Sodium acetate buffer: a diluent of choice in the clot lysis time technique

Sodium acetate buffer, 0.12 M, pH 7.4 as a diluent in the low temperature technique of dilute clot lysis time, is more effective in accelerating the velocity of lysis than phosphate buffer of similar pH and molarity. A uniform shape of the clot is maintained throughout the digestion in sodium acetate buffer and the end point of lysis is characteristically marked by an abrupt and sharply defined disintegration. Sodium acetate buffer can be employed advantageously in this technique not only to improve the observation but also to shorten the lysis times.

Fibrinolytic activity at high altitude and sodium acetate buffer

At high altitude there is a tendency for fibrinolytic activity to be enhanced depending, perhaps, on the duration of exposure and this seems to be a protective mechanism against the development of high altitude pulmonary oedema which is associated with diminished fibrinolytic activity. The fibrinolytic response at high altitude seems to be fluctuated during the process of acclimatisation though being maintained at a plateau higher than that in the plains. It apparently results from hypoxic stress but more likely reflects the physiological response to the hypercoagulable state at high altitude. As clot lysis times in high altitude pulmonary oedema are unusually prolonged an attempt at shortening their observation in the test system is desirable. Sodium acetate, 0.12 M solution with pH 7.4 as a diluent in the low temperature technique of dilute clot lysis time is potentially effective to accelerate the lysis time by approximately 33% compared to phosphate buffer solution of similar pH and molarity. Also the end point of disintegration of clot is more abrupt and sharply defined. Sodium acetate buffer can advantageously replace phosphate buffer as a diluent in this technique.

The Photo-addition of Naphthalene and Acrylonitrile. An X-ray and Nuclear Magnetic Resonance Study of the Cycloadducts

The photoaddition of naphthalene and acrylonitrile has been reinvestigated. It was found that the cyclobutane adduct described previously is endo-7-cyano-2,3-benzobicyclo[4.2.0]-octa-2,4-diene (7), and not the exo-8-cyano compound. The structure was determined from an X-ray diffraction study on the p-bromophenylurethane of the carbinol derived from the cyano-compound. The structural details are described. The crystallographic data are a = 13.85(1), b = 7.976(2), c = 12.752(4) Å, α = 90.80(3), β = 87.02(6), γ = 90.99(5)° space group [Formula: see text], Z = 2 units of C20H18O2NBr. The least-squares residual R was 0.085 for 651 X-ray reflections measured on a Syntex P1 diffractometer using graphite-monochromatized Mo radiation. The methine proton resonances in the 220 MHz n.m.r. spectrum of 7 were resolved using pyridine solvent, and the coupling constants are consistent with the structure and geometry, as derived from the X-ray work. A small fraction (7%) of 8-cyano-2,3-benzo-bicyclo[4.2.0.]octa-2,4-diene was also formed. This is tentatively assigned as the endo isomer, and on base treatment it isomerizes to a new compound, identified as the exo isomer. In contrast, the major cycloadduct 7 is recovered unchanged from base treatment. The folded geometry of the four-membered ring in these adducts apparently determines the stabilities of the epimers, and the proton–proton vicinal coupling constants.

Corticosteroid-sparing effect of -adrenergic blocking agents in pemphigus vulgaris

Beta-adrenergic blocking agents have a significant corticosteroid-sparing effect in the treatment of pemphigus vulgaris. In 18 patients, observations over a period of 8-27 months have shown that, in terms of percentage of the maintenance dose of betamethasone when administered alone, the corticosteroid-sparing effect of propranolol 120 mg was 33.3–83.3% in 17 patients and 100% in 1 patient. It is postulated that propranolol affects the vasodilator fibres as a result of which the influx of plasma in blisterformation is prevented or minimised.

Extent of possible rehabilitation of service personnel with ischaemic heart disease

Sixty unselected survivors from ischaemic heart disease, all male service personnel, were treated, within 1 to 6 months of recovery from the acute episode, by promotion of physical activity, correction of coronary risk factors, and routine use of nicoumalone and prenylamine lactate. The results showed that this approach was conducive to more rewarding rehabilitation than was obtained in 89 patients who, in the past, were on conventional treatment based on advice regarding weight, diet, and physical and mental activity. Thus within 1 to 30 months of treatment by this approach, out of 60 patients, 12 were fit for medical category A active service duties in operational areas in any part of the world in any terrain, including altitudes between 10,000 and 18,000 feet, 30 were fit for medical category B service duties in non-operational communication zones in any part of the world including altitudes below 10,000 feet, and 17 were fit for medical category C sedentary duties in non-operational areas in India only. One patient, who initially recovered from congestive heart failure, died while in a state of temporary unfitness for service. No patient was released from service on account of ischaemic heart disease. Against this, by the conventional approach, out of 89 patients, 81 were fit for medical category C sedentary duties in non-operational areas in India only, 4 were released from service, and 4 died.

Effect of frusemide on pulmonary blood volume

Intracardiac frusemide given to seven patients recovering from high-altitude pulmonary oedema caused a significant reduction in the pulmonary blood volume before the onset of diuresis. This supports the suggestion that the mobilization of fluid from the pulmonary circuit is responsible for the relief of symptoms in some patients with pulmonary oedema even when a diuresis does not occur.