Energy retention, energy expenditure, and growth in healthy immature infants

Energy balance studies were done during 10-29 days on 15 immature infants of mean birth weight 1581 g. Mean gross energy intake was 757 kJ/kg (181 kcal) and 79% of this was retained, so that metabolizable energy was 602 kJ/kg (143 kcal). Mean resting metabolic rate was 244 kJ/kg (58.1 kcal), and it increased with advancing maturity. Minimum resting metabolism averaged 199 kJ/kg (47.5 kcal). Energy expended in activity increased with maturity, but amounted to less than 17% of the total energy turnover. Postprandial metabolism caused the mean VO2 to rise by 17% in the hour after a feed, and during 24 hr resulted in consumption of energy equivalent to about 10% of the resting metabolism. Stored energy amounted to 230 kJ/kg (55 kcal) and was linearly related to weight gain (r = 0.92). Energy cost of weight gain was 24 kJ/g (5.7 kcal) and energy stored in new tissue was 16.8 kJ/g (4.0 kcal). Maintenance energy requirement at zero growth rate was about 270 kJ/kg (64 kcal).

Five-year follow-up of patients undergoing coronary artery bypass

Two hundred eighty-two patients who underwent coronary artery bypass operation between January, 1971, and July, 1972, were followed until the time of death or for 5 years after operation. The angina-free status progressively decreased during the period of follow-up but at 5 years 57% of the survivors were free from angina. The total (early and late) incidence of nonfatal myocardial infarction was 3.3 per 100 patient years of follow-up. Nine (3.2%) of the patients had a repeat coronary artery bypass operation within the first 5 postoperative years. The overall 5-year survival was 86.9%. The expected 5-year survival of the general population, matched by sex and age, is 90.7%. Five-year survival was 97% for single-vessel disease, 87% for double-vessel disease, and 85% for triple-vessel disease.

[Effect of subjective evaluation on the reproducibility of the gingivitis indices]

The gingival index, gingivitis score, sulcus bleeding index, PM(A) index, selective gingiva index, periodontal index and periodontal disease index were verified with regard to the effect of subjective evaluation on their reproducibility. The authors studied in particular the utility of these indices in case controls and in the detection of minimal changes in the inflammatory process. Due to the numerical classification, the evaluation of the extent and of the degree of severity of the gingivitis requires an subjective decision and, consequently, the choice of an index depends on the objective of the examination. For the purpose of comparison with biometrical parameters, the authors presented an index (selective gingiva index) elaborated by themselves.

Coronary artery bypass surgery for left main coronary artery disease

The course of 146 consecutive patients with significant occlusive disease of the left main coronary artery who underwent coronary artery bypass surgery during a 4 year period is reviewed. Preoperatively, 11 patients were in New York Heart Association functional class II, 57 in class III and 78 in class IV. Seventy patients had progressive angina and 12 unstable angina. There were two operative deaths (surgical mortality rate 1.4 percent). Seven patients (4.8 percent) had a perioperative acute myocardial infarction. Complete follow-up has been achieved in the surgical survivors over an average period of 18.1 months; 77 percent of the surviving patients are completely asymptomatic and 19 percent are in functional class II. Four patients (2.8 percent) had a nonfatal late postoperative myocardial infarction and five (3.5 percent) died during the late postoperative period (3.3 percent annual mortality rate during a 2 to 47 month follow-up period). Postoperative cardiac catheterization studies performed in 35 patients an average of 12.1 months postoperatively revealed 78 percent of 80 grafts and patency of at least 1 graft in 93 percent of patients. Results of 42 (89 percent) of 47 near maximal treadmill stress tests were abnormal preoperatively compared with results of 14 (26 percent) of 54 postoperatively; in 74 percent of patients having both a preoperative and postoperative stress test, abnormal preoperative test results converted to normal after surgery. This study suggests that direct myocardial revascularization may offer an effective means of improving both the quality and duration of life in a patient with significant occlusive disease of the left main coronary artery.

Thyroid scintigram. Sensitivity with sodium pertechnetate Tc 99m and gamma camera with pinhole collimator

To evaluate the reliability of thyroid scintigraphy in the diagnosis of nodular growth, scintigrams of patients who later underwent thyroidectomy were reviewed and correlated with pathologic findings. The scintigrams were all obtained with a 5-mm single-hole collimator-equipped gamma-scintillation camera after intravenous injection of 5 millicuries of sodium pertechnetate Tc 99m. In the group of 92 patients, six of whom had two histologically different lesions, 149 nodules were identified pathologically. There were 26 nodules 2 to 5 mm in diameter, of which 22 were benign and four were malignant. None of the 22 benign nodules were delineated scintigraphically. Superior image quality and resolution, low radiation dose, technical simplicity, and speed make 99mTc pinhole-camera scintigraphy the best procedure available for routine thyroid imaging.

[Studies on the penetrability of skin (author's transl)]

Subcutaneous implantation of small pieces of plastic foam leads to an exudation, the amount of which can be influenced by experimental conditions. The reproducibility of the amount of the exudation is very satisfactory. For 3 examples the possibility could be demonstrated that after cutaneous application of specific substances these can be analysed in the exudate. This could be done in the case of escin and salicylic acid (which is formed from the applied ester by enzymatic break-down during penetration of the epidermis) using thin-layer chromatography while heparin could be demonstrated disc-electrophoretically. All these substances lead to a statistically significant effect on the exudation process. Combining the 3 substances the therapeutic effect is very long lasting.

99mTc-pertechnetate thyroid scintigraphy in patients predisposed to thyroid neoplasms by prior radiotherapy to the head and neck

Histories, physical examinations and 99mTc-pertechnetate imaging were used to evaluate 1,452 persons who had had x-ray therapy to the neck region for benign conditions 18 to 35 years previously. Thyroid abnormalities were found in 301 patients (21%) and thyroid malignancy was found in 29% of 193 patients with abnormal studies who were explored surgically. Thyroid imaging detected 96% of these abnormalities, 40% of which would not have been unequivocally established by physical examination alone. Nuclear imaging could not distinguish benign from malignant lesions.