Two-dimensional echocardiography in cardiac tamponade occurring after cardiac surgery

Cardiac tamponade is an important complication after cardiac surgery, yet little has been published on the echocardiographic diagnosis of this situation. The two-dimensional echocardiograms of 11 patients who required surgical relief of cardiac tamponade complicating cardiac surgery were therefore reviewed. Four had nonloculated pericardial effusions surrounding both ventricles. The other seven patients had a loculated posterior pericardial effusion; in three of these the effusion altered left ventricular posterior wall contour so that it was concave toward the effusion in the long-axis view; in two, a strikingly abnormal motion of the left ventricular posterior wall was noted, such that the width of the posterior pericardial space diminished in systole and widened abruptly in early diastole. The quantity of pericardial contents (fluid, blood or clot) evacuated surgically was smaller than usually encountered in patients with tamponade due to various "medical" conditions. Thus, unlike tamponade with other pericardial effusions, tamponade after cardiac surgery is due to a pericardial effusion that is smaller in volume, often loculated posteriorly and associated with certain unique two-dimensional echocardiographic features.

Intrinsic polymorphonuclear chemotactic defect in a boy with chronic granulomatous disease

A six year old boy is described who suffured from recurrent and protracted infections of multiple organs by various catalase positive bacteria. A severe episode of osteomyelitis involving several bones was caused by Aspergillus fumigatus. Studies of his PMNs revealed impaired metabolic as well as microbicidal functions characteristic of CGD. Chemiluminescence in response to both opsonized zymosan and sodium fluoride was markedly depressed, while control PMNs showed significant responses. Control leukocytes suspended in patient's serum likewise evoked normal chemiluminescence. Microbicidal activity against staphylococcus aureus 502A was also decreased using patient's PMNs, whereas control PMNs were able to reduce the number of colony forming bacteria by 2 logs in 120 minutes. Viable intracellular bacteria after lysis of extracellular bacteria formed 3 X 10(7) colonies from patient's PMNs and less than 2 X 10(5) colonies from the control. NBT dye reduction studies of the family members suggested an x-linked recessive mode of inheritance. The extraordinary nature of this case lies in the discovery of an associated intrinsic cellular defect of chemotaxis involving his polymorphonuclear leukocytes. Specifically, the Rebuck skin window showed predominantly mononuclear cells from 4 up to 24 hours. In addition, the patient's PMNs failed to migrate in response to cultured filtrates of E. coli as the chemoattractant. This abnormality persisted in the presence of autologous plasma or serum as well as in control plasma or serum. Control PMNs showed normal chemotaxis in the presence of the patient's plasma or serum. The extent to which the rare coexistence of these two phenomena influence the clinical disease is not known and remains to be elucidated.

Food items and food groups as risk factors in a case-control study of diet and colo-rectal cancer

The contributions of food items and food groups as risk factors in a previously reported case-control study of diet and colo-rectal cancer have been analyzed. The study included 348 patients with colon cancer, 194 with rectal cancer, 542 neighbourhood controls individually matched to the cases on the basis of age and sex and a second control series of 535 surgical hospital controls frequency matched to the cases. For colon cancer, as in the previous analysis, the major risk factor was saturated fat, individual food items or groups failing to make a significant contribution to the risk. In particular there was no protective effect of dietary fibre and, for cruciferous vegetables, only a minor protective effect in females. No individual cruciferous vegetable made an important contribution to this effect. For rectal cancer, on the other hand, a significant effect of saturated fat, independent of other food items or groups, was only found for females in the highest consumption category. For males, consumption of eggs, beef and veal significantly increased risk but not consumption of pork, while for females, there was a non-significant increase in risk with consumption of eggs, no increased risk with consumption of beef or veal and a significantly increased risk with consumption of pork. There was no protective effect of dietary fibre or of cruciferous vegetables for rectal cancer, but in females, there was a significantly increased risk for consumption of beer, though this was somewhat reduced when controlled for consumption of saturated fat. There was no indication of an effect of alcohol in either sex or of beer in males. Thus, these results confirm the previous report in showing a significant effect of saturated fat in increasing risk of colon cancer but suggest a contribution of meats to risk of rectal cancer.

In vivo effect of mercuric chloride on tissue ATPases of Notopterus notopterus

Effect of sublethal concentrations, 0.088, 0.044, 0.029, 0.022 and 0.0176 mg HgCl2 per liter (1/5, 1/10, 1/15, 1/20, and 1/25 fractions of 96-h LC50) on Na+-K+, Mg2+, and total ATPase activities in brain, gills, kidney and liver of Notopterus notopterus have been studied after 30 days exposure. Na+-K+ ATPase were inhibited maximally and significantly in brain and minimally and insignificantly in liver. Mg2+ ATPase was inhibited maximally and significantly (P less than 0.01) in brain and minimally and insignificantly in kidney. The relative inhibition of total, Na+-K+ and Mg2+ ATPases for the tissues studied were brain greater than gill greater than kidney greater than liver. At the concentration (1/25 fraction) the enzyme activity returned to the normal range.

In vitro effect of mercury on tissue phosphatases of Notopterus notopterus and the role of EDTA and AA in their restoration

In vitro effects of four sublethal concentrations (0.10, 0.40, 0.80 and 1.20 micrograms) of mercury (hg) on acid, alkaline and glucose-6-phosphatases of liver, kidney and gills of Notopterus notopterus were studied. The maximum (80.76%) significant (P less than 0.001) inhibition in acid phosphatase of gills and minimum (36.66%) significant (P less than 0.05%) inhibition in alkaline phosphatase of kidney was observed at 1.20 microgram and 0.10 microgram Hg concentrations, respectively. EDTA and ascorbic acid (AA) restored the phosphatase activity to the greatest extent when administered with the Hg.

Ultrasound visualization of aortic dissection by right parasternal scanning, including systolic flutter of the intimal flap

Dilation of the ascending aorta and an intimal flap within it (indicating dissecting aneurysm) were visualized by M-mode and cross-sectional echocardiography, from the right but not from the left parasternal area. The diagnosis was confirmed by aortography and at surgery. Systolic flutter of the intimal flap, seen on M-mode echocardiography, was attributable to the jet from a mildly stenotic aortic valve impinging on it.

A case-control study of diet and colo-rectal cancer

A case-control study of cancer of the colon and rectum has been conducted in Calgary, Alberta and Toronto, Ontario, Canada. A total of 348 cases of cancer of the colon and 194 cases of cancer of the rectum were individually matched by age, sex and neighbourhood of residence to 542 population controls and frequency match to 535 hospital controls who had undergone an abdominal operation. Each subject received a personal medical history questionnaire and a quantitative diet history questionnaire. Data on a number of potential non-nutrient risk factors for bowel cancer and on the consumption of 9 nutrients in the 2-month period up to 6 months before interview were analysed. The dietary data thus refer to recent diet consumed in a period antedating the diagnosis of, and in most cases symptoms from, large-bowel cancer in the cases, and a corresponding time period in the controls. The major findings were an elevated risk for those with a history of bowel polyps, and for those with an elevated intake of calories, total fat, total protein, saturated fat, oleic acid and cholesterol. No association was seen with an elevated intake of crude fibre, Vitamin C and linoleic acid. The nutrients for which an increased risk was demonstrated were highly correlated, though multivariate analysis using logistic regression indicated highest risk for saturated fat, with evidence of a dose-response relationship. The findings in both cancer sites, both sexes and with both sets of controls were quantitatively very similar. The population-attributable risk for colon and rectal cancer combined was estimated from the neighbourhood controls to be 41% for males and 44% for females for saturated fat intake and 9.8% and 6.4% respectively for any history of polyps.

Evaluation of a diet history questionnaire for epidemiologic studies

This study was conducted to evaluate a detailed diet history questionnaire. Diet histories obtained from 16 men were compared with food records kept by their partners for a 30-day period. Mean estimates for all 13 nutrients calculated were higher with the diet history than with food records. Positive correlation coefficients were found between estimates from the two methods for all nutrients as well as food groups and six of the 13 nutrients gave a good fit for the corresponding regression equations. The questionnaire was also evaluated by repeating it after six months on 26 case-control pairs of an ongoing diet and cancer study. High correlation coefficients were obtained for most nutrients for the controls. However, cases showed lower correlations probably due to changes in their diet. The study found that the diet history method as an estimate of dietary patterns among groups shows sufficient validity and reliability to make it a useful instrument for epidemiologic studies.

Circadian rhythm and proliferation of lung alveolar wall cells during postnatal growth in mice

The circadian rhythm of deoxyribonucleic acid (DNA) synthesis and mitosis in lung alveolar wall cells was studied in the mouse at 4 h intervals during postnatal days 4 and 5. Rhythmic variations in DNA synthesis and mitosis were observed both days, but their peak activities differed. On day 4, the greatest DNA synthesis occurred at 10 p.m. and the highest mitotic rate occurred at 2 p.m. On day 5, the greatest DNA synthesis and the highest mitotic rate both occurred at 10 p.m. On postnatal day 4, both DNA synthetic and mitotic rates showed peaks that occurred at the same time both at 2 p.m. and at 10 p.m. On postnatal day 4, both DNA synthetic and mitotic rates showed peaks that occurred at the same time both at 2 p.m. and at the 10 p.m. On postnatal day 5, 2 DNA synthesis peaks were observed, one at 10 a.m. and one at 10 p.m., with only 1 mitotic peak at 10 p.m. The length of intermitotic phases S and G2 of lung alveolar wall cells appears to be 5.5 h and 3 h, respectively.

Nonlinear pulse propagation in optical fibers

We discuss the propagation of nonlinear optical pulses in fibers. The wave equation is solved taking the radial dependence in an average way. The radius versus wavelength curves for "no dispersion" in SiO(2) glass are calculated and plotted. These no-dispersion curves separate the regions of light and dark solitons supported by the fibers.

A comparison of dietary methods in epidemiologic studies

Three methods of estimating group and individual dietary consumption have been developed and assessed in a case-control study of diet and breast cancer. The methods comprised a 24-hour recall, a detailed quantitative diet history directed to the most recent two-month period and the two-month period six months before, and a four-day diet diary. There is a high degree of correlation between the estimates of food consumption for the controls using each of the methods. The highest estimate was obtained from the diet history, with a slightly higher estimate in the period six months before than the current period, while the lowest is found in the 24-hour recall. The latter corresponds with the same method in a Nutrition Canada Survey. It is concluded that all methods ara applicable to case-control studies, but the diet history is preferred when current food intake may be influenced by a disease.

An epidemiologic study of breast cancer

A case-control study has been conducted in four areas of Canada in which 400 cases of breast cancer matched by age and marital status with neighborhood controls were administered medical and dietary questionnaires. The study is suggestive of an increased risk of breast cancer in post-menopausal women with younger age at menarche and an increased risk with delay of age at natural menopause. No protective effect of early age at first pregnancy was demonstrated in either pre- or post-menopausal women. An increased frequency of pregnancies of four months duration or less was found in cases compared to controls and a greater frequency in pre-menopausal cases compared to controls of a history of irregular menstrual periods. In pre-menopausal women no association has been found between increased height and weight as risk factors for breast cancer. For post-menopausal women, however, a weak association with increased height has been found, while a strong association with increased weight both at the time of menopause and the 12 months preceding diagnosis has ben confirmed.

A study of diet and breast cancer

A case-control study has been conducted in four areas in Canada in which 400 cases of breast cancer matched by age and marital status with neighborhood controls were administered a medical and dietary history questionnaire, a 24-hour recall for dietary information and a four-day diet record. The Study has produced evidence of an association between an increased intake of nutrients, especially total fat, in both pre-menopausal and post-menopausal women with breast cancer. Reasons why a weak association might have been anticipated are discussed, and it is concluded that in reality the association is stronger. Furthermore, its consistency with other evidence, both experimental and international, suggests that it is causal.

Neuropsychobiology of affective disorders. Some methodological considerations

Amine hypothesis is neither an adequate nor a sufficient postulate in understanding the neuropsychobiology of affective disorders. Interactions and balance between various mechanisms and factors may be important. Better techniques and methodology need to be used and a more comprehensive approach seems to be necessary in formulating meaningful research strategies. The present paper reexamines someaspects of the available data and suggests a few approaches in the sutdy and elucidation of neruophychobiology of affective disorders.

Comparison of results for morphine urinalyses by radioimmunoassay and thin-layer chromatography in a narcotic clinic setting

Radioimmunoassay (RIA) and thin-layer chromatography (TLC) were compared for morphine detection in an actual narcotic clinic setting. A choice of urines from all those screened by TLC allowed a critical comparison as to actual use or non-use of narcotic drugs, rather than a sampling at random in which the question of possible false positives or negatives cannot be conclusively answered. Although RIA is more sensitive than TLC, its advantage is apparent only in those cases where urine specimens are difficult to obtain frequently regularly or where the use of morphine is suspected by the positive identification of quinine in urine that was morphine-negative by TLC. In a selected group of negative and positive specimens chosen without conscious bias, the two methods gave consistently similar results, indicating that the modified TLC method provided a few or no false positives or negatives if the negatives were from those cases that were not positive anytime up to 3-4 days before urine collection. We conclude that RIA can be of significant value as a supplement to a TLC screening program, without sacrificing the many advantages that TLC has to offer.