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The flexibility of rabbit erythrocytes falls during surgery and starts to rise again after 3–4 hours. At 5–6 hours, after the commencement of surgery, it is back to normal and then rises in the following few hours to become significantly more flexible than the pre-operative value. This elevated flexibility decays to its original value over the next ten days. A single intravenous injection of a small amount of heparin given prior to the operation, can prevent the initial fall. The post operative increase in flexibility still occurs but the return to normal is complete after 3–4 days. It is suggested that these changes are indicative of plasma fibrinogen levels.

Using a special apparatus for high resolution cinephotomicrography, which allows simultaneous observation and recording of microcirculatory changes, alterations in blood flow patterns and in red cell shape during norepinephrine acting have been studied. Under physiological conditions, and during slowing of capillary blood flow due to gradual removing of 20–25% of the circulating blood volume, the normal red cells are extremely deformable while passing through mesenteric capillaries. After application of norepinephrine a general arteriolar constrictive response in the bowel wall occurs, causing a further slowing of the capillary blood flow in the mesentery. Under these circumstances the erythrocytes, being in closer contact with the surrounding tissues, alter their cell shape during norepinephrine acting. Shrinkage of nearly all red cells in the mesentery occurs. This crenation effect yields distinct disturbances in microcirculation. The rigid and crenated red cells sometimes are densely packed or aggregated and often stasis arises. The red cell shapes normalize shortly after termination of norepinephrine acting. This side effect of catecholamines must be considered during therapeutic uses of catecholamines or in shock, when elevated levels of catecholamines occur.

The tissue reactions to materials of the cuff of recently developed high volume, low pressure tracheostomy tubes were assessed by intra-abdominal and intra-nasal implantation in rats. Intra-abdominal implantation over a maximum of three months showed that the polyurethane and silicone was walled off by fibrous tissue and foreign body giant cells. The degree of giant cell reaction was similar to that seen about silk sutures. There was no evidence of hepatic or renal toxicity. Polyurethane foam also caused some inflammation and ulceration of nasal mucosa when it was implanted for six days. The degree of ulceration and inflammation was greater than that seen about an inert implant (cotton wool). Further, there was progression rather than reversal of these mucosal changes when the foam was removed. These findings are discussed and it is concluded that the demonstrated reactions of the tissues to the cuff material is acceptable when related to the clinical usage of these cuffed tubes.

Corium autografts and corium zenografts prepared in Merthiolate prior to lyophilisation were used to repair surgically-created, full-thickness abdominal wall defects in rats. They were found to be equally effective in preventing the development of abdominal hernias.

Flying locusts respond to changes in wind-velocity or wind-angle with abdomen posturing in the vertical or horizontal plane, respectively. Receptor hairs on the head sense these wind parameters and evoke the responses in specific abdominal muscles. Records were made from individually identifiable motoneurones to these muscles during the performance of wind-evoked behaviour. During flight these motoneurones are excited by the central flight oscillator and show a burst rhythm at flight frequency. Wind stimuli modulate the number of spikes per burst in this rhythm, but do not affect its frequency or phase with respect to the wingbeat. Changes in wind-velocity and wind-angle evoke different relationships of muscle synergy and antagonism, resulting in the two different patterns of behaviour performed by the same group of muscles. During flightless periods the motoneurones show no flight rhythm, but only the much lower frequency ventilatory rhythm. At these times they are unresponsive to wind stimuli.

Increased resorption rates and decreased fetal weight were produced by intubating pregnant rats with various single (35001–4000 mg/kg) or multiple (2500–3000 mg/kg) doses of β-aminopropionitrile (BAPN) during days 8–17 of gestation. The most embryotoxic gestational intervals were those that included day 15. Resorption (55% ) and ectocardia and/or gastroschisis (16%) resulted when 2500 mg/kg BAPN was administered on days 14–15, whereas no gross congenital malformations occurred when BAPN was administered before day 14. Higher doses of BAPN, such as 5000 m/kg, resulted mainly in fetal resorptions; 2500 mg/kg or greater on day 16 caused only cleft palate in most fetuses. Severe degrees of kyphoscoliosis, bony curvatures, and exostoses at muscleinsertion sites were observed when BAPN was given after day 16. The pathogenesis of these malformations is compatible with the known biochemical effect of BAPN — inhibition of crosslinking of both collagen and elastin — and in doing so: (a) could decrease the tensile strength of the anterior chest wall or abdominal wall to produce ectocardia and/or gastroschisis; (b) interfere with palate closure; and (c) produce osteolathyritic effects late in gestation which resemble the skeletal effects caused postnatally in young weanling animals given this agent.

The subjects of this study were a hereditary typical acatalasemia and a hereditary atypical acatalasemia. In the latter case, the children did not show hypocatala-semia but one of the cousins proved to be hypocatalasemia. The abdominal muscle and the vermiform appendix from the case of typical acatalasemia had only a minute catalase activity. The liver from the case of atypical acatalasemia indicated a moderate catalase activity and catalase protein was observed in it.

A method for preparation of purified myosin from the abdominal muscle of spiny lobster was devised and the physico-chemical properties of the myosin obtained were examined. Intrinsic viscosity, sedimentation constant (s020, w), and diffusion constant (D020, w) of the myosin were 2.05dl/g, 6.65S, and 1.35×10-7cm2sec-1, respectively. The molecular weight was determined to be 445, 000±15, 000 (MS, D) and 500, 000±50, 000(Me). The myosin was precipitated with ammonium sulfate between 40 and 50% saturation at pH 7.0, and salted in with more than 0.15M KCl at pH6.5. The above physico-chemical properties as well as amino acid composition of spiny lobster myosin resemble, as a whole, those of other myosins so far reported.

An incarcerated hernia must be reduced before any attempt at repair can be made. The surgical anatomy of the ring in most of the hernias of the abdomen, both internal and external, is described and, in addition, the incision or other procedure required for safe reduction of the hernia.

An experimental model of gastroschisis has been developed in fetal lambs which grossly and microscopically resembles this anomaly in human infants. Histologic studies of the exposed eviscerated intestine demonstrate interstitial edema without cellular infiltration which appear to result from contact with amniotic fluid. The specific damage to the myenteric ganglion cells and a progressive disappearance of ATPase in the muscle of exposed bowel strongly suggest an alteration in neural conduction and a decrease in contractile potential. Preliminary enzyme studies show concomitant abnormalities in intracellular enzymes within the mucosa of the exposed bowel.

Two cases of rectus sheath hematoma presenting as pelvic pseudotumors are described.The anatomy of the rectus sheath permits dissection of the hematoma inferiorly into the space of Retzius, and indentation on the urinary bladder can occur, although it is rarely reported. Since the majority of hematomas of the rectus sheath occur below the umbilicus, this phenomenon is probably more common than we know.

There are approximately 400 reported cases of undescended thyroid glands. Ninety percent of these are located in the base of the tongue, and 10 percent in the anterior neck superficial to the hyoid bone. The presumptive diagnosis is usually made by scintiphotography. These glands are probably quantitatively deficient and function at marginal levels. Apparently, TSH stimulation causes hypertrophy, usually at an early age, producing undesirable symptoms or local cosmetic change. The treatment varies, depending upon the problems that arise: observation, suppressive doses of thyroid, isotope suppression, surgical excision, and autotransplantation are methods used in attempting to benefit these patients. This communication deals with guidelines for therapy and attempts to evaluate allotransplantation based on the available data. To date, some degree of success has been obtained by autotransplantation; however, a more vigorous effort by the medical community is needed to obtain and report clinical and laboratory data to evaluate autotransplantation fully.

Blood protein concentration in the western rock lobster, Panulirus longipes (Milne Edwards), decreased with starvation, but this decrease was due to increase in blood space as solid tissues were metabolized. The total amount of blood protein remained constant during starvation and throughout the moulting cycle, and may be used as a reliable measure of blood volume. No qualitative changes could be detected in blood protein constituents either during starvation or during the moulting cycle. Concentrations of blood non-protein amino acids were also related to blood volume, but there was a small, significant decrease in total amount after 4 weeks starvation. Concentrations of blood non-precipitatable total carbohydrates and blood glucose did not change significantly with starvation, but there were large changes due to the stress of handling. The water content of whole legs, whole abdomen, and abdominal muscle increased significantly with starvation. Protein and non-protein amino-acid concentrations in leg muscle did not change, but protein concentration in abdominal muscle was significantly lowered. Of all solids, those of the digestive gland showed the greatest decrease during starvation. It is concluded that quantitative measurements of blood constituents are meaningless unless related to blood volume. Blood total protein in conjunction with whole leg water content could provide a practical, simple, and non-destructive means of assessing nutritional state in populations of larger rock lobsters if the moulting history were precisely known, but would not be of use for smaller juveniles because of their relatively high moulting frequency. Other constituents (blood amino-acid or abdominal muscle protein concentrations, digestive gland solids, whole abdomen weights) are either not feasible as a field method or involve destruction of the animal. No satisfactory single index of nutritional state, suitable for field use with wild populations, has been found.

Fifteen of twenty-one infants survived operative repair of gastroschisis defects and have been followed up to six years. All had delayed return of full gastrointestinal function. Intestinal transit time was abnormally prolonged initially but returned to normal by six months of age. Intestinal absorption was studied in seven infants. Carbohydrate and fat absorption was diminished early but returned to normal by six months. A protein-losing state was present early but also improved in time. Weight curves indicated poor gain initially but gradual return to normal patterns after six months of age. These changes are thought to be the result of early ischemia of the bowel.

A case with an extraordinary arteriovenous shunt and a systemicpulmonary arteriovenous shunt has been reported. The etiology may be previous pulmonary tuberculosis and pleuritis treated with artificial pneumothorax.

Late morbidity after abdominoperineal and low anterior resections for rectal cancer was analyzed during a 10-year period, where these operations were used for cure, the latter being performed whenever it was possible to resect the rectum 5 cm below the tumor.

During the final stage of development the haemolymph of Lepidoptera does not seem to undergo great variations of pressure. At most, sudden rises of 10 to 15 mm Hg were noted during violent movements or at ecdysis. With an improved and very sensitive apparatus, a pressure eighteen times higher than the pressure measured normally was recorded. This sudden variation of blood pressure corresponds to the erectile stage of the extension of the wings. The study under different conditions has shown the importance of the part played by the abdominal muscles in the pressure of the haemolymph.

Two cases of congenital left ventricular diverticulum are reported.They are associated with several unusual anomalies including: (1) midline, supraumbilical abdominal wall defect; (2) a defect of the lower sternum; (3) a deficiency of the anterior diaphragm; (4) a defect of the diaphragmatic pericardium; and (5) congenital intracardiac defects.3 Malposition of the heart due to incomplete rotation (dextrocardia) is a constant feature as well.Because the lesion is potentially curable and often fatal, surgical correction when feasible should be instituted.The roentgenologic features are discussed and some of the underlying embryologic abnormalities are considered.

1. 1. The non-protein nitrogenous substances of the tissues of the freshwater crayfish Astacus pallipes have been examined by chromatographic methods. 2. 2. About 80 per cent of the non-protein nitrogen of abdominal muscle and 70 per cent of the non-protein nitrogen of the hepatopancreas has been accounted for. 3. 3. With the exception of betaine all the non-protein nitrogenous substances found by Kermack et al. (1955) in tissues of the marine decapped Homarus vulgaris were found in the tissues of Astacus pallipes. 4. 4. The concentrations of non-protein nitrogenous substances were much lower in the tissues of Astacus pallipes than in the tissues of Hamarus vulgaris. 5. 5. The presence of phosphorylethanolamine and of glycerylphosphorylethanolamine in the hepatopancreas of Astacus pallipes is reported.

Donald Munro in 1933 first undertook the procedure of anterior rhizotomy for the relief of spasticity in cases of thoracic cord injury and reported his results in 1945. The present series comprises 30 patients since that date, but the procedure has been modified slightly so as to avoid cutting the nerve roots to the lower abdominal muscles. The main justification for the procedure is the avoidance of any interference with the reflex arc for control of the urinary bladder and it would appear appropriate also to leave the lower abdominal reflex muscular activity intact so as to encourage full emptying of the bladder.

Since Fourneau and Bovet (1) reported 2-isopropyl-5-methyl phenoxy-ethyl-diethylamine as a potent anti-histaminic, many publications on the central action of anti-histaminics have appeared during the last three decades. However, no report on the action of anti-histaminics to the neuromuscular junction has appeared, despite the fact that listlessness of the limbs occurs when a small dose of anti-histaminics is administered, as in the case of succinylcholine administration. In the present paper, the neuromuscular blocking property of several anti-histaminics was first screened, and then its mechanism of action was studied using rat phrenicdiaphragm preparation.

SUMMARY The association of aplasia of abdominal muscles with a congenital diverticulum of tl anterior urethra is an exceptional finding. The present case is probably the second in tl literature. Localised muscular aplasia of the penile urethral floor would be the term more appropria to the urethral anomaly in this case as well as for most of the so-called diverticula of tl anterior urethra. Lack of smooth muscular fibres (i.e., in mesenchyme) of the ventral peni urethra appears to be the main common defect. The two anomalies here associated may have more than a coincidental significance. Resultin as we suppose, from a mesodermal defect in mid-ventral regions at first devoid of mesoden they seem to be closely related to one another. If so, the present case would plead against all the many classical hypotheses advocating various local incidents as pathogenic factors of eith aplasia of abdominal muscles or congenital diverticula of the anterior urethra, i.e., localisi muscular aplasia of the penile urethral floor.

1. 1. The diagnosis of clostridial sepsis after abdominal operation is difficult prior to the development of signs and wound infection. Hypotension, fever, tachycardia out of proportion to the fever, jaundice, renal failure, or mental changes may precede signs of wound infection. 2. 2. A review of the literature reveals that the average time between operation and the first indication of wound infection was twenty-four to forty-eight hours (ranging from four hours to eighteen days). The over-all mortality of clostridial infection of the abdominal wall is 60 per cent; in the presence of peritonitis (20 to 36 per cent of cases) the mortality is 86 per cent. 3. 3. Wound crepitus is a late sign not essential for the diagnosis of clostridial sepsis. 4. 4. A high index of suspicion is required to make the diagnosis of clostridial sepsis before obvious signs of wound infection occur. Once the diagnosis is suspected, the wound must be opened and inspected and material obtained for gram stain and culture. 5. 5. Despite reluctance to undertake unnecessary radical excision of a wound, treatment must be instituted rapidly if the clinical picture is compatible with the diagnosis and if organisms resembling Clostridia are present on gram stain. Treatment should consist of antibiotics and radical debridement with or without hyperbaric oxygen therapy.

The electrical activity of the respiratory muscles, including those of the diaphragm, and the intercartilaginous part of the internal intercostal and internal oblique abdominal muscles, was recorded by means of chronically implanted electrodes in dogs.

A case of right-sided diaphragmatic hernia in an adult is presented. It is believed that the hernia was congenital.

1. Deafferentation of the thoracic segments of the spinal cord causes a decrease in electrical activity of the abdominal muscles. A definite decrease in activity is observed after deafferentation of five segments. The increase in respiratory activity of the abdominal muscles which follows increased resistance to expiration is diminished or completely abolished after division of the dorsal roots. 2. Stretch receptors located in the abdominal muscles are found by recording dorsal root activity. Depending on the relationship between discharges of the receptors and phases of the respiratory cycle, “inspiratory,” and “expiratory” receptors and receptors the frequency of whose discharges is independent of the phases of respiration may be distinguished. Receptors working as “expiratory” are more numerous in decerebrate animals than in anesthetized animals. An increase in respiratory activity leads to an increase in frequency of discharge at expiration. This increased discharge is facilitated by the γ-system.

I N this era of multiple severe injuries it is very easy to overlook or disregard some of them ; acute injuries of the diaphragm fall into this category. The persistence of shock in such cases, despite all efforts to combat it, may be explained by displacement of the heart clue to the presence of abdominal viscera in the thorax . The deterioration of the patient's general condition may result from the distended stomach or intestines compressing the lung and causing a shift of the mediastinum . Unless the causes for this altered cardiorespiratory physiology are accurately determined and effective measures used to combat them, the outcome is usually fatal . However, there are some survivors who live to have traumatic diaphragmatic hernias diagnosed and repaired months to years later. Our concern in this paper is with the acute injury and how best to diagnose and treat it. A high index of suspicion is necessary . The material for this report consists of thirty-three patients admitted to Detroit Receiving Hospital between the years 1947 to 1953 . Our classification of pathology is based upon the type of injury . There were seven cases of non-penetrating wounds of the diaphragm and twenty-six cases of penetrating wounds of the diaphragm. The latter consisted of six gunshot cases and twenty stab wounds of the thorax. There were only two women in the entire group . The average age was thirty-six years ; the youngest patient was four years old and the oldest was sixty-eight years of age . There were nineteen Negroes and fourteen white patients . Initial Treatment . Initial treatment was carried out. i n the Emergency Room, and con

The ventilatory function of rectus and oblique abdominis muscles was studied by means of surface electromyography in 14 patients with severe obstructive lung disease and 9 healthy control subjects. Wh

A pacemaker sound was detected in 21 out of 40 patients (52%) with an implanted cardiac pacemaker. In eight patients, intercostal or abdominal muscle contractions synchronous with pacemaker sound coul

1. 1. Omphaloceles with small intact sacs are best treated surgically with closure of the musculofascial defect. 2. 2. Omphaloceles larger than 5 cm in diameter should be treated conservatively and with local applications of scarifying agents. 3. 3. Ruptured omphalocele or gastroschisis requires immediate surgical intervention, usually with the insertion of a temporary prosthetic material. 4. 4. Increased survival in the postoperative phase may be obtained with the use of the newer adjuncts of total intravenous nutrition or administration of an elemental diet.

Six cases of Mycobacterium infection are described. A critical evaluation of the various methods of treatment used is presented. The conclusions are that drugs have no place in the primary treatment of the condition, and that wide surgical excision and partial, thickness skin grafting followed by the application of heat by means of a specially constructed heat cradle are the best form of treatment. Problems associated with surgical management are discussed.

1. Partial duodenal obstruction can be demonstrated in a large proportion of oases with chronic dyspeptic symptoms. 2. The cause of the obstruction varies, but the most common is compression by the supr. mesenteric artery. 3. In our experience it is nearly always associated with an abnormal condition of the colon. 4. The possession of a mesentery,i.e., Mobility alone is not sufficient; some other factor is necessary, such as descent over the pelvic brim, chronic constipation or loss of tone in the abdominal muscles. 5. Treatment consists in regular emptying of the colon with support for the latter by an efficient abdominal belt. Failing improvement on these lines, colopexy is indicated, or possibly duodeno-jejunostomy.