Noninvasive measurement of systolic and diastolic blood pressure in swine

Arterial blood pressure was measured noninvasively using Doppler ultrasound and an occluding cuff. The subjects were 28 domestic pigs (10-49 kg) anesthetized with pentobarbital sodium (25 mg/kg). Indirect pressure measurements were made with the Doppler unit placed over the radial or the ulnar artery proximal to the carpal joint. Comparison was made with directly measured pressure to determine the reliability and reproducibility of the indirect method. Direct systolic pressures between 73 and 230 mmHg and diastolic pressures between 52 and 165 mmHg were measured. There was no significant difference between directly and indirectly measured systolic pressure (P greater than 0.20). Indirectly measured diastolic pressure tended to be lower than direct diastolic pressure, the difference by the paired t test being significant to P = 0.06. For systolic pressure the sample correlation coefficient was 0.94, and for diastolic pressure, 0.88. Both systolic and diastolic blood pressure can be accurately measured in the anesthetized pig using Doppler ultrasound and an occluding cuff.

Separation of newborn rat epidermal cells on discontinuous isokinetic gradients of PERCOLL

A one-step procedure has been developed for the separation of epidermal cells using PERCOLL (a new colloidal silica medium of low viscosity, osmolarity, and toxicity) for density gradient centrifugation. Newborn rat epidermal cells were dispersed with trypsin-EDTA and separated into 4 fractions in discontinuous isokinetic gradients. The cell fractions were characterized by their appearance in photomicrographs and their distribution by number and size. Preferential incorporation of 3H-thymidine and 14C-glycine, by basal and granular cells respectively, confirmed the identification of cell types. The basal cells, which were collected in the densest fraction (1.090), were the most homogeneous population with a mean diameter between 7-8 mum and showed 98% viability. The granular cells predominated in the least dense fraction (1.023). The intermediate fractions contained spinous cells admixed with the other cell types.

Cutaneous cysticercosis treated with metrifonate

Cutaneous cysticercosis in humans is an uncommon parasitic infestation. When few nodules are present, surgical excision is effective therapy. For multiple nodules, diverse forms of treatment have been employed. We describe herein a patient with myriad nodules of cysticercosis who showed dramatic improvement after two six-day courses of metrifonate (an organophosphorous compound) administered one month apart. These encouraging results could be of help to other patients, especially those with CNS involvement, although the use of this compound is not without risk.

Laboratory alert: clues to the identification of dermatophytes as the etiologic agents of subcutaneous abscesses

Trichophyton mentagrophytes was isolated on blood agar and in thioglycollate broth after prolonged incubations of four and seven days, respectively, of a routine bacterial culture taken from a subcutaneous abscess on the inner thigh of a 24 year old woman. The lesions had been present on both thighs for six months before correct diagnosis and treatment. Attention is called to the importance of clinical history to the alert microbiologist in determining the correct diagnosis of such lesions when the original bacterial culture reveals no growth after 48 hours.

The activity of interferon on ultraviolet light-induced squamous cell carcinomas in mice

The activity of interferons was tested in ultraviolet light-induced skin tumors in mice. After the tumors were well established, they were injected and measured daily for 19 days. Mouse virus type (IF-alpha + IF-beta) and immune (IF-gamma) interferons were injected intralesionally into three groups of test animals and compared with a fourth group which received mock interferon (control). When used separately, virus type and immune interferons did not affect tumor growth; however, we observed regression in tumor size when the two interferons were used in combination.

Haemostatic factors in human aortic intima

Accumulation of lipid in developing fibrous atherosclerotic plaques is associated with high concentrations of fibrin and accumulation of a tightly bound lipoprotein fraction that can be released by incubation with fibrinolytic enzymes, suggesting that fibrin may play a key role in lesion development. It is not known whether this fibrin represents incorporated mural thrombus or is produced in situ by clotting of the fibrinogen that is present in intima in high concentration. Immunoelectrophoresis was used to measure the concentrations of fibrinogen and components of the clotting system in human aortic intima and lesions, and in mural thrombi. In the lipid and fibrin rich plaque centres prothrombin concentration was almost twice that in normal intima, but concentrations of the thrombin inhibitors antithrombin III and alpha 2-macroglobulin fell, so that the molar ratios of inhibitor/prothrombin fell from 3:1 in normal intima to 1:1 in the plaque centre. In mural thrombi there was preferential sequestration of fibrinogen-like antigen and prothrombin. Distribution of factor-VIII-related antigen was highly unpredictable; in both normal intima and all types of intimal lesion substantial amounts were recovered from some samples, whereas none was recovered from others. The highest concentrations were found in samples free of endothelium from the deep layers of lesions. The results are compatible with the idea that fibrinogen may be converted to fibrin within lesions; once some fibrin has accumulated within the intima it seems to bind low-density lipoprotein and sequester fibrinogen and clotting factors, thereby producing a self-amplifying system.

Perforation of the gallbladder: a clinical study

An analysis of 3,260 admissions to St. Francis General Hospital during a 20-year period for acute and chronic cholecystitis and two traumatic gallbladder perforations revealed 115 cases for an incidence of 3.5 percent. The most common gallbladder perforation in this series was localized perforation with abscess formation in 72 patients (63 percent). Other perforations were fistulization to another hollow viscus, or to the skin, 32 (27.5 percent), and free perforation, 11 (9.5 percent) into the peritoneal cavity.Nineteen or 46 percent of 41 postoperative complications were related to bacterial infections. In spite of a complication rate of 32 percent, the mortality was zero.Of 115 cases categorized as perforated gallbladder, 63 percent were localized with abscess formation, and 9.5 and 27.5 percent, respectively, were classified as free and as fistulization. Mortality was zero; however, morbidity was 32 percent. The significant complications were related to infection, ie, wound, urologic, subphrenic, and pulmonary and leg vein. Early operation is indicated for acute cholecystitis after rapid preoperative perforation.

Melanoma

Melanoma most often occurs on the leg in women and on the head or neck in men. The appearance of the lesion should suggest the diagnosis, but pathologic examination and classification based on depth of skin penetration are essential for optimal therapy. Wide surgical excision should be followed by lymph node dissection, chemotherapy and/or immunotherapy depending on classification.

Immunity and skin cancer

Observations in humans and animal studies support the theory that immunologic surveillance plays an important role in limiting the development of skin malignancies. These immune responses undergo progressive diminution with age. In addition, other factors, such as bereavement, poor nutrition, and acute and chronic exposure to ultraviolet light, can further diminish immune mechanisms. We believe these decreases in immune function in combination with the carcinogenic effect of ultraviolet light are important in the production of skin cancers.

Distribution of plasma proteins across the human aortic wall--barrier functions of endothelium and internal elastic lamina

The concentrations of plasma proteins of different molecular weights were measured in layers across the human aortic wall. On a volumetric basis the concentration of low density lipoprotein (LDL) in inner intima, adjacent to the endothelium, was almost twice the concentration in the patient's plasma. With the exception of transferrin, which behaved anomalously, the concentration of each protein was a linear function of is plasma concentration and molecular weight, so that the relative retention of albumin was only 15% of LDL retention and its concentration in inner intima less than one-quarter of the plasma concentration. Between the inner (luminal) and outer layers of intima the concentration of all proteins decreased by about 40%. In aortas in which the internal elastic lamina (IEL) appeared to be intact it provided an almost total barrier to LDL, but for smaller proteins the concentrations in the layer immediately outside it were inversely related to molecular weight; the concentration of LDL was only 0.3% of the intimal concentration whereas albumin was 26% of the intimal concentration. However, in aortas in which the IEL appeared morphologically frayed, fragmented or discontinuous there was an 80% increase in albumin, and a 25-fold increase in LDL in this layer. The differential barrier functions of endothelium and IEL produce bizarrely different macromolecular environments for smooth muscle cells in intima and media.

Leiomyomas of the esophagus: a clinical experience

The most common benign tumor of the esophagus is a leiomyoma. Our experiences with six cases during a recent ten-year period at St. Francis General Hospital are presented. A case report that includes the clinical picture, diagnostic tests, and definitive management is presented. These tumors may be symptomatic or asymptomatic. Esophagogram and esophagoscopy are two essential preoperative diagnostic tests. The ideal approach and technique for excision depend upon the location and size of the tumor.

General surgery in Jehovah's witnesses--personal experience: a 22-year analysis

The author has had experience with 73 surgical patients who professed the Jehovah Witness faith. The refusal of blood transfusions created problems in circulatory fluid volume, respiratory exchange, and wound healing. The surgical complication rate was excessive and the most frequent was wound infection in 79.4 percent of cases and an overall mortality of 1.4 percent.

Coronary heart disease in North-East Scotland a study of genetic and environmental variation in serum lipoproteins and other variables

1. Serum lipoprotein concentrations and other variables such as relative weight, skinfold thickness, blood pressure, serum glucose, uric acid, fibrinogen smoking habits, etc. have been recorded on about 700 persons, including about 200 survivors of myocardial infarction under age 50 years, 250 of their relatives and 250 unrelated controls. 2. Elevated levels of VLDL and LDL are several times more frequent in survivors of infarction than in controls. 3. Cigarette smoking is associated with 20 to 30 per cent increase in VLDL. 4. Relative weight and skinfold thickness together account for a quarter of the variance of VLDL in men, 9 per cent in women. 5. LDL and HDL are uncorrelated; there is a low, consistently negative correlation between HDL and VLDL and IDL. 6. Parent-offspring regression and sib correlations indicate high, intermediate and low heritability for respectively HDL, LDL and VLDL. First degree relatives of survivors of infarction have levels of VLDL, IDL and LDL but not HDL.

Diminished immune response in sun-damaged skin

In previously sensitized volunteers, higher concentrations of 2,4-dinitrochlorobenzene were necessary to elicit positive patch test reactions on the sun-damaged skin of the neck than on the protected skin of the upper part of the back. This difference was not found in subjects without evidence of sun damage, and there was no difference between sun-damaged and nondamaged skin in response to a primary irritant. Responses to intradermally injected common antigens were also less intense in sun-damaged skin that in nonexposed skin. These findings suggest the existence of a local defect in cell-mediated immunity in skin altered by long-term sun exposure.

Effectiveness of the closed method utilizing iodophors in the degermination of hands and arms of the surgical team and operative sites

A closed method utilizing the E-Z Prep Tray and the E-Z Scrub with iodophors is an effective means of degerming the hands and arms of surgical team members and the patients' operative sites. Fifty unselected surgical cases were evaluated bacteriologically, pre-preparation, post-preparation, and post-operatively. The data indicated that bacterial colony counts decreased, and the postoperative wound infection rate decreased to two percent.

HDL - should we be 'chasing' it now?

Although 'within defined population groups the association of low HDL level with increased coronary risk seems to be established', the author concludes 'The inverse relation between plasma HDL level and risk of CHD remains a phenomenon that we cannot explain in scientific terms'.

The effect of delipidated high density lipoprotein on human leukocyte sterol synthesis

Sterol synthesis is increased when whole human serum is added to leukocytes in buffer. Addition to the buffer of an equivalent amount of serum from which lipid has been extracted by organic solvent leads to a greater increase in synthesis. The addition of whole high density lipoprotein to buffer has little effect on sterol synthesis whereas addition of delipidated high density lipoprotein stimulates sterol synthesis. Delipidated high density lipoprotein may be responsible for the stimulation of sterol synthesis by delipidated serum.