Long-term Prognosis following Ventricular Fibrillation in Acute Ischaemic Heart Disease

Of 160 patients who survived ventricular fibrillation complicating acute ischaemic heart disease, 80 had had a clinically mild coronary attack. Most of the long-term survivors had ventricular fibrillation within 24 hours of the onset of symptoms. The longterm prognosis of the survivors was similar to that of patients whose myocardial infarction was not complicated by ventricular fibrillation. Those patients who survived ventricular fibrillation which occurred within four hours of the onset of symptoms were younger, usually had had a mild coronary attack, and had the most favourable longterm prognosis. The number of episodes of ventricular fibrillation did not affect adversely the long-term prognosis. Of those who at the time of review were eligible to work, 86% were fit to work and 68% were actually at work.     

Alpha-Fetoprotein Levels in Amniotic Fluids from Spontaneous Abortions

Alpha-fetoprotein (A.F.P.) levels in the amniotic fluid were determined in 54 cases of spontaneous abortion in which the amniotic sac remained intact. These levels were correlated with the morphological and cytogenetic status of the fetus. Of the 29 fetuses with no apparent abnormality 22 had A.F.P. levels below 50 μg/ml, while 10 of the 11 fetuses with severe neural tube defects had raised levels (50-305 μ/ml). Seventeen fetuses had chromosome anomalies of various types. Three out of four which were 45, X had considerably raised A.F.P. levels (78-210 μg/ml) but fetuses with other chromosome constitutions and no neural tube defects had levels no higher than 32 μg/ml.     

Use of Glucagon in the Treatment of Acute Diverticulitis

Glucagon given intravenously to 20 patients with acute diverticulitis was followed by symptomatic relief within an average of 12 hours and obviated the need for therapy with analgesics or other antispasmodics. In a similar group of patients receiving conventional treatment symptoms persisted for an average of 96 hours. The administration of glucagon had no apparent effect on abdominal symptoms which mimicked those of diverticulitis but were caused by other conditions. There was no clinically apparent difference in effectiveness between continuous infusion and intermittent injection of glucagon.     

Scrapie I. Transmission and Pathogenesis

Homogenized brain, extracts, and residues of brain from normal and scrapie sheep were inoculated into 116 sheep. Of 72 sheep inoculated with scrapie material 27 developed the disease, whereas four of 44 inoculated with ;normal' brain material showed symptoms similar to those of scrapie. The scrapie agent survived extraction for 18 hours with diethyl ether followed by water for 24 hours. Similarly the agent survived extraction in a Soxhlet apparatus with 95 per cent ethanol containing 2.0 per cent 4 M HC1 for 24 hours. There was no evidence of demyelination in sections of brain and spinal cord supporting the view that allergic encephalomyelitis is not responsible for the scrapie symptoms. Liver function, as measured by the bromsulfalein test, remained normal until just before death. These results preclude that liver dysfunction contributes to the disease but do not exclude the possibilities of other metabolic derangements.     

Mitogenesis in normal human fibroblasts by polyinosinic . polycytidylic acid and other synthetic acidic polymers: enhancement of action by glucocorticoids

The ability of specific synthetic polyelectrolytes to act as mitogens for quiescent normal human fibroblasts in cultures is described. Of several acidic polymers tested, polyinosinic acid .polycytidylic acid (poly I.poly C) and dextran sulfate were the most effective in stimulating 3H]thymidine incorporation (2-to 10-fold). The concentration for a half-maximal effect (ED50) was 0.4 microgram/ml (0.8 nM) for poly I.poly C, and 1.7 microgram/ml (3.4 nM) for dextran sulfate. Single-stranded polyinosinic acid or polycytidylic acid had no effect. The time course of stimulation of DNA synthesis by these acidic polymers was similar to that for naturally occurring mitogens such as epidermal growth factor, beginning at about 18 hours and reaching a maximum rate 26 to 30 hours after the addition of polymer. Glucocorticoids that have an 11-beta hydroxyl group (e.g., dexamethasone) had no effect on DNA synthesis alone, but enhanced several-fold the mitogenic activity of poly I.poly C or dextran sulfate; the ED50 for dexamethasone was 0.75 ng/ml (1.9 nM). Glucocorticoids with an 11-keto group were inactive in this respect. The labeling index following treatment of cultures with poly I.poly C and dexamethasone was 14%, compared with a labeling index of 25% following stimulation by fetal calf serum. The extent of stimulation of DNA synthesis by poly I.poly C and dexamethasone was comparable to that induced by epidermal growth factor. It appears that both the poly I.poly C and dexamethasone are required for only a short period of time (approximately 3 hours) in order to produce maximal stimulation of DNA synthesis 30 hours later.     

Ambulatory pH monitoring of gastro-oesophageal reflux in "morning dipper" asthmatics.

A causal relation between gastro-oesophageal reflux and nocturnal asthma has been postulated. Forty four adult asthmatics underwent ambulatory monitoring of their oesophageal pH over 24 hours to find out if there was such a relation. Of these 21 showed significant "morning dipping" in which the peak expiratory flow falls during the night. Asthmatics with morning dipping had a history of nocturnal wheeze and a higher incidence of reflux symptoms, but measurement of oesophageal pH showed no significant difference in the amount or pattern of reflux when compared with "non-dippers." Overall, 15 asthmatics had gastro-oesophageal reflux, and these participated in a randomised, double blind crossover trial of ranitidine versus placebo. No significant difference was found in the peak expiratory flow rates or subjective evaluation of well being of the patients.     

PERFUSION FOR MYOCARDIAL REVASCULARIZATION WITHOUT AN ARTIFICIAL OXYGENATOR (New Method to Reduce Surgical Morbidity)

Thirteen patients were submitted to direct myocardial revascularization (saphenous vein graft) without the use of an artificial oxygenator. The perfusion was done by a left ventricle-to-aorta bypass and autogenous oxygenation. Most patients had three grafts implanted plus endarterectomy of the distal right coronary artery. There was one hospital death that was apparently not related to the method used. Perfusion time ranged from 45 minutes to 4 hours. Body temperature during perfusion was kept between 25 and 30 degrees C. Perfusion flow was maintained between 25 to 50 ml per kg of body weight per minute. Ischemic, hypothermic cardiac arrest was employed. We demonstrated for the first time that perfusion for this kind of heart surgery could be done with no artificial oxygenators and, apparently, is safer for the patients. There were no bleeding problems even in perfusions as long as 4 hours. There was no respiratory dysfunction, and artificial respiration was used for only 6 to 12 hours. The patients awoke at the end of surgery with no signs or symptoms of central nervous system damage, and vasopressor drugs were rarely used after surgery. Although the experience is very small, it suggests that many postoperative problems, especially those related to bleeding and respiratory dysfunction may be reduced or eliminated by this new method.     

双侧迷走神经和颈总动脉联合切断法建立急性脑缺血大鼠模型

目的建立一种操作简单的急性脑缺血动物模型。方法取雄性Wistar大鼠40只,体重200～230g,手术前禁食12 h,自由饮水,随机分为对照组A、B、C组及模型D组,共4组,每组10只。即A组:假手术组,仅切开颈部两侧皮肤,分离双侧颈总动脉和迷走神经,不切断,然后缝合;B组:仅切断双侧颈部迷走神经;C组:结扎并切断双侧颈总动脉(CCA);D组:联合组,即结扎并切断双侧颈总动脉,同时切断双侧颈部迷走神经。观察各组大鼠手术后的脑缺血症状,记录各组大鼠在8h内的死亡情况,超过8h死亡的动物按8h计,计算死亡率和死亡时间。结果 A组大鼠没有脑缺血症状,无死亡;B组大鼠无脑缺血症状,呼吸变慢变深,心率血压上升,但无死亡;C组大鼠部分出现脑缺血症状,眼睑下垂,活动能力低下,自发运动减少,有些大鼠术后自发运动增加,在8 h内无死亡;D组大鼠大多数出现较为明显的脑缺血症状,在8 h内全部死亡。结论采取同时结扎并切断大鼠双侧颈总动脉和双侧颈部迷走神经的方法,可以建立急性脑缺血大鼠动物模型,此方法具有手术简单,成功率高,术后动物缓慢死亡的特点。     

Reduction of paraquat toxicity by superoxide dismutase

The effect of intravenously administered superoxide dismutase on paraquat-treated rats kept either in air or an atmosphere of 90%–95% oxygen was investigated. Of those rats maintained in the oxygen-enriched atmosphere, 50% died within 30 hours whereas, 50 hours elapsed before 50% mortality was observed for the superoxide dismutase-treated rats. Those animals allowed to remain in air were more responsive to superoxide dismutase treatment. Of those animals for which paraquat was fatal, untreated rats showed 50% cumulative mortality within 35 hours after paraquat administration, whereas those rats treated with superoxide dismutase showed 50% mortality after 80 hours. Sections of lung tissue examined at low magnification indicated that the extensive alveolar and vascular damage caused by paraquat was ameliorated with the administration of superoxide dismutase. These findings may have particular relevance in the treatment of paraquat intoxication in humans.     

RNa-polymerase,type I: Activity in rat brain cell nuclei and peripheral blood mononuclear cells after Venezuelan Equine Encephalomyelitis virus infection

Rats inoculated intraperitoneally with 100 LD₅₀ of Venezuelan Equine Encephalomyelitis virus (VEE), showed a significant decrease of DNA-dependent RNA polymerase type I activity of brain nuclei of 29.7% and 59.3% at 24 and 48 hours after infection, respectively, while the animals had no clinical symptoms of illness. No alterations were observed in the nuclei of mononuclear cells at any time. VEE virus titer was higher in the serum than in the brain. The results suggest that viral infection produced a modification in the activity of this enzyme only in brain, even with a low amount of virus, and had no effect on enzyme activity of mononuclear cells.     

Temperature Effects on the Activity of the Alternative Respiratory Pathway in Chill-Sensitive Cucumis sativus

After 48 hours at 2°C, hypocotyls from chill-sensitive Cucumis sativus seedlings showed a burst of O₂ uptake. The alternative pathway became engaged to close to 45% full capacity during this postchilling respiratory burst. However, it only accounted for up to 50% of this increased respiratory O₂ uptake. By 24 hours after chilling, when the seedlings were fully recovered from visible symptoms of chilling injury, the flux through the alternative pathway was back to the level (about 10%) found before chilling. Blocking chilling-induced ethylene production with aminoethoxyvinylglycine had no effect on this increased utilization of the alternative pathway.     

Evaluation of adverse events after influenza vaccination in hospital personnel.

Reactogenicity of trivalent influenza vaccine prepared for the 1988-89 season was assessed as part of a first-time voluntary influenza prevention program among hospital staff. Of approximately 500 full-time workers in areas with the highest concentrations of patients at high risk for influenza complications offered the vaccine 288 accepted. Of these, 266 (92%) returned a questionnaire regarding any symptoms experienced within 48 hours after vaccination; 238 (90%) of the respondents reported adverse effects. Soreness at the injection site was described by 229 subjects, 58 (25%) of whom had constant aching and 123 (54%) soreness with arm movement. Symptoms resolved in 1 to 2 days, and only 21 (9%) of those who reported symptoms said they took analgesic medication. Systemic adverse effects were described by 130 subjects (49%). Intercurrent illness accounted for some of these complaints, but 65 people (24%) described at least two of the following symptoms: generalized aching, tiredness, nausea, chills or onset of fever within 12 hours after vaccination (a symptom complex previously attributed to influenza vaccine). Systemic symptoms resolved within 0.5 to 2 days. Thirteen subjects (5%) reported missing work because of arm soreness (1 subject) or systemic symptoms (12). Adverse effects were encountered more often than expected, probably because most of the workers were young and lacked immunity to influenza. Acceptability of the program could likely be improved by using a split-virus vaccine.     

Quinine-induced granulomatous hepatitis.

Many adverse reactions to quinine have been reported. A 65 year old woman taking quinine sulphate for nocturnal leg cramps presented for investigation of episodes of malaise, fever, nausea, vomiting, and polyarthralgia. Granulomatous hepatitis was diagnosed, for which no common cause was found. She was challenged with quinine sulphate; within hours her temperature had risen and her symptoms returned; transaminase activities rose within 48 hours, as did erythrocyte sedimentation rate. After withdrawal of the drug symptoms abated and transaminase activities returned to normal. The biochemical response to challenge with quinine implicates the drug as the cause of the liver disturbances. Quinine should be added to the list of drugs known to cause granulomatous hepatitis and should be considered in cases where symptoms are episodic or where no other cause is apparent.     

褶纹冠蚌精子球的形态和超微结构观察

利用光镜和电镜技术研究了褶纹冠蚌精子球的形态和超微结构.结果表明:精子球呈球形,直径约65-70μm,容纳2300多个精子.从外向内,精子球由非细胞层、表面层和内部区组成.非细胞层薄,厚约0.6μm,易碎.表面层厚约7.5μm,被分隔成许多辐射状排列的小室,单个精子头部位于小室内,指向精子球的中央,而精子的单个鞭毛由精子球的表面伸出.精子质膜在鞭毛领处与表面层相连,相邻精子间无细胞质桥相连.内部区呈球状,内含絮状物质.精子球从雄蚌出水管排出后,位于精子球外周的鞭毛沿固定方向不停地摆动,精子球翻滚着向前运动,且单个精子依次从精子球上脱落下来,最后精子球成为一中空的球,历时120h.       

Incidence of Hypoglycemia in the Low-Birth-Weight Neonate

Of 179 consecutively born single infants whose birth weights were below the twenty-fifth percentile for gestational age, four were hypoglycemic in the first 18 hours of age with true blood glucose levels of 17 mg. per 100 ml. or less. All four had symptoms referable to the respiratory system and the two deaths were from pulmonary causes.     

An Affinity Chromatographic Reactor for Highly Efficient Turnover of Dissociable Cofactors

A conjugated enzyme system of alcool dehydrogenase and lactate dehydrogenase was immobilized in an ultrafiltration hollow fiber tube, which was inserted in a fine nylon tube to form a hollow-fiber-capillary reactor. To this reactor, the substrates, pyruvate and ethanol, were supplied continuously. The necessary cofactor, NAD, was supplied as a pulse for a short time. The retention time of NAD in the reactor, estimated from the response curve of lactate produced, was much longer than those of the other substrates and products because of the strong adsorption of NAD to the immobilized enzymes through affinity. Therefore, the reactor could produce lactate from pyruvate for a long time without any more NAD. As a typical case, when the enzyme concentration is sufficiently high, the estimated retention time of NAD was 50 times as long as those of other materials so that the NAD turnover obtained was 412,000. The effects of NAD pulse concentration and the immobilized enzyme concentration on the retention time of NAD and NAD turnover were investigated experimentally and theoretically.     

Reduced incidence of retained placenta with induction of parturition in the cow

Two experiments were designed to determine whether pretreatment with Opticortenol (OPT), a long-acting corticosteroid, prior to induction of parturition with 25 mg of dexamethasone (DEX) alone or in combination with 500 mug cloprostenol (CLO) would result in a reduced incidence of retained placenta. In Experiment 1, 70% of the cows pretreated with 25 mg OPT on Day 270 of gestation calved before or within 24 hours of the scheduled induction treatment on Day 277. Cows induced to calve with DEX plus CLO without OPT pretreatment had an increased rate of placental retention (P<0.05), whereas, cows that received OPT were not different from the controls. In Experiment 2, cows received either 1 mg/25 kg OPT (high dosage) or 1 mg/50 kg OPT (low dosage) on Day 270 of gestation and were induced with DEX plus CLO on either Day 274 (4 days) or Day 276 (6 days). Cows claved 29.0 to 31.8 hours after induction treatment with 95% beginning to calve between 0700 and 1900 hours. The interval from calving to placental release and the incidence of retained placenta was not different between the high dosage 6-day group (29.4+/-8.2 hours, 29%) and the non-induced control cows (16.1+/-10.7 hours, 5%). When three cows in the high dosage 6-day group that retained their placentas for 30 to 36 hours were considered as not retained, the incidence of placental retention for that group was reduced still further to 17%. First service conception rates and pregnancy rates were lower in cows with retained placentas. Differences were significant (P<0.01) in Experiment 1 but not in Experiment 2. It was concluded that pretreatment with 1 mg/25 kg OPT 6 days prior to induction of parturition with DEX plus CLO in combination results in a predictable calving time, high calf viability, and a low incidence of placental retention.     

Early mobilisation and outcome in acute sprains of the neck.

OBJECTIVE--To assess the long term effect of early mobilisation exercises in patients with acute sprains of the neck after road accidents. DESIGN--Single blind randomised prospective study of patients receiving physiotherapy, advice on mobilisation, or on an initial period of rest followed up after two years by postal questionnaire. SETTING--Accident and emergency department in urban hospital. PATIENTS--247 Consecutive patients (mean age at injury 30.6 years) presenting within 48 hours after injury with no pre-existing disease of the neck or serious skeletal injury. Of these, 167 patients responded to the questionnaire; 77 who responded but had not completed their treatment or review course were included in the analysis as a fourth group (non-attenders). MAIN OUTCOME MEASURE--Presence of symptoms after two years. RESULTS--Of the 167 patients (68%) responding, the percentage of patients still with symptoms was not significantly different in those receiving rest or physiotherapy (46%, 12/26 v 44%, 24/54), but that in those receiving advice on early mobilisation was significantly lower (23%, 11/48, p = 0.02). Of the 104 patients without symptoms, 94 (90%) recovered within six months and 62 (60%) within three months. Patients without symptoms who received advice or physiotherapy wore a collar for a significantly shorter time than those with persistent symptoms (mean duration 1.4 (SD 0.7) months v 2.8 (1.6) months, p = 0.005 and 1.6 (1.1) months v 1.8 (1.3) months, p = 0.006 respectively). CONCLUSIONS--Advice to mobilise in the early phase after neck injury reduces the number of patients with symptoms at two years and is superior to manipulative physiotherapy. Prolonged wearing of a collar is associated with persistence of symptoms.     

Value of Mammary Thermography in Differential Diagnosis

Thermographic examinations of the breasts were carried out in 359 women, most of whom had mammary symptoms. Of the 195 patients with abnormal thermograms, 27 had cancer of the breast, 53 had benign lesions, and 115 had no confirmed organic disease. The incidence of false-positive thermograms was 59%. Of the 164 patients with normal thermograms, 116 had no confirmed organic disease, 41 had benign lesions, and 7 had cancer. The incidence of false-negative mammary thermograms was 29%.We conclude that mammary thermography is of no practical value in the differential diagnosis of symptomatic mammary disease.     

Inactivation of virus during anaerobic digestion of manure in laboratory scale biogas reactors

Reduction of porcine parvovirus, bovine enterovirus and faecal enterococci were measured in biogas reactors continuously run on manure and manure supplemented with household waste at 35°C and 55°C and in batch test run at 70°C. The aim of the experiments was to study the sanitation effect of anaerobic digestion and to evaluate the use of faecal enterococci as an indicator of sanitation. Parallel studies on the reduction of virus and faecal enterococci were done in physiological saline solution. Heat ínactivation was found to be an important factor in thermophilic biogas plants and the overall dominant factor at 70°C. However, other environmental factors with a substantial virucidal and bactericidal effect were involved in inactivation. The death rates for faecal enterococci were generally higher than for porcine parvovirus and lower than for bovine enterovirus. For faecal enterococci, a logarithmic reduction of 4 (corresponding to the recommended minimum guaranteed retention time) was obtained after 300 hours at 35°C and after 1–2 hours at 55°C. In continuously-fed reactors, a high reduction rate was initially seen for the virus tested, followed by a reduction in the rate. For porcine parvovirus, a minimum guaranteed retention time of 11–12 hours is necessary at 55°C in the initial phase (0–4 hours) and 54 hours hereafter (4–48 h). Correspondingly, for bovine enterovirus a MGRT of 23 hours was necessary at 35°C and < 0.5 hours at 55°C. The data indicate that faecal enterococci measurements give a good indication of inactivation of enterovirus and other more heat sensitive virus, especially under thermophilic conditions. Parvovirus is very suitable for comparative investigations on inactivation in the temperature range of 50–80°C, due to the extreme thermal resistance of this virus. However, in stipulating sanitation demands for biogas reactors it seems more reasonable to use less resistant virus, such as a reovirus or picornavirus, which better represents the pathogenic animal virus.Abbreviations BEV bovine enterovirus - CFU colony forming unit - FE faecal enterococci - HRT hydraulic retention time - MGRT minimum guaranteed retention time - ND not detected - PPV porcine parvovirus - TCID₅₀ tissue cell infective dose 50 % - VFA volatile fatty acids - VS volatile solids