THE INSECTICIDES—Their Hazard in Industry and in the Home Part I—Chemistry and Pharmacology

Chemical, pharmacologic and toxicologic properties of the chlorinated hydrocarbon and organic phosphate insecticides have been reviewed. The chlorinated group present problems if there is either acute or chronic exposure, whereas the problems associated with the organic phosphates develop only in event of acute exposure.Chlorinated hydrocarbon insecticides accumulate in body fat depots and cause both liver and kidney damage while being metabolized and excreted. Organic phosphates destroy cholinesterase and produce effects related to overstimulation of the cholinergic branch of the autonomic nervous system. Barbiturates control the convulsions produced by the chlorinated hydrocarbon insecticides. Atropine blocks most of the effects of the organic phosphate insecticides. These compounds may be grouped in the following order of decreasing toxicity: TEPP, HETP, parathion, OMPA, ENP, aldrin, chlorophenothane, toxaphene, gamma benzene hexachloride, malathon and chlordane.     

THE AMINASE OXIDASE INHIBITORS—Their Current Place in Clinical Medicine

Development of the MAO-inhibitors has been an important advance in the treatment of tuberculosis, mental depression, several of the collagen diseases, hypertension and angina pectoris. Treatment must be carefully controlled and individualized. A sufficient number of MAO-inhibitors is available at present to afford ready and correct selection of the proper one for a given patient and disease. Provided such care is observed, treatment is most successful and side effects are few and, as a rule, readily corrected.     

Magnetic Resonance Imaging Part II—Clinical Applications

Magnetic resonance (MR) imaging is the most promising new technology to appear in the clinical imaging arena since the advent of x-ray transmission computed tomography in the early 1970s. Five independent tissue characteristics (spin density, spin-lattice and spin-spin relaxation times, flow and spectral shift information) are accessible to MR imaging, and their relative influence in the magnetic resonance image can be varied by appropriate selection of pulse sequences and pulse times. All major organ systems appear to be amenable to MR imaging, and some are revealed with superior definition compared with their appearance in images obtained by alternate imaging technologies. Of particular interest is the superior contrast resolution in MR images of the brain and spinal cord, and the absence of bone- and motion-induced artifacts in images of the abdomen and pelvis. Applications of MR imaging to the heart and great vessels are just developing, as are new types of contrast agents for use in MR imaging. In vivo chemical spectroscopic measurements by magnetic resonance are heralded by some investigators as the most significant contribution that magnetic resonance will make ultimately to clinical diagnosis.At present, the number of MR imaging units is extremely low, and clinical studies are proceeding at a slow rate. Nevertheless, it is possible to provide a preliminary evaluation of the usefulness of MR imaging in a variety of clinical applications. This article is such an evaluation, tempered by the acknowledgement that much additional work remains to be done.     

THE MYELOPROLIFERATIVE DISORDERS—Current Clinical and Laboratory Considerations

The various hemopoietic and supportive cells of the marrow may proliferate beyond physiologic boundaries in response to a number of stimuli.In certain instances, the stimuli are known, and upon their removal the myeloproliferation returns to normal boundaries. These, the reactive myeloproliferations, are best represented by the leukemoid states and the secondary polycythemias.In other cases, the stimuli responsible for the myeloproliferation remain unknown and the clinical disease ends fatally. These, the neoplastic myeloproliferations, include the granulocytic, monocytic and red cell leukemias, as well as the polycythemia vera and myelofibrosis syndrome.In clinical practice it is important to identify the various myeloproliferative syndromes. This task has been facilitated by cytochemical tests that have recently become available, among which the estimation of the leukocyte alkaline phosphatase (LAP) in peripheral blood is a technically simple and extremely useful example.The LAP is normal in secondary polycythemias and decidedly elevated in polycythemia vera, myelofibrosis and leukemoid states. It is greatly decreased in the granulocytic leukemias.