Complications of intravenous therapy

A survey of 130 patients receiving intravenous therapy was undertaken. There were no instances of speticaemia over this period, despite a positive bacterial culture rate for cannulae of 48%. The incidence of phlebitis was 31%, and was associated with usual physicochemical factors. These included a cannulation time of greater than two days, an intravenous potassium supplement and antibiotics. Normal saline solutions given alone were associated with a lower incidence of phlebitis and continuous intravenous heparin administration may prolong the period of cannulation before phlebitis occurs. The institution of intravenous therapy teams should help to minimize the complications.

Liver scanning in patients with suspected metastatic malignant disease

Liver scans of 72 patients with suspected malignant disease were evaluated to determine the accuracy of the investigation in detecting disease, including metastases and also its use to the referring surgeon. A comparison between the liver scan result and clinical and biochemical findings was also made. The liver scan had an overall accuracy of 83% in diagnosing metastases, compared with 64% for the serum alkaline phosphatase (SAP) level and was more useful clinically than the SAP level. Careful classification of the liver scan patterns allowed more consistent interpretation and improved the specificity of the diagnostic information obtained. Clinical assessment of liver and spleen size by abdominal palpation was unreliable and occasionally misleading.

Chronic gastric ulcer in the rat produced by wounding at the fundo-antral junction

Standardized 8-mm mucosal wounds were made in the rat stomach at the rumeno-fundic junction, fundus, fundo-antral junction, and antrum, and examined at intervals up to 8 months. All wounds at the rumeno-fundic junction and fundus were healed within 4 weeks and at the antrum within 12 weeks. The majority of wounds at the fundo-antral junction remained chronic and at 8 months 41 of 50 rats still had ulcers 2 mm or greater in diameter. These findings suggest that the fundo-antral junction is an area which is susceptible to the development of chronic ulcers. This is a simple and reliable method of producing chronic gastric ulcers and does not alter the continuity or disturb the function of the gastrointestinal tract.

Treatement of excessive weight gain in patients taking lithium

Six female primary affective disorder patients who had gained an average of 9.5 kg while taking lithium lost an average of 2.9 kg on a 10-day 900 calorie a day hospital diet containing 100 mEq of sodium per day. No evidence of lithium toxicity was observed on this regimen. There was no evidence that fluid retention played a major role in the weight gain.

Professional drivers: protection needed for a high-risk occupation

"On the job" motor vehicle deaths number more than 4,000 annually in the U.S. and comprise nearly one-third of all work-related deaths. Yet the Department of Labor has set no standards relating to on-the-road safety of the millions of workers whose jobs entail large amounts of driving, and Department of Transportation standards affecting occupational safety cover only drivers in interstate commerce. Drivers of some commercial vehicles, such as heavy trucks, are at special risk of injury because trucks have usually been exempted for many years from federal motor vehicle safety standards--such as standards for brakes and seatbelts--designed to prevent crashes or protect occupants in crashes. Observations based on a series of 150 fatal crashes involving tractor trailers illustrate the need for better protection of this large population of high-risk workers. Clarification of responsibility within the various federal agencies and application of available knowledge and technology are essential.

Comparative isolation of vaginal yeasts on selective and nonselective media

The isolation of vaginal yeasts was compared on a selective medium, phosphomolybdic acid agar, and on starch agar, a nonselective differential medium used primarily to isolate Corynebacterium vaginale. The majority of the Candida albicans strains were isolated on starch agar, but the selective medium was required for isolating all yeasts from the greatest number specimens.

Low-affinity interaction of ethanol with the fluorescent complex between horse liver alcohol dehydrogenase and auramine O

Quenching of the fluorescence of the complex between horse liver alcohol dehydrogenase (alcohol:NAD+ oxidoreductase (EC 1.1.1.1) and auramine O complex is inconsistent with a simple competitive displacement of auramine O by ethanol. Instead, the action of ethanol requires an explanation in terms of a solvent effect, or the formation of an enzyme-auramine O-ethanol ternary complex. The latter complex would have to be the low-affinity variety similar to the enzyme-NADH-ethanol ternary complex encountered in the kinetic system.

A simple dichromatic densitometer for repeated measurements of cardiac output in small animals

The construction of a simple device for continuous monitoring and recording of plasma indocyanine green concentration in small animals is described. The apparatus is designed to hold a vascular bed such as the ear or the omentum and to transilluminate it with white light from a fiber optic bundle. The transmitted light is divided by a dichroic mirror. Appropriate filters select a narrow band of frequencies from each segment. There are two photovoltaic cells, one sensitive to the dye and the other insensitive to it. Both are approximately equally reactive to changes in transilluminence caused by changes in blood content or hematocrit and are relatively insensitive to changes in oxygen saturation of the transilluminated blood. Reproducible estimates of cardiac output have been obtained with the injection of 300 mug indocyanine green in a volume of 20 mul with the densitometer applied to the small intestine or to the ear of the animal. The device responds linearly to increasing plasma indocyanine green concentrations and can be calibrated with less than 0.1 ml of blood.

Heterotopic bone formation in abdominal scars

Twelve patients with heterotopic ossification in abdominal scars have been studied. Two patients were elderly females. Operative excision was required in seven: two for local symptoms, two for suspected local malignant recurrences and three for further intra-abdominal procedures. The other five instances were diagnosed roentgenologically. The mechanisms of formation of such lesions are not clear, but both the implantation and metaplasia theories may be correct.

Transpiration vapour pressures and activities in the molten salt systems ZnCl2 + NaCl and ZnCl2 + KCl

Vapour pressure measurements were made by a transpiration method for molten zinc chloride and molten mixtures of this salt with sodium and potassium chlorides, respectively. Activities of zinc chloride in the mixtures were calculated and from these values, those of the alkali chloride were calculated by Gibbs-Duhem integration. For this purpose a convenient computer method has been devised. Although the large deviations of activity and activity coefficients qualitatively support independent evidence that complex ions are formed in these systems, the results cannot quantitatively be explained using a calculation due to Braunstein in terms of interactions in the melt to form complex ions of a unique type, e.g. ZnCl3- or ZnCl42- etc. This indicates that the departure from ideal behaviour needs to be explained by a more detailed theory.