Visualization of Histoplasma capsulatum in bone marrow with Prussian blue iron stain

Bone marrow specimens from patients with disseminated histoplasmosis revealed yeast cells that stained positively with Prussian blue.

Ultrasound assessment of fetal growth

Consecutive ultrasonic measurements of the fetal head area, thorax area, abdomen area, head/thorax (H/T) area ratio and head/abdomen (H/A) area ratio were obtained from 100 patients with a normal pregnancy and from 186 patients with suspected intrauterine fetal growth retardation. Of all the measurements used, H/A area ratio was found to be most accurate in identifying intrauterine fetal growth retardation predicting 82.9 per cent at 33 weeks and 85.7 per cent at 36 to 38 weeks of gestation. This technique was also found to be useful in distinguishing between the two types of growth retardation. The H/A area ratio was helpful in identifying the growth acceleration pattern of a large baby.

Defective colour vision in diabetes: a hazard to management

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Isolated unilateral gaze palsy

A case of an isolated unilateral horizontal gaze paralysis is presented. The abnormality has remained static and in isolation for more than three years. A review of the benign causes of pontine gaze palsies is presented. The unique features of this case is the fact that the gaze paralysis is unilateral and unassociated with any other neurologic or systemic abnormality.

Kinetics of indomethacin degradation II: Presence of alkali plus surfactant

The kinetics of indomethacin were studied in the presence of the surfactants ethoxylated lanolin, polysorbate 80, and cetrimonium bromide under alkaline conditions at 30.3 degrees. The degradation followed apparent first-order kinetics. Plots of kobs versus surfactants; concentrations were curved with negative slopes for nonionic surfactants; but with the ionic surfactant, the plots showed a marked positive change in kobs as the surfactant concentration passed through the critical micelle concentration. Literature model systems adequately explained the data for nonionic surfactants but not for the ionic surfactant. A new set of equations was derived for each case using electrochemical potentials. The experimental data for all three surfactants fit the derived equations quite well.

Isolation and chemical characterization of antitumor agents from plants

This paper reviews methods which have evolved at the Research Triangle Institute during the last 15 years for the isolation and characterization of antitumor agents from plants. The isolation procedures stress mild, nonchemical methods. Solvent partition and the Craig Counter Current Distribution are used during the early stages of fractionation. Subsequent purification involves many types of chromatography: adsorption, partition, thin-layer, preparative thin layer, gel-exclusion, and medium- and high-pressure liquid chromatography. The pure compound is crystallized from a suitable solvent. The fractionation is monitored with in vitro and in vivo bioassays. Physical methods used for structure determination are: ultraviolet, infrared, and nuclear magnetic resonance spectrometry, and X-ray crystallography.

Ventilatory abnormalities in hospital admissions

The incidence of unrecognised ventilatory impairment was investigated in a group of 531 routine hospital admissions who had been considered to be free of significant respiratory disease. Using spirometric tests of FEV 1, FVC and FEV 1/FVC percent before and after sympathomimetic bronchodilator, it was found that 42 percent of these patients had abnormal ventilatory tests, and 47 percent were considered to have obstructive lung disease. Routine use of screening respiratory function tests would be useful in the assessment and management of general medical and surgical hospital admissions.

Orbital and conjunctival involvement in multiple myeloma. Report of a case

Benjamin, Ivy, Taylor, Herbert, and Spindler, James: Orbital and conjuctival involvement in multiple myeloma. Report of a case. Am J Clin Pathol 63: 811-817, 1975. Orbital and conjunctival involvement in multiple myeloma are rare. In most reported cases of multiple myeloma with orbital involvement proptosis has been the initial manifestation that has led to diagnosis of the disease. Our case represents and example of terminal involvement of the orbit and conjunctiva, causing proptosis. The minimal conjunctival changes were the first indication of neoplastic proliferation of plasma cells in this location and, presumably, the orbit.

Effect of propranolol on myocardial oxygen consumption and its hemodynamic correlates during upright exercise

Measurements were made of heart rate, aortic blood pressure, systolic ejection period/beat, myocardial blood flow, and myocardial oxygen consumption in nine normal young men during three bouts of upright bicycle exercise: 1) at the workload which produced a heart rate of 120 beats/minute, 2) at the higher workload necessary to produce a heart rate of 120 beats/minute after administration of intravenous propranolol 0.25 mg/kg, and 3) with infusion of propranolol, at the same workload as the first exercise bout. Comparing exercises 1 and 2, we found a much higher workload was required to produce the same heart rate after propranolol. The blood pressure, heart rate-blood pressure product, and myocardial oxygen consumption were the same despite the much greater level of exertion. Comparing exercises 1 and 3, the heart rate, blood pressure, heart rate-blood pressure product, and myocardial oxygen consumption were all significantly lower during exercise 3 after propranolol despite the fact that the same degree of exercise was being done. As in previous studies, the heart rate-blood pressure product was an excellent correlate of myocardial oxygen consumption despite the change in contractility induced by propranolol. The systolic ejection period was prolonged significantly altering the tension-time index (TTI), which became an inadequate index of myocardial oxygen consumption. It is concluded that the heart rate-blood pressure product is a good index of myocardial metabolic needs during exercise and the relationship is undistorted by marked changes in contractility, but the tension-time index is a poor correlate. This data emphasizes the fact that the relative metabolic loads for the whole body and for the heart are determined separately and may not change in parallel with a given intervention.

Characterization of a monoclonal IgA rheumatoid factor. II. Evidence for reactivity with a specific IgG Fc fragment determinant

Evidence is provided which supports the concept that a previously characterized monoclonal IgA-λ rheumatoid factor with a medium-binding avidity reacts with a select Fc region antigenic determinant. The interaction between this rheumatoid factor and anti-Rh-coated human erythrocytes is inhibited by IgG1 Fc fragment, IgG1 heavy chains, and a single peptide pool isolated from this tryptic digest by paper chromatography. Cyanogen bromide cleavage of the isolated heavy chains abolishes this reactivity. A methionine residue is assumed to be near, involved in, or necessary for reactivity between the IgA and its antigenic determinant. The data thus provide further evidence for a specific autoantigenic, rheumatoid factor-reactive determinant.

Sector mastectomy in selected cases of breast cancer

Seventy-seven patients with stage I or II carcinoma of the breast, usually less than 5 cm. in diameter and more than 2·5 cm. from the nipple, were treated by sector mastectomy and postoperative radiotherapy. Fourteen subsequently required simple mastectomy for local recurrence. The 5-year survival rate was 71 per cent; the 10-year rate 50 per cent. The cosmetic result was good in the majority of cases.