Treatment of mild hypertension in elderly males

1. Males, born between 1900 and 1925, with mild hypertension have been treated for periods varying from 300 to 2000 days. 2. The life and death status of all patients (except two) was known on 1st November 1978. 3. A group of patients with mild hypertension receiving treatment based on a thiazide diuretic had a greater mortality than the other drug-treated group. 4. The increased mortality was caused by an increased number of myocardial infarcts. 5. Elderly male patients with mild hypertension probably have preexisting vascular disease and therapy should not automatically be started. If therapy is started, beta-adrenoreceptor-blocking drugs may be a preferred therapy.

The scrotal pouch operation for undescended testis

Patients who had undergone a total of 167 orchidopexies by the scrotal pouch technique were followed up for 1-3 years. The technique is described in detail. At follow-up 6 testes were found to have retracted out of the scrotum and these were successfully dealt with at a second operation. One testis was hypoplastic in the scrotal pouch and another infarcted in the groin after the first stage of a planned two-stage procedure. The remaining 159 tests were entirely satisfactory, giving an overall success rate of 95.2%. This technique compares favourably with other methods of orchidopexy, both in achieving a satisfactory anatomical position and in avoiding damage to the testis.

High-frequency recombination within the gag gene of Rous sarcoma virus

We isolated 28 recombinants of Rous sarcoma virus at early (24 h) and late (7 days) times after infection. These recombinants were selected for wild type in the pol and src genes and analyzed for their env and gag phenotypes. We were unable to show strong linkage between any two markers, including two markers within a single gene (gag).

Lead poisoning. A comprehensive review and report of a case

Lead, a ubiquitous heavy metal which has realized increased use, can cause poisoning by environmental contamination in either its organic or its inorganic form. Lead poisoning can be either acute or chronic, with the latter being the more common. The clinical signs and symptoms of lead poisoning are nonspecific, resulting in a difficult diagnostic problem, especially when it is not industrially related. On occasions, the dentist or oral surgeon may be the first to see an afflicted patient because of oral manifestations.

Inhibition of neutrophil migration by sera from patients with rheumatoid arthritis

Sera from patients with rheumatoid arthritis inhibited the migration of human neutrophils in 63% (twenty-two out of thirty-five) of the cases tested. The inhibition was not due to a toxic effect of the serum as it was reversed by a chemotactic stimulus. There was a strong correlation between the degree of inhibition of neutrophil migration and the amount of immune complexes present in the sera as determined by the C1q binding activity. It is suggested that the inhibition of neutrophil migration is due to the presence of circulating immune complexes, and that the capacity of immune complexes to inhibit neutrophil migration in vitro may also contribute to the accumulation of neutrophils at sites of immune complex formation in vivo.

"Push-up palpitations": unusual presentation of ruptured chordae tendineae: a case report

A 47-year-old man experienced palpitations and shortness of breath following push-up exercises. Because of paroxysmal atrial fibrillation and fatigue, the patient underwent investigation. Echocardiography and cardiac catheterization indicated the diagnoses of mitral valve prolapse and rupture of the chordae tendineae. This report represents the first description of such a sequence of events.

Synovial fat necrosis associated with ischemic pancreatic disease

A 59-year-old man with ischemic pancreatic disease, polyarthritis, and cutaneous nodules has shown histopathologic findings indicative of disseminated fat necrosis in a percutaneous biopsy specimen from the right knee. The histopathologic findings in the synovium included necrotic fat cells, distorted fat cells and adjacent lymphocytes, lipid laden histiocytes, and giant cells. In prior histopathologic studies of the joint involvement associated with this disorder, fat cell necrosis has been found only in the periarticular tissues, and the synovium has appeared normal or showed nonspecific inflammation. However, the present study shows that the synovial membrane may also be the site of fat necrosis and an associated inflammatory reaction; thus patients with this disorder may manifest arthritis in addition to periarthritis.

Inhibition of human neutrophil migration by aggregated gammaglobulin

Heat-aggregated human gammaglobulin has been shown to inhibit the random migration of human neutrophils in serum-containing medium. This inhibition was not due to metabolic exhaustion or deactivation of the cells, since migration in the presence of aggregated gammaglobulin and casein as a chemotactic stimulus was not inhibited. The inhibition of migration was not mediated by a negative chemotactic gradient produced as a result of complement activation, and could be demonstrated in complement-depleted serum. Sera obtained from patients with rheumatoid arthritis with evidence of circulating immune complexes were able to significantly inhibit neutrophil migration, indicating that this phenomenon may be a useful means for the detection of circulating immune complexes. It is suggested that aggregated gammaglobulin or immune complexes can inhibit the chemokinetic effect of serum on neutrophils by a reversible interaction with the neutrophil surface, and that this inhibition could contribute to the accumulation of neutrophils at sites of immune complex deposition in vivo.

Perceived value-orientations toward premarital virginity of female virgins and nonvirgins

Various studies have suggested an increase in the incidence of premarital intercourse among women with a corresponding decline in premarital virginity. The present study was conducted in an attempt to determine perceived value-orientations toward premarital virginity of female virgins and nonvirgins. It examined the possibility of different orientations for different virgin or nonvirgin classifications and motivations. Results suggested significant differences between female virgins and nonvirgins among ten value-orientation criteria.

Erythropoietin levels in uremic nephric and anephric patients

Erythropoietin titers were measured in anemic nephric and anephric patients undergoing chronic hemodialysis by utilizing a plasma concentration technique. In eight out of 11 anephric patients studied, decreased but detectable levels of erythropoietin were found, suggesting that extrarenal erythropoietin plays a role in the regulation of red cell production in anephric patients. In 14 nephric uremic patients, erythropoietin production was found to be more variable, with one group of eight patients having erythropoietin levels in the range for normal nonanemic individuals (3.9 to 15 mU/ml), and a second group of six patients with erythropoietin higher than normal (greater than 15 mU/ml). Both groups were found to be equally anemic, indicating that in the second group the bone marrow is less responsive to erythropoietin. The severity of secondary hyperparathyroidism was found to be higher in this second group, suggesting a role of PTH in the bone marrow unresponsiveness. A good correlation between biological and immunological erythropoietin activities was found in the plasma from normal subjects and uremic nephric and anephric patients.

Thermometers and rectal perforations in the neonate

Three neonates with rectal perforations probably caused by the use of the rectal thermometer, are reported. The dangers of this condition and the difficulty of diagnosis even at laporatomy are emphasised. It is suggested that since the axillary temperature in the neonate is an adequate reflection of the core temperature the routine use of the rectal thermometer, except in exceptional circumstances, should cease.

Exercise training and plasma catecholamines in patients with ischemic heart disease

A 3 month program of exercise training was carried out in 10 patients with ischemic heart disease to assess the contribution of catecholamines to the training effect of improved exercise capacity and enhanced myocardial oxygen delivery. Training resulted in a significant increase in maximal treadmill exercise time (mean +/- standard error the mean 374 +/- 28 versus 567 +/- 33 seconds, P less than 0.0001). The heart rate-arterial pressure product, an index of myocardial oxygen consumption, was decreased at rest and at all levels of exercise after training. After training, the mean plasma norepinephrine level during supine rest was reduced (320 +/- 23 to 191 +/- 20 pg/ml, P less than 0.01) and plasma epinephrine values were unchanged. When these previously sedentary patients exercised on a treadmill to the maximal level attained before exercise training, the mean plasma norepinephrne and plasma epinephrine concentrations were significantly reduced. These data suggest that the beneficial adaptations of the cardiovascular system to exercise training are at least partially mediated by changes in the catecholamine response to exercise.

Skin closure with polyglycolic acid (Dexon)

Cosmetically satisfactory scars were achieved in 94.5% of skin crease orchidopexy wounds sutured with subcuticular polyglycolic acid. Of twenty-seven similar wounds closed with interrupted black silk sutures 18.5% developed hypertrophy at the medial end.

Female virgin and nonvirgin psychological orientations toward premarital virginity

Literature on premarital heterosexual intercourse suggest increases in its incidence, frequency and acceptance among college-aged youth. Simultaneously, the studies suggest a decline in female premarital virginity. The present study was conducted to determine perceived psychological orientations toward premarital virginity of female virgins and nonvirgins. It examined the possibility of different orientations for different virgin or nonvirgin classifications and motivations. Results suggested significant differences between female virgins and nonvirgins among ten psychological orientation criteria.