During the Bremerhaven Workshop, effects of contaminants along a well characterised North Sea contaminant gradient heading northwest of the port of Bremerhaven in the German Bight were determined in dab Limanda lirnanda using i n vitro techniques on isolated hepatocytes. Results demonstrated that lysosomal membrane integrity was impaired following contaminant exposure which resulted in an inability to retain the supravital dye neutral red and in reduced lysosomal uptake of the fluorescent probe acridine orange. There was an improvement in the condition of exposed hepatocytes in samples taken further offshore, and away from the source of the contaminant, however, this trend was reversed in samples taken from the furthermost station on the northeast tail of the Dogger Bank. These findings are related to the histopathological evidence of abnormal lysosomal enlargement and disturbance of liver cell structure.

This study shows that the continuing presence of activity similar to normal sleep in the EEG in conjunction with the EEG polygraph (EEGP) can be used to determine the severity of brain damage after head injury. Recordings were taken within seven days of head injury from 154 unselected patients after resuscitation and emergency surgery. Sixteen patients with ongoing seizures were excluded. In the remaining 138 patients the presence of activity in the EEG, EEGP, or both, which can also be recognised in normal alertness and sleep, was noted. Particular attention was paid to the presence or absence of arousal related phasic activity involving EEG, motor, and autonomic changes. The traces were allocated to one of five groups: group 1, wakeful traces with normal alpha in at least one hemisphere; group 2, sleep-like traces with K complexes responsive to stimulation; group 3, traces with phasic activity related to abnormal spontaneous arousal including EEG changes; group 4, traces with abnormal spontaneous arousal activity without EEG changes; group 5, traces with no spontaneous arousal activity. The mean follow up was 21-5 months. Groups 2 and 3 were significantly associated with a good outcome and group 5 with death or a vegetative state. Comparison between the EEG/EEGP findings and the Glasgow coma scale at the time of the recording showed the EEGIEEGP to be the better predictor of outcome, particularly for individual patients.

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SYNOPSISThe EEG changes, with associated cardiorespiratory phenomena and, where possible, postmortem findings, are described in six patients in coma, with some reference to other similar cases. Spontaneously occurring periodic changes were observed at varying intervals between 20 s and 4 min but most commonly at 4-2 min. These involved simultaneous cardiorespiratory, EEG, and somatic motor phenomena related to changes in the level of arousal. It is suggested that a physiological periodicity of the arousal mechanisms exists which may be of importance in the understanding of the pathophysiology of comatose states.

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