The value and cost analysis of the ENG as of 1978

The use of ENG in office practice and its use as a helpful, time-saving procedure is discussed. The following practical clinical questions are answered: 1. Is the vestibular mechanism normal or abnormal? 2. Is the vestibular pathology peripheral or central? 3. Is the peripheral disease right or left sided? Cost analysis of ENG in office practice is presented.

The use of epon embedding with the Falck-Hillarp technique to preserve the serotonin-associated fluorescence of endocrine and mast cells in the rat stomach

Epon embedding was used with the Falck-Hillarp Technique in a study of rat gastric endocrine cells in order to improve morphological resolution. The epon embedding not only produced excellent morphological results, but also resulted in the long-term preservation, now for 10 years of the serotonin-associated fluorescence in the gastric endocrine and mast cells.

Effect of aspirin on thrombogenesis and on production of experimental aortic valvular Streptococcus viridans endocarditis in rabbits

Because thrombus formation at the site of endothelial injury has been thought to be a critical step in the pathogenesis of bacterial endocarditis, the effect of aspirin on experimental valvular thrombosis and bacterial endocarditis in rabbits was evaluated. Aortic valvular injury and thrombosis were induced in aspirin-treated and control rabbits with intracardiac catheters. A subsequent inoculation of Streptococcus viridans resulted in the development of infective endocarditis. Rabbits were sacrificed as early as 6 hr, and the effectiveness of aspirin was determined by the weight of the sterile vegetations and the quantitation of bacteria in the thrombotic vegetation. Aspirin, in levels in excess of 50 mg/dl did not attenuate the evolution of infective endocarditis, since the formation of sterile thrombotic vegetation and bacterial endocarditis in aspirin-treated rabbits was similar to those in controls.

In vitro activity and clinical efficacy of clindamycin in the treatment of infections due to anaerobic bacteria

Clindamycin, rosamicin, josamycin, and metronidazole had similar inhibitory activity against 29 clinical isolates of Bacteroides fragilis, i.e., 100% of strains were inhibited by 0.8 microng of metronidazole or josamycin/ml and 100% by 1.6 microng of clindamycin or rosamicin/ml. Metronidazole was bactericidal against 97% of the isolates, and clindamycin or rosamicin (in concentrations of 1.6 microng/ml) was bactericidal against 80%. Erythromycin and josamicin were the least bactericidal agents in vitro. Thirty-two patients with pleuropulmonary and intraabdominal or pelvic infections caused by anaerobic bacteria were treated with clindamycin. Cure was achieved in 27 patients. In another group of 37 patients treated with parenteral clindamycin, diarrhea developed in 30% and was significantly more common in those patients with abdominal or pelvic infection. Only one patient developed pseudomembranous colitis. These observations suggest that clindamycin is an excellent and relatively safe antibiotic for treatment of infections caused by anaerobes when combined with surgery or with other antibiotics selected for activity against aerobic gram-negative bacilli.

Gastritis, duodenitis, and bleeding duodenal ulcer following mefenamic acid therapy

A 46-year-old woman developed hematemesis and melena two weeks after starting mefenamic acid therapy for osteoarthritis of the spine. Esophagogastroduodenoscopy, arteriography, and a laparotomy revealed antral gastritis, duodenitis, and an acute bleeding ulcer in the third portion of the duodenum. Although mefenamic acid has many of the pharmacologic and physicochemical properties of aspirin and produces gastrointestinal ulceration in animals when administered in large doses, the English literature reveals only one case of gastric ulceration and a single instance of upper-gastrointestinal tract hemorrhage associated with its use. This case warns that mefenamic acid may cause serious gastric and duodenal inflammation and ulceration more commonly than is presently suspected.

Demonstration of a cytochemical difference between the tubulovesicles and plasmalemma of gastric parietal cells by ATPase and NPPase reactions

Pieces of rat and human gastric mucosa were fixed in glutaraldehyde and paraformaldehyde and were processed by the methods of Wachstein-Meisel and of Ernst for the cytochemical demonstration of adenosine triphosphatase (ATPase) and p-nitrophenylphosphatase (NPPase) respectively. Electron microscopic examination of reacted sections revealed the ATPase reaction to be localized to the plasmalemma and to mitochondrial cristae and the NPPase reaction to the plasmalemma. The tubulovesicles were unreactive. By thus demonstrating a cytochemical difference between the plasmalemma and tubulovesicle membrane, this study suggests that the tubulovesicles do not represent an extension of or reserve of mature plasmalemma. If the tubulovesicles represent a reserve of membrane that can be rapidly utilized to expand the plasmalemma, then these studies suggest that additional membrane constituents are added, activated, or unmasked in the process.

Electronystagmography: a review of 17 years experience

The clinical concepts of electronystagmography (ENG) and vestibular testing are simple. They are not mysterious, complicated, nor time consuming. Every patient afflicted with dizziness deserves such a recording as part of the vestibular workup. No one would consider the evaluation of a patient with a hearing loss complete without an audiogram, and in 1975 no patient with a complaint of dysequilibrium has been properly or sufficiently evaluated without an ENG recording of balance function.

Tuberculous meningitis in children during the isoniazid era

Fifty-nine cases of tuberculous meningitis in children seen at the Charity Hospital at New Orleans since the addition of isoniazid to the therapy in 1952 are reviewed. Fourteen of the children died during hopsitalization. At discharge 21 children had complete or nearly complete clinical recovery. Follow-up of 21 available long-term survivors revealed a significant number with neurologic and social disabilities. The endemicity of tuberculous infections in the households of the children and factors responsible for transmission of tubercle bacilli from an adult source are reported. The importance of chemoprophylaxis and public health measures in eliminating this disease are stressed.

Degenerative changes in the human vestibular sensory epithelia

A study of the vestibular end organs from humans of different ages is presented. The inner ears were exposed by microdissection, and the vestibular sensory regions were either sectioned and studied with light or electron microscopy, or prepared and studied with the surface specimen technique. A change, which can be related to aging, is the accumulation of lipofuscin inclusions in sensory and supporting cells, especially pronounced in the type I sensory cell. Changes of the hair bundles, such as disarrangement of cilia, increased fragility of cilia and formation of giant cilia, have also been observed in aged individuals. In three cases there was a history of vestibular disturbance of vertigo. All three cases had shown caloric hypo-reactivity. In two cases, one with a history of herpes zoster oticus and another with a brain stem glioma, no morphological changes which could be attributed to the diseases, were found. The third case showed degeneration of macula utriculi and the lateral and superior cristae, possibly as a result of vascular disturbance.

A fine structural characterization of the proliferated endocrine cells in atrophic gastric mucosa

This study shows that most of the proliferated endocrine cells in nonintestinalized epithelium in the body of stomachs in patients with pernicious anemia have the fine structure of ECL (enterochromaffin-like) cells, the principal endocrine cell in the body of normal stomachs, and notes an absence of G (gastrin) cells, the principal endocrine cell in the normal pylorus. Since gastrin has been identified in many of these proliferated cells by immunofluorescence, these findings question the position that gastrin synthesis in the stomach is only associated with G cells.