification.


Food and nutrition policies in a changing environment.


On taking vows in two priesthoods, scientific and christian.


The ethical responsibility of the physicians: a judeo-christian perspective.


An evaluation of "informed consent" with volunteer prisoner subjects. "Informed consent" sets a goal for investigators experimenting with human subjects, but little is known about how to achieve or evaluate it in an experiment. In a 3-year, double-blind study with incarcerated men, we attempted to provide a "free and informed consent" and evaluated our efforts with an unannounced questionnaire administered to subjects after they completed the experiment. At that time, approximately two-thirds had sufficient information for an informed consent, but only one-third was well informed about all key aspects of the experiment and one-third was insufficiently informed to give an informed consent. We found that institution- or study-based coercion was minimal in our experiment. From our evaluation of the questionnaire and experience at the study institution, we conclude that an experiment with human subjects should be designed to include an ongoing evaluation of informed consent, and active attempts should be made to avoid or minimize coercive inducements. Experiments with significant risk, which require a long duration and/or large sample size relative to the institution's population, should probably not be performed on prisoner subjects. The experimenter should be independent of the penal institution's power structure. Presenting and explaining a consent form to volunteers on one occasion is probably an in adequate procedure for obtaining and maintaining an informed consent.


Coronary artery disease with single coronary artery. The authors have reviewed the literature in search of the coexistence of single coronary artery with significant coronary artery disease. Two cases of single right coronary artery are described. In both, the anomalies were unsuspected and diagnosed roentgenographically in life. Both patients had angina pectoris, positive graded-exercise stress tests, and hemodynamically significant obstruction or occlusion to the coronary arteries. In neither case was the stenosis proximal or amenable to bypass surgery.


Intestinal absorption of iron alone and in combination with authentic or natural vitamin C and carotene. The effect of vitamin C and carotene derived from authentic or natural sources on intestinal iron absorption was studied. Vitamin C caused slight enhancement to iron absorption, while carotene hindered it. The three juices tested, namely orange, parsley and pepper, which were found to be rich in these two vitamins, hindered intestinal iron absorption to different extents. It was recommended that patients suffering from iron deficiency are not supplied with nutrients rich in carotene particulary during iron therapy.


The use of Lupinus termis L. cultivated in Egypt, as a food protein supplement. 1. General analysis of the seeds for protein, fats, carbohydrates, fiber and ash contents were carried out and the results were given in g/100 g dry seeds. Lupinus termis contained a higher percentage of protein (40.36), 290 mg calcium and 6.5 mg iron. 2. All the essential amino acids are present in fair amounts with the exception of sulphur-amino acids and Lysine. 3. Cooking the seeds resulted in a slight decrease of most of the amino acids with the exception of Tryptophan and Lysine, which exhibited a slight increase after cooking. 4. Of the toxic substances present in the seeds is Trypsin inhibitor, which was destroyed by heat treatment, and alkaloids, which were removed by soaking the seeds three days in running tap water. 5. Supplementing the debittered seeds with Lysine and Methionine resulted in an increase in its nutritive value.


Comparison of xylitol and glucose metabolism in nonhepatic rat tissues. Capability and extent of xylitol metabolism in vitro was studied in a variety of non-hepatic tissues of rats, using enzymatic and isotopic methods. Only kidney was found to be able to utilize xylitol at a significant rate while in all other organs tested - lung, brain, heart muscle, skeletal muscle and adipose tissue - no uptake of xylitol was detectable using two independent methods. In accordance with these results the incorporation of radioactivity from [U-14C]-xylitol as substrate into the products CO2 and lactate was found to be very small in all organs with the exception of kidney and when compared to that from [U-14C]-glucose it was less than 5%. From these results it is concluded that besides liver only kidney can utilize xylitol to a significant extent while for the other tissues studied xylitol is not a suitable substrate.


Effect of vitamin C and carotene on the absorption of calcium from the intestine. The effect of vitamin C or carotene either in the authentic form or naturally occurring as in orange, parsley and pepper juices on calcium absorption was studied. Results obtained revealed that ascorbic acid, orange and pepper juices enhanced intestinal calcium absorption. Carotene and parsley proved to be without effect.


Nutritive studies on some raw and prepared leguminous seeds commonly used in the Arab Republic of Syria. 1. The proximate analysis of raw Syrian lentils (Lens esculentus), variety red chick pea (Cicer arietinum) variety balady, has been made. The protein content of the two raw seeds were 23 and 22 g% for lentils and chick peas, respectively. Ethereal extract, fiber, ash, calcium, phosphorus and iron content of the two raw seeds have been also assayed. 2. The levels of most of the amino acids were also estimated in the raw and cooked seeds. It was found that tryptophan- and sulphur-containing amino acids were the most limiting ones. Cooking the seeds by the same methods commonly used in Syria resulted in the loss of most of the amino acids, with the exception of lysine and tryptophan which were slightly increased. 3. Trypsin inhibitors and saponins were detected in the raw seeds. Haemagglutinins were present in raw lentils only. Cooking the seeds destroyed the trypsin inhibitors and haemagglutinins and did not affect the saponins. 4. The net protein utilization of whole lentils and chick peas were 38 and 53, respectively. Decortication of lentils or cooking without decortication has no effect on the NPU values. Cooking the decorticated lentil seeds raised its NPU values from 38 to 56. Cooking chick peas resulted in a slight increase in their NPU. Supplementation of the raw and treated seeds with methionine and tryptophan raised its NPU values markedly.


[Case report on the problem of individual glycoside requirements]. A report is given on a patient with ischaemic heart disease, whose recompensation in tachyarrhythmia absoluta was for some times possible only by means of unusually high doses of digitoxin (fully effective dose to 5.72 mg, maintenance dose to 0.4 mg). The patient survived a severe decompensation with pulmonary oedema, which appeared under "normal" applications of glycosides, 2 1/2 years under this therapy. Thus it must again be referred to an individual glycoside treatment.


An opaque material apposed to the periphery of the subplasmalemmal Cisterns of cochlear outer hair cells.


Neurohypophysial-adrenal gland responses to water-deprivation in the rose-ringed parakeet. The aim of the present investigation is to study the relative influence of neuohypophysis, adrenal cortex and adrenal medulla under dehydration stress in the parakeet. Birds subjected to dehydration for 7 days lost body weight. Neurosecretory material (NSM) was partially depleted from the neurohypophysis. Adrenal gland weight was increased followed by a hypertrophy of the cortical tissue. A fall in adrenal cholesterol and ascorbic acid level was marked. Adrenaline and noradrenaline contents of the adrenal medulla were suppressed as was evident from cytochemical and biochemical findings. It is suggested that neurohypophysis, adrenal cortex and adrenal medulla are involved in maintaining water homeostasis in this avian species.