Rest and exercise hemodynamics in pulmonary stenosis: comparison of children and adults

To better understand the hemodynamics of pulmonary stenosis (PS), 24 adults and 53 children with similar degrees of PS who had undergone cardiac catheterization at rest and during supine exercise were retrospectively studied. Three groups were defined. Group I consisted of 9 adults and 18 children with a pulmonary valve area of less than 0.5 cm2/m2; group II, 6 adults and 25 children with a pulmonary valve area of 0.5 to 1.0 cm2/m2; and group III, 9 adults and 10 children with pulmonary valve area of more than 1.0 cm2/m2. The mean ages of the adults were 29, 26 and 22 years for groups I, II, and III, respectively. The mean ages of the children were 11, 10 and 9 years for groups I, II and III, respectively. The pertinent data collected from catheterization included oxygen consumption, cardiac rate and index, arterial venous oxygen difference, stroke index, right ventricular (RV) systolic pressure and RV end-diastolic pressure. Adults and children in groups II and III had an appropriate response to exercise. Group I children responded abnormally by increasing their RV end-diastolic pressure and decreasing their stroke index. In group I adults both of these variables increased. Group I adults exhibited a significantly lower cardiac index at rest and exercise secondary to a significantly lower absolute cardiac rate. Long-standing severe PS results in hemodynamic compromise. Hence, early relief of PS is recommended.

Morphological and functional investigations on macrophages with heterogeneous fluorescent staining

Four heterogeneous colors of fluorescence were demonstrated in macrophages from rabbit lymph nodes and mouse peritoneal exudate using fluorescent staining. They were bright blue, light blue, bluish green and yellow colors of fluorescence respectively. All of these 4 types of macrophages with heterogeneous colors of fluorescence could form EA or EAC rosettes and were able to phagocytose chicken erythrocytes and ink carbon granules. Among them the macrophages with bright blue color of fluorescence could form large EA or EAC rosettes and showed more rapid and stronger activity to phagocytose chicken erythrocytes, while those with bluish green and yellow colors of fluorescence showed stronger activity to phagocytose ink carbon granules.

Antitumor activity of a new fluoropyrimidine derivative, 5'-deoxy-5-fluorouridine, against murine and human experimental tumors

5'-Deoxy-5-fluorouridine (5'-DFUR) was evaluated for antitumor activity against four murine tumors (L1210 leukemia, P388 leukemia, Lewis lung carcinoma, and B16 melanoma) and a human mammary carcinoma (MX-1) xenografted in athymic mice. Intraperitoneal administration of 5'-DFUR was ineffective against B16 melanoma implanted intraperitoneally and showed less marked antitumor activity against P388 and L1210 leukemias implanted intraperitoneally or intravenously as compared with that of 5-fluorouracil (5-FU) or 1-(2-tetrahydrofuryl)-5-fluorouracil (FT-207), while oral administration of 5'-DFUR showed a similar or superior antitumor activity to that of 5-FU or FT-207 against L1210 leukemia implanted subcutaneously. 5'-DFUR showed a marked antitumor activity against MX-1 implanted subcutaneously and also showed slight antitumor activity against Lewis lung carcinoma implanted subcutaneously, while 5-FU and FT-207 did not show any significant antitumor activity against these tumors. These results suggest that 5'-DFUR may be worthy of clinical trial against solid tumors, especially cancers of the breast.

Inhibition of human T lymphocyte proliferation in vitro by commercial factor VIII concentrates

Several investigators recently described a T lymphocyte subset abnormality (reversed helper/suppressor cell ratio) in haemophiliacs, especially following previous substitution therapy. We studied in vitro the potential effects of two commercial factor VIII concentrates on incorporation of 3H-thymidine by isolated human peripheral blood lymphocytes after stimulation with either phytohaemagglutinin or monoclonal antibody OKT3. Dose-related inhibition of thymidine incorporation was found for both concentrates but none using the purified main protein constituents, i.e. factor VIII, fibrinogen or fibronectin. Furthermore, the 'inhibitor' was completely removed by dialysis.

The technique of the Fontan procedure with posterior right atrium-pulmonary artery connection

A detailed technique is described for use of a modified Fontan procedure applicable to transposed as well as nontransposed anatomy. In the modified procedure, the use of circumferential grafting is eliminated, as are the complications arising from an anterior conduit in front of the aorta. Clinical results are reported for 9 young adults undergoing this operation.

Leprosy control in Shandong Province, China, 1955-1983; some epidemiological features

A comprehensive leprosy control program was launched in Shandong Province, People's Republic of China, in 1955, with the establishment of the Provincial Skin Disease Control Institute and a network of Skin Disease Control Stations and leprosy hospitals at the county level. Through repeated different methods of case finding, dapsone monotherapy, and intensive follow up, incidence has decreased from 5.1 to 0.46/100,000 in 25 years. Findings such as the increase in the mean age at onset and in the lepromatous-to-tuberculoid ratio, and a general decline in the age-specific incidence in successive cohorts, are in concurrence with the findings in other countries where leprosy is disappearing.

Isolation, chemical structure, acute toxicity, and some physicochemical properties of territrem B' from Aspergillus terreus

We have isolated a metabolite of territrem, designated territrem B', from the chloroform extract of a rice culture of Aspergillus terreus 23-1 by using the same isolation procedure as that for territrems A, B, and C. The present isolation procedure gave about 10 mg of territrem B' from 4 kg of rice culture per batch. Analysis of the high-resolution mass spectrum showed that the molecular composition of territrem B' is C29H34O10 (found, 542.2167; required, 542.200). Some results of physicochemical and acute tests are presented in this paper. Single-crystal X-ray diffractometry of territrem B' indicated that the three-dimensional structure of territrem B' has not changed significantly from that of territrem B except for the insertion of one oxygen atom into territrem B to make an additional pyron ring in the E ring. The tremorgenic activity of territrem B' is greatly reduced as tested by intraperitoneal injection in mice.

Unilateral demonstration of the atlas in ipsilateral maxillary alveolar bone destruction

In conventional sinus films in occipito-frontal projection, the atlas is superimposed on the maxillary alveolar processes. If destruction of the alveolar process is present, the atlas-half on the affected side may be unusually clearly demonstrated. The value of this 'unilateral demonstration of the atlas' was confirmed by comparing a group of 20 patients with alveolar process destruction with two groups of 50 patients, one reported as normal and another with mucosal thickening, fluid levels or entirely dense sinuses.

Botulism in metronidazole- treated conventional adult mice challenged orogastrically with spores of Clostridium botulinum type A or B

Conventional adult mice were pretreated with metronidazole to make their intestinal tracts receptive to colonization by Clostridium botulinum. These mice, in groups of 10, were fed 0 (controls), 10(2), 10(3), 10(4), or 10(5) C. botulinum type B spores and were placed for observation in filter-lid cages whose screen floors minimized the amounts of feces available for coprophagy. The opportunity to eat feces was made equal for all mouse groups by placing one mouse of every group in each of 10 cages. Mice given a spore inoculum began to develop botulism after incubation periods of slightly less than 2.75 days. Morbidity rates, which reached maxima within 5 days of challenge, were related to inocula levels. Mortality rates were also dose related. Mice given 10(5) spores and then type B antitoxin intraperitoneally, a treatment not affecting intraintestinal toxin production, remained healthy. Morbidity among control mice was seldom more than 10% and could be ascribed to toxin ingested with feces. A C. botulinum type A spore suspension gave similar results, although morbidity and mortality rates were generally lower than after challenge with a comparable number of type B spores. Mice challenged with 10(2) or 10(5) spores had similar toxin levels in their large intestines 48 h later. Morbidity rates correlated better with toxin levels in the small intestines.

Atrial volume in a normal adult population by two-dimensional echocardiography

Left atrial (LA) and right atrial (RA) volumes were calculated from two-dimensional echocardiography (2D echo) in 54 normal volunteers, of whom 23 were nonathletic men and 25 nonathletic women; 6 additional men had a history of athletic training. Ages ranged from 20 to 66 years (average nonathletic group, 38 years; athletic men, 28 years). The LA volume was measured by single-plane area-length algorithm from apical 2-chamber (2CH) and 4-chamber (4CH) views and from their combination by means of Simpson's rule. The RA volume was analyzed only in the 4CH view. Mean LA volume was larger for men than women; for nonathletic men, 46 +/- 14 ml for 2CH view and 38 +/- 10 ml for both the 4CH view and for Simpson's rule combination of the apical views. For women it was 36 +/- 11 ml for the 2CH view, 34 +/- 12 ml for the 4CH view, and 32 +/- 10 ml by Simpson's rule. Right atrial volume was 39 +/- 12 ml in nonathletic men and 27 +/- 7 ml in women. In the six athletic men, LA volume and volume index, but not RA volume and volume index, were significantly larger than in nonathletes. These findings in this small sample suggest that caution should be exercised in interpreting atrial enlargement in athletes. There were no significant correlations between atrial volumes and age, although individuals over 65 years with normal hearts were not represented. In evaluating LA volume in a given patient, it is advisable to use specific values for each apical view and algorithm and to correct for either sex or body surface area (BSA) but not for both. In the RA it is necessary to correct for both sex and BSA.