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On 1 250 patients admitted to our hospital for gastrointestinal hemorrhage from 1979 to 1987, 4% (50) had severe hematochezia with a bleeding point distal to the ligament of Treitz. Fourty-four patients needed a transfusion of the least 2 red cell units and 6 patients had hypovolemia and anemia. All the patients underwent colonoscopy with a total of 68 examinations. Precise diagnosis of the bleeding lesion by colonoscopy was made in 41 (82%). Bleeding diverticula and ulcers were the most frequent lesions. Seventeen patients were examined by angiography, which was diagnostic in 6 patients. Fourteen patients were treated endoscopically by electro coagulation. One perforation occurred and two patients had persistent bleeding. Nine patients were managed surgically; two complications occurred. No rebleeding occurred in any patient. We conclude that colonoscopy is a safe method of diagnosing the source of lower intestinal hemorrhage. Moreover, half of the 50 patients ceased to bleed spontaneously with a supportive medical therapy.

Unsere vergleichende Forschung zur Anrufung von Gerichten fur die Schuldbeitreibung bei Verbrauchern in Grosbritannien und Westdeutschland in den letzten 20–25 Jahren steckt noch in den Anfangen. Wir beginnen mit der Beschreibung von Trends im Geschaftsanfall und im Vollstreckungsaufkommen in den beiden Landern und untersuchen sodann die Beziehung zwischen dem Gebrauch der Gerichte zur Beitreibung von Verbraucherschulden und wichtigen demographischen, okonomischen und sozialen Veranderungen. Da die Annahme, das die ersteren durch die letzteren erklart werden konnen (Hypothese I), sich nicht erharten lies, werden schlieslich alternative Erklarungen fur die Entwicklung der Beitreibungshaufigkeit bei den Gerichten aufgezeigt (Hypothesen II und III).

Synapses between neuroblastoma-hybrid cells and myotubes exhibit a high degree of plasticity. Increase of cyclic adenosine monophosphate (AMP) levels of the hybrid cells for several days results in the appearance of functional voltage-sensitive Ca2+ channels, which are required for evoked secretion of acetylcholine. The results show that cyclic AMP regulates synaptogenesis by regulating the expression of voltage-sensitive Ca2+ channels, and suggest that cyclic AMP affects posttranslational modifications of some glycoproteins and cellular levels of certain proteins.

Renal failure may lead to changes in structure and function of virtually every segment of the digestive tract. As extensive papers devoted to gastrointestinal abnormalities in uraemic patients have been published (1–4), the aim of this chapter is to vitalise the topic by reviewing recent literature and referring to personal experiences resulting from collaborative studies between nephrologists and gastroenterologists at our institution.

Publisher Summary This chapter discusses default risk and the demand for forward exchange. The development of the so-called modern theory (MT) of the forward foreign exchange market purports to offer at least three contributions. First, it establishes that forward exchange market equilibrium can occur at a forward rate that does not correspond to interest rate parity (IRP). Second, it predicts usefully for forecasting purposes that the equilibrium forward rate invariably falls in between the IRP forward rate and the expected future spot rate. And third, it supplies a theoretical foundation for government policies of intervention in the forward market that are deemed—given certain assumptions regarding speculators' expectations as to the results of the intervention—to be potentially successful even under market demand conditions that are such as to produce IRP. The several deficiencies of the MT stem essentially from its treatment of the forward exchange market as a closed system, isolated from other markets. The urge to identify the equivalent of demand and supply sides in the market forced many authors to posit an artificial segmentation of forward market transactions, as between pure arbitrage and pure speculation: arbitrageurs never speculate and vice versa.

Liver function and liver biopsy findings were studied in a selected group of 29 overweight patients. Fatty liver, fatty hepatitis, fatty fibrosis and fatty cirrhosis were seen with equal frequency. Diabetes was also present with an equal incidence in each of these four pathologic groups. Lipoprotein abnormalities, particularly type IV hyperlipoproteinemia, were found mostly in the two groups with the lesions with less fibrosis (fatty liver and fatty hepatitis). The pathologic picture resembled that of alcohol and postjejunoileal bypass-induced liver diseases suggesting a common denominator in these three conditions.

Severe hepatic vascular disease developed in two patients 4 and 8 years after kidney transplantation, while receiving combined immunosuppressive therapy with prednisone and azathioprine. Portal hypertension and marked liver failure were observed in both cases. The diagnosis was established by histological examination of liver biopsies showing typical veno-occlusive disease of the liver associated with peliosis in both cases. Azathioprine was discontinued. Two years later one patient was asymptomatic and liver function tests were normal. The second patient died 3 years later from liver failure. Early recognition of hepatic vascular disease arising in kidney transplant recipients would be of utmost importance, as substitution of another immunosuppressive agent for azathioprine could halt the process leading to portal hypertension.

Die Hauptfrage, mit der sich diese Arbeit befast, ist, ob das Gesetz dazu benutzt werden kann, die unumschrankte Handlungsfreiheit der professionellen Berufsausubung in der Sozialverwaltung in Schranken zu halten, und ob die Stellung der Benutzer von Sozialeinrichtungen durch Verleihung von Rechten verbessert werden kann. Die Arbeit kommt zu dem Schlus, das das Gesetz kein besonders wirksames Mittel zur Einschrankung der Professionen ist und das andere Mittel gefunden werden mussen, um diese Berufe rechenschaftspflichtiger zu machen.

The toxicity of organophosphorous cholinesterase inhibitors is believed to result primarily from inhibition of acetylcholinesterase (AChE) and consequent increases in acetylcholine (ACh) lifetime (10). At the vertebrate neuromuscular junction, blockade of AChE leads to increases in the amplitude and time course of spontaneous miniature endplate potentials (MEPPs), evoked endplate potentials (EPPs) and their underlying currents (7, 9, 11). In mammalian but not amphibian preparations, anticholinesterase agents also cause repetitive antidromic firing in the presynaptic axon in response to a single conditioning stimulus (12). This phenomenon has been attributed to nerve terminal depolarization due to accumulation of Ach (17) or K+ (12) in the synaptic cleft following blockade of ACh hydrolysis.

The clinical efficacy and patient acceptability of a new solution containing mainly sodium sulfate and polyethylene glycol (solution II) compared with a balanced standard electrolyte solution (solution I) for whole gut lavage prior to colonoscopy were evaluated in 240 ambulatory and hospital patients randomly allocated to receive either of the two solutions. On the basis of the quality and rapidity of the bowel preparation and the good results obtained by clinical and biological parameters, we found that the newly designed solution was superior.

Cultures of continuous cell lines have proved useful for studying excitation-secretion coupling. Such cell lines enable the investigator to perform both biochemical and electrophysiological experiments on a relatively homogeneous cell population and to manipulate the state of cellular differentiation by suitable alterations of culture conditions. Among the better characterized cell lines are those derived from the C-1300 neuroblastoma tumor (Augusti-Tocco and Sato, 1969). A number of cholinergic and adrenergic clones have been isolated from this murine tumor. They were shown to synthesize, store and release the appropriate neurotransmitters and to generate action potentials following electrical stimulation. Fusion of the neuroblastoma clone N18TG-2 with the glioma cell line C6BU-1 has yielded the hybrid NG108-15 (Amano et al., 1974) with enhanced electrical excitability and the ability to form nicotinic cholinergic synapses when co-cultured with primary or clonal myotubes (Nelson et al., 1976; Christian et al., 1977).

The effects of various organic Ca2+ channel inhibitors were investigated on the binding of the alpha 1-antagonist 3H-labeled 2-[(2',6'-dimethoxyphenoxyethyl)aminomethyl]-1,4-benzodioxane ([3H]WB-4101) to membranes from rat brain and neuroblastoma-glioma hybrid cells (NG108-15). As found by monitoring binding of [3H]WB-41-1, the Ca2+ channel inhibitors methoxyverapamil (D600), verapamil, and the nifedipine analogue YC-93 bind to two different sites in rat brain: a high-affinity site (dissociation constant Kd = 2.9 nM and binding capacity B = 360 fmol/mg of protein) and a low-affinity site (Kd = 260 nM and B = 2700 fmol/mg of protein). In NG108-15 cells, where no alpha 1 receptors were detected with [3H]WB-4101, the Ca2+ antagonists were found to bind to nonadrenergic sites in the membrane with a capacity B = 976 fmol/mg of protein. The binding of Ca2+ antagonists to [3H]WB-41-1 sites led to the investigation of WB-4101 as a Ca2+ inhibitor by electrophysiological techniques. WB-4101 depressed the amplitude and reduced the rate of rise of the CA2+ spike with an affinity slightly greater than that observed for D600. The concentration for 50% inhibition of the Ca2+ spike amplitude was 48 microM for WB-4101 and 80 microM for D600. The WB-4101-induced blockade of the Ca2+ spike was antagonized by high Ca2+ concentrations, indicating a common site for Ca2+ and the alpha-antagonist. D600 and WB-4101 also inhibited voltage-dependent Na+ and K+ conductances. The results suggest that Ca2+ channels can account for a fraction of the sites labeled with [3H]WB-4101 in membrane preparations from brain and NG108-15 cells.

Tetraethylammonium (Et 4 N + ) ions depressed the amplitude and accelerated the decay rate of spontaneously occurring and nerve-evoked endplate currents (EPCs) in frog sartorius muscle. The relationship between peak EPC amplitude and membrane potential became nonlinear in the presence of 100 μM Et 4 N + , and with drug concentrations of 250 μM or greater the current-voltage relationship exhibited negative conductance in the hyperpolarized region. Et 4 N + modified the exponential dependence of the EPC decay on membrane potential such that the decays between -150 and -50 mV were abbreviated and voltage independent but remained near control levels at more positive membrane potentials. The minimal effective concentration of Et 4 N + for altering the EPC time course was 10, and maximal effects were attained with 100 μM. Little additional shortening in the EPC decay phase was detected on raising the drug concentration to 1000 μM. Acetylcholine noise analysis revealed a voltage-dependent reduction in the mean channel open time, which was comparable in magnitude to the shortening in the EPC decay, and a depression of single-channel conductance. In concomitant biochemical studies, Et 4 N + was found to inhibit the binding of both [ 3 H]acetylcholine and [ 3 H]perhydrohistrionicotoxin to receptor-rich membranes from the electric organ of Torpedo ocellata with K i values of 200 μM and 280 μM, respectively. These results suggest that Et 4 N + interacts with both the acetylcholine receptor and its associated ionic channel. The voltage-dependent actions of Et 4 N + are attributed to blockade of the ionic channel in closed as well as open conformation.

The standard treatment for patients with chronic hepatitis C is a 6-12-month combination therapy with interferon alpha and ribavirin. Induction treatment could result in a faster early decline of the hepatitis C virus (HCV) load and a better response rate. Naive chronically infected HCV patients (n = 454) were randomized into two arms to receive either induction treatment with interferon alpha 2b 5 million units (MU) subcutaneously (s.c.) daily during a period of 8 weeks (arm A); or treatment with interferon alpha 2b 5 MU s.c. three times a week (TIW) for a period of 8 weeks (arm B). After week 8, interferon treatment in both arms was 3 MU s.c. TIW for a total period of 12 months. In both arms, ribavirin (1000-1200 mg orally per day) was added at week 4. Induction treatment resulted in a higher virological response at week 8 of treatment (66% vs 47'%; P < 0.01). However, response at the end of treatment and at 6 months follow-up was not different (53% vs 50%). 41%, vs 33%). The occurrence of adverse events and the drop-out rate were similar in both arms. Although an early virological response is observed more frequently in the induction treatment. end of treatment response and sustained responses did not differ.

Better tools for predicting the risk of death while awaiting transplantation are urgently needed because organ shortage is increasing the numbers on transplantation waiting lists. The aminopyrine breath test (ABT), model for end-stage liver disease (MELD), and Child-Pugh (C-P) score were compared as predictors of this risk in 137 cirrhotic candidates for liver transplantation. Eighty-three were transplanted within 3 months of registration, 35 others survived, 13 died before transplantation, and 6 were removed from the list. By univariate analysis, the continuous variables significantly associated with death while awaiting transplantation were: history of infected ascites, C-P score, ABT, and international normalized ratio or prothrombin time. Receiver operating characteristic curves for quantitative variables showed that the area under the curve was greatest for ABT (0.858±0.067). By Youden curve analysis, the best cut-off points for identifying cirrhotic patients at high risk of death while on the waiting list were: >10, >16, and

A currency is not risky because devaluation is highly likely. If the devaluation were certain, there would be no risk at all. A weak currency can be less risky than a strong currency. A strong currency does not become risky because it has been used to denominate a firm's debt.

[1] Adler, F. M., "The Relationship between the Income and Price Elasticities of Demand for United States Exports," this REVIEW, LII (Aug. 1970), pp. 313-319. [2] Banca D'Italia, Elasticita di domanda e di prezzo nel cominercio estero dei principali paesi industriali, Rome, 1970. Salvatore Leonetti is the author. An abridged version appeared in the Bank of Italy's Bolletino, XXV (Jan.-Feb. 1970). [3] Houthakker, H. S. and S. P. Magee, "Income and Price Elasticities in World Trade," this REVIEW, LI (May 1969), pp. 111-125. [4] Office of Statistics and Reports, Agency for International Development, Gross National Product: Growth Rates and Trend Data by Region and by Country (April 30, 1970), RC-W-138.

The purpose of this paper is to review critically, though far from exhaustively, some of the outstanding issues in the economic analysis of U.S. direct foreign investment activities. The unsurprising main conclusion is that the complexity of the issues and the multiplicity of contributing factors and inter-relationships will continue to preclude for some time to come resolution of the debate over whether direct investment abroad should be controlled. While the conclusion itself borders on the obvious, the route to it is less so. The decision as to whether foreign investment activities should be controlled depends on two logical choices which correspond to two possible interpretations of the word framework appearing in the title. First, one must define the national policy problem which direct investment controls are supposed to solve. Already at this initial stage, the United States and others are confronted by dilemmas. For, to select the balance of payments crisis as the starting point, as the United States has, is to ignore other essential aspects of national well-being which also are affected by direct investment abroad. Further, even if the balance of payments context is chosen as most appropriate, the deficit can be reduced by alternative methods some of which require no direct investment control at all. The relevance of direct investment controls to policy is logically, therefore, quite narrowly confined to the choice of one very particular policy framework. These issues are discussed in Section I. To make the decision to regulate direct investment abroad implies a fairly careful balancing of the costs and benefits of so doing. Measuring these costs and benefits then becomes a crucial issue. The deficiencies of most past and recent research in this regard are emphasized in Section II. A different choice, that of an improved framework or methodology within which the requisite information can be specified and analyzed, must therefore be made. Section II proceeds to argue for a promising econometric approach which, though it falls short of perfection, enjoys major advantages. Conclusions are briefly outlined at the close.

In a recent issue of this Journal, Makinen1 presented balance-of-payments payback periods for investments abroad by the U.S. automobile industry. This note will (1) question the usefulness of single-industry payback computations for national policy purposes, and (2) argue that certain assumptions in Makinen's approach vitiate his numerical results. For both sets of reasons, policies based on these findings might do more harm than good.

R ECENT empirical studies in international trade, by Junz and Rhomberg [10], Kreinin [14] and in a major contribution, by Houthakker and Magee [6], have stressed the importance of different price and income elasticities of demand for exports and imports among countries as determinants of trade patterns. However, questions as to why such differences in elasticities arise remain open. An important component of the problem is whether the price and income elasticities of demand for individual exporters' products vary systematically across customer markets. This paper attempts partially to address the latter issue by examining the elasticities of United States exports of manufactured goods. The major finding is that a relationship exists between the competitiveness of United States manufactured goods exports in various foreign countries and the nature of the customer market. The result has implications, outlined below, for projections of future United States trade balances.

This article has two goals. The first is to contrast two widely used definitions of risk aversion. The second is to establish the feasibility of plunging behavior, in the sense that a possibly large number of risk averse investors will not be diversifiers.