Ewing's sarcoma of the ribs. A report from the cooperative Ewing's sarcoma study

31 patients with primary Ewing's sarcoma of the ribs were treated according to the protocols of CESS 81, CESS 86P and CESS 86. The results of treatment were reviewed and analysed. 24 patients presented with localised disease and 7 with regional disease. 20 of 24 localised cases and 6 of 7 regional cases underwent tumour resection. All but 2 localised cases received irradiation. The cumulative relapse-free survival (RFS) rate of 31 patients was 61% at 12.8 years. Patients with poor prognosis had tumour of the upper ribs (P = 0.0338), the posterior component of the ribs (P = 0.0597), or regional disease (P = 0.0001). Tumour size, existence of pleural effusion, type of the surgical margin and response to chemotherapy were not significant prognostic factors. Most of the localised cases could be controlled by combined treatment, but in regional cases prognosis remained poor.

[The magnetic resonance tomography of Ewing's sarcomas: the morphology and tumor extension]

PURPOSE

The morphology and delineation of Ewing sarcoma in magnetic resonance imaging was investigated.

METHODS AND MATERIALS

Magnetic resonance images (spin-echo techniques; T1-w pre/post gadolinium, T2-w) of 59 patients as part of a multicenter study were evaluated retrospectively. Qualitative image analysis was performed: signal intensity (point of reference extraosseous: muscle, intraosseous: bone marrow), enhancement patterns, lesion delineation and differentiation between tumor and oedema.

RESULTS

Signal intensity: T1-w: extraosseous: 75% isointense, intraosseous: 92% hypointense; T2-w extraosseous: 100% hyperintense, intraosseous: 93% hyperintense. Enhancement pattern: 97% both extra- and intraosseous. Best delineation intraosseous in T1-w (53% good, 36% very good), extraosseous in gadolinium enhanced T1-w (46% good, 37% very good) and T2-w (55% good, 33% very good). Differentiation between tumour and oedema was intraosseous not possible, extraosseous in T2-w in 61%.

CONCLUSION

Morphology of Ewing sarcoma in magnetic resonance imaging is rather uniform. The lesion is intra- and extraosseous sharply delineated, though tumour and oedema can be rarely differentiated.

Acquired von Willebrand disease in malignant peripheral neuroectodermal tumor (PNET)

In week 12 of the EICESS 92 protocol a 12-year-old boy with pelvic PNET developed acquired von Willebrand disease: bleeding time was prolonged (> 15 min) and von Willebrand factor antigen (54%) and ristocetin cofactor activity (50) were reduced. Platelet aggregations with thrombin and collagen and the number of major platelet glycoproteins/per platelet did not differ from the controls. After Haemate P (Behring Werke, Marburg, Germany) bleeding time normalized and surgery could be performed without occurrence of bleeding episodes. Three weeks after surgery bleeding time, ristocetin cofactor activity, and von Willebrand factor antigen increased to normal paediatric values. Without occurrence of further bleeding episodes the patient received another 10 courses of polychemotherapy (EICESS 92).

Reference tables for the intrasubject coefficient of variation in bioequivalence studies

Bioequivalence studies are usually performed as crossover studies and, therefore, information on the intrasubject coefficient of variation is needed for sample size planning. However, this information is usually not accessible in publications on bioequivalence studies, and only the pooled inter- and intrasubject coefficient of variation for either test or reference formulation is reported. It is the purpose of the present communication to provide reference values of the intrasubject coefficient of variation for various previously investigated drugs. The presentation includes pertinent pharmacokinetic characteristics for immediate- and extended-release formulations in single- and multiple-dose crossover studies.

[Prognosis in Ewing sarcoma patients with initial pathological fractures of the primary tumor site]

In this retrospective analysis, data of 52 patients with Ewing's sarcoma or PNET with a pathological fracture in the area of the primary tumor were evaluated. All patients were treated according to the trials CESS 81, CESS 86 P, CESS 86, CESS 91 P and EICESS 92 of the German Society of Pediatric Oncology and Haematology (GPOH). At the date of evaluation (15. September 1994) all patients had completed treatment and had been under observation for at least one year following diagnosis. The median follow-up time was 28 months. 22 patients were female, 30 male. The median age was 12 years. 75% of primary tumors had a volume of > or = 100 ml. 30 patients presented with fractures in proximal, 12 in central and 10 in distal parts of the skeleton. 10 patients had primary metastases. The histological definition was Ewing's sarcoma (including atypical Ewing's sarcoma) in 43 patients, PNET in 8 and small-cell osteosarcoma in 1 patient. For local therapy the patients underwent surgery, definitive radiotherapy or a combination of both. The percentage of primary metastases in the group of the patients with pathological fractures is comparable to the whole reference group. The present analysis focuses on those patients with pathological fractures who had no metastases at diagnosis. The relapse-free survival of patients with a pathological fracture and no primary metastases is 58%, the overall survival 65%. These rates are similar to those of the reference group of protocol patients without pathological fractures at diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Intraoperative clotting factor dilution and activated hemostasis in children with Ewing's sarcoma or osteosarcoma: a prospective longitudinal study

BACKGROUND

The study was designed to evaluate prospectively intraoperative changes in coagulation and fibrinolysis in young patients with Ewing's sarcoma (n = 12) or osteosarcoma (n = 12) who underwent major surgery, and to relate them to hematocrit (HCT) readings.

MATERIALS AND METHODS

Blood samples (von Willebrand factor, fibrinogen, antithrombin III, protein C, plasminogen, t-PA ag, PAI 1 activity, F1+2, D-dimer, PAP) were obtained immediately prior to starting anesthesia, two and four hours later, immediately after surgery and on the first postoperative day. Intra- and postoperative hemostatic parameters were adjusted to preoperative HCT readings.

RESULTS

Major surgery induced dilution coagulopathy due to blood product transfusion to support the patient's vascular volume. Postoperatively, VWF (0.01) and fibrinogen (0.007) were found to be significantly enhanced, whereas antithrombin III levels were significantly (0.007) decreased. D-dimer formation showed a clear, significant (0.0019) rise two hours after skin incision and remained elevated through the first postoperative day. F1+2 and PAP showed only minor deviations. T-PA (0.012) and PAI 1 (0.001) rose during the operation and normalized on the first postoperative day. Within 36 hours of the initial operation, six of the 24 patients (25%) returned to surgery to stop severe hemorrhage.

CONCLUSIONS

These findings indicate that hemostatic parameters may be useful when monitoring surgery- and transfusion-induced hemostatic imbalance. Furthermore, the significant differences between the HCT-uncorrected concentration of the various plasma proteins clearly demonstrated the need to use HCT correction factors which may influence the necessity for and/or the frequency of substitution therapy with protein concentrates.

[Subjective evaluation criteria in psychiatric care--methods of assessment for research and general practice]

Evaluation of psychiatric care is an important task in research and in routine conditions. It requires definition of criteria. Subjective criteria are, for different reasons, of increasing interest. Subjective quality of life, subjective needs for help and support and patients' assessment of psychiatric treatment are regarded as particularly relevant criteria. We present and briefly discuss instruments for assessment of these criteria, that are new at least in the German language. Results of a first cross-sectional study in a community care setting are reported. Regarding quality of life healthy groups were examined too. The findings suggest that the instruments are usefully applicable and that they may produce plausible results.

Comparative bioavailability of metronidazole formulations (Vagimid) after oral and vaginal administration

Bioavailability of Vagimid 500 tablets (film coated, 500 mg metronidazole) and absorption of metronidazole into the systemic circulation after vaginal administration of Vagimid vaginal tablets (100 mg metronidazole) relative to respective listed references were studied in 16 female healthy volunteers (age 21-37 years, weight 45-67 kg, height 158-179 cm). Metronidazole and its main hydroxylated metabolite were measured using an HPLC-method with detection limits of 0.025 and 0.25 micrograms/ml (for vaginal and oral studies), respectively. Extent of absorption was assessed by AUC0-infinity (bioequivalence range 0.80-1.25), rate of absorption by Cmax/AUC0-infinity (bioequivalence range 0.70-1.43). Geometric means and 90%-confidence intervals of the ratios of these primary characteristics were calculated using a multiplicative model. Vagimid 500 tablets were bioequivalent to the reference formulation with regard to extent and rate of absorption of metronidazole because of AUC0-infinity = 0.995 (0.84-1.18) and Cmax/AUC0-infinity = 1.11 (0.94-1.30). The absorption of metronidazole into the systemic circulation after vaginal administration of Vagimid vaginal tablets caused maximal serum concentrations between 433 and 1,156 ng/ml after 8-20 h which are bactericidal only for the most susceptible anaerobic germs and which are most likely only of marginal importance for drug safety.

Nitric oxide mediates microvascular permeability in the isolated perfused rat mesentery?

The permeability influencing effect of nitric oxide was studied by means of an isolated perfused mesentery preparation in combination with a intravital/fluorescence microscopic set up. As a fluorescent marker served FITC-dextran mol wt 70,000 daltons. Tissue treatment was performed by application of NO-donors like SNP or GTN. Additionally the effects of bradykinin, L-nitroarginine or the combination of both were tested in regard to a permeability modulation. The results point out that NO-donors did not enhance microvascular permeability, whereas the permeability increasing effect of bradykinin is mediated by an NO-independent pathway.

Effects of acidosis and alkalosis on mechanical properties of hypertrophied rat heart fiber bundles

Effects of alkalosis (pH 7.4) or acidosis (pH 6.8) on the intrinsic mechanical properties of control and pressure-overloaded rat hearts were studied in Triton X-100-treated left ventricular fiber bundles. In control bundles, Ca sensitivity [pCa required for one-half maximal response (pCa50)] was 5.520 +/- 0.012 at pH 7.1. Alkalosis increased it by 0.357 +/- 0.018 pCa unit, whereas acidosis decreased it by 0.365 +/- 0.014 pCa unit with no change in Hill coefficient. Maximal tension was decreased by acidic pH and increased by alkaline pH. Stiffness was measured by the response to quick length changes. Acidosis decreased maximal stiffness but increased the stiffness-to-force ratio, whereas alkalosis increased maximal stiffness but had no effect on stiffness-to-force ratio, suggesting that acidosis decreased the force generated per cross bridge. Alkalosis increased the time constant of tension recovery following a quick stretch from 10.6 +/- 0.66 to 17.45 +/- 1.83 ms, suggesting a decreased cross-bridge cycling rate. Pressure overload induced by thoracic aortic stenosis for 4-6 wk led to a 200% cardiac hypertrophy associated with a shift from fast to slow ventricular myosin. pCa50 of hypertrophied bundles was not different from control (5.541 +/- 0.012). Ca sensitivity was increased by 0.383 +/- 0.008 in alkaline medium and decreased by 0.325 +/- 0.009 in acidic medium. Stiffness-to-force ratio was decreased in acidic pH, and the time constant of tension recovery was increased from 31.0 +/- 0.4 to 34.9 +/- 0.25 ms by alkalosis. In hypertrophied bundles, maximal tension was decreased by acidic pH but not changed by alkalosis. These results show that in the small pH range of our study 1) pH changes have symmetrical effects on Ca sensitivity in both control and hypertrophied bundles, 2) a decrease or an increase in H+ concentration does not have symmetrical effects on the mechanics of the cross bridges, and 3) changes in the phenotype of contractile proteins induced by aortic stenosis do not influence Ca sensitivity, only moderately influence the response to pH changes, and mainly affect the cross-bridge cycling rate.

[Initial findings using dynamic magnetic resonance tomography in the diagnosis of inflammatory diseases of the sacroiliac joint]

Up to now 42 patients with clinically suspected diagnosis of sacroiliitis (including 19 patients with confirmed spondylitis ankylosans) and 12 healthy volunteers were examined via magnetic resonance tomography. In oblique sections parallel to the plane of the sacrum the signal intensity patterns from normal and pathological tissues of the sacroiliac articulations were evaluated by plain T1-weighted spin-echo sequences and T2*-weighted FLASH sequences. In addition we used a dynamic FLASH measurement following intravenous application of gadolinium-DTPA for quantitative calculation of signal-time courses. This method has proved to be capable of definitely differentiating normal findings of sacroiliac articulations from inflammatory changes (p = 0.0001) and also enables quantification of the inflammatory activity.

Mechanical properties of rat cardiac skinned fibers are altered by chronic growth hormone hypersecretion

Chronic growth hormone (GH) hypersecretion in rats leads to increased isometric force without affecting the unloaded shortening velocity of isolated cardiac papillary muscles, despite a marked isomyosin shift toward V3. To determine if alterations occurred at the level of the contractile proteins in rats bearing a GH-secreting tumor (GH rats), we examined the mechanical properties of skinned fibers to eliminate the early steps of the excitation-contraction coupling mechanism. We found that maximal active tension and stiffness at saturating calcium concentrations (pCa 4.5) were markedly higher in GH rats than in control rats (tension, 52.9 +/- 5.2 versus 38.1 +/- 4.6 mN.mm-2, p < 0.05; stiffness, 1,105 +/- 120 versus 685 +/- 88 mN.mm-2.microns-1, p < 0.01), whereas values at low calcium concentrations (pCa 9) were unchanged. In addition, the calcium sensitivity of the contractile proteins was slightly but significantly higher in GH rats than in control rats (delta pCa 0.04, p < 0.001). The crossbridge cycling rate, reflected by the response to quick length changes, was lower in GH rats than in control rats (62.0 +/- 2.6 versus 77.4 +/- 6.6 sec-1, p < 0.05), in good agreement with a decrease in the proportion of alpha-myosin heavy chains in the corresponding papillary muscles (45.5 +/- 2.0% versus 94.6 +/- 2.4%, p < 0.001). The changes in myosin heavy chain protein phenotype were paralleled by similar changes of the corresponding mRNAs, indicating that the latter occurred mainly at a pretranslational level. These results demonstrate that during chronic GH hypersecretion in rats, alterations at the myofibrillar level contribute to the increase in myocardial contractility observed in intact muscle.

[Clinical pharmacokinetics of lidocaine after intraoral nerve block]

Aim of this study was to show the time course of plasma concentrations of 2% lignocaine with adrenalin at a concentration of 1:100,000. Four retinated third molars were removed in one session in 23 patients. For local anaesthesia in each patient we used 10 ml of Xylocaine 2% (Astra), which is commonly used in dentistry. The plasma-concentration was measured for the first 30 minutes after injection of the local anaesthetic using high pressure liquid chromatography (HPLC). Our results suggest that partially intravascular injection could not be avoided although careful aspiration was carried out before injecting. Neither subjective nor objective adverse central nervous effects were seen in our patients. Nevertheless we consider a peripheral intravenous cannula and ECG-monitoring strongly recommended in all major operations under local anaesthesia.

Pediatric bone marrow transplants: psychological aspects

On a pediatric bone marrow transplant unit, hematologist-oncologists, nurses, social workers, psychiatrists, psychologists, and others on the team deal with children and adolescents whose cancers are either treatable by marrow transplantation or are ultimately fatal. Contrary to original assumptions, many children and families cope well, especially in relatively uncomplicated cases with good outcome. Treatment may include direct psychotherapeutic intervention with the child and family, as well as use of psychopharmacologic agents such as antidepressants or anxiolytics for frank psychiatric disorders. Psychotherapists often have to function adjunctively with other staff members in their interactions with the patient and the family. A stress disorder model appears to best explain child, parent and family reactions to bone marrow transplantation. Given the medical severity and complexity of the conditions treated, and the approximately equal rates of overall success and failure, a supportive consultative approach is usually most helpful for child patients, parents and staff throughout the procedure. A retrospective study of the children treated over seven years in a tertiary pediatric hospital bone marrow transplant unit is presented. The level of child, parent, and family psychopathology was usually mild to moderate, but there were clear differences between patients. Mothers were more supportive than fathers under this extreme type of stress. Prospective longitudinal studies of children and families are needed to establish causal chains and optimal therapeutic interventions.

[Doppler echocardiographic diagnosis of pulmonary hypertension in children with mucoviscidosis]

Today Doppler echocardiography is a reliable noninvasive method in the diagnostic of pulmonary hypertension. We investigated 52 patients (age 1 to 19 years) with pulsed- or continuous-wave Doppler. Systolic pulmonary artery pressure (SPAP) was calculated about the equation of Akiba using acceleration time, corrected by heart rate. SPAP estimated in this way was less than 20 mmHg in 14% of the patients. 20-39 mmHg in 29%, 40-59 mmHg in 31% and about 60 mmHg in 26%. No correlation was found between age and SPAP and only low correlation between score of Shwachman (r = 0.37) or score of Norman-Crispin and SPAP. Between body fat, calculated from the thickness of skin folds, and SPAP was found a good correlation (r = -0.73, p = 0.01).

The craniodigital syndrome of Scott: report of a second family

We report on a boy with a characteristic combination of facial anomalies, syndactylies of fingers and toes, and mental retardation. Scott et al. (Journal of Pediatrics 78:658-663, 1971) observed 3 brothers with almost identical manifestations. The mother of these patients had bilateral syndactyly of toes 2 and 3. This led the authors to suggest X-linked inheritance. The mother of our patient also has cutaneous syndactyly between the second and third toes, strengthening the hypothesis of X-linked inheritance.

[Chemical and thermal compatibility of all-ceramic systems]

The chemical and thermal compatibility of the all-ceramic systems Vitadur-N, Hi-Ceram and In-Ceram as well as the combinations of Dicor with Vitadur-N, Dicor with NBK 1000 and Dicor with Vivodent, respectively, were investigated by means of electronmicroscopy and microprobe measurements at the interface of each compound, and thermomechanical analyses of the components were performed. The results show good contact at the interface of all combinations investigated. No evidence was found for diffusion at the interface except in the In-Ceram system, were a migration of K+ from Vitadur-N dentine into the glassy phase of In-Ceram occurs. The thermomechanical analyses showed a good thermal compatibility of all compounds investigated.

Flow cytometric analysis of G1- and G2/M-phase subpopulations in mammalian cell nuclei using side scatter and DNA content measurements

Several subcompartments of the cell cycle in addition to the G1-, S-, and G2-phases usually observed were identified by simultaneous flow cytometric measurements of ethidium bromide fluorescence and side scatter intensity of cell nuclei. Metaphase cells and very early G1-phase cells (G1A) with low side scatter intensities were discriminated from interphase cells with high side scatter intensities. The reason for the various side scatter intensities was found to be the different structure of metaphase cells and early G1-phase cells due to chromatin condensation as shown by sorting of the respective cell nuclei. The G1A-phase could further be subdivided into two compartments with very low side scatter (G1A1) and intermediate side scatter (G1A2) intensities. Using partially synchronized cells the duration of these subcompartments of the G1-phase could be estimated. The durations of G1A1- and G1A2-phases were found to be about 10 min and 20 min, respectively, compared to the total duration of the G1-phase of about 3 h. Additional flow cytometric measurements of side scatter intensities of cell nuclei provide therefore further information on subcompartments of the G1- and G2/M-phases.

Localization of a putative cell adhesion molecule (gp110) in Wistar and Fischer rat tissues

A plasma membrane glycoprotein (gp110) involved in cellular adhesion was studied in Wistar and Fischer rats. For quantitative analysis of the gp110 molecule a sandwich-ELISA was used. High quantities of gp110 were found especially in the liver, small intestine, submandibular gland and lung. The distribution and localization of the gp110 were investigated by immunohistochemistry utilizing soluble complexes of alkaline phosphatase and monoclonal anti-alkaline phosphatase antibodies. Immunoreactivity was present in plasma membranes of vascular endothelial cells of some organs. Furthermore, immunostaining also occurred in plasma membranes of lymphocytes, exocrine gland cells, excretory duct cells, hepatocytes, epithelial cells of the small intestine, kidney and vesicular gland and in the cytoplasm of renal connecting and collecting duct cells. The localization of gp110 in the luminal domain of the plasma membrane at many sites suggests that this glycoprotein is also involved in processes distinct from cell adhesion.

[Diagnosis of mucoviscidosis by examination of sweat: value of conductometry]

Two methods for the determination of sodium in the sweat after stimulation by pilocarpine-iontophoresis were compared in 227 patients, among them 27 with a known cystic fibrosis. These two methods were 1. the standardized method by flame fotometry (State Pharmacopoeia of the German Democratic Republic) and 2. the determination of the sweat conductance by the new apparatus "CF-Conductognost". Both methods showed a good correlation. We recommend the conductometry for the decentralized screening because it saves time and gives results immediately. But in all patients with a questionable or pathologic value of conductance the sweat test should be repeated with the standardized method. This concerns only about 10 per cent of all patients.

Primary cardiac tumors--clinical experiences and late results in 48 patients

Between 1971 and 1987 48 patients (35 female and 13 male) underwent operations at the Department of Cardiovascular Surgery, Justus-Liebig-University Giessen, for primary cardiac tumors. The age of the patients ranged from 21 to 71 years. Clinical symptoms were congestive heart failure, cardiac murmurs and findings similar to mitral stenosis, chest pain, arrhythmias, arterial embolism, myocardial infarction and pericarditis. 39 of the tumors were benign and 9 were malignant. Diagnosis was confirmed by echocardiography and/or cineangiocardiography. The left atrium was most commonly involved, followed by the right atrium. Surgery was performed in all cases using cardiopulmonary bypass. Benign tumors were totally removed, including attachment to the atrial septum or the free wall. In one case the tumor resection was carried out by autotransplantation of the heart. During the perioperative period we lost one of the 39 patients with benign tumors due to low cardiac output. Observing a mean follow up period of 48 months, no recurrence of tumors was noted and all patients are doing well now. The malignant neoplasms could not be removed completely, and in 4 cases only a reduction of the tumor mass was possible. Three of the 9 patients died during the postoperative period. Only one patient survived longer than 48 months. Whereas surgical therapy of malignant cardiac tumors is still a matter of discussion based upon these discouraging results, benign or semimalignant cardiac neoplasms have a very favourable prognosis when the surgical intervention can be performed prior to the occurrence of severe complications, such as congestive heart failure and arterial embolism.(ABSTRACT TRUNCATED AT 250 WORDS)

Rapid purification of dipeptidyl peptidase IV from rat liver plasma membrane

Dipeptidyl peptidase IV (EC 3.4.14.5) was solubilized from rat liver plasma membranes with sulphobetaine 14 and purified by successive affinity chromatography on Con A-Sepharose, wheat germ lectin-Sepharose and arginine-Sepharose columns. The specific activity of the final preparation was 49.4 mumol Gly-Pro p-nitroanilide/min per mg protein, representing a 1098-fold purification of the homogenate. SDS-polyacrylamide gel electrophoresis of the arginine-Sepharose eluate showed a single protein band with a molecular weight of 105,000. The isoelectric point was determined to be 3.9 under non-denaturing conditions with sulphobetaine 14. The preparation was free of post-proline cleaving enzyme. The content of aminopeptidase M was 0.2% of the total protein.

Doppler-sonographic examination of the arterial flow in the carotid and supratrochlear arteries during carotid angiography

In 55 patients, the blood flow in the carotid and supratrochlear arteries was examined by Doppler sonography during cerebral angiography. In general, a threefold response was observed: an initial phase of turbulence during the injection was followed by a phase of depressed and then of increased arterial flow. The second phase of reduced perfusion which probably is caused by the increased viscosity of the mixture of contrast medium and blood, is more pronounced in the internal carotid artery, whereas the third phase of accelerated flow is more marked in the external carotid artery. In patients with an occlusion of the internal carotid artery, the cerebral blood supply often depends on the collateral pathway via the ophthalmic artery. In these cases, the reduction of the blood flow is specially marked and long-lasting, as we could show. This may contribute to a higher angiographic risk of those cases with an important ophthalmic collateral flow.

[Late extrapyramidal hyperkinesis and neuroleptic withdrawal dyskinesia. Practical problems]

Neuroleptic-induced, late-occurring dyskinesia has gained more and more of importance. Essential causes are: increased continued long-term treatment as well as the advanced age of long-term patients treated with neuroleptics. Problems of daily practice and their treatment find little attention, contrary to the wide-spread literature on theoretical cases and diagnostic criteria of disturbances. Withdrawal- and tardive dyskinesiae are the most important among neuroleptic-induced dyskinesiae. The manifold disturbances of motion are generally found in the orofacial region, the trunk, and the extremities. Errors in differential diagnosis will occur occasionally.

[Heck's focal epithelial hyperplasia]

Three patients with focal epithelial hyperplasia Heck are presented. In two cases biopsies were made and investigated biochemically and by electron microscopy. In one case typical papillomavirus and HPV 1-DNA could be demonstrated, in the other the attempts of isolation failed. Virologic results and epidemiologic considerations suggest a viral etiology of focal epithelial hyperplasia Heck, but they are not sufficient to prove this.

[Behavior therapeutic training for weight reduction]

A behaviour therapeutic program for weight reduction was worked out by a team of psychologists, dieticians and doctors. A 10 week's course for weight reduction was given by 8 dieticians to a group of 5-7 female overweights (N=50). All dieticians based their work on a written handout. 4 of them had an additional training in behaviour and group therapy prior to the course. During the course all participants showed a significant weight loss and a change in their eating behaviour, the patients counselled by an additionally trained dietician (group E1) showing a significantly greater weight loss than the others (group E2). A follow-up after 3 1/2 months revealed similar differences but subsequent controls after 6 and 20 months showed a gradual decrease of the difference between the two groups. However three different patterns of the patient's weight curve could be distinguished. Pattern a): 26.3% of the participants showed a sinking tendency over all 20 months. Pattern b): 21.4% of the participants showed a significant weight loss over the 20 months with a slight upward tendency after the second follow-up (6 months). Pattern c): 52.3% of the participants lost weight only during the course which was regained in the following 3 months period. In pattern a) and c) group E1 and E2 are evenly represented. Pattern b) was only seen with participants of group E1. The results suggest that there are different characteristics of obese persons which influence the success of weight reduction programs. Further studies will have to describe these characteristics and define their therapeutical implications.

Lithium and rubidium: effects on the rhythmic swimming movement of jellyfish (Aurelia aurita)

The effects of adding LiCl, RbCl, KCl or NaCl to sea water at concentrations up to 30 mmoles/1 on the frequency of contraction of jellyfish (Aurelia aurita) suggest that studies on phylogenetically low animals with relatively simple nervous systems may be of use to determine mechanisms of action of lithium and rudidium on movements.

Time of natural exfoliation of deciduous teeth

Over 6000 naturally exfoliated deciduous teeth were sent in to the Department of Preventive Dentistry, University of Sydney over a 10-year period 1964-1974. Adequate histories for 2,828 teeth from 1,558 children were used to determine average ages of children at time of exfoliation of the teeth. Teeth lost at an earlier age were most frequently returned with similar numbers of left and right teeth. There were no differences in exfoliation times for corresponding teeth from left and right sides of arches. Girls had earlier exfoliation times than boys and lower teeth were generally exfoliated prior to upper teeth.

Metabolism and mode of action of androgens in target tissues of male rats. 3. Metabolism of 5 alpha-androstane-3,17-dione, of 5 alpha-androstane-3 beta,17 beta-diol and of 5 alpha-androstane-3 beta,17 beta-diol in target organs and peripheral tissues

Either 1.3 μg [5,6-3H]5α-androstane-3,17-dione (27 Ci/mm), or 12 μg respectively 0.8μg [5,6-3H]5α-androstane-3α,17β-diol (3 Ci/mm), or 12μg respectively 0.8 μg ([5,6-3H]5α-androstane-3β,17β-diol (3 Ci/mm) were administered intravenously to normal adult rats on days 0, 3 and 12 after castration. 30 min after the injection the animals were sacrificed. Total radioactivity counting was performed on aliquots of extracts of blood, peripheral muscle, prostate and seminal vesicles. In the remaining extracts the steroids were isolated by repeated chromatography with and without derivative formation. The following results should be mentioned: 1. Compared to muscle an accumulation of radioactivity is found especially in the prostate on day 3 after castration. 2. Regarding the unconjugated metabolites in plasma no measurable interconversion of both diols has been observed, whereas androstanedione was efficiently metabolised to both diols and to androsterone. In muscle a substantial oxydation of both diols to the corresponding 17-keto-3-hydroxy derivative occurred. 3. In both target organs the three androgens were converted to 5α-DHT2) though in varying amounts. 4. From a calculation of the data available in both target organs a figure of 200 to 300 pg 5α-DHT/mg DNA has been obtained which is regarded as the receptor protein capacity limit. The influence of castration, of enzyme activities and of the chemical structure of the androgens administered on this figure is discussed.