A comparative study of salivary secretion by parotid and mandibular glands of anaesthetized Capra hircus: effect of pilocarpine

A study was made of basal secretion and the effect of the infusion of pilocarpine on the flow and composition of saliva in the parotid and mandibular glands of the anaesthetized lactating goat. In the parotid gland there was a basal flow (1.6 +/- 0.29 microliter/min) which was not present in the mandibular gland. There is a statistically significant dose-effect relationship between pilocarpine and salivary flow in both glands. Salival composition and its variation with respect to the flow of saliva did not conform to either of the two glands to an exclusive monogastric or ruminant model.

Urologic complications after surgery on lumbosacral spine

Forty-five of 74 patients (60%) postsurgery for disk disease showed findings of neurogenic bladders. Sixty-nine of these patients had no complaints before surgery and presented with complaints only after surgery. We believe this is a high surgical morbidity, and all patients should have a presurgical urodynamic diagnostic evaluation to aid in selection of patients in whom surgery will be most helpful and to establish a presurgical baseline for further postsurgical urodynamic comparison.

Effect of sympathetic stimulation on salivary secretion in submandibular gland in the rabbit stimulated by pilocarpine

The sympathetic stimulation under slow pilocarpine-induced flow conditions brought about a decrease in this flow rate that could be due to vasoconstriction, since such an effect was not observed after the administration of phentolamine (4 mg/kg i.v.). Contrariwise the injection of a beta-adrenergic blocking agent (propranolol 2-2.5 mg/kg i.v.) produced a decrease of the salivary flow rate that was even greater than in the control animals. These results suggest that the secretory effect in this gland and species is predominantly beta-adrenergic. The stated results are related to the changes observed in the blood outflow from the gland.

Role of alpha and beta adrenoceptors on the salivary secretion in the mandibular gland of the rabbit

The stimulation of the superior cervical ganglion increased the salivary flow rate (about five-fold) in all 35 rabbits studied but two. The administration of alpha or beta adrenoceptor blocking drugs was unable to eliminate the positive effect of the sympathetic stimulation on the salivary flow, though the flow rate fell about 50% with the administration of each of the blockers. According to these results both types of receptors may be involved in the secretory response of this gland. Nevertheless it seems that the beta-adrenoceptors play a more important role in the secretory response and the alpha-adrenoceptors in the motor one.

[Segmental analysis of the movement of the posterior mitral valve in mitral stenosis]

We have analyzed independently, both, early diastolic and end diastolic (A wave) movements of the posterior mitral leaflet in 302 cases of mitral stenosis with sinus rhythm, as well as in a control group of 100 subjects without mitral stenosis. Studied patients were separated into two groups: 275 that were not treated surgically, and 27 studied after mitral commisurotomy. We described 4 patterns of posterior mitral leaflet early diastolic movement, and 3 patterns of A wave motion. Only those patterns that showed anterior drift of the studied segment of the posterior mitral leaflet, were considered diagnostic of mitral stenosis. The sensitivity found was 49% for the anterior early diastolic movement; 89,5% for the anterior A wave, and 95,3% for both signs considered together. The specificity was 99% for anterior A wave, with a predictive value of 99,6%. When surgical and non surgical groups were compared, the absence of anterior drift in early diastole in the former group, showed to have statistical significance when the Chi square test was employed, while A wave pattern (anterior drift) did not show any difference between both groups. It is concluded that the most sensitive and specific sign for M-mode echocardiagraphic diagnosis of mitral stenosis in patients with sinus rhythm is the anterior drift of posterior mitral leaflet's A wave.

Hip fractures in patients with Parkinson's syndrome

Hip fractures in patients with Parkinson's syndrome present a continuing challenge to orthopaedic surgeons. Sixty-two consecutive such patients have been reviewed. With or without operation, there was very high rate of mortality (31%) and complications. However, the functional results, the ability to walk, progression of the disability, and the quality of life were significantly better after operation. The results suggest that operation is the preferable solution for these patients. They require, however, much more particular care than other patients with hip fractures. This includes adequate adjusted antiparkinson medication, appropriate anesthesia with special attention to adequate ventilation and postoperative analgesia, more intensive respiratory and functional physiotherapy, very meticulous nursing care, and a relatively extended period of preventive antibiotics.

[Comparative study of different serological tests for the diagnosis of brucellosis (author's transl)]

The diagnosis of brucellosis is frequently a difficult one, and it is founded basically on the results of blood cultures and serological tests. Wright's classical agglutination test is commonly utilized in the serological diagnosis of brucellosis and its value is well established in the acute forms of the disease; for the diagnosis of subacute or chronic forms, however, a Coombs test must be performed to show incomplete antibodies. The agglutination carried out with serum treated with 2-mercaptoethanol allows the determination of the type of immunoglobulins present. Indirect immunofluorescence has been infrequently utilized in the diagnosis of brucellosis. The first three tests have been compared with indirect immunofluorescence using sera from 100 patients presenting with fever of unknown origin. All tests were negative in 40 sera, and of the 60 remaining sera only 32 were positive to all four tests. The highest titers were found with the Coombs test, while immunofluorescence yielded titers which were never above 1/320. Significant correlation coefficients were obtained between the tests. The best correlation was obtained between immunofluorescence and 2-mercaptoethanol, followed by immunofluorescence and Coombs, and by immunofluorescence and agglutination. Only immunofluorescence titers above 1/80 corresponded to the same of superior titers in the remaining tests; thus immunofluorescence titers below 1/80 can not be considered as diagnostic of the disease. The authors believe that immunofluorescence to 1/80 can be utilized as a quick routine test for the diagnosis of brucellosis, its disadvantages being a high cost and the requirement for an immunofluorescence microscope which may not be available in many laboratories.

A heat stable paraoxonase (O,O-diethyl O-p-nitrophenyl phosphate O-p-nitrophenyl hydrolase) from Russell's viper venom

Fractionation of Russell's viper venom revealed separate phosphohydrolase activities directed against p-nitrophenyl phosphate, bis(p-nitrophenyl) phosphate, p-nitrophenylthymidylic acid, and O,O-diethyl p-nitrophenyl phosphate (paraoxon). On gel fractionation, the first two activities are eluted ahead of the latter. They could be resolved further by phosphocellulose cation exchange chromatography. The hydrolytic activities directed against p-nitrophenylthymidylic acid hydrolyzing component is heat labile, while the paraoxon hydrolyzing component manifests an unusually high degree of heat stability. Gel filtration yields 9600 for the molecular weight of the "paraoxonase". This enzyme, as all known enzymes of this type, requires the presence of a divalent cation. Maximum activity is obtained in the presence of Ca2+. In the presence of Sr2+ the reaction rate is 50% of that of Ca2+; other divalent cations show lower activities. The presence of the enzyme is species specific. Of four species tested, only Russell's viper venom showed significant paraoxonase activity. Enzyme activity is intact following incubation with iodoacetate of p-chloromercuribenzoate. Activity is partially preserved even in the presence of 8 M urea.

Mechanical ventilators as vehicles of infection

Twenty-five patients from the intensive care unit who had been subjected to tracheostomy and require mechanical respiration were studied. Data are presented concerning the bacteriological controls performed on the tracheal exudates, various parts of the ventilators (Engström Model 200 and Bennett PR-2), and the Wright spirometer. The germs found were mainly pseudomonas, enterobacteriaceae germs and bacteria from the acinetobacter group. There was a high incidence of infection in the tracheostomies of these patients. We found a cause and effect relationship between the contaminating bacteria isolated from the cannula and the bacteria isolated from the tracheal exudates in the case of pseudomonas aeruginosa. However, this was not found to be the case where enterobacteriaceae were concerned. Acinetobacter calcoaceticus were isolated almost exclusively in the ventilators. The study calls attention to the need for rigorous disinfection of ventilators to prevent hospital cross infections.