Rupture of the lateral ligaments of the ankle: operation or plaster cast? A propective study

The material comprises 444 patients, aged 12-50 years, with acute sprain of the ankle, seen over an 11-month period (1.10. 1977 to 31.8. 1978). Clinical examination showed no rupture of the ligaments in 53. Arthrography in the remaining patients revealed rupture of the lateral ligaments in 209 (in two-thirds of the anterior talofibular ligament and in one-third of the anterior talofibular as well as calcaneofibular ligament). Conservative treatment with a below-knee plaster cast for 5 weeks was employed in 107 patients, while 102 were treated surgically by suture of the ruptured ligament(s) and subsequently wore a below-knee plaster cast for 5 weeks. The follow-up 1 year after the accident was attended by 63 per cent of the patients. Good results were found in 76 per cent of those treated by plaster cast only and in 81 per cent of those treated by surgery. The difference is not statistically significant.

Clinical testing of Conray meglumine and Amipaque in cerebral angiography

Amipaque 280 mg I/ml and Conray meglumine 282 mg I/ml have been compared in a double-bind trial in cerebral angiography. Altogether 55 cerebral artery branches have been examined in 21 patients, who served as their own controls. The effect of the contrast injections on the intra-arterial blood pressure, pulse rate, ECG, circulatory rate and the patients' reactions were recorded under standardized conditions. The quality of the films was also evaluated. No significant difference in the cardiovascular effects of the two contrast media was found. There was a significant difference in favour of Amipaque in the discomfort of the patients--less pain and sensation of warmth. No serious side effects were observed.

Relation between left ventricular filling pressure and angiographic findings in coronary heart disease. Ventriculography used as a stress test

In 80 male patients with coronary heart disease maximum diastolic pressure in the left ventricle (LVMDP) (usually the top of the a wave), and 'post a' end-diastolic pressure (LVEDP) before and 2 and 3 minutes after ventriculography were correlated to angiographic estimates of left ventricular function (aneurysm, ejection fraction (EF), and to lesions shown by selective coronary arteriography using a score system (coronary artery lesions index, CALI). A significant correlation between CALI and LVEDP (or LVMDP) could not be shown either before or after ventriculography. Before ventriculography, however, LVEDP and LVMDP were good predictors of left ventricular dyskinesia (aneurysm and/or EF less than 50%). A positive and significant correlation between CALI and the LVEDP (and LVMDP) increments following ventriculography (delta LVEDP, delta LVMDP) was found in patients with LVEDP (or LVMDP) below 12 mmHg before ventriculography. Using delta LVEDP the correlation coefficient was 0-51 (n = 41, P less than 0-001, 95 per cent confidence interval 0-24 to 0-88). Using delta LVMDP r = 0-47 (n = 41, 0-001 less than P less than 0-01). Delta LVEDP greater than 12 mmHg was found only in patients with triple vessel disease.

Maternal hyperphenylalaninemia: an experimental model in rats

Experimental maternal hyperphenylalaninemia produced in pregnant F344 rats by the combined use of p-Chloro-DL-phenylalanine and L-phenylalanine reduced fetal birth weight in comparison to saline-injected controls. Offspring who experiences hyperphenylalaninemia in utero died within 5 days after birth. Fetal plasma phenylalanine levels were several times higher than maternal plasma phenylalanine levels, indicating that the placenta actively concentrates maternal phenylalanine. Fetal brain phenylalanine levels rose in direct proportion to elevations in fetal plasma phenylanaline, whereas maternal brain phenylalanine levels remained low during maternal plasma phenylalanine elevation; the contrast suggests that the maternal brain is better able than the fetal brain to screen itself against high circulating plasma phenylalanine levels.