Acute cholangitis in Singapore

115 cases of acute calculous cholangitis were analysed for their presentations, treatment and complications. There were slightly more Chinese males than females (1.4:1) and the mean age was 62 years old. Though pain was the commonest symptom (95.7%), only 35.7% of patients had complete Charcot's triad. 21.7% presented in septicaemic shock. E. Coli and Klebsiella were the commonest organisms isolated. All patients had cholecystectomy and exploration of common bile ducts. Twenty patients had additional choledochontrostomy performed. 50.4% of patients developed complications and the overall mortality was 16.5%. Patients over 60 presented in shock carried a significantly higher mortality (40%).

Allergy in the Mediterranean area. III: Cross reactivity among Oleaceae pollens

Pollens of closely related species often share common antigens and allergens although this is not always the case. Four species of Oleaceae pollens commonly found in the Mediterranean area were investigated for cross-reactivity: olive (Olea europaea), ash (Fraxinus exselsior), privet (Ligustrum vulgare) and Phillyrea angustifolia, a common bush. Twenty individual sera of patients allergic to Oleaceae were investigated for specific IgE antibodies against the four species of Oleaceae pollens. The results indicated a high degree of correlation between RAST titres of Oleaceae pollens but three gave a particular emphasis on one species only. Cross-reactivity among these four pollen species was sought by means of RAST inhibition, iso-electric focusing and tandem cross-immunoelectrophoresis. All tests revealed a high degree of cross reactivity although there is no total identity among these four pollen species.

Cardiac electrophysiologic effects of pancuronium

A microelectrode examination of guinea pig left ventricular papillary muscle was performed to determine whether there was a direct effect of pancuronium on cardiac cells and, if so, to attempt to ascertain the mechanism of this effect. Electrical events were measured before and during superfusion with pancuronium, epinephrine, propranolol, and verapamil; alone and in various combinations. Pancuronium prolonged the duration of the action potential (AP); increased resting potential (Em), AP magnitude, and rate of rise of the AP (dV/dt); and resulted in spontaneity in 12% of the muscles. Epinephrine and pancuronium combined caused spontaneity in 80% of the muscles and oscillatory behavior. Additionally, this combination decreased AP magnitude, Em, and dV/dt in several preparations--a pattern of response similar to that seen in ouabain-treated myocardial cells under the influence of catecholamines. These changes were always reversed by verapamil or by perfusion with a drug-free medium, and were usually reversed by propranolol. The data suggest a combined pancuronium/epinephrine induced increase in cardiac membrane permeability to Ca2+.

Tumoral calcinosis--a case report

Tumoral Calcinosis is a well established but rare clinical entity. It was first described in 1899, and since then, scattered reports have occurred in the literature from many parts of the world. The main controversy lies in the aetiology of the condition. One such case is presented in this paper, along with a review of the literature.

Rehabilitation of newly reconstructed thumb

This paper documents the rehabilitation of newly reconstructed thumb using five different techniques of creating a new thumb. We have attempted to assess the functional usefulness that each method offers to the recipient hand.

Ceruloplasmin elevation and synthesis in rats with transplantable tumors

In rats with transplantable mammary or hepatic tumors, plasma ceruloplasmin oxidase activity was increased 50--200%. This occurred progressively with tumors weighing 0.3% of body weight of more, and did not occur upon sham operation or implantation of normal tissue. Incorporation of [3H]-leucine indicated a specific enhancement of ceruloplasmin synthesis in the tumor-bearing rats, and a greater state of activation of the enzyme was also observed. The mechanism of the increase in ceruloplasmin levels in rats and humans with cancer thus appears to involve increased synthesis and activation of the enzyme.

Aging changes in CD-1 HaM/ICR mice reared under standard laboratory conditions

Three hundred CD-1 HaM/ICR mice were observed for 2 years, and useful necropsies were done on 99 males and 102 females. Mortality was 50% at 16 months in the males and 18 months in the females. Among mice that came to autopsy, total tumor incidence was 54% for males and 75% for females, with most neoplasms occurring after 18 months. Adenomas or adenocarcinomas of the lung were the most frequent, followed by lymphoreticular tumors, vascular tumors, hepatomas, subcutaneous fibrosarcomas, and adenocarcinomas of the mammary glands. Some degree of amyloidosis was seen in half the mice of both sexes, beginning at 8 months in males and 12 months in females. Variability in tumor incidence among small groups if mice emphasized the need for adequate samples.

Plaque formation and implantation of Odontomyces viscosus in hamsters fed different carbohydrates

A sucrose diet supported implantation of Odontomyces viscosus and a caries-inducing streptococcus in albino hamsters. Caries and periodontal disease occurred simultaneously when both types of bacteria were implanted. Odontomyces, but not the streptococcus, became implanted in albino hamsters on a starch diet. Glucose and fructose diets also supported implantation of odontomyces and development of periodontal disease in golden hamsters. Caries development was minimal.

Levan formation by Odontomyces viscosus

The authors present some physiological parameters involved in levan formation by Odontomyces viscosus, a filamentous organism in gingival plaque of the hamster.