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Sahrawat KL, Rego TJ, Burford JR, Rahman MH, Rao JK, Adam A. Response of sorghum to fertilizer phosphorus and its residual value in a Vertisol. ACTA ACUST UNITED AC 1995. [DOI: 10.1007/bf00749519] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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252
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Pou K, Ong H, Adam A, Lamothe P, Delahaut P. Combined immunoextraction approach coupled to a chemiluminescence enzyme immunoassay for the determination of trace levels of salbutamol and clenbuterol in tissue samples. Analyst 1994; 119:2659-62. [PMID: 7879870 DOI: 10.1039/an9941902659] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A monoclonal immunoglobulin G1 (IgG1) antisalbutamol, which exhibits a 75% cross-reactivity with clenbuterol, has been used in the setup of an immunoaffinity chromatography method and a chemiluminescence enzyme immunoassay for the extraction and the quantification of salbutamol and clenbuterol in tissue samples. After analytical validation, the proposed methodology was applied to liver, kidney and muscle samples obtained from calves and pigs treated with these beta 2-agonists (100 micrograms per kg of body weight) for 10 d. This methodology allowed the quantification of both drugs until 6 d after the final dose. At this time, however, salbutamol and clenbuterol were concentrated in the liver. Our results indicate that the liver is the preferred tissue to sample for the detection of illegal use of beta 2-agonists as growth promoters, in the absence of urine samples.
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Adam A, Gervais N, Panoyan A, Ong H, Beliveau L, Ayotte C, Delahaut P. Detection of clenbuterol residues in hair. Analyst 1994; 119:2663-6. [PMID: 7879871 DOI: 10.1039/an9941902663] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Sixty rats were grown in the presence of 10 (n = 30) and 100 (n = 30) micrograms kg-1 body mass of clenbuterol for a period of 10 d. An immunoextraction step coupled with a competitive enzyme immunoassay allowed the quantification of clenbuterol in hair upon 20 (10 micrograms kg-1) and 30 d (10 micrograms kg-1) after the last dose. This accumulation in hair contrasts with the rapid clearance in tissues. The nature of the immunoreactive material was confirmed by mass spectrometry.
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Ribuot C, Yamaguchi N, Godin D, Jetté L, Adam A, Nadeau R. Intracoronary infusion of bradykinin: effects on noradrenaline overflow following reperfusion of ischemic myocardium in the anesthetized dog. Fundam Clin Pharmacol 1994; 8:532-8. [PMID: 7721230 DOI: 10.1111/j.1472-8206.1994.tb00834.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of intracoronary bradykinin (BK) infusion on noradrenaline release and ventricular arrhythmias induced by coronary occlusion and reperfusion in the anesthetized dog. METHODS 14 anesthetized adult mongrel dogs of either sex underwent a 60 min occlusion of the left anterior descending coronary artery (LAD) followed by a 30-min reperfusion period. BK (1 ng.kg-1.min-1, n = 7), or its vehicle (Lactate Ringer, n = 7), infusions just distal to the left coronary ostium started 15 min before the LAD occlusion and were maintained throughout the experimental period. An epicardial vein, running parallel to the LAD was cannulated to enable the biochemical determinations. The effects of BK on ventricular arrhythmias, cardiac noradrenaline and lactate releases and creatine kinase activity were assessed. RESULTS BK significantly reduced the amount of noradrenaline released at reperfusion by ischemic myocardium (from 82.1 +/- 31.7 to 11.9 +/- 9.6 ng.min-1), as well as plasma creatine kinase activity at 30 min of reperfusion. This is accompanied by a significant reduction in the incidence of reperfusion-induced sustained ventricular tachycardia. CONCLUSION This suggests that the protective effect of bradykinin against reperfusion-induced sustained ventricular tachycardia could be associated with a reduction in cardiac noradrenaline release.
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Lortie M, Sirois MG, Regoli D, Couture R, Adam A, Plante GE. Regional changes in the extravasation of albumin in the canine kidney: comparison of bradykinin and water diuresis. Microvasc Res 1994; 48:282-94. [PMID: 7731393 DOI: 10.1006/mvre.1994.1055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This report describes the adaptation of the albumin bound Evans blue dye (EB) extraction technique and its use in identifying regional changes in albumin extravasation rates. We present data to justify our technical approach and highlight the use of this method by describing differences resulting from two different models of induced diuresis and natriuresis. Results observed under control conditions (Group 1) are compared to those obtained following the infusion of bradykinin (BK) into the left kidney (Group 2) or hypotonic saline-induced water diuresis (Group 3). EB and water content of tissue samples of cortex (CTX), outer medulla (OM), inner medulla (IM), and papilla (PAP) regions are reported. Under control conditions a significant heterogeneous distribution of EB and water content (wet/dry tissue weight) between zones was observed. Left kidney EB values for the CTX, OM, IM, and PAP in Group 1 were 125 +/- 11, 398 +/- 56, 763 +/- 51, and 741 +/- 52 micrograms EB/g dry tissue and respective wet/dry tissue ratios were 4.48 +/- 0.05, 5.10 +/- 0.19, 7.13 +/- 0.37, and 6.35 +/- 0.32. In Group 2, BK caused a selective increase in cortex EB content to 201 +/- 7 (P < 0.01) micrograms EB/g dry tissue, without altering water content values. Results of EB extraction in Group 3 revealed no change in the CTX but significant increases in the OM, IM, and PAP regions: 576 +/- 40 (P < 0.01), 910 +/- 60 (P < 0.01), and 850 +/- 69 (P < 0.05) micrograms EB/g dry tissue, respectively. Likewise, tissue water content values were unchanged in the CTX but significantly greater in the OM, IM, and PAP: 6.02 +/- 0.22, 8.90 +/- 0.25, and 8.40 +/- 0.17, respectively (P < 0.01, all three values). This technique clearly shows the regional heterogeneity of the renal microvascular network and allows the localization of intrarenal changes in albumin extravasation. This method provides evidence that BK increases albumin extravasation in the cortex only and that changes in the renal medulla are obtained in hypotonic saline-induced water diuresis.
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Adam A, Watkinson A, Ellul J, Entwisle K, Mason R. Oesophageal perforation treatment with plastic-covered wallstent endoprostheses. Clin Radiol 1994. [DOI: 10.1016/s0009-9260(05)82816-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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257
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Adam A. Clin Radiol 1994; 49:731-732. [DOI: 10.1016/s0009-9260(05)82680-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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258
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Zheng YQ, Adam A. Potassium trans-tetraaquadicarbonatonickelate(II), K2[Ni(CO3)2(H2O)4]. Acta Crystallogr C 1994. [DOI: 10.1107/s0108270193012855] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Abstract
In patients with obstructive jaundice caused by unresectable malignant tumors, biliary endoprostheses inserted percutaneously or endoscopically can provide excellent palliation. Conventional plastic stents are associated with a relatively high rate of occlusion caused by biliary sludge. Migration is another significant problem. Self-expandable, metallic stents can be inserted percutaneously via a small transhepatic track but expand to achieve a relatively large internal diameter. This minimizes the problem of occlusion due to encrusted bile and reduces the rate of reintervention. Migration rarely occurs. Metallic stents have also been employed in the management of recurrent benign biliary strictures unsuitable for surgery. In those patients in whom the frequency of radiological intervention is unacceptably high, such endoprostheses can provide a means of preventing restenosis.
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Souvannavong V, Brown S, Sarih M, Adam A. Expression and visualization during cell cycle progression of alkaline phosphatase in B lymphocytes from C3H/HeJ mice. J Leukoc Biol 1994; 55:626-32. [PMID: 8182340 DOI: 10.1002/jlb.55.5.626] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The expression of alkaline phosphatase (APase) activity by purified B cells from lipopolysaccharide (LPS)-hyporesponsive C3H/HeJ mice was determined. Optimal APase activity was expressed after costimulation with interleukin-5 and dextran sulfate (DXS), whereas LPS, which is highly effective on B lymphocytes from normal mice, was unable to induce enzyme expression, even in the presence of DXS. The simultaneous determination by flow cytometry of both cellular APase, by using a fluorescent azo dye technique, and DNA content showed that APase was highly expressed by about one-tenth of cells in G1 phase, whereas it was present in more than 50% of cells in S and G2/M phases. The enzyme, as visualized by confocal microscopy after cell sorting on the basis of DNA content, was found to be localized mainly in vesicular structures distributed throughout the cytoplasm in G1 cells. It was distributed in patches and essentially localized at the cell periphery in S cells, whereas clear capping of activity was observed in G2/M cells.
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Adam A. Clin Radiol 1994; 49:290-291. [DOI: 10.1016/s0009-9260(05)81864-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rossi P, Bezzi M, Rossi M, Adam A, Chetty N, Roddie ME, Iacari V, Cwikiel W, Zollikofer CL, Antonucci F. Metallic stents in malignant biliary obstruction: results of a multicenter European study of 240 patients. J Vasc Interv Radiol 1994; 5:279-85. [PMID: 7514463 DOI: 10.1016/s1051-0443(94)71483-4] [Citation(s) in RCA: 154] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
PURPOSE In this retrospective multicenter study, the authors analyzed the clinical efficacy of different metallic stents in the palliative treatment of patients with neoplastic obstructive jaundice. PATIENTS AND METHODS Two hundred forty patients were treated in four European centers. Causes of obstruction were pancreatic carcinoma (n = 84), biliary neoplasm (n = 99), metastases in hilar nodes (n = 34), primary or secondary liver tumors (n = 4), and other tumors (n = 19). A total of 388 metallic stents were used: 300 Wallstents, 35 nitinol Strecker stents, 40 Gianturco-Rosch Z stents, and 13 tantalum Strecker stents. RESULTS Overall 25- and 50-week survival rates were 42% and 16%, respectively; the 30-day mortality rate was 14.6%. Two deaths were related to the procedure (0.8%); 19 patients (8%) had major complications. The 25-week patency rate was significantly higher for the nitinol Strecker stents and the Wallstents (78% and 67%, respectively) than for the Z stents and the tantalum Strecker stents (30% and 20%, respectively) (P < .01 and P < .001, respectively). Average patency was 8.3, 5.9, 2.3, and 4.0 months, respectively. Reintervention due to stent obstruction was necessary in 53 patients. CONCLUSION The Wallstent and the nitinol Strecker stents were the most effective in achieving long-term palliation. Patency was significantly affected by the level of obstruction but not by the type of obstructing tumor.
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Legris F, Martel-Pelletier J, Pelletier JP, Colman R, Adam A. An ultrasensitive chemiluminoenzyme immunoassay for the quantification of human tissue kininogens: application to synovial membrane and cartilage. J Immunol Methods 1994; 168:111-21. [PMID: 8288887 DOI: 10.1016/0022-1759(94)90215-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A sandwich enzyme immunoassay using a chemiluminescent detection has been developed for the quantification of total human (high and low molecular weight) kininogens in tissue extracts. This assay uses monospecific polyclonal IgG labelled with alkaline phosphatase and the commercially available dioxetane derivatives as substrates, for the detection of immune complexes. This method exhibits a sensitivity level of 1 fmol/ml and allows a precise quantification of total kininogens in synovium and cartilage extracts. When characterized by Western blot, the immunoreactive material reveals the presence of both high and low molecular weight kininogens.
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Adam A. Society for Minimally Invasive Therapy: The need for restructuring. MINIM INVASIV THER 1994. [DOI: 10.3109/13645709409153014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Adam A. Clin Radiol 1994; 49:72. [DOI: 10.1016/s0009-9260(05)82924-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Décarie A, Drapeau G, Closset J, Couture R, Adam A. Development of digoxigenin-labeled peptide: application to chemiluminoenzyme immunoassay of bradykinin in inflamed tissues. Peptides 1994; 15:511-8. [PMID: 7937327 DOI: 10.1016/0196-9781(94)90214-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A new ultrasensitive chemiluminoenzyme immunoassay (CLEIA) using digoxigenin-labeled bradykinin (BK) as a tracer is proposed to quantify kinins in tissue samples. Rabbit polyclonal IgGs anti-BK directed against the C-terminal end were used for the immunoconcentration step along with dioxetane derivative for the revelation step. The sensitivity of the assay for BK was 0.1 fmol/ml with ED50 of 0.78 pmol/ml. This method was applied on extracts of normal and carrageenan-inflamed tissues. The edema produced by the injection of carrageenan in rat hindpaws was associated with a sevenfold increase of immunoreactive kinins in the inflamed paw extract (from 0.021 +/- 0.007 to 0.141 +/- 0.021 pmol/g tissue; p < 0.01), the immunoreactivity corresponded to BK, kallidin, and T-kinin after HPLC separation. When a mixture of inhibitors of kininase I (mergepta) and kininase II (captopril) was coinjected with carrageenan, the carrageenan-induced edema was unaffected but the kinin tissue content was significantly enhanced (0.207 +/- 0.003 pmol/g tissue; p < 0.01). However, the kinin tissue content and the edema response were unaltered by inhibitors given separately. Hence, this highly sensitive assay provides a biochemical evidence that kinins may act as proinflammatory mediators, and highlights a compensatory increase of kininase I and II activities in inflamed tissues.
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Sørensen SH, Proud FJ, Adam A, Rutgers HC, Batt RM. A novel HPLC method for the simultaneous quantification of monosaccharides and disaccharides used in tests of intestinal function and permeability. Clin Chim Acta 1993; 221:115-25. [PMID: 8149629 DOI: 10.1016/0009-8981(93)90026-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The quantification of monosaccharides and disaccharides used as probes in intestinal function and permeability tests can be technically demanding, detracting from the value of this approach to the indirect assessment of intestinal damage. In this study, a procedure is described for the simultaneous quantification of rhamnose, lactulose, 3-O-methyl-D-glucose and xylose in urine by HPLC using an anion exchange column with pulsed amperometric detection. This method is relatively fast and simple to perform, requiring no pre-treatment of urine samples or post-column derivatization. Accuracy and precision of determinations are illustrated by analytical recoveries (mean percentage +/- S.D., CV., n = 30) for multiple batch analyses of a diluted urine sample containing 20 mg/l of rhamnose (100 +/- 6.8, 6.2%), lactulose (100 +/- 6.1, 5.5%), 3-O-methyl-D-glucose (98 +/- 5.9, 5.5%) and xylose (104 +/- 7.1, 6.5%). Linearity of standard curves indicated that the lower limit for accurate quantification was 0.1 mg/l for all four sugars. Urinary recoveries following oral administration of these sugars to control dogs were determined as a baseline for the investigation of intestinal damage in this species and comparison of chromatograms illustrated enhanced permeability in dogs with gluten-sensitive enteropathy.
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Sarih M, Souvannavong V, Brown SC, Adam A. Silica induces apoptosis in macrophages and the release of interleukin-1 alpha and interleukin-1 beta. J Leukoc Biol 1993; 54:407-13. [PMID: 8228619 DOI: 10.1002/jlb.54.5.407] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Resident adherent peritoneal cells selectively released high amounts of interleukin-1 (IL-1) activity when treated with silica. The use of anti-IL-1 antisera showed that both IL-1 alpha and IL-1 beta were present in supernatants of silica-treated macrophages. In contrast, intracellular IL-1 activity was totally neutralized by anti-IL-1 alpha antibodies and was easily converted into the mature IL-1 alpha form by autolysis in cytoplasmic extracts. Anion exchange chromatography clearly separated the two IL-1 species present in supernatants of silica-stimulated macrophages. Natural IL-1 beta was further characterized by chromatofocalization; it had an apparent isoelectric point, pI, in the range 8.3-8.6. In agreement with previous findings showing that IL-1 beta was released only by apoptotic cells, we have found that silica-treated macrophages underwent apoptosis. This was demonstrated by the characteristic laddering electrophoretic pattern of DNA extracted from silica-treated cells and by the morphology of macrophage nuclei stained with the DNA-specific dye DAPI. In addition, quantification of apoptotic cells was performed by a flow cytometric analysis based on the reduction of cellular DNA content exhibited by apoptotic cells. Treatment of macrophages with silica, therefore, results in an active process that promotes the processing and liberation of IL-1 beta.
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Wong WL, Dourado R, Roddie M, Jackson J, Adam A. Considerations in percutaneous positioning of the lower end of wallstent biliary endoprostheses. Clin Radiol 1993. [DOI: 10.1016/s0009-9260(05)81251-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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270
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McKeown B, Wong W, Adam A. True single stage percutaneous insertion of wallstent biliary endoprostheses. Clin Radiol 1993. [DOI: 10.1016/s0009-9260(05)81245-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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271
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Blanquer JJ, Rapa M, Melchor A, Jiménez T, Adam A, Mulet MJ. [Traffic accidents: a health problem in primary care]. Aten Primaria 1993; 12:212-4. [PMID: 8374020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To discover the prevalence and most relevant epidemiological characteristics of the victims of traffic accidents which occur in our health area. SETTING Hospital Casualty department (HC), Health area 19, Alcoy. PATIENTS This was an observational, crossover study, based on the collection of data from all those patients who had been brought into the HC for attention because of a traffic accident and who were attended between October 1, 1990 and September 31, 1991. MEASUREMENTS AND MAIN RESULTS During the study period a total of 1,111 traffic accident victims were attended. Their average age was 26.62 (SD +/- 15.95), with 69.6% being men and 30.2% women. 60.7% of the victims were attended on non-working days or the eve of a non-working day. 44.5% of those involved in accidents were in four-wheeled vehicles; 40% on two-wheeled vehicles and 11.1% of the victims were pedestrians. Injuries were light in 73.3% of cases; moderate in 15.9% and in the other 8.8% serious, grave or critical. 43.7% of the total had the accident in an urban area and 40.9% on the open road. CONCLUSIONS The high prevalence of victims of accidents (8.3 per 1000 inhabitants) observed in our health area can be explained by the type of study. It is vital to obtain valid information of the real importance of this health problem. The primary care doctor must take preventive action concerning traffic accidents: a) through full studies of traffic accident levels among primary care centre users; b) primary preventive action, through the spreading of information on norms of safety; and c) secondary and tertiary prevention, by means of effective and efficacious outpatient emergency measures, as well as a thorough rehabilitation of accident victims.
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Adam A, Roddie ME, Benjamin IS. Case report: Mirizzi syndrome--treatment with metallic endoprosthesis. Clin Radiol 1993; 48:198-200; discussion 200-1. [PMID: 8403768 DOI: 10.1016/s0009-9260(05)80283-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Adam A, Reidy J. Clinics in interventional radiology. Clin Radiol 1993. [DOI: 10.1016/s0009-9260(05)80282-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Walker AR, Adam A, Küstner HG. Changes in total death rate and in ischaemic heart disease death rate in interethnic South African populations, 1978-1989. S Afr Med J 1993; 83:602-5. [PMID: 8211526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Ischaemic heart disease (IHD) in prosperous Western populations rose markedly in the 1940s, peaked between 1970 and 1975 and then fell variably--by about 50% in the USA and Australia. Undoubtedly, decreases in serum cholesterol levels, in the incidence of hypertension and in smoking frequencies are largely responsible. In South Africa, in all population groups other than blacks, IHD rates rose analogously, with Asians and whites attaining very high rates. However, from 1978 to 1989, the total death rate among white males (per 100,000 world population) fell from 1,002 to 631 (37%), and the IHD mortality rate from 312 to 139 (56%). Rates for Asians were 1,306-1,130 (14%) and 355-226 (36%), respectively, and for coloureds 1,691 to 1,392 (18%) and 171 to 110 (36%). For blacks, the total mortality rate remained unchanged; IHD rates were low, but these data are unreliable. Percentage falls in the IHD rate exceed those in the total death rate, especially among whites, indicating true decreases in IHD rate. Understandably, the accuracy of the data, as with such data overseas, is questionable. Local falls are none the less in line with those noted in Western countries. Rates for whites remain very high, and are even higher for Asians. While knowledge of the reasons for the rises and falls in IHD rates remains incomplete, whites have none the less taken some preventive action, although Asians and coloureds apparently little.
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