Smoking--the effects on cerebral vascular circulation. A variable in patient decision making

Stroke, caused by either infartion or subarachnoid haemorrhage, can have devastating and debilitating effect on its victims. Traditional therapy has focused on the risk factors of hypertension, hyperlipidemia, atherosclerotic heart disease and diabetes milletus. More recently, the literature has focused on smoking and the short and long term effects of cerebral blood flow. The purpose of this paper will be to review the most recent research literature on both the chronic and acute effects of smoking on the cerebral vascular system. More specifically, there will be an examination of the effect of smoking on the outcome of a carotid endarterectomy, subarachnoid haemorrhage and the progression of atherosclerosis. Smoking is harmful and its cumulative effects, along with additive effects must be recognized. Despite increased risk, people continue to smoke affecting disease progression and treatment. Two models will be discussed--the health belief model and the health decision model. These models can provide a basis for nursing to develop and assess comprehensive smoking cessation programmes.

First report of the Australian Corneal Graft Registry

In the Australian Corneal Graft Registry's first 18 months of operation, May 1985 to November 1986, data supplied by 53 surgeons relating to 322 graft recipients have been entered and analysed with respect to: the most common presenting diseases (primarily keratoconus, bullous keratopathy and corneal opacities), risk factors (especially prior sensitisation to HLA antigens, corneal vascularisation, past or present anterior segment inflammation and history of raised intraocular pressure [IOP]), donor and recipient sex, cause of donor death, storage procedures for donor eyes, operative procedures accompanying the grafts themselves, and preliminary indications of overall graft survival by actuarial analysis. It is hoped that the establishment of this Registry will not only reinforce the use of actuarial graft survival analysis as the method of choice for transplantation surgeons wishing to monitor the survival of their patients and grafts, but will also provide a useful service for the Australian ophthalmic community in general.

Characteristics of schizophrenic patients and the outcome of fluphenazine and of electroconvulsive treatments

We examined the outcome with fluphenazine treatment and ECT in a group of 120 patients according to the incidence of psychopathological symptoms, the patients' status on a variety of sociodemographic and anamnestic variables, and their diagnoses according to 13 systems for diagnosing schizophrenia. All had previously been considered to be schizophrenic patients at least once in hospital settings. The outcome with fluphenazine was better in patients with passivity feelings, auditory hallucinations and other hallucinations and delusions. The outcome with patients who had ECT, as judged from the hospital files, was better in those who were preoccupied with delusions or hallucinations and less successful in those who had been diagnosed as having schizophrenia on the first previous occasion when they had been discharged from the hospital.

Sorption studies of heavy metal ions on a novel chelating resin and its application in the stripping of mercury (II)

A chelating resin containing a stable thiol group was synthesised, using polystyrene as the starting material. The resin is stable towards conc. HCl, 0.1M HNO(3) and 0.1M NaOH. The resin shows affinity towards Ag(+), Hg(2+), Bi(3+), Pb(2+), Cu(2+), Zn(2+) and Cd(2+). Extraction of these metal ions as a function of pH, kinetics of exchange and breakthrough capacities is evaluated. The selectivity of the resin for the metal ions is in the order Ag(+) > Hg2+ > Cu2+ > Pb2+ > Cd2+ > Zn2+. The equilibrium constants for exchange and kinetics of exchange are favourable for the recovery of mercury from lean sources. Application of the resin in the stripping of mercury from chlor-alkali plant affluent, and in the enrichment of mercury from seawater, have been investigated. Mercury sorbed resin can be regenerated using 5% thiourea in 0.1M HCl.

Comparison of T8+ cell-mediated suppressor and cytotoxic functions in multiple sclerosis

Patients with progressive multiple sclerosis (MS) and controls were compared with regard to: (a) in vitro pokeweed mitogen (pwm)-induced IgG secretion, as an indirect measure of T8+ cell-mediated suppressor function; (b) alloantigen-directed cytotoxic activity, a predominantly T8+ cell-mediated function. The MS group had increased IgG secretion (4790 +/- 372 ng/ml vs. 1866 +/- 233 ng/ml, P less than 0.001) compared to controls. In contrast, alloantigen-directed cytotoxic activity did not differ between MS and control groups. These results suggest a selective defect of suppressor cell function in MS rather than a generalized dysfunction of T8+ cells. Defective immunoregulatory control coupled with preserved effector functions may contribute to the autoimmune process, suspected to underlie the pathogenesis of MS.

Dissociation of T8+ cell-mediated cytolytic and suppressor functions in young adults

In the normal young adult population, in vitro levels of polyclonally-induced IgG secretion by mononuclear cells (MNCs) vary widely amongst individuals. Levels of IgG secretion correlate with functional suppressor activity of T8+ cells but not with their proportion within the MNCs either prior to culture, or as found in this study, at the end of the culture period. The current study also demonstrates a lack of correlation between T8+ cell-mediated suppressor (Ts) function and a second predominantly T8+ cell-mediated function, alloantigen-directed cytolytic (Tc) activity. Whether this dissociation between Ts and Tc functions reflects quantitative differences in subsets contained within the T8+ population or qualitative differences in the mechanisms required for induction or generation of Ts and Tc remains to be established.

Motility of the human ureter, with special reference to the effect of indomethacin

Ureteral motility was studied in isolated preparations obtained from 19 patients at surgery. Contraction was monitored in an organ bath and contraction recorded isometrically. In all but one patient rhythmic activity with a frequency of 2.0 +/- 0.3 contractions/min was recorded. In 6 patients contractions had to be elicited by stimulation with prostaglandin E2 or F2 alpha. In the remaining cases motility started spontaneously within 30 min. In patients with bilharzia nephropathy various pathological types of contraction were recorded. Motility was dose-dependently inhibited with indomethacin.

Intramammary arterial calcifications associated with diabetes

Arterial calcification was seen on the mammograms of 37 of 319 patients. Twenty-eight patients were known diabetics, while 7 had an abnormal fasting blood sugar level or glucosuria but were not being treated for diabetes. Eighteen (51%) of the 35 diabetic and borderline diabetic patients had breast arterial calcification, compared to only 19 (6.7%) of the 284 nondiabetics (p greater than 0.01). These findings suggest that arterial calcification on mammograms may be a sign of co-existing diabetes.