Plasminogen activator activity in venous walls of patients who died of myocardial infarction

The aim of this study was to compare the activity of the plasminogen activator in walls of various veins obtained from 29 patients who died of myocardial infarction in the first 24 h. The control group consisted of 12 dissected persons without thrombotic complications before death. The activity of the plasminogen activator was determined by using the chromogenic substrate S-2251 according to SHIMADA technique. The twofold higher plasminogen activator activity was found in vessels of patients who died of myocardial infarction in comparison with persons who died of other causes. A significant correlation between the plasminogen activator activities of veins obtained from different parts of the body was also stated.     

Microalbuminuria as predictor of increased mortality in elderly people.

OBJECTIVE--Correlation of the urinary albumin excretion rate and the risk of death among elderly subjects. DESIGN--216 Subjects aged 60-74 whose urinary albumin excretion rate had been determined were followed up 62-83 months later. SETTING--Municipality of Fredericia, Denmark. SUBJECTS--223 People who had been selected as control subjects for diabetics found during a systematic screening for diabetes of all people aged 60-74 living in the municipality of Fredericia, Denmark. Of these subjects, 216 had an extensive clinical and biochemical examination within a few weeks of selection. MAIN OUTCOME MEASURE--Death. RESULTS--The median urinary albumin excretion rate was 7.52 micrograms/min. Eight of those with a rate below the median died compared with 23 with a rate equal to or greater than the median (p = 0.0078). The median albumin excretion rate in the 31 who died was 15.00 micrograms/min. Cardiovascular disease was the most common cause of death in both groups. A multivariate regression analysis of survival data was performed using the proportional hazards model. Besides albumin excretion rate, male sex, serum creatinine concentration, and hypertension were found to be of prognostic value. CONCLUSIONS--The association between the albumin excretion rate and mortality that has been described in recent years in patients with diabetes mellitus may be present in elderly people in general, even when other known risk factors are taken into account.     

Oral KCl dietary supplement extends survivability of dogs with Heidenhain pouch gastric fistulas

Supplementing the food of Heidenhain pouch gastric fistula dogs with a KC1 product greatly extends the survivability of these dogs. Since there is a continuous discharge of gastric juice from the pouch to the exterior each time a meal is consumed, clinical signs such as dehydration, anorexia, rough hair coat and lethargy usually occur within a few months after gastric pouch surgery and, unless extensive supportive measures are taken, most dogs will die shortly thereafter. The five dogs which did not receive KC1 supplementation died within 6 months after surgery with a mean survival time of 2.4 +/- 0.9 months. Seven dogs that received a daily oral supplement of 1.5 g KC1 (20 mEq) in their food have, on average, survived more than ten times longer than dogs which received no KC1 supplementation, with a mean survival time of 25.1 +/- 4.4 months. All KC1 supplemented dogs survived for more than 15 months with three dogs currently surviving for 36-40 months. When two dogs experienced decreased serum potassium, sodium and/or chloride levels and showed clinical signs of electrolyte imbalance despite receiving daily oral KC1 supplementation, intervention with intravenous (i.v.) lactated Ringer's solution and increased amounts of oral KC1 supplement reversed these symptoms within 1-2 weeks. Dogs that received only i.v. Ringer's therapy died with 1 week of the onset of clinical signs. Daily oral KC1 supplementation, careful observation of behavior and eating patterns, and routine physical examinations and serum electrolyte measurements can greatly extend the life expectancy of dogs with Heidenhain pouch gastric fistulas.     

Acute Post-Treatment Enterocolitis in 13 Horses Treated in a Norwegian Surgical Ward

Case histories, results of laboratory analyses, treatment regimens and outcome are de-scribed for 13 horses that developed acute enterocolitis after various surgical treatments. Twelve of the 13 horses had been cast in lateral recumbency, and 10 of those 12 had re-ceived general anesthesia. Eleven horses had been treated with antimicrobial drugs. Most horses (11) developed diarrhea 2 days after initiation of treatment, with a variation from 1 to 5 days. The most apparent symptoms were fever, up to 40.5°C, elevated heart rate, discoloration of mucous membranes, and diarrhea. Dehydration, acidosis and leu-kopenia were marked at the time clinical signs occurred. Packed cell volume and total serum protein values were elevated. Therapy was directed toward replacement of fluid losses, restoration of acid-base balance, and counteraction of inflammation. Seven horses (54%) died or were euthanized. At necropsy, pathological changes showed large variations between individuals. Salmonella spp. were not isolated from any of the horses, and no common causative agent was identified. Preventive efforts to avoid post-treatment enterocolitis have been taken with regard to preoperative routines, premedic-ation and anesthesia, with apparent success.     

Microscopic anatomy of small-intestinal lymphoid patches in children and adults

Longitudinal histological sections of lymphoid patches (LP) in the small intestine, stained after van Gieson and with hematoxylin--eosin, obtained from 105 corpses of persons at the age of 0 up to 90 years have been studied. The LP parenchyma is presented as accumulation of lymphoid nodules++ with a germinative center, or without it and diffuse lymphoid tissue. The lymphoid nodules++ situate both in the mucous membrane and in the submucous tela of the small intestine. The area of the LP components in the newborns is the greatest--84% from the whole area of the LP section. During the human life it decreases and by the old age it makes 47%. The lymphoid nodules++ area with the germinative center in the newborns makes 21% from the area of the LP section, in children from 1 to 3 years of age it increases up to 50%, then it gradually decreases and in the elderly age it makes only 3.8%. The diffuse lymphoid tissue in the LP composition is revealed in all age periods. Size of the lymphoid nodules++ patches, situating in the jejunum and ileum walls in the newborns is the same. In children at the age of 10 days--12 years the LP nodules++ in the ileum are larger than those in the sejunum. The size of the LP noduli increase up to the period of the second childhood then decreases. The height of the lymphoid noduli in persons of mature, elderly and old ages decreases twice in comparison with the children of 3-12 years of age.     

Reorganization of the lymphomicrocirculatory bed of human myocardium in ontogenesis

By means of Gerota mass and silver nitrate solution, injected into the myocardium and its vessels, as well as using the scanning electron microscopy technique for corrosive casts, links of the human myocardial lymphomicrocirculatory bed have been studied, beginning from 6-9-month-old fetuses up to elderly and old age persons. Changes in form, dimensions and amount per a volumetric unit have been stated in myocardial capillaries and postcapillaries. These signs demonstrate that the myocardial lymphatic system has different importance for each stage of individual development of the human heart.     

Synaptic structure of human cerebral cortex in chronic hypoxia and epileptic changes in the brain

Comparative quantitative analysis of the synaptic pool of the neuropil in the molecular layer at the temporal epilepsy and cerebral chronic hypoxia (brain tumor, that is not accompanied with a convulsive syndrome) has been performed using biopsy material. As a control the brain of practically healthy persons, who died a sudden death, has been used. The contrasting method of the phosphoric tungsten acid alcohol solution and OsO4 has been applied. An essential complication in the cerebral cortex synaptic structure in the zone with a regular epileptic activity, as well as preservation of quantitative density of synapses near to the control level at epilepsy have been revealed. At the chronic hypoxia simplification in organization of interneuronal connections at the level of synapses and reduction in the quantitative density of synapses have been noted. The complication of the cerebral cortex synaptic structure and epileptic changes++ of the brain is considered as an increase in the neuropil informativity, contributing to keeping a long-term memory about the character of epileptic manifestations.     

Effects of botulism on ducks drinking saline water

Mallard (Anas platyrhynchos) ducklings (2 wk old) were given water from natural saline wetlands or fresh water as drinking water for 1 or 2 wk prior to, and after, receiving material containing Clostridium botulinum type C toxin. Water with conductivity ranging from 3,460 to 6,690 mu mhos/cm had no detectable effect on the occurrence or severity of clinical signs of botulism. Ducks drinking water with conductivity of 7,130 mu mhos/cm for 1 wk prior to receiving toxin had more severe clinical signs and greater mortality than did birds drinking fresh water. Ducks given the same water for 2 wk prior to receiving toxin did not differ from the controls in response to toxin. Fewer ducks in groups drinking the most saline water tested (conductivity = 13,500 mu mhos/cm) had clinical signs of botulism than in groups drinking fresh water.     

Combination Therapy for Myelomatosis

Twenty-eight patients with multiple myeloma have been treated with a quadruple chemotherapeutic regimen consisting of 1, 3 bis (2-chloroethyl)-1-nitrosourea (BCNU), cyclophosphamide, melphalan, and prednisolone. Nineteen new patients and nine who had escaped from previous single-agent therapy were included in the study. The results to date, on eight criteria of response, seem to be superior to those obtained from previous chemotherapeutic regimens. The study has been in progress for 18 months and only three patients have died. Only one who had not received previous therapy died, and she had complicating hyperparathyroidism, which almost certainly contributed to her death.     

Lymphoid structures in the wall of the human esophagus during postnatal ontogenesis

Lymphoid aggregates in the wall of the human oesophagus have been studied in corpses of 107 persons died a sudden death and who had not any disease in the digestive organs and in the immune system (total plane preparations, slices stained with hematoxylin--eosin, azure-2-eosin and after van Gieson). The lymphoid aggregates are arranged as longitudinal chains. Their number increases from birth towards the second childhood, and then decreases towards the old age. In the upper oesophageal parts these aggregates are more numerous than in the lower ones. The lymphoid aggregates look like convexoconvex lenses. Their size is maximal during the second childhood, the longitudinal dimensions are nearly two times as great as their thickness. With time, the sizes of the formations become small. The arrangement density of the lymphoid cells in the subepithelial layer of the mucous membrane is maximal in newborns, and then it decreases up to the old age. The lymphoid aggregates are situated in the oesophageal wall, mainly, near the ducts of the oesophageal glands.     

Role of exercise testing early after myocardial infarction in identifying candidates for coronary surgery.

It has been suggested that ST depression in lead V5 or equivalent on early exercise testing after acute myocardial infarction predicts a high risk of death. To evaluate exercise testing and radionuclide ventriculography in this context 103 consecutive patients with myocardial infarction who were able to undertake a limited exercise test before discharge from hospital were exercised and underwent gated blood pool scanning. No serious complications resulted from exercise testing. Twenty nine patients developed ST depression in lead V5, 19 had exertional hypotension, 31 developed a heart rate of greater than or equal to 130 beats/min, and 15 had complex ventricular arrhythmias. Death during the first year after discharge from hospital was associated with exertional hypotension (p less than 0.001) and a heart rate on exercise testing of greater than or equal to 130 beats/min (p less than 0.05); these two variables identified all nine deaths. Inability to complete the exercise protocol for any reason was also predictive of death (p less than 0.01). Ventricular arrhythmias and ST depression in lead V5 induced by exercise were not significantly associated with an increased risk of death. The mean (SD) radionuclide ejection fraction in the patients who died was 29 (16%) compared with 43 (11)% in the patients who survived (p less than 0.001). ST changes on exercise testing after myocardial infarction appear to be less predictive of later complications than haemodynamic signs, which may indicate left ventricular damage rather than ischaemia.     

Osteolytic lesion in chronic myelogenous leukaemia

Destructive bone lesion of the femur was observed in one patient from a series of 103 patients with CML. Numerous myeloblasts were seen on touch preparations of the fresh surgical specimen obtained by open biopsy of the affected area. Bone marrow and peripheral blood differential count were compatible with chronic phase of CML at this time. 5 months later blastic crisis developed. Local radiotherapy produced effective palliation of pain but did not prevent blastic transformation of CML. The treatment of blastic crisis was unsuccessful and patient died 3 years after diagnosis of CML, 6 months after the first clinical evidence of bone infiltration.     

Terminal cancer care and patients' preference for place of death: a prospective study.

OBJECTIVE--To assess the preference of terminally ill patients with cancer for their place of final care. DESIGN--Prospective study of randomly selected patients with cancer from hospital and the community who were expected to die within a year. Patients expected to live less than two months were interviewed at two week intervals; otherwise patients were interviewed monthly. Their main carer was interviewed three months after the patient''s death. SETTING--District general hospital, hospices, and patients'' homes. MAIN OUTCOME MEASURE--Stated preferred place of final care; actual place of death; reason for final hospital admission for those in hospital; community care provision required for home care. RESULTS--Of 98 patients approached, 84 (86%) agreed to be interviewed, of whom 70 (83%) died during the study and 59 (84%) stated a preferred place of final care: 34 (58%) wished to die at home given existing circumstances, 12 (20%) in hospital, 12 (20%) in a hospice, and one (2%) elsewhere. Their own home was the preferred place of care for 17 (94%) of the patients who died there, whereas of the 32 patients who died in hospital 22 (69%) had stated a preference to die elsewhere. Had circumstances been more favourable 67% (41) of patients would have preferred to die at home, 16% (10) in hospital, and 15% (9) in hospice. CONCLUSION--With a limited increase in community care 50% more patients with cancer could be supported to die at home, as they and their carers would prefer.     

Bronchogenic carcinoma in San Diego County; relation of mortality rates to findings in mass chest x-ray survey

Nearly half the population of San Diego County was examined by chest x-ray for bronchogenic carcinoma. The disease was correctly diagnosed in 20 persons, of whom 17 died. Twenty-four others in whom it was not detected in survey films died of the disease in the following two years. Of the 20 cases found, 16 were in men, all more than 54 years of age, and of the 24 who died after "negative" classification, 20 were men over 40. The death rate for men over 40 years of age from bronchogenic carcinoma is about one in a thousand. Because of the frequently rapid progress of the disease after onset, and the poor prognosis after the appearance of symptoms, x-ray examination every six months for men over 40 should be considered.     

流行性感冒裂解疫苗临床免疫效果观察

兰州生物制品研究所研制的流行性感冒病毒裂解疫苗于2003年9月~12月在广西进行Ⅰ~Ⅲ临床试验,对疫苗的安全性和免疫原性进行考核评价。试验中随机选取852人(6月龄~67岁)接种试验疫苗,227人接种对照疫苗。6~36月龄的婴幼儿接种2针,每次0.25m l,间隔28天;成人接种0.5 m l。所有接种对象均未见红肿和硬结等局部反应;发生低热反应(37.1℃~37.5℃)率为3.5%,均于48小时内恢复正常。疫苗接种后易感人群的H I抗体总阳转率为100%,非易感人群的H I抗体几何平均效价增长7.1~16.8倍,抗体4倍增长率为73.1%~91.7%。证实该疫苗具有良好的安全性和免疫原性。     

Unrecognised HIV related deaths.

OBJECTIVES--To establish whether follow up of deaths from selected HIV related causes could increase the number of cases of HIV infection reported to the Public Health Laboratory Service Communicable Disease Surveillance Centre (CDSC), and to estimate the proportion of deaths among HIV positive men that occurred in men who were not known to be HIV positive at the time of death by the person who signed the death certificate. DESIGN--Follow up of draft death entries received by the Office of Population Censuses and Surveys on which one of 11 medical or external causes likely to be related to HIV was stated; letters were sent to the people who signed the certificates. The respondents were invited to report men known to have been HIV positive who were not already on the CDSC register. SETTING--England and Wales. SUBJECTS--Men aged 15-54 who died in February 1989 to July 1989 with one of the 11 selected HIV related diseases as cause of death on their death certificates. MAIN OUTCOME MEASURES--Number of men reported to the CDSC as a result of this follow up; estimate of excess deaths due to an HIV related cause; estimate of the proportion of excess deaths that occurred in those who were not known to be HIV positive at the time of death. RESULTS--Replies were received for 473 deaths (86%). Forty were for men known to have been HIV positive, 31 of whom had been reported to CDSC by the time they died; six were subsequently reported. The respondent did not know that the decreased was HIV positive for 20 (35%) of the 57 excess deaths in men for whom one of the medical causes was stated and 41 (93%) of the 44 excess deaths in men for whom one of the external causes was stated. CONCLUSION--Follow up of death registrations is not an efficient way of increasing the number of cases of HIV infection reported to CDSC. Between 35% and 60% of HIV positive people for whom certain causes are stated may be dying without HIV positivity having been diagnosed. There may be implications for those caring for people with these conditions and those who carry out postmortem examinations.     

Antitumor effect of photodynamic therapy with zincphyrin, zinc-coproporphyrin III, in mice

We studied the antitumor effects of photodynamic therapy (PDT) with Zincphyrin, coproporphyrin III with zinc, derived from Streptomyces sp. AC8007, in vitro and in vivo. The photokilling effect of Zincphyrin in the presence of 0.78-100 microg/ml with visible light of 27.2 mW x min/cm2 for 10 min was lower than the hematoporphyrin (Hp) used as a control with L5178Y or sarcoma-180 cells. On the other hand, Zincphyrin apparently reduced tumor growth after intraperitoneal injection at doses of 12.5-50 mg/kg with light irradiation of 75.48 mW x min/cm2 for 10 min in sarcoma-180-bearing mice. Although no mice treated with Zincphyrin died, Hp did cause the death of mice. In B-16 melanoma-bearing mice, both Zincphyrin and Hp had a similar phototherapic effect. Further improvement of the phototherapic effect was observed with the continuous administration of Zincphyrin at 12.5 mg/kg per day for 3 days. The concentration of Zincphyrin in the serum reached a maximum level of 16 microg/ml within 20 min, and the concentration remained at 4.2 microg/ml at 1 hour after the onset of treatment, indicating its rapid action in the body. No animals died after the intraperitoneal administration of Zincphyrin at 100 mg/kg plus exposure to light of 10 mW x min/cm2 for 2 hours, and the body weight of the mice did not decrease. In contrast, all animals receiving 100 mg/kg of Hp under the same conditions died. These results indicate that Zincphyrin would be a useful photosensitizer with low phototoxicity.     

Clinical treatment of chronic lymphatic leukemia by means of extracorporeal blood irradiation]

A chronic lymphatic leukaemia (CLL) with hepato-splenomegaly was treated in a 76 years old female patient by means of extracorporeal irradiation of blood (ECIB), after which a complete involution of the tumour in the spleen had taken place. Leukocytes initially increased to 35,500/mm3, amounting to 10,700/mm3 later on. The patient died of pneumonia in general cachexia. No signs of CLL could be found macroscopically after autopsy. An involution of the lymphatic infiltration could be identified microscopically in the bone-marrow.     

Testicular Ca++ ATPase activity in mice: effects of age and gonadotropin administration

These studies describe a high affinity calcium (Ca++)-dependent ATPase in purified testicular plasma membranes, which exhibits increased activity from weaning age to adulthood. Administration of human chorionic gonadotropin (hCG; 5 IU) increased enzyme activity in 21-day old and pubertal (35 to 40-day old), but not in adult mice. In pubertal mice, these increases in testicular Ca++-ATPase activity were dose-related and evident 60 min after hCG administration. A second challenge dose of 5 IU hCG administered either 24, 48 hrs, or 5 days later, had no additional effect on Ca++ ATPase in purified testicular plasma membranes in these pubertal animals. The present findings indicate that testicular plasma membrane Ca++ATPase activity exhibits a developmental pattern concomitant with increased testicular steroidogenic activity during sexual maturation. Furthermore, enzyme activity is increased by gonadotropic stimulation and exhibits a refractoriness similar to that of androgen biosynthesis to repeated hCG stimulation.     

Quantitative microscopic characteristics of cardial glands in in the human esophagus in postnatal ontogenesis

Microscopical investigation of oesophagus, obtained from corpses of 33 men and 33 women has been carried out (staining with hematoxylin and eosin, van Gieson). The cardial glands have been revealed in 92.4% of cases in the inferior and in 4.6% of cases in the superior third of the oesophageal wall. They have not been revealed in the superior third of the oesophageal wall. They have not been revealed in its medial third. Amount of acini in the section is essentially changeable. In elderly and old persons the ducts of the glands often form ampullar dilatations. The acinar areas on the section remain stable during the greatest++ period of the postnatal ontogenesis and only during old age they decrease slightly. The proper plate of the mucous membrane in the inferior part of the oesophagus in the zone, where the cardial glands are situated, is always thicker than in the area free from the acini. Close interrelations have been revealed between the cardial glands and lymphoid tissue of the oesophageal wall. The intensity of the glandular-lymphoid interrelations is insignificant in newborns and in children of suckling age. It is maximal in persons of mature and elderly age. Remaining at a sufficiently high level, the glandular-lymphoid associations in old persons are manifested in a less degree than in the previous age groups. No difference in organization of the cardial glands has been revealed in the superior and inferior parts of the oesophageal wall, as well as any sex peculiarities.