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The work presented below is enclosed in a research on depressive retardation in children. It deals with the measurement of reaction time to sensori stimuli (visual or auditory) among children from 7 to 13 year old. Patients with major depressive episode were presented twice, before medication and at their discharge. The assessment which is performed to the nearest thousandth of a second thanks to a program developed on micro computer includes 5 test situations: 1. simple visual stimulation; 2. simple auditory stimulation; 3. choice situation between visual and auditory stimulation; 4. unlocated visual stimulation; 5. choice situation between two different visual stimulations. Generally speaking the best scores are logically achieved for the simple auditory tests followed by the simple visual test. The highest scores almost systematically appear for the test offering the choice between two different visual stimulations. For each of the five tests the values are always correlated between the two passation periods. These correlations mean that the passation time depends on each child. Those who achieved "good scores" in the depression phase before medication are the same who achieve good scores at their discharge and vice versa. These performances have no relation either with the age of the children. The analysis of the results brings out two factors: For simple stimuli tests, performances do not vary between the two passation periods and therefore show a motor normal function. On the other hand, for tests which involve a choice (and therefore decision making) before medication children react significantly more slowly than after improvement.(ABSTRACT TRUNCATED AT 250 WORDS)

We investigated the necrotizing effect of a 75% alcoholic solution of phenol on normal tissue harvested during surgery (muscles, fatty or connective tissue) or post mortem (peripheral nerves, arteries, epidermal tissue, joint and epiphyseal cartilage) and on tumor tissue (60 samples freshly harvested from patients suffering from bone tumors). The necrotizing effect was measured by determining the thickness of the cell layers demonstrating nuclear pyknosis or necrosis after 2 min of phenolization in a light microscope by ocular measurements in microns. No effect could be seen in epidermal tissue and in cartilage, whereas all other normal tissues exhibited necrotic zones between 40 and 500 microns. In all the tumors except those with chondromatous tissue, necrotic zones between 40 and 1000 microns were found. No difference in extension of the necrotic zone was seen between specimens from benign and malignant tumors and tumor-simulating processes. Phenolization cannot be recommended for the treatment of chondromatous tumors.

The devitalizing effects of 5-90 percent phenol for 30 seconds on bone marrow cells were examined on vertebral bodies of fresh animal cadavers. Evaluation was made by measuring the width of the zone of necrotic cells. The zone increased with rising phenol concentration up to 75 percent, reaching an average width of 0.75 mm. However, when protected by bone trabeculae, the cells escaped devitalization.

Iliac crest biopsy and clinical laboratory investigations are the important criteria to diagnose metabolic osteopathies and osteoporosis. The technic of iliac crest biopsy, the histological technic and the histomorphological and histometric criteria will be discussed. The necessity to compare clinical data with the histomorphology and the importance of surgical pathology, especially osteopathology, will be emphasized.

The tendon and ligaments inserted into the perichondrium of the epiphyseal plate were examined in 152 autopsy specimens of tubular long bones. In the region of two areas where tendons were inserted (Ranvier's nodes), the normal medullary tissue is replaced by fibroblastic tissue. A retrospective radiological examination of 155 fibrous metaphyseal defects shows that they are situated at characteristic sites on the circumference of the metaphysis of long tubular bones. This can be related to the insertion of a tendon or ligament near the epiphyseal growth plate which corresponds to areas found in the morphological study and is the site of origin of fibrous metaphyseal defects.

Sublingual nifedipine 20 mg as an emergency treatment for severe hypertension or hypertensive crisis in 30 patients gave an effective and gradual reduction in blood pressure. Side effects were rare and not severe. The heart rate remained fairly stable or sometimes even decreased. Thus, sublingual nifedipine may now be considered a reasonable first choice in the treatment of severe hypertension or hypertensive crisis.

A low priced, efficient frozen section cutting device is described to produce 5 microns sections of frozen undecalcified bone specimen blocks in routine pathology. The device was developed by combining two commercially-available instruments, namely a frozen section microtome with methyl alcohol cooling and a hard tissue microtome. Bore holes were drilled in the hard tissue knife to permit cooling, using the methyl alcohol system of the other microtome.

The prosthesis loosening represents the main complication of an endoprosthesis. When using bone cement for an anchorage, the most important factors of loosening are the impairment of tissue during toxical and thermic influence, foreign body reaction on the abraded material of the prosthesis, the resorption effect through foreign body giant cells as well as the parallel effect of monomer impoverishment and the dissapearance of polymerization matrix material. Histological examinations of the reparation proceedings of not loosened cement-bone surfaces at total endoprostheses are rarely found in literature, and the extent of a long term effect of the cement on the bone layer has not been sufficiently ascertained. To obtain an insight into the reaction of the bone tissue to the bone cement, the bone-cement surface was examined histologically after 3-10 years TEP-implantation.

Firmly attached screw-in polyethylene acetabula which had been implanted for between 16 and 54 months were explanted after autopsies and subjected to macroscopic, radiologic and histologic examination. Metaplasias were seen around the threads and on the floor of the acetabulum. Their tendency to ossify represents an attempt at secondary stabilization. Due to the low stability of the polyethylene this causes increased wear on the floor of the acetabulum. The small defects in the polyethylene found in the threads, resembling damage done by mice, may be a sign of biodegradation. In view of the tissue reactions pointed out, the material stability of the polyethylene needs to be improved or implantation must be restricted to a very limited range of indications.

A malign giant cell tumor of the soft parts is reported and the specific localization of the hand is pointed out; on this basis, a possible connection or a common origin is discussed and the latest literature reviewed.

Perforation could be observed in 10.14% of all patients with gastroduodenal ulcer admitted to our clinic from 1946 to 1976. 23.16% of these patients were older than 61 years, whereas 15.9% were younger than 30 years. 91.18% had typical symptoms of perforation, symptomless were 6.93%. 1.81% arrived moribund in the hospital. During the last 30 years as a rule the perforation was only sutured, primary resection was being performed only in rare cases. Nowadays, in cases of perforated duodenal ulcer we add vagotomy plus pyloroplasty to the suture. The total mortality rate came up to 22%, with a significant decrease from 1946 to 1975.

Sulphate conjugation represents an efficient mechanism for inactivating catecholamines (CA) with more than 80% of total noradrenaline (NA) and adrenaline (A) and nearly 100% of dopamine (DA), circulating as conjugates. Sulphate conjugation responds rapidly to changes in sympathetic activity and may buffer the haemodynamic and metabolic consequences of wide fluctuations in CA release in phaeochromocytoma. This hypothesis was tested in seven patients with phaeochromocytoma by consecutive measurements of plasma free and conjugated NA, under resting conditions, before operation and at least 4 weeks after tumour removal. Free and total (free plus sulphates) NA were markedly elevated before (4.3, s.e.m. = 1.8 and 13.7, s.e.m. = 4.4 ng/ml, respectively) compared with 1-4 months after surgery (0.48, s.e.m. = 0.13 and 1.8, s.e.m. = 0.53 ng/ml). A and DA were similarly elevated before surgery; after surgery, A was undetectable in three patients and DA was undetectable in all patients. Before surgery consecutive measurements of total NA, 5 min apart, were markedly different (18.8, s.e.m. = 4.8 and 12, s.e.m. = 3.1 ng/ml, respectively), whereas only small differences in free NA levels were present (4.0, s.e.m. = 1.5 and 4.4, s.e.m. = 1.8 ng/ml). In three patients, fluctuations in total NA concentration greater than 12 ng/ml were associated with either no change (one patient) or changes of 0.6 and 2.8 ng/ml in levels of free NA, respectively. Mean blood pressure varied less than 8 mmHg in these patients. These findings indicate that sulphate conjugation is a dynamic process which may limit wide fluctuations in free CA concentration during episodic secretory activity in phaeochromocytoma.

Infancy psychomotor yield in lower socioeconomic levels can be damaged from the first year of life. This implies future consequences to individuals, family-and society. Early stimulation programs have demonstrated to improve psychomotor yield in the above mentioned children. In Temuco, Chile, in groups of children with different risks, that were incorporated to an early stimulation program, it has been seen that the lower the birth weight the greater the risk of future psychomotor deterioration, which is also true for children that survived neonatal meningitis. On the other hand, in children that presented hyperbilirubinemia, low Apgar scores and neonatal septicemia, no significant statistical differences in psychomotor development have been observed in comparison with those of similar birthweight but without these antecedents. In this study the Chilean Health Ministry's Evaluation and Psychomotor Stimulation Program is reviewed as to adapt it for children at greatest risk.

We examined the rates of necrosis of newly formed capsula tissue (the number of newly formed capsular tissues with necrosis) after the reoperation of 95 cemented and 11 uncemented total and cup endoprostheses, consisting of different arteficial joint materials. A comparison was made to the joint capsular tissue of 492 patients with arthrosis. The necrosis rate shows a lack of statistical significance within the two year-groups over a period of 12 years and between the different types of prostheses by using PMMA-bone cement. Therefore, it is assumed that a biological equivalence of the prostheses wear products is reached. It is also argued that necrosis can possibly develop from the sudden increased accumulation of PMMA-bone cement particles from the bone bed, caused by the loosening of the prosthesis. In comparison the newly formed capsular tissue of the uncemented prostheses, of which no necrosis was shown, evidence is given that the development of necrosis is chiefly due the quantity of PMMA wear products present. Because of the difficulty to exactly identify the PMMA-bone cement wear products, the toxicity of the PMMA-bone cement--who ist good known and in agreement in recent literature--or its wear products continues to be of hypothetical value in the production of necrosis. This is inspite of the successful detection by the gaschromatograph of the highly toxic paratoliudine in PMMA-bone cement. On the basis of the high statistical significance of the rate of necrosis in comparing the arthrosis joint capsules (14.83%) to the newly formed capsules (73 : 100%) it is shown that the capsulare fibrosis and scar formation to the obliteration of the lymphatic vessels is of secondary importance.

First clinical experiences with a new atrial tined J-shaped pacemaker electrode are reported. The electrode was used for permanent atrial stimulation and--together with a ventricular lead--for bifocal stimulation. Implantation technique, stimulation thresholds and complications are described. Advantages and disadvantages of various atrial electrodes are discussed.

A new method is described for quantitative evaluation in lung perfusion scintigraphy, which allows to conclude from the increased perfusion of normal lung-tissue to a virtual total lung perfusion. The relationship between this and the real total lung perfusion leads to the pulmonary perfusion defects in per cent. The findings of a comparison of 40 patients between the perfusion scan method and the lung function tests is presented, which proves the validity of the new method. It is shown that restrictive lung diseases have a good and obstructive have a bad correlation. It is demonstrated furthermore that the perfusion defects of bronchogenic carcinoma can be quantified very well by the method.

At present the technique of selective proximal vagotomy (SVP) seems to be standardized. Nevertheless, the surgical procedure is practiced by many authors in a different way concerning the proximal and distal borderline of denervation. In our opinion pylorplasty should only be performed in those patients suffering from retention or stenoses.

This study presents a descriptive approach to communication and interactions in a psychotic group children, without adult intervention. This investigation use a ethological method. The results show correlation between children's non verbal communication degree and the degree of severity in psychiatric troubles.

This review covers the following aspects: Cancer associated with asbestos and other fibers: Epidemiology. - Cancer types and location (mesothelioma; bronchogenic carcinoma; cancer of the upper respiratory tract; abdominal cancer). - Experimental asbestos cancer. - Other kinds of fibers and cancer (wool and cotton; glass; talc; others). - Cancer determining or influencing factors (individual predisposition; species susceptibility; type of material; shape and size of fibers; smoking). - Preneoplastic signs in man (fibrosis; ferruginous bodies; pleural plaques; milky spots). - Preneoplastic development in animals. - Fiber effects on cell cultures (macrophages; fibroblasts). Cancer associated with schistosomiasis: Epidemiology. - Patient age and cancer latency. - Pathology. - Foreign body reaction and preneoplastic development. Scar cancer. Foreign body cancer: In man. - Experimental (species differences in susceptibility; individual genetic differences in tumor incidence and latency; influence of sex, age, nutrition; tumor histopathology and ultrastructure; tumor growth, invasiveness, metastases, transplantability, immunology; search for tumor viruses). - Properties of foreign body materials in relation to tumorigenicity (chemical and physical properties; size and shape; surface properties; porosity). - Investigations and findings concerning the origin of foreign body sarcomas (the foreign body reaction; search for foci of tumor origin; an analytical method; monoclonal tumor origin; heterogenicity of carcinogenic events; surface dependency; identification of originator cells; time and location of the emergence of tumor originator cells; the carcinogenic initiation event; surface-independent and dependent preneoplastic maturation; the carcinogenic role of the foreign body). - Earlier hypotheses and theories in the light of new experimental findings. The results of experimental foreign body tumorigenesis in relation to foreign body-, asbestos-, schistosomiasis-, and scar-cancer in man. (Common factors of promotion; differences regarding induction mechanisms, cells of origin, latencies, frequencies; immune defense). Consequences for prevention: Asbestos cancer. - Fiber cancer. - Schistosomiasis cancer. - Foreign body cancer (assessing the peril in man; testing of materials for carcinogenicity; recommendations).

Four cementless prosthetic hip implants of Ti-6Al-4V-alloy with and without longitudinal grooves and Al2O2 ceramic ball heads, with implant periods of 3, 4, 5, and 10 months, were sectioned and examined histologically in undecalcified thin ground sections. Especially on the medial and lateral sides of the prostheses, there was direct bone-to-metal contact without interposed connective tissue, spreading to the dorsal and ventral areas of the prosthesis shaft, which was considered osseointegration. This is based mainly on the technique of implantation with primary stability in the cortical bone by press-fit and on the bioinertness of the titanium alloy. Ungrooved prosthesis areas seem to favor bone growth at the shaft. The secondary bone ring, occurring on the dorsal and ventral areas of the prosthesis, with evidence of further bone remodeling with the passage of time, indicates that osseointegration is a dynamic process that continues to improve prosthetic stability.

In the era of selective vagotomy the gastric motility is increasingly important. Measuring methods are demonstrated as to electromyography, intraluminal pressure measuring, measuring of emptying using isotope labeled food, and serial X-ray technique with amplifier photography. Measurings were performed in 12 patients, before and 4 months after selective proximal vagotomy. The bioelectric gastric activity is hardly influenced by selective proximal vagotomy. Enhanced antral peristalsis (tonic and peristaltic contraction) and delayed emptying are observed in cases without pyloroplasty. The authors therefore recommend that preoperative examination of motility in combination with intraoperative findings should indicate the pyloroplasty.

A short-time-study (1 to 24 hours) and a long-time-study (1 to 96 hours) after a single alcohol intake were made in 23 healthy probands. The pancreas and liver parameters as alpha-amylase, bilirubin, ASAT, ALAT, gamma-GT and GLDH in the serum were determined at regular intervals. The pancreas showed a sensitive reaction to alcohol expressed by an early rise of lipase activity. The liver enzymes of young healthy probands remained unchanged. Older probands, on the other hand, react by a distinct increase of the gamma-GT and GLDH as well as a decrease of the ASAT and ALAT. Also the enzyme quotients gamma-GT/ASAT and (ASAT + ALAT)/GLDH be obviously well suited to recognizing very early stages of liver lesion by serum examinations. For this purpose only a definite alcohol intake (I ml ethanol per kg body weight) is necessary.

We describe a dual phase embedding method employing a routinely used methylmethacrylate mixture with a commercially available resin. Combination of both embedding materials provides fast and complete tissue penetration as well as the necessary hardness and stability for the consecutive grinding procedure.

A case of juxtaglomerular tumour (sometimes called hemangiopericytoma) in a 17 year old boy, presenting with severe hypertension and hypokalemia, is described. Plasma renin activity was markedly elevated in both renal veins and failed to lateralise the tumour. This is attributed to chronic stimulation of renin secretion by Captopril treatment. Removal of the tumour cured the hypertension and hypokalemia.

More than 80% of total noradrenaline (NA) and adrenaline (A) and nearly 100% of dopamine (DA) circulate in blood as sulphates, and it has been proposed that sulphate conjugation contributes to the inactivation of catecholamines (CA). Sulphate conjugation rapidly responds to changes in sympathetic activity and may buffer the haemodynamic and metabolic consequences of wide fluctuations in CA release in phaeochromocytoma. This hypothesis was tested in seven patients with phaeochromocytoma by consecutive measurements of plasma-free and conjugated NA, under resting conditions, before operation and at least 4 weeks after tumour removal. Free and total (free + sulphates) NA were markedly elevated before compared with 1-4 months after surgery. Similar elevations were seen in free and total A and free DA. Before surgery consecutive measurements of total NA, 5 min apart, were markedly different (17 +/- 4.1 and 13.7 +/- 4.4 ng/ml, respectively), whereas only small differences in free NA levels were present (4.1 +/- 1.5 and 4.3 +/- 1.8 ng/ml). These differences between total and free levels were also apparent for A and DA, but to a lesser degree. In three patients, fluctuations in total NA concentration greater than 12 ng/ml were associated with either no change (one patient) or changes of 0.6 and 2.8 ng/ml in free levels for the other two patients, respectively. Mean blood pressure (BP) varied less than 8 mmHg in these patients. These findings suggest that sulphate conjugation is a dynamic process which may limit wide fluctuations in free CA concentration during episodic secretory activity in phaeochromocytoma.