Adenocarcinoma of the gallbladder: chromosome abnormalities in a genetic form of cancer

Chromosome studies on gallbladder adenocarcinoma in a Papago Indian woman were performed. These studies revealed a high degree of aneuploidy including multiple instances of missing chromosomes, extra chromosomes, and chromosome rearrangements. Double minute chromosomes and homogeneous staining regions on chromosomes were present in the cancer cells. To our knowledge this is the first report on the cytogenetic analysis of a gallbladder cancer. Chromosome studies on gallbladder cancers will be of unusual interest because of the relatively high frequency of this rare genetic form of cancer in American Indians.

Maternal factors associated with small-for-dateness among twins

The maternal risk factors that correlate with small-for-dateness among twins have been analyzed using a sample of 659 twins pairs and a matched sample of singletons. Non-marital status, job involvement, and the previous delivery of a low-birth weight (less than 2,500g) infant present a negative interaction with twinning, as low gestational age-adjusted birth weight does not correlate significantly with these risk factors among twin gestations, while it does among singleton gestations. On the other hand, the effects of parity, habitual maternal weight, smoking during pregnancy, and twinning are additive on gestational age-adjusted birth weight. Indeed, the decrease in adjusted birth weight associated with these risk factors is of the same magnitude among twins and singletons and is statistically significant in both cases. These findings suggest that exposure of twin pregnancies to these latter risk factors, and particularly to smoking during pregnancy, can lead to the delivery of newborns with extremely low birth weights.

[Haemophilus influenza infections in infants and mothers. Three cases (author's transl)]

The three cases reported were diagnosed at the time of contamination by direct examination and culture, at birth, of placental tissue, gastric fluid and peripheral specimens. The culture media included a chocolate agar medium favourable to the growth of H. influenzae. One of the isolates was beta-lactamase producer and therefore resistant to the group A penicillins usually prescribed. Determination of the M.I.C.s of eight antibiotics showed that cefotaxime constitutes, for the time being, a suitable alternative to penicillins against such strains. Early detection of H. influenzae perinatal infections make it possible to treat neonates before complications develop. Among the 19 cases published, there were 4 cases of meningitis, 8 cases of septicaemia and 1 case of arthritis.

[The cardiotokogram in congenital fetal cardiac abnormalities (author's transl)]

The authors have studied in retrospect 36 cardiotocographic registrations of women who had given birth to foetus affected by congenital cardiac disease. Emphasis is placed on antepartum diagnosis for appropriate postpartum management of newborns with congenital cardiac anomaly in which such diagnosis is possible.

Twinning following oral contraceptive discontinuation

The characteristics of 673 mothers of twins were compared to those of a matched sample of mothers of singletons. Both groups of mothers were interviewed just after delivery, and births in each group were matched for time and place. Of the characteristics studied, the use of oral contraceptives (OC) displayed a significant negative association with dizygotic twinning, with an estimated relative risk of 0.55 (95% confidence limits: 0.39/0.78). Among other maternal trails significantly associated with dizygotic twinning, ony age, parity and weight were possible confounders as far as the relationship between OC use and dizygotic twinning was concerned. Adjustment for these 3 characteristics left this relationship unaltered. These findings are compatible with the existence of the a direct relationship between OC use and a reduction in dizygotic twinning. Review of the available evidence concerning reproductive capacities following OC discontinuation suggests that the higher incidence of chromosomic abnormalities among spontaneous abortuses of OC users or their lower fertility could explain a reduction of dizygotic twinning rate after OC discontinuation. It is concluded that examination of te time and place variations in OC use and dizygotic twinning would help to clarify the nature of their relationship.

Post mortem changes in drug-metabolizing enzymes of rat liver and human liver

The aim of this investigation was to obtain information on the time-dependent decrease of the drug-metabolizing system in autolysing rat liver, and also in human cadaver liver. Rat liver, divided into three parts, was tested immediately after removal and 6 and 12 hrs later. Parameters investigated were: microsomal protein, cytochrome P-450, NADPH cytochrome C reductase, glucose-6-phosphatase, aminopyrine-N-demethylation and aniline-p-hydroxylation. In human liver, samples taken from 0.5 up to 3.5 hrs after death, microsomal protein cytochrome P-450, NADPH cytochrome C reductase and phospholipids were tested. Nearly all parameters based on microsomal protein decrease during autolysis, but by different amounts. Interestingly, the cytochrome P-450 content of patients with signs of shock 12 hrs before death is significantly lower than in patients without shock.

[Double-blind-study on treatment with clobetasol-17-propionate and other topical corticoids (author's transl)]

90 patients suffering from chronic skin diseases-mainly psoriasis vulgaris-were treated in a double-blind-study for two weeks with topical Clobetasol-17-propionate compared with other topical corticoids. In 81% was seen a better therapeutical effect on the Clobetasol-17-propionate treated skin area.

[Prevention of urinary tract infections with a single dose of cotrimoxazole (bactrim forte) in patients with a urinary catheter (author's transl)]

Prevention of urinary tract infections (UTT's) in female patients with postoperative indwelling catheter was investigated by applying a single dose of cotrimoxazole on the day of removal of the catheter, and the results compared to the morbidity from perioperative urinary tract infections in the years 1978-1979. Hence, it was the aim of this open study to establish whether the incidence of postoperative nosocomial UTT'S could be lowered and development of clinical symptoms prevented. Bacteriological problem and the diagnostic value of urinary sediment were also investigated. A single dose of Cotrimoxazole proved to be significantly effective in preventing or treating nosocomial UTT's. Urinary sediment in preventing or treating nosocomial UTT's. Urinary sediment is a simple, cheap and effective screening method for detecting uncomplicated urinary tract infections. However, interpretation of the sediment is doubtful if analysed in the early phase following gynaecological operations.

Hypertension management: the computer as a participant

A computerized system called ARTEMIS has been taking part in the management of a referral hypertension clinic since September 1975. From January 1, 1976 to January 1, 1979, 3,624 patients' records were set up and updated, all of them accessible on line. The mean rate of response to 17 questions with obligatory answers concerning patients' past history was 97.6 per cent. The 10 routine laboratory tests included in the initial in-hospital work-up were registered in over 92 per 100 of the 2,651 hospital records examined. Negative responses were registered with the same accuracy as positive ones, when the computerized questionnaires were appropriately drafted. Standardized collection of information insured homogeneity of the medical staff and has already made possible epidemiologic studies. ARTEMIS has detected strategical errors such as the lack of yearly programmed tests for cardiovascular risk-factors associated with hypertension. The computer has helped to achieve a high rate of patient compliance at one year (81.3 per cent), by providing patients up-dated editions of their personal summary reports as well as sending periodical letters of recall to them and to their physicians. At a total annual cost of 11 dollars per patient, the computer provides continuous information on process and outcome, for each patient and physician, and for the entire population followed up at the clinic. It facilitates physician adherence to predefined protocols and reinforces follow-up continuity by creating a communications network between the referral clinic, the patient and the general practitioner.

[A computerized medical record for the follow-up of hypertensive patients (author's transl)]

The authors present a computer system for hypertension control in a specialized department in Paris. The hypertension clinic performs the initial evaluation of the disease in ambulatory care or during a short hospitalization period. The general practitioner (GP) is mainly in charge of the long term follow-up. The objective of the system is to improve the communication between the patient, the clinic and the GP. Data are collected during each visit at the clinic. The computer is used to produce evolutive summary reports for each patient and to control the appointment system. Thus, the data processing system improves the quality of the individual follow-up and, at the same time, a medical data bank is available for epidemiological and pharmacovigilance studies.

["Serratia marcescens" in neonatology: epidemiology of a hazard (author's transl)]

A case of meningitis, caused by Serratia marcescens in a 6-day old newborn triggered a search for Serratia in the Neonatology ward. Fifteen out of 38 newborns were found fecal carriers of S. marcescens. The source of S. marcescens was found in flasks containing almond oil with 1% cetyltrimethylammonium bromide used for skin care. All strain of S. marcescens belonged to pigmented biotype A6a and serotype 014 : H10. The spread of S. marcescens was controlled by heat sterilizing and renewing twice a week the almond oil flasks. Means of control of contamination sources are discussed.

[Society of Nephrology, Computer Technology Commission. Dialysis computer program. VI. - Survival and risk factors]

The sixth report of the "Diaphane Dialyse Informatique" Program concerns 2,518 adult patients (age 15 and over) treated by chronic hemodialysis or hemofiltration in 33 French dialysis centres between June 1972 and December 1978. 1) The number of centers participating to the program is progressively increasing. Overall duration of follow-up represents 4,192 patient-years, allowing precise evolutive studies of terminal renal failure treated by hemodialysis. 2) Mean age at start of treatment continues to increase. Among 709 patients who started treatment in 1977-1978, 8,8 p. 100 of men and 11 p. 100 of women were over 69 years old. 3) Patients with diabetic nephropathy represent 4,4 p. 100 of all patients dialyzed between 1972 and 1978 and 5,9 p. 100 of the patients starting treatment in 1977-1978. 4) The percentage of patients temporarily treated by peritoneal dialysis before hemodialysis decreases from 32,9 p. 100 in 1973-1974 to 15,9 p. 100 in 1977-1978. 5) In 1978, 65,3 p. 100 of patients are dialyzed 3 times a week with a mean weekly duration of 14,0 h for male and 12,9 for female. 73 p. 100 of the patients are dialyzed during the night. 6) Disposable parallel plate hemodialyzers (71,8 per cent of dialysis sessions in 1978) and hollow fiber hemodialyzers (11,6 per cent) progressively replace disposable coil dialyzers and non disposable Kiil dialyzers. 7) Transient hypotensive episodes during dialysis sessions remain the most frequent complications (21,7 per cent of sessions in 1978). Transient hypotensive episodes are more frequently observed with coils than with parallel plate hemodialyzers or with hollow fiber dialyzers. 8) Mean diastolic blood pressure (DBP) +/- SD is 101,9 +/- 21,7 mmHg at start of dialysis and 81,4 +/- 11,8 mmHg when dialysed. During the course of treatment 28,7 per cent of the patients receive long term antihypertensive treatment. In spite of dialysis and antihypertensive treatments 11 per cent of all patients followed up maintain DBP greater than or equal to 95 mmHg. 9) Viral hepatitis remain the most prominent infectious problem with 30 per cent of patients being chronic Hbs antigen carriers. 10) Annual death rate calculated in the 2,518 patients dialyzed between 1972 and 1978 (78/1000) is 12 times superior to the death rate of the French population, adjusted for sex and age to the dialysis population. 43,1 per cent of deaths are of cardiovascular origin. Risk factors for overall mortality are age, sex (male), existence of a vascular or diabetic nephropathy, twice weekly dialysis strategy, elevation of systolic or diastolic blood pressure during the course of dialysis treatment, hypocholesterolemia and to a lesser extent hypotriglyceridemia. On the contrary, hypercholesterolemia, hypertriglyceridemia and hyperuricemia do not appear as risk factors for overall mortality or cardiovascular mortality. These results plead for a perfect control of hypertension and to the extension of thrice weekly dialysis for the whole population of patients treated by maintenance hemodialysis.

[Forceps deliveries in epidural or general anesthesia (author's transl)]

It was the aim the present study to evaluate maternal morbidity and fetal outcome of 832 pelvic outlet forceps deliveries during the years 1974 through 1977 with special reference to the method of anesthesia (Epidural anesthesia (EA) with Bupivacain 0,5% or general anesthesia (GA) with Methohexital-Na and Succinylcholin). Maternal vaginal and/or cervical injuries were seen significantly (p less than 0,001) more often in the forceps group than in spontaneous, vacuum, or breech deliveries. Vaginal injuries occurred less often (p less than 0,01) in the EA- than in the GA-group. Forceps deliveries were not associated with increased maternal morbidity in fetuses weighing 3750gr or more. The cardiotocography scores (Hammacher et al. 1974) of the 30 minutes preceeding delivery (final scores) were better with EA than with GA (p less than 0,01). Arterial cord pH and 1 minute Apgar values were similar in both groups. The same was true for fetuses with a birthweight of 3750gr or more. The time for cervical dilatation from 7 to 10 cm and duration of the second stage of labor did not influence maternal morbidity or fetal outcome, regardless of the method of anesthesia.

[Analysis of the geographical variations of twinning rate in France. An indirect approach to study spontaneous abortions (author's transl)]

The hypothesis of the existence of spatial variations of spontaneous abortion rates has two logical consequences on dizygotic twinning rates: they must be heterogeneously distributed and show a positive correlation with natality. French data available on dizygotic twinning rates from 1950 to 1974 are in agreement with both implications. Although alternative explanations are possible, these findings do reinforce the relevance of dizygotic twinning rate variations as a tool for the assessment of reproduction failures.