Quadriceps atrophy in the anterior cruciate insufficient knee

Atrophy of the quadriceps musculature is frequently associated with chronic knee instability. This atrophy may persist despite the patient's ability to return to athletic competition. When open biopsies of the quadriceps muscle from unstable knees were compared with those from normal acutely injured knees, it was found that clinical evidence of atrophy correlated with a relative decrease in the size of Type II or fast twitch muscle fibers. This supports the subjective, clinical impression that the unstable knee is less effective in explosive push-off. The findings also indicate the necessity of including exercise specific for the training of Type II fast twitch fibers in any program designed to rehabilitate the injured knee.

Low antibody response in infants with measles and children with subclinical measles virus infection

During a measles epidemic (December 1979-March 1980) in two adjacent villages in Tamil Nadu, 78 of 143 under-fives were affected, eight of whom died, giving an attack rate of 54% and case-fatality rate of 10%. Seven months later 72 children (41 with measles, seven with history of measles in prior epidemics and 24 with no history of measles) were bled to measure measles virus haemagglutination-inhibition antibody. Of the 48 with measles history, 46 had measurable antibody. Surprisingly, of the 24 without a history, 16 had measurable antibody indicating the frequency of subclinical measles during epidemics. The geometric mean antibody titre was lower in infants with measles than in older children (P less than 0.05). The mean titre was lower in those with subclinical measles than in those with clinical measles (P less than 0.01).

Improved diagnosis of unilateral renal artery lesions after captopril administration

Captopril was administered (1 mg/kg of body weight) to 37 unselected hypertensive patients undergoing bilateral renal vein catheterization to determine its safety and efficacy in diagnosing hypertension related to unilateral renal artery lesions. In the 18 patients who had a unilateral renal artery lesion demonstrated by angiography, the ratio of plasma renin activity of the involved to uninvolved renal vein rose significantly after administration of captopril, whether or not patients were taking antihypertensive medication. This postcaptopril ratio differentiated cases of unilateral lesions from cases of bilateral lesions or absence of lesions without any overlap. The test was well tolerated despite occasional large drops in blood pressure. These data show that converting enzyme inhibition increases the diagnostic accuracy of renal vein catheterization by increasing the difference between the amount of plasma renin secreted by the two kidneys in cases of unilateral renal artery lesions.

Antibody response to measles immunization in India

Antibody response to measles vaccine was measured in 238 subjects aged 6-15 months. Seroconversion rates ranged from 74% at 6 months of age to 100% at 13-15 months; the differences in age-specific rates were not statistically significant. The postimmunization antibody titres increased with increasing age of the vaccinee. Seroconversion rates and antibody titres in 49 subjects with grades I and II malnutrition were not significantly different from those in the 189 normal subjects.These results support the recommendation of 9 months as a satisfactory age for commencement of measles immunization in India. However, the highest antibody levels and seroconversion rates were obtained in children over 12 months of age.

Exclusive breast feeding versus supplementation: a prospective study in a rural south Indian community

In a non-interventional, prospective study in three south Indian villages, exclusively breast-fed infants were compared with those given supplements in addition to breast milk. The supplements provided less than 30% of caloric requirement in most cases. Both groups grew similarly and the growth curves showed a sharp fall after the third month. Whether this fall is physiological, or a result of poor socio-economic conditions is not clear.

In vitro antibacterial activity of concentrated polyethylene glycol 400 solutions

It was found that concentrated polyethylene glycol 400 (PEG 400) solutions have significant antibacterial activity against various pathogenic bacteria, including Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus. This effect might be attributed to two effects: lowering of water activity and, superimposed on this, the specific action of PEG-400 molecules on bacterial cells. Phase-contrast microscopic observations of cells placed in contact with PEG 400 revealed clumping and morphological changes of bacterial cells. The larger changes in appearance were evidenced by the species which were more rapidly killed by PEG 400. The results obtained suggested that concentrated PEG 400 solutions may have a potential value in medicine as a topical antibacterial agent. The feasibility of this application is the subject of present investigation.

Assessment of gall-bladder storage function in man

1. We have validated a scintiscanning method for measuring fasting-state gall-bladder (GB) filling in man. 99mTc-labelled diethyl phenylcarbamoylmethyliminodiacetate (Tc-HIDA) was given intravenously, and 90 min later GB and gut activity were measured by using two isosensitive rectilinear scanning heads (anterior and posterior). Studies with a phantom GB in vitro, and studies in man in vivo, showed that the maximum error due to differences in isotope depth was 8%, compared with 300% when only one head was used.

2. By combining this technique with measurement of biliary lipid concentrations of fasting-state GB bile obtained by nasoduodenal intubation and intravenous cholecystokinin infusion, we were able to measure for the first time the total mass of all three biliary lipids in the GB. GB bile samples obtained in this way were divided into three consecutive portions of equal size in order to assess GB mixing. Bile acid pool size was also measured by isotope dilution.

3. We studied 12 healthy non-obese men. Fasting-state GB filling over 90 min (mean ± sem) was 54 ±8%. Biliary lipid mass in GB was 4.9 ±0.5 mmol for bile acids (67 ± 5% of the total bile acid pool), 1.6 ±0.2 mmol for phospholipid and 0.5 ± 0.1 mmol for cholesterol. The three consecutive portions of fasting GB bile gave values of 1.05 ± 0.07, 1.05 ± 0.06 and 1.03 ±0.10 for cholesterol saturation index (SI) and 6.6 ±1.1, 7.4 ± 1.6 and 6.5 ± 1.0 for Tc-HIDA c.p.m. × 1000 per mmol of bile acids.

4. The SI of fasting-state GB bile was significantly correlated with fasting-state GB filling (r = 0.63; P < 0.05). It was also correlated with cholesterol mass in GB (r = 0.64; P < 0.05), but not with bile acid and phospholipid mass.

5. We conclude that: (a) valid measurements of GB filling can be made in man by a simple scintiscanning technique employing 99mTc-HIDA as a biliary marker; (b) biliary lipid mass can also be measured if GB bile is obtained; (c) SI in health is in part determined by the degree of fasting-state GB filling, and in part by cholesterol mass in GB; (d) fasting-state GB content is well mixed in health.

In vitro study of bacterial growth inhibition in concentrated sugar solutions: microbiological basis for the use of sugar in treating infected wounds

The use of sugar for the treatment of infected wounds was investigated in in vitro experiments with bacteria pathogenic to humans, such as Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Staphylococcus aureus. Studies showed that solutions of appropriate sugar concentration incubated at pH 7.0 and 35 degrees C were lethal to the bacterial species studied. On the basis of these results, it is proposed that an important function of sugar in the treatment of infected wounds is to create an environment of low water activity (aw), which inhibits or stresses bacterial growth.

A complex rearrangement involving three autosomes in a phenotypically normal male presenting with sterility

This paper reports a rearrangement involving three autosomes: 11, 12, and 21. The translocation carrier, a 31-year-old azoospermic male, is phenotypically normal.

Cytogenetic investigations in 150 cases with complaints of sterility or primary amenorrhea

Cytogenetic investigations were carried out on 150 individuals. Out of these 107 were females and 43 males. Eighty seven of the above (43 males and 44 females) had been referred for sterility. Sixty three patients had primary amenorrhea and had been referred directly to this laboratory by clinicians, having been suspected of genetic abnormalities. Twenty-two cases (14.7%) involved in this study chromosomal abnormalities and seven cases (4.7%) showed chromosomal polymorphism. Of the 107 females (44 sterile and 63 with primary amenorrhea), 11 (10.2%) showed numerical or structural sex chromosomal abnormalities. Five patients (4.67%) showed chromosomal polymorphism (involving the paracentromeric and centromeric regions of chromosomes 1 and 9, double satellites, and giant satellites. Of the 43 males, 11 (25.59%) showed numerical and structural abnormalities. Ten cases were anomalies involving the sex chromosomes. One case of a triple autosomal translocation in an otherwise phenotypically normal azoospermic male was of particular interest. Two cases (4.65%) showed double satellites of the acrocentrics.

Determining populations at risk for developing anorexia nervosa based on selection of college major

The prevalence of symptoms of anorexia nervosa among students majoring in the areas of dance, drama, physical education, and English was determined by using the Eating Attitudes Test (EAT). It was hypothesized that female students who might be prone to develop anorexia nervosa as indicated by anorectic symptoms on the EAT would concentrate in areas of study emphasizing exercise and body image. Results indicate the prevalence of anorectic symptoms among the dance and drama majors to be significantly higher than in the English and physical education groups. These findings are compatible with the belief that individuals at risk for developing anorexia nervosa will gravitate toward areas of culture where there is increased focus on body image but not on physical exercise.

Immunosuppressive treatment of idiopathic thrombocytopenic purpura in children

Eleven children with symptomatic idiopathic thrombocytopenia were treated with immunosuppressive agents. Ten children received cyclophosphamide; 1 was given azathioprine. Only 1 child produced a full response, and 6 subsequently needed splenectomy which was curative. It is concluded that immunosuppressive treatment is ineffective in childhood thrombocytopenia and that splenectomy remains the treatment of choice for the rare case which fails to settle spontaneously or respond to corticosteroids.

Bilateral cavernous sinus metastasis and ophthalmoplegia. Case report

✓ A 59-year-old man developed bilateral total ophthalmoplegia with trigeminal hypesthesia immediately after the placement of burr holes for drainage of a subdural hematoma. Metastatic lung carcinoma to both cavernous sinuses was suspected, eventually proven, and confirmed postmortem.

School-survey in a rural leprosy endemic area

In the Kaniyambadi Panchayat Union area of known leprosy endemic population this study was undertaken. Out of 10,163 students examined, a total of 137 leprosy cases were detected--122 cases (89.1%) belonged to Tuberculoid type and the rest 15 cases (10.9%) belonged to Borderline leprosy. There were no cases of Lepromatous type, and none of them had any deformity. 86.1% had single lesion and the rest multiple lesions. Study of the distribution of patches over the body surface did not reveal any significant difference between covered and uncovered parts of the body.