Emotional response to intravenous delta9tetrahydrocannabinol during oral surgery

The administration of delta9THC intravenously as a premedicant to oral surgery resulted in acute pronounced elevations in anxiety states, a predominance of dysphoria over euphoria, and varying degrees of psychotic-like paranoiac thought. Neural effects that appeared to promote these effects included distortions of perception with sensory delusions, and heightened sensory receptiveness including antalgesic impressions of surgery; autonomic and visceral arousal greater than control or placebo levels; lack of overt behavioral signals of distress due to depersonalization; and time disintegration leading to fear-inducing misinformation about real surgical events. Introverted subjects who generally were inclined to rely on drug solutions to their problems tended to respond poorly to surgical pain and anxiety with delta9THC. These results, obtained from subjects considered to have levels of presurgical apprehension that were average or below average, suggest that the environment in which high doses of cannabinols are experienced is a potent factor in determining the quality of the emotional response. A surgical environment containing even the mild stress of outpatient oral surgery appears to have the potential to precipitate undesirable emotional responses among cannabinol-intoxicated patients. There is continued high-level social use of cannabinols inour society, with an estimate of 40% to 55% among the college-age group seen frequently by oral surgeons. Results of this study suggest that clinicians should be prepared to detect the subtle signs of marijuana intoxication to protect their patients from further psychophysiologic complications during surgery.

A device to measure roentgenographic structures

A simple device and a nomogram are presented to permit rapid, accurate measurement of structures shown on roentgenograms. The arrangement is designed specifically for measurement of coronary vessels, but it can be adapted to other structures.

Regional myocardial blood flow measurements before and after coronary bypass surgery. A preliminary report

Myocardial blood flow in 16 patients before and after coronary bypass surgery in conjunction with coronary angiography, left ventricular function measurement, and graded exercise test. Radioactive 133-Xe was injected into the coronary artery or bypass graft and the washout was recorded by an Anger camera. Myocardial blood flow increased in 11 out of 14 patients and decreased in three patients. The average flow was 55 (plus or minus 6) preoperatively and 96 (plus or minus 10) ml 100 g/min postoperatively. Increase of blood flow occurred in both the bypassed left anterior descending coronary artery (LAD) region and the nonbypassed left circumflex coronary artery (LCIR) region. The postoperative flow increase and the absolute postoperative flow values are higher with saphenous vein than with mammary artery grafts. Statistically significant correlation is not found between myocardial blood flow changes and exerice tolerance. The volume measurements (end diastolic volume, stroke volume, ejection fraction) remained unchanged.

Current results from treatment of bladder tumors with total cystectomy at roswell park memorial institute

Results of our recent cystectomy series revealed good survival for patients with superficial bladder tumors. The morbidity rate was low, 8.6 per cent. Our series showed a statistically significant postoperative morbidity rate in a high risk patient group, then justifying preoperative selection of patients as condidates for this major operation. However, we believe that despite relatively good results in reducing the morbitidy and mortality rates and improvement in survival, the over-all results in treatment of bladder tumors with operation alone are still unsatisfactory and there is an urgent need to develop and to investigate new and combined modalities of treatment.

Regional Myocardial Blood Flow Measurement in the Evaluation of Patients with Coronary Artery Disease

Myocardial imaging with 133-Xe and a gamma camera was employed to evaluate total and regional myocardial blood flow. The technique detected vasodilatation after injection of papaverine or diatrizoate. Contrast medium caused transient vasodilatation with return to baseline flow within five minutes. Myocardial tissue flow tended to decrease as coronary artery stenosis became more severe. There was overlap of flow measurements in patients with and without coronary artery disease. Coronary flow measurements made at rest are not considered to be an essential clinical tool. gpreater diagnostic benefit is obtained from the scintigram which distinguishes between akinesia caused by ischemia and akinesia due to extensive scarring.

The evaluation of high-speed screen-film combinations in angiography

Various high-speed screen-film combinations were evaluated to compare increase in speed, loss of resolution, and increase in radiographic mottle. Results indicate that the rare-earth film-screen system is the fastest and has a higher x-ray absorption efficiency. The Kodax X-Omatic screen has the greater resolving power but is slower than the high-speed calcium tungstate system. A smaller focal spot can be used with the fast speed of the rare-earth system to increase resolution.

Renal adaptation to a high potassium intake. The role of hydrogen ion

The influence on urinary acidification of prolonged ingestion of a high potassium diet was explored in normal men and dogs. In men, the response to acute ingestion of ammonium chloride was assessed in a paired fashion after 5 days of ingesting a formula diet of normal or high potassium content; whereas in animals chronically ingesting a small amount of hydrochloric acid, the response to an increase in daily potassium intake was assessed. Urine pH was lower in the potassium-loaded state with both these models, and the effect persisted in the dog studies as long as a high potassium intake was continued. The decrease in urine pH could not be accounted for by changes in plasma acid-base status, net acid excretion, rate of urine flow, urine ionic strength, or fixed buffer excretion, i.e., phosphate, creatinine, or organic acids. Studies of men with administration of exogenous aldosterone and studies of adrenalectomized dogs with constant, maintenance steroid replacement indicated that the decrease in urine pH does not result from altered aldosterone secretion.In the human studies the largest decreases in urine pH were associated with a concomitant diminution in both ammonium and net acid excretion, suggesting a primary decrease of ammonia diffusion into the urine. These events during potassium loading, which are the mirror image of changes during potassium depletion, suggest that the relation between potassium, urine acidification, and ammonia metabolism may play an important role in the maintenance of hydrogen ion and possibly potassium homeostasis during alterations in potassium intake.

Acute ileostomy diarrhoea with incipient renal failure due to fish tapeworm infestation

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Determination of Urinary Formaldehyde Following Administration of Methenamine Salts

Earlier studies on formaldehyde determination in the urine of subjects receiving methenamine salts have given questionable results. A modification of the Tannenbaum and Bricker procedure was utilized to evaluate formaldehyde production from 3 methenamine salts and methenamine base. Formaldehyde production was studied in vitro and in vivo.