Similarities and differences on the MMPI between women with bulimia and women with alcohol or drug abuse problems

This study compared the MMPI MacAndrew Scale, mean profile, mean scale scores, and codetypes of women with bulimia and women with alcohol or drug abuse problems. Women with alcohol or drug abuse problems scored significantly higher on the MacAndrew Scale and several mean MMPI scale scores than women with bulimia. However, mean MMPI profiles and distribution of MMPI codetypes were similar between these two groups.

Reproducibility of prick skin tests to five allergens

Thirty-five patients had prick skin tests to the common allergens Candida albicans. Aspergillus fumigatus, grass pollen, horse dander and Dermatophagoides pteronyssinus performed on a regular basis from Autumn 1973 to Autumn 1975. Specific IgE to the same allergens (except C. albicans) was determined at the time of skin testing for the first five seasons. It was found that the position on the volar aspect of the forearm on which the test was performed did not affect the reaction. There was a significant variation in the percentage of patients with positive skin tests to A. fumigatus, grass pollen and horse dander with the latter showing as significant decrease with time. There was evidence of variation in weal size for all but C. albicans, and for grass pollen, horse dander and D. pteronyssinus there were reduction in weal size with time. Significant differences were found for results of Log specific IgE for grass pollen and D. pteronyssinus over the study, but there was no trend. A good correlation between weal size and Log specific IgE for grass pollens and D. pteronyssinus was observed. For the four allergens, the coefficient of concordance between IgE levels within patients for the five seasons was highly significant.

Role of the cervix in the induction of labor

A study on induction of labor was carried out to test the hypothesis that changing the cervix will enhance the effectiveness of induction of labor. Fifty pregnant women near term with Bishop scores of 4 or less were divided into 5 study groups, in which a 12-hour preparation phase procedure was carried out to produce cervical or myometrial changes. All women had continuous measurement of uterine activity by an extraovular catheter. The patients were divided into 1) control subjects, and into groups treated with 2) laminaria, 3) Foley catheter, 4) amniotomy, and 5) oxytocin infusion. These preparation techniques were used for 12 hours, after which rupture of membranes was carried out in all cases. Although all procedures significantly changed the cervix, none but oxytocin affected the induction-to-delivery interval. The authors concluded that when a study design rigidly controls for cervical Bishop score, timing of rupture of membranes, and oxytocin infusion rates, the cervical preparation alone will not enhance inducibility.

The catecholaminergic nerve supply to small intracerebral vessels following a cold injury to the mouse cortex

A cold lesion was produced in the mouse parietal cortex. The damaged area was examined for alterations in the catecholamine fibres either by fluorescence microscopy or by electron microscopy. Within 24 h of injury many damaged catecholaminergic nerves were observed in close association with small intracerebral blood vessels. This relationship between nerves and blood vessels was not apparent in the control cortex. In the electron microscope, swollen non-myelinated axons containing an accumulation of dense-cored vesicles were observed close to the vessel wall but separated from it by astrocytic process. Six days after injury regenerating catecholaminergic nerve fibres were found close to immature capillaries. Axonal-like profiles containing dense-cored vesicles were observed adjacent to the endothelial call basement membrane. The number of regenerating nerves declined with time and the only fluorescent catecholaminergic nerves that remained 12 weeks after injury were in an area known to be rich in capillaries.

On the mechanism of the uptake of horseradish peroxidase into the retrograde transport system of ligated postganglionic sympathetic nerves in vitro

The mechanism of the uptake of horseradish peroxidase (HRP) by damaged post-ganglionic sympathetic axons was studied in vitro. HRP was applied to the damaged axons at the time of nerve injury or after a 3 hours or 17 hours delay. An interval of 3 hours or 17 hours between nerve injury and exposure to HRP had no effect on the localisation of the HRP in the damaged axons or on its retrograde transport to their perikarya. Evidence was found for the pinocytotic uptake of the enzyme by the damaged axons and its accumulation within those axons in elongated cisternae and larger rounded vesicles. In further experiments the damaged axons were treated with HRP at 0 degrees C and then washed in HRP-free medium. The tracer entered the axons in a diffuse form under these conditions but no pinocytotic uptake was observed. However, following 24 hours further incubation at 37 degrees C, HRP could not be found in the perikarya. Treatment at 0 degrees C did not produce any lasting damage to the retrograde transport mechanism. The results of these experiments are compatible with the involvement of pinocytosis in the uptake of HRP in a form suitable for retrograde transport.

Cimetidine prophylaxis for gastric ulcers in laboratory swine

Bleeding gastric ulcers were a major cause of morbidity and mortality in young swine subjected to surgery, chronic catheterization, and daily experimental manipulation. Some of the animals died suddenly due to exsanguination into the gastrointestinal tract, while others survived for several days following the onset of clinical signs. These signs included dark, tarry stools, lethargy, pale mucous membranes, decreased appetite, and dyspnea. Abnormal clinical laboratory findings included decreased hematocrit, hemoglobin and erythrocyte counts indicative of chronic blood loss anemia. On postmortem examination, single or multiple ulcers of variable sizes were found in the nonglandular cardiac portion of the stomach, and the gastrointestinal tract often contained blood. Histologically, the ulcers had a base of granulation tissue with surface suppuration. Prophylactic treatment of these ulcers was initiated using cimetidine, a histamine II blocker. The drug was administered via the drinking water at 15 mg/kg body weight/day. Fourteen of 62 (22.5%) pigs that did not receive cimetidine developed bleeding ulcers. Of 45 animals given daily prophylactic doses of cimetidine, none manifested clinical signs indicative of a bleeding ulcer. These results indicated that cimetidine was effective in preventing morbidity and mortality due to bleeding gastric ulcers in young swine used in chronic laboratory experiments.

A morphological study of the uptake and orthograde axoplasmic transport of horseradish peroxidase by damaged autonomic neurons in vitro

A preparation comprising the guinea-pig inferior mesenteric ganglion (IMG) and ligated hypogastric nerves was maintained in vitro in a twin-chamber apparatus. Horseradish peroxidase (HRP), added to the ganglion compartment, was taken up via coated pinocytotic vesicles into the neuronal perikarya, and subsequently accumulated in many polymorphic cytoplasmic organelles, but it did not enter the Golgi complex. After 24 h incubation, HRP was also localized in membrane-bounded organelles in the nonmyelinated axons of the hypogastric nerves in the ligated nerve compartment. HRP-labelled organelles accumulated in swollen nonmyelinated axons immediately proximal to the ligation along with other organelles known to undergo fast axoplasmic transport. It is suggested that HRP taken up by the neuronal perikarya subsequently underwent fast axoplasmic transport without passing through the Golgi complex. The organelles in which HRP was transported in an orthograde direction were very similar to those in which the enzyme is known to be transported retrogradely in the same neuronal system. The advantages of this in vitro system for studying the orthograde transport of exogenous protein are discussed.

The origin of the preganglionic parasympathetic fibres to the mandibular and sublingual salivary glands in the rat: a horseradish peroxidase study

Horseradish peroxidase was applied to a ligation of the chorda tympani nerves running alongside the submandibular duct in order to label the preganglionic parasympathetic salivatory neurons in the brain stem. Labelled neurons were found in the ipsilateral motor trigeminal nucleus, lateral reticular formation and in the facial motor nuclei of both sides. However, the labelling of neurons in the motor nuclei of the trigeminal and facial nucleus was caused by the uptake of horseradish peroxidase by axons in the musculature surrounding the injection site which were probably damaged by the dissection procedure. The salivatory neurons were fusiform multipolar cells which were mainly located in the ipsilateral nucleus reticularis parvocellularis. No evidence for salivatory neurons in the nucleus supragenualis was found.

Methemoglobinemia from isobutyl nitrite preparations

Ingestion of preparations containing isobutyl nitrite can lead to rapidly fatal methemoglobinemia. We report the cases of three patients presenting with methemoglobinemia secondary to ingestion or inhaling the contents of an over-the-counter room odorizer preparation containing isobutyl nitrite. The condition was treated successfully with administration of intravenous methylene blue.

Propiram and codeine in episiotomy pain

To evaluate relative efficacy, safety, and time course of analgesia, propiram fumarate (50 and 100 mg), a new narcotic agonist-antagonist, was compared with codeine sulfate (60 mg) and placebo in a clinical trial with a single peroral dose, parallel, stratified, randomized, and double-blind design involving 80 hospitalized postpartum women with medium or severe episiotomy pain. Using verbal subjective reports as index of response, patients rated pain intensity and side effects at periodic interviews for 6 h. Relative efficacy findings based on peak effects and summed pain-intensity differences suggested dose-dependent analgesia with propiram and also that 60 mg codeine lay between 50 mg propiram and placebo. Moreover, after 50 or 100 mg propiram, 8 of 20 patients reported greater than 50% reduction of initial pain compared with 7 of 20 after 60 mg codeine and 2 of 20 after placebo. After each of the propiram doses, distinct analgesia began within 1/2 h and reached peak effect between 1 h (p less than 0.02) and 2 h (p less than 0.05). After f60 mg codeine, onset was slower and peak later (4 h, p less than 0.05). All three active drugs continued to act until the 5th or 6th h. Drowsiness was the only statistically significant side effect reported after propiram. These results suggest that single 50 or 100 mg doses of propiram were effective in episiotomy pain, induced stronger analgesia than 60 mg codeine, and took effect more rapidly.

The uptake and retrograde transport of horseradish peroxidase--polylysine conjugate by ligated postganglionic sympathetic nerves in vitro

The uptake and retrograde transport of horseradish peroxidase (HRP) and horseradish peroxidase-poly-L-lysine conjugate (HRP-PL) were compared using a system comprising the guinea-pig inferior mesenteric ganglion (IMG) and ligated hypogastric hypogastric nerves maintained in vitro in a twin chamber apparatus. 0.5 mg of HRP-PL applied to the ligated nerves produced stronger retrograde labelling of neurons within the IMG than did 10 mg of HRP. This may have been due to the greater uptake of HRP-PL in a vesicular form by the axons immediately proximal to the ligation. The possible roles of large rounded vesicles and elongated cisternae in retrograde axoplasmic transport are discussed.

Cerebral ventriculitis in the hydrocephalic mouse: a histological and scanning electron microscope study

Staphylococci are the commonest organisms found in infected cerebrospinal fluid shunts in hydrocephalic patients. In the present study, staphylococcus albus was injected (1200-500,000 organisms in 10 microliters saline) into the ventricles of the hydrocephalic mouse SUMS - hy - 3/+ (temporary strain name). The bacteria appeared to have little direct effect upon the ependymal cells lining the ventricles and were not found as free organisms in the subependymal tissue. Staphylococci were phagocytosed by polymorphonuclear leukocytes which entered the ventricle from the choroid plexus and through the ependyma from subependymal vessels. Macrophages on the lining of the hydrocephalic ventricles also played a significant role in the phagocytosis of bacteria in the early stages of infection.

Primary malignant mediastinal germ cell tumors: a study of three cases

Three patients with primary malignant mediastinal germ cell tumors are presented and the literature is briefly reviewed. A great disparity exists in the literature regarding the classification and differential diagnosis of these tumors. Resection and irradiation of seminomas give relatively satisfactory results. The prognosis of malignant teratomas, embryonal cell carcinomas and choriocarcinomas is poor, regardless of the mode of treatment.

Peripheral neuropathy following intraneural injection of mercury compounds

Between 0.25-25 micrograms of an aqueous solution of either mercuric chloride or methyl mercuric acetate was injected directly into the sciatic nerve of 28 adult Wistar rats. The resultant pathological changes in the nerve were examined by teasing individual fibres and by light and electron microscopy. In most respects mercuric chloride was more toxic than methyl mercuric acetate. The large doses of mercuric chloride produced a hind limb paresis within 24 h but no clinical signs followed injection of organic mercury. The predominant effect of mercuric chloride was on Schwann cells which showed cytoplasmic swelling and necrosis, associated with extensive segmental demyelination. In contrast methyl mercuric acetate caused axonal degeneration in many of the large myelinated fibres but only minor alterations were observed in Schwann cells.

Consultees' representations of consultants' psychiatric diagnoses

In an attempt to characterize consultees' representations of consultants' psychiatric dagnoses, the authors reviewd the medical records from 190 psychiatric consultations in a general hopsital. Using specific outcome criteria, they rated 50% of representations as concordant and 39% as nonconcordant. Five variable,s icluding the primary medical diagnosis at discharge and the referring service, were significantly related to concordance. Surprisinlgy, concordance was independent of the psychiatric diagnosis, indicating theat consultees did not respond differentially to varying magnitudes and implications of the different disorders. This work raises the question of possible strategies to improve receptivity to psychiatric diagnoses in the consultation setting.

Evaluation of kerb negotiation in a prototype and standard model wheelchair

This article outlines an evaluatory study of kerb negotiation in a conventional wheelchair and a prototype diamond configuration, lever articulated wheelchair. The kerb negotiation sequence in both models is presented with the results of tests involving users able to negotiate kerbs (N = 16); users unable to negotiate kerbs (N = 15); and non-wheelchair users (N = 20). Results indicate preferences for the prototype amongst the first group, particularly for kerb descent. Free rolling tests of the loaded wheelchairs over various terrains revealed that while the standard wheelchair invariably turned downhill the prototype was relatively insensitive to loss of direction on sideslopes. A significant number of subjects (P = 0.01, N = 20) found the articulated framework of the prototype reduced the difficulties of self propulsion over rough and cambered surfaces. The prototype was found to possess a smaller turning circle (103 cm to 122 cm) and a longer wheelbase (94.7 cm to 39.7 cm) than the standard model though overall dimensions were broadly comparable. The implications of the prototype wheelbase for manual, attendant and powered propulsion are considered.

Issues in the design and use of a distributed file system

This paper discusses an independent file facility, one that is not embedded in an operating system. The distributed file system (DFS) is so named because it is implemented on a cooperating set of server computers connected by a communications, network, which together create the illusion of a single, logical system for the creation, deletion, and random accessing of data. Access to the DFS can only be accomplished over the network; a computer (or, more precisely, a program running on one) that uses the DFS is called a client . This paper describes the division of responsibility between servers and clients. The basic tool for maintaining data consistency in these situations is the atomic property of transactions, which protects clients from system malfunctions and from the competing activities of other clients. Several cooperating clients may share a transaction. The DFS provides an unconventional locking mechanism between transactions that supports client caches and eliminates a novel form of deadly embrace. We have implemented and put into service a system based on these concepts.

The uptake of intravenous horseradish peroxidase by the guinea-pig inferior mesenteric ganglion

The uptake of intravenously injected horseradish peroxidase (HRP) by the neuronal perikarya and SIF cells has been studied in the guinea-pig inferior mesenteric ganglion (IMG). The HRP rapidly penetrated the walls of the blood vessels within the ganglion and was taken up by neurons and SIF cells by means of coated pinocytotic vesicles. HRP reaction product was subsequently found within larger vesicles which were most prominent 6--9 hours after injection. Thirty hours after injection all the neurons and SIF cells within the IMG were free of peroxidase reaction product. The implications of these findings were considered in relation to retrograde axonal transport studies in autonomic neurons.

Nefopam and propoxyphene in episiotomy pain

To evaluate relative efficacy, safety, and time course of analgesia, nefopam (45 and 90 mg), a new centrally acting nonnarcotic analgesic, was compared with propoxyphene (65 mg) and placebo in a single oral dose, parallel, stratified, randomized, double-blind trial with 100 hospitalized postpartum women with medium or severe episiotomy pain. Using subjective reports as indices of response, patients rated pain intensity and side effects at periodic interviews for 6 hr. After 45 and 90 mg nefopam, 21 of 25 and 20 of 25 patients (p less than 0.01) reported more than 50% reduction of pain, whereas after 65 mg propoxyphene 18 of 25 (p less than 0.05) and after placebo 11 of 25 reported reduction in pain. Relative efficacy, based on summed pain intensity differences, showed measurable but modest dose-dependent analgesia with nefopam, suggesting that the effectiveness of 65 mg propoxyphene lay between 45 mg nefopam and placebo. Side effects included mild dizziness and hypothermia after nefopam and mild elevation of diastolic arterial pressure after nefopam and propoxyphene. Our results suggest that 45- and 90-mg doses of nefopam induced more analgesia than 65 mg propoxyphene in the relief of episiotomy pain.

Endoscopy--Review

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Two-dimensional echocardiography in mitral annulus calcification

Mitral annular calcification, established by fluoroscopy, was studied by M-mode and two-dimensional echocardiography in 18 patients. M-mode echocardiography revealed the typical dense, linear echo of mitral annular calcification, but not its extent. Two-dimenstional echocardiography demonstrated a dense, elipsoidal echo at the junction of the left atrium and ventricle in the long axis view, and an area of calcification below the mitral valve in the short axis view. These patterns were not seen in 20 control patients without mitral annular calcification by fluoroscopy. Two-dimensional echocardiography establishes the site and extent of mitral annular calcification, minimizes the potential for diagnostic error associated with M-mode echocardiography, and is superior to M-mode echocardiography for the recognition of mitral annular calcification.