Follow-up of oral leukoplakia after carbon dioxide laser surgery

We evaluate the 3-year result of 145 oral leukoplakias operated on by outpatient carbon dioxide laser surgery at the Istituto Nazionale Tumori, Milan, Italy. The surgical technique that was used consisted of excision in 140 patients and vaporization in 5 patients. Cancer was found in 14 out of 140 patients who underwent excision (10%). In the analysis of the disease-free survival rate and of the unfavorable pattern of events, only 131 patients with benign postoperative histologic diagnosis were considered. Fifty-eight patients developed unfavorable events. The probabilities of remaining free of disease or of developing local relapses or new lesions at 3-year survival was 0.57, 0.27, and 0.19, respectively. Two patients had oral carcinomas after the operation. Forty patients modified their alcohol or tobacco habits or their teeth and/or prosthesis. Moreover, only two patients modified these factors before the unfavorable events occurred.

Direct detection of paramagnetic species in adriamycin perfused rat hearts

Direct detection of paramagnetic species in control and adriamycin-perfused rat hearts has been carried out. Depending on the flow rate of the perfusion solution (8,4,2 and 1 ml/min) different paramagnetic species were observed: Fe(III)(g = 2.12) at 4 ml/min; three types of oxygen centered radicals of which two in control hearts (g = 2.05 g = 2.038 g = g = 2.008) and the third one (g = 2.03 g = 2.005) in adriamycin perfused hearts, at 2 ml/min. The latter radical was the only one observed at perfusion rate of 1 ml/min both in control and adriamycin treated systems. A relationship between the intracellular enzymatic reductive activation of the anthracycline and the occurrence of ischemic conditions (4,2 and 1 ml/min) in myocardial tissues is proposed basing on the relative amounts of the paramagnetic species above mentioned.

Discriminative stimulus properties of muscarinic agonists

In a two-lever, food-reinforced drug-discrimination paradigm separate groups of rats were trained to discriminate either arecoline, pilocarpine or oxotremorine from saline. The discriminative cues of all three agonists were potently blocked by scopolamine, but only by 30-60 fold higher doses of methylscopolamine. The three agonists all suppressed overall response rate. These rate-suppressant effects were not blocked by scopolamine in doses which blocked the discriminative cues. In generalization tests, arecoline elicited selection of the drug-appropriate lever in all groups of trained animals. Pilocarpine was discriminated as drug by all pilocarpine-trained animals and by a majority of oxotremorine-trained animals, but was not significantly discriminated by the arecoline-trained group. Oxotremorine was discriminated by all oxotremorine-trained animals but only by some pilocarpine-trained animals, and was not significantly discriminated by the arecoline-trained group. Morphine, haloperidol, chlordiazepoxide, pentobarbital and nicotine were not generalized to any of the training drugs. The discriminative stimuli produced by the training drugs are therefore specific and exhibit properties indicative of an origin at central muscarinic receptors but may not be identical.

Professional nursing practice in neurology ambulatory care

The ambulatory care setting is an important expanding area for professional nursing practice. The demand for ambulatory care nurses is stimulating the definition and development of professional nursing practices in outpatient clinics. Neurology ambulatory care at the National Institutes of Health, Bethesda, Md, is provided in the context of contributing to biomedical research. This article discusses the components of patient selection criteria, experimental therapy, and research data collection that have implications for nursing care. Visit categories are used to discuss administrative and practice issues of the research patient population at all institutes. Management plans are discussed, and a case study is presented along with a care plan.

[Correlation between QT interval, ventricular arrhythmias and left ventricular function in chronic alcoholics]

Prolonged QT interval and arrhythmias have been reported to occur in chronic alcoholics. To investigate the role of chronic alcohol consumption in the onset of arrhythmias and the development of the preclinical left ventricular dysfunction, in a group of 12 asymptomatic chronic alcoholics with no clinical evidence of heart disease, with histologically proven hepatic damage, after a week of abstinence from alcohol, the following investigations were performed: measurements of the corrected QT interval (QTc), 24-hours Holter monitoring, systolic time intervals, M-mode echocardiograms. The results were compared to those of 10 normal subjects. Our data suggested no difference in QTc interval between chronic alcoholics and normal persons. The distribution of arrhythmias was not statistically different in the two groups, particularly frequent and complicated arrhythmias occurred in only one subject in each group. Preejection period corrected for heart rate (PEPI) was significantly longer in alcoholics (132 +/- 16 vs 119 +/- 11, p less than 0.05). All echocardiographic parameters examined were not significantly different in the two groups. On the basis of our results, our impression is that the arrhythmogenic role of alcohol, not under acute ingestion, is relatively unimportant and further studies are needed to become a definitive conclusion about subclinical alcoholic cardiomyopathy.

Practical application of the Bristol Perinatal Growth Chart to Mediterranean populations

The Bristol Perinatal Growth Chart (gestogram) has been applied to different Mediterranean populations and compared to traditional percentile intrauterine growth charts. The opinion is stressed that the gestogram system can successfully replace traditional intrauterine growth charts and offers the advantage of greater simplicity and adaptability.

Action of DCCD on the H+/O stoichiometry of mitoplast cytochrome c oxidase

The mechanistic H+/O ejection stoichiometry of the cytochrome c oxidase reaction in rat liver mitoplasts is close to 4 at level flow when the reduced oxidase is pulsed with O2. Dicyclohexylcarbodiimide (DCCD) up to 30 nmol/mg protein fails to influence the rate of electron flow through the mitoplast oxidase, but inhibits H+ ejection. The inhibition of H+ ejection appears to be biphasic; ejection of 2-3 H+ per O is completely inhibited by very low DCCD, whereas inhibition of the remaining H+ ejection requires very much higher concentrations of DCCD. This effect suggests the occurrence of two types of H+ pumps in the native cytochrome oxidase of mitoplasts.

Clinical neuropsychology: a discipline in evolution

The future of neuropsychology is considered first in terms of the potential impact of events occurring in clinical medicine, neuroscience research, basic behavioral science and applied psychology, and related disciplines. The focus is then turned inward on clinical neuropsychology itself and a series of suggestions are made concerning how this specialty can evolve to best meet the challenges it will face.