Similarity of the intraocular pressure response to different corticosteroid esters when compliance is controlled

Fifty-four subjects with initial intraocular pressures under 20 mm Hg received a different commercial corticosteroid ester of prednisolone or dexamethasone in each eye for three to six weeks. Compliance was controlled. The intraocular pressure responses of the two eyes of a subject were similar. It was concluded that the absorptions of all four corticosteroids were in excess of the minimum amounts needed to maximally elevate pressure. Subjects complained that prednisolone acetate was irritating. Corticosteroid-induced uveitis developed in 3% (3) of the eyes.

An evaluation of the Illinois trauma system

The impact of the Illinois Trauma System is assessed in the Southernmost region of the state. A sample of vehicular injuries and deaths are compared for a four year study period: two years prior to system implementation (FY 1970-1971) and two years after system initiation (FY 1972-1973). Decreases in mortality rates are experienced at trauma hospitals in FY 1972-1973 while mortality rates at those hospitals which did not become trauma centers remained constant. Trauma hospitals also exhibit significant declines in mortality rates during weekends and for the age group 45 to 64. When examined on a statewide basis the Illinois Trauma System appears to have little impact on urban mortality rates but a substantial effect upon rural mortality rates.

Lymphoma cutis of apparent B cell origin

A nodular, poorly differentiated lymphocytic lymphoma involving lymph nodes, spleen, and skin is reported in a 60-year-old man. The clinical course of this disorder strongly implied cutaneous involvement as the initial site of disease. Immunologic studies indicated that the neoplastic cells carried surface immunoglobulin (IgMgamma), thus suggesting a B lymphocyte origin for the lymphatic neoplasia.

The estimated survival probability index of trauma severity

An index of survival rates associated with ICDA injury codes was constructed with data from the 1973 Hospital Discharge Survey (HDS). Discharge records from three regions covered by the HDS allowed estimation of survival rates among patients suffering single injuries coded under 92 ICDA integers. These estimated rates were then applied to records from the fourth HDS region, including those for patients suffering multiple injuries: estimated survival probability index values were generated as the product of the single-condition survival rates for each patient's various injuries. Mortality rates predicted from the index values correlated well with mortality rates estimated for the universe of patients discharged in 1973 from the fourth region. The index is intended for retrospective analysis of discharge records as a possible approach to care evaluation.

Origin and length of left main coronary artery: its relation to height, weight, sex, age, pattern of coronary distribution, and presence or absence of coronary artery disease

The distance from the base of the left coronary sinus to the origin of the left main coronary artery was measured in 54 patients. The length of the left main coronary artery and the pattern of arterial dominance were determined in the last 37 patients. These variables were correlated with height, weight, age, sex, and presence or absence of coronary artery disease. Average distance from the basis of the left coronary sinus to the origin of the left main coronary artery was 19.4 +/- 2.7 mm. Average length of the left main coronary artery was 9.7 +/- 4.3 mm. There was a large inherent variability between distance from the base of left coronary sinus to the origin of the left main coronary artery and height of the subjects. Other variables did not show positive correlation. Similar large variability was noticed between of the left main coronary artery and height of the subjects. Thus, from these observations it was not possible to predict the distance from the base of the left coronary sinus to the origin of the left main coronary artery or the length of the left main coronary artery using height or any other variable. The importance of these findings in relation to coronary angiography is discussed.

Combination chemotherapy and radiotherapy in small-cell carcinoma of the lung

A combination of chemotherapy (Cytoxan, vincristine, and CCNU) and radiation therapy was used to treat 37 patients with small-cell carcinoma of the lung. There was 49% complete remission and an overall 76% objective response with an overall median survival of 12.5 months and 17 months for those showing a complete response. No serious morbidity was observed.

The Illinois Trauma System: changes in patient survival patterns following vehicular injuries

To assess the impact of the Illinois Trauma Program on Region 5, Southern Illinois, samples of vehicular injuries and deaths were compared for a four-year study period: two years prior to system implementation (FY 1970-1971) and two years after system initiation (FY 1972-1973). Trauma center hospitals exhibited a statistically significant decrease in mortality rate during FY 1972-9173 while other hospitals (those in the region not designated as trauma centers) had no change in mortality rate. Decreases in mortality rates were statistically significant at trauma hospitals for weekends and patients between the ages of 45 and 64. The methodology of conducting such a study as well as the implications of the study are discussed.

[Modifying smoking habits at school--experiences in a town of the GDR (author's transl)]

The number of juvenile smokers in the age-group of 12-16 years is increasing. Sequels of nicotine abuse--as bronchial carcinoma, chronic bronchitis and cardiovascular diseases-are more frequent in persons who begin smoking in the younger age-group. It is our obligation to influence youth in such a way that young people do not begin to smoke at all, or as less as possible. For that reason in 1974 the Chest Clinic of Schwedt began with taking intensive influence to school children for stopping smoking or not beginning smoking. Smoking habits in the youth cannot be changed only by engagement and the possibilities of the physicians. One antismoking campaign confined in time will not result in lasting success. A deep change in the smoking habits of the youth can be achieved only by a continuous, systematic and substantial cooperation between the medical staff, the educational system and the parents. We are reporting about our approach and the experiences collected in this aimed work.

Ability to remain abstinent after methadone detoxification. A six-year study

Three hundred thirty-five persons successfully detoxified from methadone hydrochloride maintenance were followed up for as long as six years to determine their ability to remain abstinent from narcotic use. At the end of the observation period, of the 269 persons located, 35% were narcotic-free, 58% had returned to narcotic use, and 8% were either jailed or deceased. The ability of a person to refrain from narcotic use was found to be highly associated with staff's assessment of progress and duration of methadone maintenance treatment. Relapse to narcotic use occurred regardless of length of abstinence, with 35% of relapses occurring after three or more years. While abstinence after narcotic dependency is possible, it is not a realistic goal for all. Premature detoxification from methadone maintenance is associated with a high recidivism rate to narcotics.

Thrombocytotic suppression of megakaryocyte production from stem cells

Megakaryocytopoiesis in the spleens of lethally irradiated mice transplanted with marrow cells was suppressed by platelet transfusions. In one group of experiments, animals were irradiated and transfused with bone marrow cells on day O. They were then given either no treatment, platelets, platelet-poor plasma, or saline on days 0, 2, 4, 6, and 8, and then were sacrificed on day 10. Megakaryocytes per section in the spleens of mice receiving platelets were 24%-48% of the values in the groups given plasma, saline, or bone marrow only. The number of pure megakaryocyte colonies was also diminished by platelet hypertransfusion. Another experiment examined the effect of platelets or plasma administered on days 1 and 2 or days 6 and 7 after irradiation and bone marrow transfusion. Hypertransfusion on days 6 and 7 was as effective in suppressing megakaryocytopoiesis as hypertransfusion every other day for 10 days. Animals given platelets or plasma only on days 1 and 2 did not have any significant change in their megakaryocyte number. These results implied that committed megakaryocyte precursors were more sensitive to inhibition by increased platelet levels than pluripotential stem cells. Further experiments with plethoric animals indicated that different levels of erythropoietin did not account for the effects of platelet hypertransfusion. The findings could be explained by inhibition of cell proliferation or of differentiation of megakaryocyte precursors by increased platelet levels.

Adrenal insufficiency after unilateral radical nephrectomy

A case of adrenal insufficiency occurring after unilateral radical nephrectomy is presented. Recommendations for identification and treatment of this condition are discussed.

Biofeedback training to overcome poststroke foot-drop

The technique has exciting potential for elderly hemiplegic patients, even those who are confined to a nursing home. There are limiting factors, of course; the method is time-consuming and the initial outlay for equipment is high. But the rewards can be well worth the time, effort, and cost involved. The recovery potential of some geriatric patients after a cerebrovascular accident may seem bleak because of multiple disabilities, e.g., paralysis, delayed reflexes, aphasia. Fortunately, these disorders do not necessarily decree failure of biofeedback training. Neither does advanced age. The strongest component in success is motivation. A case in point is the 82 year old woman described here who had been hemiparetic for seven years. With biofeedback training, she gained--and maintained--muscle strength.

Immunologic and cytochemical cell markers in non-Hodgkin's lymphomas

Lymph nodes were obtained from 28 patients with non-Hodgkin's lymphoma and 24 patients without hematologic malignancy. Cases of undifferentiated lymphoma, diffuse histiocytic lymphoma, diffuse and nodular mixed histiocytic-lymphocytic lymphoma, nodular poorly differentiated lymphocytic lymphoma, and diffuse well differentiated lymphocytic lymphoma were analyzed. Touch preparations were stained for nonspecific esterases, peroxidase, Sudan black B activity and with periodic acid-Schiff and Wright-Giemsa reagents. Mononuclear cell suspension from lymph nodes and, in some cases, peripheral blood were tested for spontaneous rosette formation with sheep erythrocytes and for the presence of surface immunoglobulin. The remainder of the lymph node was examined after staining with hematoxylin and eosin. Analysis of the lymphocyte surface markers indicated that 15 cases of various histologic types of lymphoma were B cell proliferations. However, three out of four cases of diffuse poorly differentiated lymphocytic lymphoma and one of seven cases of diffuse histiocytic lymphoma appeared to represent T cell neoplasia. Lymph nodes from four cases of lymphoma representing diverse histologic types were replaced by neoplastic cells devoid of discernible cell markers. In five cases, the distribution of cell surface markers in the malignant lymph node failed to differ from data obtained in the analysis of non-neoplastic lymph nodes. The study indicates that the histopathologic entities recognized in the currently employed classification of lymphoreticular malignancies are heterogeneous. Alterations in the distribution of cell surface markers in the peripheral blood from five of 12 patients indicated involvement prior to demonstrable morphologic evidence of peripheral blood involvement in four patients and bone marrow infiltration in two patients.

Evoked cerebral responses to noxious thermal stimuli in humans

Brief pulses of Laser emitted radiant heat were used to induce cutaneous painful sensations in human volunteers. Accurate timing of the stimuli permitted recording of scalp averaged evoked potentials. A late negative-positive component of the EP which correlated in amplitude with the subjective sensation was observed in four subjects. The latency of this component (130-160 msec) correlated with stimulus intensity.

[L'"apprentissage social" chez le termite de santonge]

Termites, when they are in groups, are able to learn a maze between their nest and the food. Workers lay an odorous trail on the most direct way. The gallery will be built on this train. Kinesthetic information also seem implicated.