Haemoperfusion with R-004 Amberlite resin for treating acute poisoning

Eleven patients who had taken overdoses of barbiturates, glutethimide, tricyclic antidepressants, and chloroquine were treated by resin haemoperfusion using an R-004 haemoperfusion cartridge containing XAD-4 resin. All but one patient showed rapid clinical recovery and the drugs were cleared rapidly from the plasma. There were few complications. Resin haemoperfusion is more effective than dialysis and other perfusion methods, especially in poisoning with tricyclic antidepressants. Although haemoperfusion is expensive, it greatly reduces the length of the patient's stay in an intensive care unit and hence is cost-effective.

Abdominal wound dehiscence. A 10-year survey from a district general hospital

The incidence of abdominal wound dehiscence at a district general hospital was found to be about 1.5%. Analysis of a group of 123 patients with dehiscence in 3 separate years during a 10-year period confirmed that disruption most commonly occurs during the second postoperative week. The suture material used for primary closure appeared to have no influence on subsequent dehiscence. After resuture the recorded incidence of incisional herniation was 19% and the mortality was 24%. Patients who survived resuture remained in hospital for a prolonged period.

Affinity of labetalol for ocular melanin

1 The toxicity of labetalol has been studied in mice, rats, rabbits, and dogs, and reproductive studies have been carried out in rats and rabbits. Nothing was observed in any of these species to suggest that patients taking labetalol might be exposed to any toxic hazard. 2 During the reproductive studies 14C-labetalol was used to study placental transfer. Radioactivity was present in the uveal tract of the foetal eye. 3 Radioactive labetalol but not its metabolites was bound to the melanin pigment of the eye. This binding was reversible. It was not possible to saturate the melanin of the cat and dog eye even with prolonged dosing with labetalol. 4 Chloroquine, given orally at doses of 1.5-6 mg/kg/d for 4-7 weeks, produced changes in the cat retina. When oral doses of 20 mg labetalol/d were given to cats for 7 months, no oculotoxic effects were observed. 5 Detailed ophthalmological and histological examinations were carried out on the rats, rabbits, cats and dogs used in these studies. No changes indicative of oculotoxicity were observed. In the reproductive studies no effects were observed in the developing rat or rabbit eye, which could be consequent on the placental transfer of labetalol or its metabolites.

The 5' ends of bacterial RNA. II. The triphosphate-terminated ends of primary gene transcripts

Bacterial RNA, Pulse labeled with 32Pi, was digested with pancreatic RNAase. Oligonucleotides containing a triphosphate group at the 5'-hydroxyl, and therefore derived from the original beginning ends of the RNA transcripts, were purified by hydroxyapatite chromatography and analyzed by two-dimensional paper electrophoresis. A broad diversity of species was found, although the distribution among these species was not completely uniform. Possible methods of utilizing these methods in combination with in vitro synthetic techniques are discussed.

The contribution made by school milk to the nutrition of primary schoolchildren

1. The contribution of school milk to the nutrition of 396 Kent primary schoolchildren aged 8-11 years was assessed using information collected in a survey which included a weighed-diet record, a socio-economic questionnaire and a medical examination. 2. Over half the children (59% for boys, 54% for girls) drank school milk every school day of the diet-record week. 3. Children who drank school milk every school day, when compared with those not drinking it, had a significantly higher mean daily intake of liquid milk, a higher total daily intake of several important nutrients including animal protein, calcium, thiamin and riboflavin, and a diet richer in Ca and riboflavin (boys) and animal protein and Ca (girls). They were also less likely to have intakes of Ca and riboflavin below the recommended daily intakes for these nutrients, (Department of Health and Social Security, 1969). 4. The increased nutritional intake associated with school milk consumption was not related to any differences in height, weight, arm circumference or skinfold thickness. 5. There was no evidence that school milk consumption was associated with obesity (as assessed clinically).

Bone abscess due to Mycobacterium xenopi

Destructive infection of a cuneiform bone due to M. xenopi is described. The organism was isolated and its significance established by a strong skin reaction to xenopi antigen and by demonstration of bacilli in the lesion with fluorescence microscopy. This evidence of metastatic disease suggests that an alimentary route of infection as an alternative to inhalation could be considered.

Serological tests in the differentiation of staphylococcal and tuberculous bone disease

The haemagglutination test for antileucocidin is frequently positive in cases of bone tuberculosis in the absence of obvious staphylococcal infection. This test is therefore of little practical use in the differentiation of staphylococcal and tuberculous bone disease, and its use has been discontinued at the Royal National Orthopaedic Hospital. The antigamma haemolysin test in bone tuberculosis appears to give rise to few false positive results. Our observations confirm that the anti-alpha haemolysin and antigamma haemolysin tests used together reveal about 80 percent of cases of staphylococcal bone infection on first presentation or relapse.

Anti-immunoglobulin analysis by diffusion patterns of inhibition and facilitation of complementary lysis in agar. I. Diffusion-lysis patterns of heterologous guinea pig anti-immunoglobulins

Anti-rabbit immunoglobulin-containing sera were produced by immunizing guinea pigs with guinea pig red cells sensitized with rabbit-produced haemolysin against them. Such sera, and their 7S and 19S fractions, were radially diffused in agar containing sheep red cells sensitized with rabbit haemolysin and fractions thereof. After diffusion, the preparations were treated with guinea pig complement, which produced partial lysis in the background and a series of alternating rings of more and less lysis than that in the background. These were interpreted as a due to the presence of at least four anti-immunoglobulins (anti-Ig's) as follows: a 19S anti-Ig which inhibited lysis by 7S and 19S haemolysin; a 7S anti-Ig which facilitated lysis by 7S and 19S heamolysin; a 7S anti-Ig which inhibited lysis by 7S and 19S haemolysin; a 7S anti-Ig which facilitated lysis by 19S haemolysin. Similar patterns were obtained using correspondingly produced sera against mouse immunoglobulin, and sensitizing the sheep cells in the agar with mouse-produced haemolysin.

Anti-immunoglobulin analysis by diffusion patterns of inhibition and facilitation of complementary lysis in agar. II. Diffusion-lysis as a method for recognizing in vivo immunosuppressive activity of anti-immunoglobulins

This paper provides evidence that it is possible to prepare facilitating anti-mouse immunoglobulin (that is, anti-mouse immunoglobulin which facilitates complementary lysis of red cells sensitized with mouse-produced haemolysin) which, when injected into mice 24 hours before an injection of sheep red cells, very markedly reduced the number of haemolysin-producing cells detectable in spleen four days later. The diffusion-lysis method was used to recognize this and other anti-Ig's in heterologous antiserum and fractions thereof. The effective antibody was in the gamma2 fraction of antiserum produced in guinea pigs by injecting them with guinea pig red cells sensitized with mouse-produced haemolysin. This method of immunizing was used in order to stimulate the production of antibody against immunoglobulin which had undergone the configurational change characteristically occurring when antibody unites with antigen. The 19S fraction of the antiserum contained inhibiting anti-mouse immunoglobulin (anti-mouse immunoglobulin which inhibits complementary lysis of red cells sensitized with mouse-produced haemolysin) and interfered with immune depression by the gamma2 fraction. It is postulated that the gamma2 fraction induces complementary lysis only of lymphocytes whose surface immunoglobulin receptors have bound antigen and undergone configurational change. It is suggested that facilitating anti-immunoglobulin of the type described is responsible for immune suppression by anti-lymphocyte serum (ALS). Facilitating anti-mouse immunoglobulin was demonstrated in two samples of ALS (anti-mouse) which were active in suppressing graft rejection, but inhibiting anti-mouse immunoglobulin only was found in a sample which was ineffective in suppressing graft rejection.

Use of acute medical and general-practitioner beds by the practitioners working in one new town

Patients admitted to hospital by a defined group of general practitioners under their own care differ in age, diagnostic category, perceived needs, use of services and outcome, from those admitted by the same general practitioners to consultant beds. However, problems of methodology have to be kept in mind when interpreting the results.These findings suggest that general practitioners see consultant and general-practitioner care as having different attributes but only broadly indicate the nature of these. This study has not attempted to answer the question of outcome: What are the needs of the patient which can be most satisfactorily met by different forms of care-consultant care, general-practitioner care in hospital, and general-practitioner care at home?The next stage must be the development of both a more valid measure of a wide range of needs, and controlled trials of care into the effects of different forms and place of care on patients with differing types of needs.

Cholinergic modification of glucose-induced biphasic insulin release in vitro

An in vitro system for perifusion of rat pancreatic islets has been utilized to define the effects of cholinergic agents on the dynamics of insulin release. In the absence of glucose the effects of either acetylcholine or acetyl-beta-methylcholine were minimal at concentrations up to 10(-5) mM. In the presence of low glucose concentration (2.4 mM), both of the muscarinic agents produced dose-dependent biphasic insulin release. Under these conditions significant insulin release was observed over both phases at concentrations of the muscarinic agents as low as 10(-8) mM. Further, the dose response curves relating muscarinic concentration to the total amount of insulin released in each of the two phases showed lack of parallelism between the curves. Nicotinic acid in concentrations up to 10(-5) mM had no effect on insulin release in the presence of 2.4 mM glucose. When the glucose concentration was increased to 16.4 mM, the effects of the muscarinic agents were significantly less than those observed in the presence of 2.4 mM glucose. This held true whether the effect was defined as absolute increment due to the muscarinic agent or as percentage of enhancement. Atropine inhibited insulin release induced by both acetylcholine and by 16.4 mM glucose. These data indicate that cholinergic stimulation can play a significant role in modifying insulin release patterns.