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Background: Methamphetamine is a neurotoxic agent. Its chronic abuse may result in cognitive impairment with negative consequences for patients' treatment and rehabilitation. The aim of the study was to compare Wisconsin Card Sorting Test profiles of Czech subjects dependent on methamphetamine with healthy individuals., Subjects and Methods: Forty-three hospitalized Czech Caucasian patients including twenty-seven men at the average age of 25.3±5.2 years dependent on methamphetamine for 6.2±3.3 years were assessed by the Wisconsin Card Sorting Test. We used the same neurocognitive test for the comparison group of healthy controls with the same ethnicity (N=52, men N=28, average age of 38.7±12.1 years). We applied the Chi-Square Test, Two-Sample T Test, Mann-Whitney U Test and Kolmogorov-Smirnov Test to compare methamphetamine dependent patients with healthy volunteers., Results: All recorded Wisconsin Card Sorting Test parameters were significantly different in the group of methamphetamine dependent patients versus healthy volunteers (P=0.04-0.006; Mann-Whitney U Test, Two-Sample T Test). The results showed a higher error rate and a smaller achievement quality in the patients as against healthy subjects. We ascertained a significant cognitive deterioration in the patients as compared to healthy volunteers even if the average patients' achievements were in the normal range according to the test norms., Conclusions: A cognitive impairment was present in the group of patients as compared to healthy controls. Better understanding of neurocognitive symptoms in methamphetamine dependent subjects should help to generate modern therapeutic approaches, both pharmacological and psychosocial, to prevent or attenuate the long-term negative consequences of methamphetamine use disorders.

Background: Verbal memory is an essential cognitive ability with scope for adequate treatment of information and for orientation in everyday life. Our study is centered on memory performance in the wake of treatment for ruptured intracranial aneurysm., Methods: Three psychological tests were performed: (1) within a month of the neurosurgical intervention, (2) 1 year and (3) 5-7 years after the ruptured aneurysm treatment. Under comparison are the overall results of tests for verbal memory capacity in a cohort of patients (N = 59) and in the control group., Results: Three post-treatment measurements revealed a persistent deficit of verbal memory. The cohort's average performance improved from -1.3 SD (standard deviation) below the average of the norm to -0.5 SD below the norm at the second test 1 year after treatment, while at the third test the deficit had worsened to -0.68 SD. Similarly, testing for long-term recovery at 5-7 years postoperatively showed the patients' performances to be 2/3 SD below the average of the general population., Conclusions: The results of the study imply the need for long-term rehabilitation of memory in this particular group of patients.

Background: Cortisol, along with other hormones of hypothalamo-pituitary-adrenal axis, belongs to one of the main factors influencing psychological and pathognomic factors, intelligence, and memory., Methods: The aim of our study was to review a large battery of psychological, performance, IQ and memory tests as to their relation with cortisol, testosterone and estrogen levels in groups of 100 men and 93 women who attended the Central Military Hospital in Prague for regular entrance psychological examinations for military personnel., Results: In men, we detected positive correlations between cortisol and emotional lability, and negative correlations with impulsivity, while in women hypochondria and psychopathology were negatively correlated, and aggression measured with the Meili selective memory test had a positive relation to cortisol level. Testosterone correlated positively with emotional liability and negatively with impulsivity in men, and negatively with hypochondria and psychasteny, indirect aggression, irritability and paranoia in women. Estradiol correlated positively with psychopathology in men, and negatively with phobia. It was positively correlated with negativism in women. No clear correlation was observed between the concentration of steroid hormones and psychomotor performance or intelligence., Conclusions: Concentrations of steroid hormones correlate with results of several psychological tests, the sign and magnitude of these correlations, however, very often differ in military men and women.

Background: Examination of existing research on posttraumatic adjustment after disasters suggests that survivors' posttraumatic stress levels might be better understood by investigating the influence of the characteristics of the event experienced on how people thought and felt, during the event as well as afterwards., Objective: To compare survivors' perceived post- and peritraumatic emotional and cognitive reactions across different types of disasters. Additionally, to investigate individual and event characteristics., Design: In a European multi-centre study, 102 survivors of different disasters terror attack, flood, fire and collapse of a building were interviewed about their responses during the event. Survivors' perceived posttraumatic stress levels were assessed with the Impact of Event Scale-Revised (IES-R). Peritraumatic emotional stress and risk perception were rated retrospectively. Influences of individual characteristics, such as socio-demographic data, and event characteristics, such as time and exposure factors, on post- and peritraumatic outcomes were analyzed., Results: Levels of reported post- and peritraumatic outcomes differed significantly between types of disasters. Type of disaster was a significant predictor of all three outcome variables but the factors gender, education, time since event, injuries and fatalities were only significant for certain outcomes., Conclusion: Results support the hypothesis that there are differences in perceived post- and peritraumatic emotional and cognitive reactions after experiencing different types of disasters. However, it should be noted that these findings were not only explained by the type of disaster itself but also by individual and event characteristics. As the study followed an explorative approach, further research paths are discussed to better understand the relationships between variables.

Pervasive refusal syndrome (PRS) has been proposed as a new diagnostic entity among child and adolescent psychiatric disorders. It is characterized by a cluster of life-threatening symptoms including refusal of hood intake, decreased or complete lack of mobilization, and lack of communication as well as retreat from normal life activities. Active refusal to accept help as well as neglect of personal care have been core features of PRS in the limited number of cases reported in the last decade. There have, however; been cases with predominantly passive resistance, indicating the possibility that there may be a continuum from active refusal to passive resistance within PRS. Postulating this continuum allows for the integration of "depressive devitalization" -- a refusal syndrome mainly characterized by passive resistance -- into the concept of PRS. Here, three case vignettes of adolescent patients with PRS are presented. The patients' symptomatology can be allocated on this continuum of PRS. PRS and dissociative disorders are compared in greater detail and contrasted within this discussion of differential diagnoses at the poles of such a continuum. PRS is a useful diagnosis for cases involving symptoms of predominating refusal and retreat which cannot satisfactorily be classified by existing diagnostic categories, and which can mostly clearly be separated from dissociative disorder.

Although neuropsychological deficits have been reported in patients with major depressive disorder (MDD) during an acute episode, relatively little is known about the persistence of these deficits in remission. This study investigated the performance of attention, executive function and verbal memory during remission from unipolar depressive episodes. We tested the hypothesis that outpatients do not differ in cognitive variables from controls. We did this using a well-defined outpatient sample, consisting of medicated and unmedicated patients, with a history of MDD. Ninety-seven subjects with MDD in remission ranging from young to old were compared with 97 healthy control subjects. Both samples were balanced for age, gender, and education levels. The Auditory Verbal Learning Test (AVLT) and the Trail Making Test (TMT) were used. Patients with remitted MDD, in comparison with controls, were impaired on tasks of attention, executive function and verbal memory. The individual level of depressive symptoms was not related to the cognitive performance. Small- to medium-sized significant correlations exist between cognitive test variables (as represented by Trail Making B and AVLT delayed recall) and level of depressive symptomatology (as measured by MADRS or BDI-II) in the total sample, indicating that higher levels of depressive symptomatology are associated with lower cognitive function. These findings suggest deficits in attention and delayed verbal recall can serve as an indicator for MDD in outpatients.

Objectives: We have investigated the changes of Temperament and Character Inventory (TCI) dimensions of personality in outpatients during 6 months of antidepressant treatment., Subjects and Methods: 30 outpatients were treated for mild or moderate depressive episode, current mild or moderate episode of reccurent depressive disorder or mixed anxiety and depressive disorder (ICD-10). The intensity of depression was assessed by the Montgomery-Asberg Depression Rating Scale (MADRS) at the beginning of treatment and then after the 1st, 3rd and 6th month of treatment. The TCI dimensions were assessed by the Temperament and Character Inventory-Revised (TCI-R) at the same time periods as the MADRS. The mean scores of the TCI-R dimensions and MADRS were processed by Wilcoxon pair test., Results: We have observed a significant decrease in harm avoidance (HA) score after 6 months of treatment (p<0.05), between the 1st and 6th month (p<0.05), between the 3rd and 6th month, (p=0.033), significant increase in persistance (P) between the 1st and 6th month (p<0.05) and a significant decrease in self-transcendence (ST) score after 3 months (p<0.05) and after 6 months (p<0.05). In the MADRS total score we have observed a significant decrease after the 1st (p<0.001), 3rd (p<0.001) and also 6th month (p<0.001)., Conclusions: Our findings showed changes of personality dimensions HA, P and ST in outpatients during antidepressant treatment.

Childhood depressive disorders are a health risk that need to be taken seriously due to their potential associated complications. A literature search of previously published studies about this subject utilizing PubMed, Psycontent and Psyndex has been performed. The data has been analyzed and the results discussed critically. It becomes apparent that few studies focus on depressive disorders in children and not much consideration is given to possible gender-related differences. Further investigation is needed in regard to epidemiology, symptoms, comorbid factors and duration of these disorders including studying the children's developmental psychopathology. It is especially essential to establish adequate pharmaco- and psychotherapeutic treatments to ameliorate prognosis, progression and persistence of depressive disorders in children.

We explore psychometric characteristics of a modified version of the Cloninger's personality questionnaire, the Temperament and Character Inventory-Revised (TCI-R) in a 200-subject sample. This sample was stratified in accordance with the Czech population. We performed principal component analyses and explored the factorial structure of the questionnaire, to establish internal consistency of each dimension. The factorial structure of the TCI-R was well defined for temperament, but not for character. A robust factor was obtained for Persistence. All dimensions obtained higher alpha Cronbach coefficients with the TCI-R than with the TCI. There were high reliability coefficients in test-retest for TCI-R and lower for TCI/TCI-R were found. Significant correlations were obtained between age and NS, RD and SD. The TCI-R seems to have similar psychometric characteristics to TCI, with significant improvements in temperament factor structure and internal consistency of most dimensions.

Objective: 133Xe has been widely used for measuring blood flow in various organs. Because an injectable solution of 133Xe is not commercially available, a technique is presented that allows both the production of the radiopharmaceutical and the drawing of individualized patient doses., Method: A system was designed to crush ampoules of 133Xe gas inside a sealed cylinder containing sodium chloride injection 0.9%., Results: 133Xe ampoules of different sizes and filled with different activities were crushed within the system. The steel cylinder shielded 98% of the radiation. With 34 GBq 133Xe a total of 20 studies of cerebral blood flow were performed. No bacteriological contamination of the drawn doses was detected., Conclusion: The crusher system allows the efficient and safe production of an injectable solution of 133Xe with sodium chloride 0.9%.

Purpose: Decreased hippocampal volume reported in neuropsychiatric and endocrine disorders is considered a result of putative neuronal damage mediated by corticosteroids. This is the first prospective study of hippocampal volume and function in patients treated with corticosteroids., Methods: 14 subjects treated systemically with prednisone or betamethasone for dermatological or rheumatic disorders underwent prospective neurocognitive testing (Auditory Verbal Learning Test-AVLT, Trail Making Test-TMT, Digit Span-DS) and nine of them also repeated magnetic resonance volumetry., Results: The mean duration of treatment between the first and the second assessment was 73+/- 38 days with mean daily dose of 37+/- 17 mg prednisone and 193+/- 29 days, with mean daily dose of 24+/- 15 mg prednisone between the first and the third assessment. There was a trend towards decreases in total AVLT scores and an improvement in the TMT and DS, but no significant changes in the volumes of the right or the left hippocampi between the assessments. Prednisone dose did not correlate with the hippocampal volume change., Conclusion: We observed a trend for decline in verbal memory despite improvement in psychomotor speed, attention/working memory and no macroscopic hippocampal volume changes during 36-238 days of treatment with therapeutic doses of corticosteroids.

Background: Recently, a negative association between Toxoplasma-infection and novelty seeking was reported. The authors suggested that changes of personality trait were caused by manipulation activity of the parasite, aimed at increasing the probability of transmission of the parasite from an intermediate to a definitive host. They also suggested that low novelty seeking indicated an increased level of the neurotransmitter dopamine in the brain of infected subjects, a phenomenon already observed in experimentally infected rodents. However, the changes in personality can also be just a byproduct of any neurotropic infection. Moreover, the association between a personality trait and the toxoplasmosis can even be caused by an independent correlation of both the probability of Toxoplasma-infection and the personality trait with the third factor, namely with the size of living place of a subject. To test these two alternative hypotheses, we studied the influence of another neurotropic pathogen, the cytomegalovirus, on the personality of infected subjects, and reanalyzed the original data after the effect of the potential confounder, the size of living place, was controlled., Methods: In the case-control study, 533 conscripts were tested for toxoplasmosis and presence of anti-cytomegalovirus antibodies and their novelty seeking was examined with Cloninger's TCI questionnaire. Possible association between the two infections and TCI dimensions was analyzed., Results: The decrease of novelty seeking is associated also with cytomegalovirus infection. After the size of living place was controlled, the effect of toxoplasmosis on novelty seeking increased. Significant difference in novelty seeking was observed only in the largest city, Prague., Conclusion: Toxoplasma and cytomegalovirus probably induce a decrease of novelty seeking. As the cytomegalovirus spreads in population by direct contact (not by predation as with Toxoplasma), the observed changes are the byproduct of brain infections rather than the result of manipulation activity of a parasite. Four independent lines of indirect evidence, namely direct measurement of neurotransmitter concentration in mice, the nature of behavioral changes in rodents, the nature of personality changes in humans, and the observed association between schizophrenia and toxoplasmosis, suggest that the changes of dopamine concentration in brain could play a role in behavioral changes of infected hosts.

We applied the temperament and character inventory (TCI) personality questionnaire in 41 inpatients dependent on metamphetamine, and 35 controls. Novelty seeking, harm avoidance and self-transcendence were significantly higher, and persistence, self-directedness and cooperativeness were significantly lower in the patients than in the healthy volunteers. The detected differences may be important for prevention and treatment.

Toxoplasma gondii, a parasitic protozoan, infects about 30-60% of people worldwide. The latent toxoplasmosis, i.e. life-long presence of cysts in the brain and muscular tissues, has no effect on human health. However, infected subjects score worse in psychomotor performance tests and have different personality profiles than Toxoplasma-negative subjects. The mechanism of this effect is unknown; however, it is supposed that presence of parasites' cysts in the brain induces an increase of the concentration of dopamine. Here we search for the existence of differences in personality profile between Toxoplasma-positive and Toxoplasma-negative subjects by testing 857 military conscripts using a modern psychobiological questionnaire, namely with Cloninger's Temperament and Character Inventory (TCI). ANCOVA showed that Toxoplasma-positive subjects had lower Novelty seeking (NS) scores (P=0.035) and lower scores for three of its four subscales, namely Impulsiveness (P=0.049), Extravagance (P=0.056) and Disorderliness (P=0.006) than the Toxoplasma-negative subjects. Differences between Toxoplasma-negative and positive subjects in NS was inversely correlated with duration of toxoplasmosis estimated on the basis of concentration anti-Toxoplasma antibodies (P=0.031). Unexpectedly, the infected subjects had also lower IQ (P(2)=0.003) and lower probability of achieving a higher education (P(2)<0.0000). Decrease of NS suggests that the increase of dopamine in brain of infected subjects can represent a missing link between toxoplasmosis and schizophrenia.

After more than 40 years of heart valve surgery, the indication for double valve procedures still represents a problem in the presence of an obviously leading single valve disease. If the isolated valves do not already represent a clear indication for surgery then this situation is the best example for a good deal of thought in cardiac surgery and discussion with competent cardiologists.

Patients and Methods: Herein we report the case of a 37 year old pregnant women with Marfan syndrome with dilatation of the aorta ascendens of 42 mm preconceptionAl. The dilatation remained stable until 34 weeks of gestation when a aortic dissection (De Bakey type I) occurRed rapidly. The patient underwent a cesarean section and hysterectomy, followed by surgery of the aorta asc. by means of implantation of a valved graft immediately., Conclusions: The criteria of a dilatation of the aorta ascendens < 40 mm does not identify reliably those patients who are at risk of dissection during pregnancy. A interdisciplinary approach together with obstetricians, cardiologists and cardiac surgeons is mandatory in all cases of Marfan syndrome and pregnancy.

We report a case of a right atrial sessile tumor combined with a patent foramen ovale and the characteristics of fat containing tumor in magnetic resonance imaging. Histologic study revealed this to be an aneurysmal and partially thrombosed formation of a coronary artery fistula.

After more than 40 years of heart valve surgery, the indication for double valve procedures still represents a problem in the presence of an obviously leading single valve disease. If the isolated valves do not already represent a clear indication for surgery then this situation is the best example for a good deal of thought in cardiac surgery and discussion with competent cardiologists.

We compared clinical data from 45 patients with Huntington's Disease (HD) with CAG triplet repeats and the planimetric measurement of the caudate nucleus head area (CNHA) in CT scans. The mean age of patients was 50.4 yrs (SD +/- 10.2), the mean duration of HD 7.4 yrs (4.6), the mean age at the onset of HD 43.1 yrs (11.1). HD started with motor symptoms in 28 patients, with psychiatric symptoms in 14 patients, the history was unknown in 3 patients. The paternal transmission was observed in 29 patients, the maternal one in 12 patients, unknown in 4 patients. The mean number of CAG repeats was 46.6 (6.1). The mean CNHA was 0.4 cm2 (0.1). We found statistically significant reversed correlation between CAG repeats and the age at the onset of HD (p < 0.0001, r -0.6). The earlier onset of HD in patients with the paternal transmission compared to the maternal one was found statistically significant (p < 0.05). This phenomenon was not related to the larger number of CAG triplets in patients with the paternal transmission. No differences either of the age at the onset of HD or numbers of CAG repeats were found between subgroups of HD patients starting with motor or psychiatric symptoms. We also observed the significant reversed correlation between the duration of HD and CNHA measurement (p < 0.001, r -0.5). Even in the earliest stage of HD patients showed the marked atrophy of CNHA.

Background: Cardiac localization of hydatiosis is uncommon, involving 0.5 to 2% of all cases., Case Reports: The first patient was a 15 year old adolescent whose cardiac hydatidosis was revealed by tamponade. The second case was discovered in a 28-year-old woman without cardiac signs who was explored for allergy manifestations with fever, urticaria and joint point. Both patients underwent surgery. Eighteen months after the operation, the second patient developed hemiplegia leading to the discovery of multi-organ localizations (brain, spleen, kidney) which were not evidenced at the initial work-up. The neurological deficit and brain cysts regress with albendazole treatment., Discussion: The risk of rupture of the cardiac hydatic cyst requires rapid surgical cure. Medical treatments are discussed. Anti-hydatic drugs can be used alone in case of a contraindication for surgery. In other patients they are given during the perioperatie period and for a prolonged period after surgery.

Background and Aims of the Study: This study was performed to evaluate the time course of intracranial high-intensity transient signals (HITS) in patients undergoing elective heart valve replacement., Methods: Thirty-three patients were enrolled in this study. The examination protocol included serial (before and at one, five, 90 and 180 days after surgery) monitoring sessions with transcranial Doppler and detailed neurological examination. Monitoring was performed bilaterally over the middle cerebral arteries for one hour per session using 2 MHz probes. Microembolic signals were recognized according to standard criteria and stored on a computer for later evaluation., Results: HITS prevalence increased from 3% preoperatively to 41% on the first postoperative day and remained unchanged during the postoperative period. No influence of the intensity of anticoagulation or valve type on HITS counts was evident. Unilateral monitoring provided adequate results in 83.9% of cases., Conclusions: The causative role of the valve implant in the pathogenesis of HITS appears certain, since their prevalence dramatically increases following valve implantation. Valve type, duration of valve implant or intensity of anticoagulation did not influence HITS counts. Bilateral monitoring is warranted for accurate evaluation of HITS counts in this patient group.

The authors draws attention to the problem of neuropsychological rehabilitation. He emphasizes the problem of exploiting the patient's experience during rehabilitation into practical life. He provides data on rehabilitation in vivo and in vitro. He reflects on the development of computer rehabilitation of cognitive functions from neuropsychological tests and presents some examples based on Scandinavian experience. The author also draws attention to his own experience with the neuropsychological computer programme TRAIN THE BRAIN and gives an account of the work with this programme. He recommends the use of computer programmes in psychological and neuropsychological practice. He emphasizes their possibilities in patients with traumatic brain damage and the possibility to follow up systematically changes during recovery which are difficult to record in written tests. Changes in recovery which were recorded by the computer programme frequently did not correspond with changes of the mental state of the patient. Rehabilitation computer programmes also enable to activate of psychiatric patients with performance disorders. The author emphasizes possibilities of neuropsychological rehabilitation and recommends its further development in the Czech Republic.

The presented paper is focused on substantial features of neuropsychological examinations. The author emphasizes the application of different tests focused on the relationship between the brain and behaviour, but in particular the neuropsychological battery. He describes the Halstead--Reitan battery and possibilities of its application in children. He emphasizes the importance of neuropsychological rehabilitation and differentiates it from mere recording of the process of spontaneous recovery. He characterizes the main neuropsychological factors which affect recovery after traumatic brain damage. He mentions some of his own examples where he used these factors in clinical practice. The author describes also his own experience with computer rehabilitation using the SERMION--Train the Brain programme.

The author deals with the neuropsychology of traumatic brain damage in children. He mentions briefly the development of neuropsychology with regard to problems encountered in children. Based on an analysis of the literature he assesses four basic factors when establishing the diagnosis. These factors are: age, type and extent of damage, duration of coma and posttraumatic amnesia and premorbid personality. The author finds discrepancies between assessment of coma in different experimental publications and emphasizes the practical aspect of these basic factors in clinical reflections. He presents results of studies concerning mild, medium and severe cerebral affections in children. He emphasizes the importance of psychotherapy, neuropsychological rehabilitation and crisis intervention.

The aim of this study was to assess the clinical efficacy of a combination of penicillin G and ofloxacin in the treatment of community acquired pneumonia. Thirty eight patients (23 males, 15 females, mean age 62.8 years +/- 19.6) were included. They presented a CAP with the following criteria: fever, abnormal chest X-ray pattern. They received the combination of IV penicillin 12 x 10(6) U daily and IV ofloxacin 200 mg bid. After 48 hours of apyrexia, this treatment was followed by oral ofloxacin alone 200 mg bid. In six cases, the etiologic agent was identified: 2 S. pneumoniae, 1 Chlamydiae psittaci, 2 Staphylococcus aureus, 1 Mycoplasma. In 32 cases, the bacteriological investigation was negative. Five patients were excluded: 2 deaths due to heart failure, 3 alterations of treatment. Twenty eight patients recovered: apyrexia was obtained in 3.5 days. Penicillin G was prescribed for 7.5 days +/- 2.65, followed by ofloxacin alone for 11.43 +/- 3 days. Five patients were considered as clinical failures: 2 deaths due to extensive pneumonia, 3 recoveries after alteration of treatment. Side effects were rare: 1 confusion, 2 skin rashes. As a conclusion: penicillin G and ofloxacin in combination for the initial therapy of CAP, rapidly relayed by ofloxacin alone, permitted 84.3% of recovery in our patients.

Optically active D-arylglycines, which are of interest for preparation of semisynthetic penicillins and cephalosporins, were isolated from the racemic mixtures of their derivatives using immobilized proteolytic enzyme subtilisin (EC No. 3.4.4. 16). The performance of these reactions in two-phase systems, consisting of water and an immiscible organic solvent, improved the yield, purity, and economics of the process by increasing the substrate solubility and reducing the rate of nonenzymatic hydrolysis. The proportion of the organic phase can be as much as 75% of the overall volume without seriously impairing the enzymatic activity. The optically pure D-and L-arylglycines were liberated from their D- and L-derivatives by acid hydrolysis. The substituent influence of the various arylglycine derivatives on the rate of the enzymatic cleavage reaction was investigated.

Specific nitrogenase activity in Azospirillum brasilense ATCC 29145 in surface cultures under air is enhanced from about 50 nmol C2H4 X mg protein -1 X h-1 to 400 nmol C2H4 by the addition of 1 mM phenol. 0.5 and 2 mM phenol added increase the rate 5-fold and 4-fold. This enhancement effect is observed only between 2 and 3 days after inoculation, with only a small reduction of the growth of the cells by the phenol added. In surface cultures under 1% O2, nitrogenase activity is slightly reduced by the addition of 1-0.01 mM phenol. Utilization of succinate is enhanced during the period of maximum enhancement of nitrogenase activity by 60% by addition of 1 mM phenol. The cells did not produce 14CO2 from [U-14C] phenol, neither in surface cultures nor in liquid cultures and less than 0.1% of the phenol was incorporated into the cells. A smaller but significant enhancement of nitrogenase activity by about 100% in surface cultures under air was found with Klebsiella pneumoniae K 11 after addition of 1 mM phenol. However, in Rhizobium japonicum 61-A-101 all phenol concentrations above 0.01 mM reduced nitrogenase activity. With 1 mM phenol added activity was reduced to less than 10% with no effect on the growth in the same cultivation system. With this Rhizobium japonicum strain significant quantities of phenol (25 mumol in 24 h by 2 X 10(12) cells) were metabolized to 14CO2, with phenol as sole carbon source. With Azospirillum brasilense in liquid culture under 1% and 2% O2 in the gas phase, no enhancement of nitrogenase activity by phenol was noticed.

The authors report the results of a prospective study in a geriatric unit. 287 upper gastro intestinal endoscopies were performed on 265 patients the endoscopic examinations, oesophagitis in the population was found 40 times (15%). Most of the clinical oesophagitis presentation is non-specific, the nutritional status is quickly involved. As for adult people, relationship between oesophagitis and hiatal hernia is strong; 27 of 40 oesophagitis (67.5%) had a concomitant hiatal hernia whereas 27 of 62 hiatal hernia were associated with oesophagitis. A permissive role of medicine who decrease lower oesophageal sphincter pressure cannot be assessed. This study about oesophagitis in the elderly confirm the importance of performing endoscopic procedures, even in case of non-specific symptoms.

Classically, the frequency of latent left-sided Kent bundles and ventricular tachycardia (VT) is increased in mitral valve prolapse (MVP). To verify this hypothesis, 23 patients with clinical and echocardiographic (M mode and 2D) signs of MVP underwent electrophysiological studies for dizziness or syncope (12 cases) or palpitations (11 cases). In addition to the standard electrophysiological studies, analysis of sinoatrial and atrioventricular conduction, they underwent programmed ventricular pacing (St V2): coupled and then paired St V2 in sinus rhythm and during ventricular pacing (100-150/min) under basal conditions (15 patients), after injection of 2 mg Atropine (6 patients), and 10 micrograms of Isoproterenol (4 patients). These manoeuvres showed that symptoms of dizziness were due to increased vagal tone in 6 cases (associated with paroxysmal nodal tachycardia--PNT--in 3 cases), to sinoatrial block in 2 cases (associated with atrial tachycardia in 1 case), to suprahisian conduction defects in 3 cases (associated with atrial tachycardia in 1 case) and to VT in 1 case. Palpitations were due to VT in 1 case, atrial tachycardia in 1 case and PNT in 9 cases. Our analysis showed a high incidence of PNT (10 cases) with normal inter critical ECG. These arrhythmias were due to intranodal reentry in 7 cases (70%), to a latent left-sided Kent bundle in 2 cases and to a paraseptal Kent bundle in 1 case. These PNT were characterised by induction during exercise (6 cases) and by their association with flutter-type reentry (5 cases).(ABSTRACT TRUNCATED AT 250 WORDS)

A 52 year old man presented with effort and resting angina with positive exercise stress testing and myocardial scintigraphy. The initial coronary angiogram showed a single coronary vessel arising from the right coronary ostium dividing into a right coronary artery with a normal trajectory lined with a few non stenotic atheromatous plaques and a left coronary artery which passed between the aorta and pulmonary artery to reach the left atrioventricular groove. At first, it was suggested that the angina was due to compression of the left coronary vessel by the great arteries during effort, but this mechanism could not explain attacks of resting angina and the failure of betablocker therapy. An ergometrine test performed during repeat coronary angiography induced almost complete occlusion of the right coronary vessel and Prinzmetal diaphragmatic ischaemia. The anginal attacks were completely suppressed by Calcium antagonist drugs. The association of coronary spasm and a single coronary artery is rare; only one case has been previously reported. We do not believe that there was a relationship between the two phenomena in our case: the spasm occurred at a distance from the aberrant course of the vessel. The authors emphasise the diagnostic problems and the potential danger of this association.

Massive filling of thigh and calf arterial network was noted during phlebography in a patient with a typical clinical picture of "blue" phlebitis of lower limb. This paradoxical vascular injection allows support of current physiopathologic concepts of "blue" phlebitis (phlegmasia cerulea dolens).