Quantitative analysis of reflection spectra of the surface of the guinea pig brain

For a nearly constant light scattering coefficient a method is presented which allows the quantitative analysis of reflection spectra of the brain using a nonlinear multicomponent analysis ( NLMCA ).

Tube cecostomy and staged resection for obstructing carcinoma of the left colon

Over a 17-year period, all patients presenting with acute obstruction of the left colon due to carcinoma were treated by emergency tube cecostomy. There were 57 patients aged between 35 and 93 years. After the decompressive procedure, eight died, 34 had complications, and eight were left with permanent cecostomies. Forty-one underwent secondary procedures of which 35 had resections. Seven patients died postoperatively and 15 had complications. Of the 34 survivors, in 23 the cecostomy closed spontaneously, and 11 had operative cecostomy closure. Of the latter, four died postoperatively, and nine had complications. Thus, 30 survived the entire treatment program. Reasons for the high morbidity and mortality are discussed. Comparison is made with other forms of treatment in the literature. A treatment program is suggested, using tube cecostomy for poor-risk patients and primary resection without anastomosis for patients in better condition.

Unsuccessful experience with closure of Jaboulay gastroduodenostomies in the treatment of post-vagotomy dumping and diarrhea

Eight patients after vagotomy and Jaboulay gastroduodenostomy had their gastroduodenostomy closed to treat dumping and diarrhea. Eight gastroduodenostomies were closed once and four were closed twice, a total of 12 procedures. Of these, ten were "simple" closures (direct suture of the opening into the duodenum via a gastrotomy) and two were "formal" (gastroduodenostomy formally dismantled). Among those gastroduodenostomies closed "simply," the closure remained intact for 2 to 9 months, relieving the patients' symptoms. Thereafter, the suture line broke down, leaving the patient with a patent gastroduodenostomy and recurrent symptoms. The two patients closed "formally" developed severe complications: one patient's stomach failed to empty permanently after the procedure and the second developed a duodenal leak. In addition to these major complications, another four of the 12 procedures were followed by transient gastric retention, and five of the 12 procedures were accompanied by minor pulmonary and wound complications. A satisfactory result was not achieved in any patient.

[CT-guided celiac plexus block with ventral approach]

A modified procedure for infiltrating the coeliac plexus for the treatment of chronic pain syndromes is described. The injection of the analgesic is made through a fine needle introduced via a transabdominal approach under CT guidance. The advantages of this technique, compared with the dorsal approach, are a more accurate placement of the solution and the ability to carry out this procedure in very sick patients. No complications have been observed.

Comparative studies on thrombin inhibitors in experimental microthrombosis

The influence of thrombin inhibitors, which differ both in their chemical structure and type of inhibition on thrombin-induced microthrombosis was studied in rat lungs. The antithrombotically effective doses and blood levels of the compounds correlated with their kinetic constants for inhibition of thrombin. In preventing microthrombosis, some of the synthetic inhibitors tested surpassed the effectiveness of heparin and approached that of the naturally occurring inhibitor hirudin.

Rectal temperature in the diagnosis of acute lower abdominal pain

The accurate diagnosis of acute lower abdominal pain continues to be a problem. In Israel, a diagnostic sign often sought as indicating pelvic peritonitis is a rectal temperature of greater than 1.0 C higher than the simultaneous oral temperature. We established that in each of the 20 emergency rooms surveyed both oral and rectal temperatures are measured as part of the admission procedure for patients with acute lower abdominal pain. The charts of three groups of 100 patients with acute lower abdominal pain were studied retrospectively. A rectal temperature of greater than 1.0 C higher than the oral was found in about 10% of each group. Both oral and rectal temperatures were raised in 56, 69 and 37% of each group, respectively. The rectal temperature alone was elevated in 8.5% of patients with appendicitis or pelvic inflammatory disease (PID), as well as in 6% of patients with undiagnosed abdominal pain. Oral temperatures alone were elevated in 4.5% of patients with acute appendicitis or PID and also in 13% of patients with undiagnosed abdominal pain. These differences were not significant. We conclude that the common Israeli practice of measuring both rectal and oral temperatures in patients with acute lower abdominal pain gives no more information than the measurement of either one.

Antrectomy for recurrent ulcer after parietal cell vagotomy

The results of antrectomy for recurrent ulcer after parietal cell vagotomy are reviewed. Eighteen patients underwent precise antrectomy between 6 months and 7 years after their primary operation. Fourteen patients were reconstructed with a gastroduodenostomy and 4 with a gastrojejunostomy. Eighteen patients were available for follow-up of between 18 months and 10 years. One patient (6.25 per cent) developed a recurrent ulcer 1 year after antrectomy. There was no operative mortality. Six patients (33 per cent) had minor complications in the immediate postoperative period, and one (5.5 per cent) had a major complication. According to Visick grading, 75 per cent had good or excellent results and 25 per cent poor results. Antrectomy following parietal cell vagotomy can be achieved with a low operative mortality, a low ulcer recurrence rate and a satisfactorily low incidence of post-gastrectomy problems.

Correlation of field potentials with redox-states of cytochromes recorded from the olfactory cortical slice of guinea pig

Field potentials and the reflection spectra of cytochromes were continuously recorded from the olfactory cortical slice of a guinea pig which was incubated under the normoxic and anoxic conditions. The reduction of the oxidated spectra of the cytochromes occurred before the decrease of field potential heights and the oxidation of the reduced spectra occurred before their recovery. In a 3 min anoxic experiment, a 90% recovery of the cytochromes aa3, b, and c, and the field potential amplitudes took place in this order after the restoration of oxygen.

[Pulmonary effect of inhaling leather-impregnation sprays (author's transl)]

After inhaling a leather-impregnation spray in a confined space, coughing fits and dyspnoea occurred in a 40-year-old man and an 20-year-old woman, previously in good health. The cardinal symptoms on admission to an emergency ward were of interstitial pulmonary oedema in the X-ray but without increased pulmonary arterial pressure. Administration of corticosteroids both by aerosol and intravenously improved the acute symptoms within a few hours. Two subsequent chest X-rays demonstrated complete healing. The acute symptoms were caused by the impregnation spray producing an alveolitis or toxic lung oedema in both cases. The early topical administration of corticosteroids would appear to be the most important preventive and protective measure.

Different levels of gene realization in the diurnal control of rat liver enzymes

Diurnal rhythms are demonstrated in five rat liver enzymes : argininosuccinate synthetase, ATP : citrate lyase, glutamate dehydrogenase, phosphoenolpyruvate carboxykinase, and succinate dehydrogenase. In a 12 : 12 h light-dark cycle, maxima of enzyme activities occur at the beginning of the dark phase in the case of phosphoenolpyruvate carboxykinase, at the end of the dark phase in ATP : citrate lyase, and in the middle of the dark phase in the other three enzymes. The diurnal increase of phosphoenolpyruvate carboxykinase is blocked by cycloheximide, cordycepin, alpha-amanitin, and 5-azacytidine. The maximum of ATP : citrate lyase is likewise suppressed at the levels of both translation and transcription, as shown by administration of cycloheximide and 5-azacytidine, respectively. Hence, these two enzymes appear to be regulated transcriptionally. The diurnal rise of argininosuccinate synthetase an glutamate dehydrogenase is also totally inhibited by cycloheximide, whereas cordycepin, alpha-amanitin, and 5-azacytidine are ineffective in the first phase of enzyme accumulation. In a later phase, however, alpha-amanitin and 5-azacytidine become inhibitory. The two enzymes therefore seem to be regulated sequentially by post-transcriptional and transcriptional mechanisms. The diurnal increase of succinate dehydrogenase is nearly insensitive to alpha-amanitin and 5-azacytidine; cycloheximide is only partially inhibitory and, in particular, almost ineffective during the late rise. Thus, the rhythm of this enzyme might be controlled mainly by an activation and, perhaps, by a transitory post-transcriptional mechanism.

[Combination of beta-receptor blocking agents and saluretica in outpatient treatment of hypertension. Results of a comparative study (author's transl)]

In a randomized single-blind study a comparison was made between the blood pressure lowering effect and the tolerance of two different combinations of beta-blockers and diuretic agents, one of the combinations being given in a sustained-release form. The study was made in 60 out-patients suffering from hypertension of the severity degrees I and II (WHO). The blood pressure reduction achieved as well as the diminution of the increase in heart rate and blood pressure under ergometric load proved to be almost equal in both groups. The number of patients whose blood pressure was normalized by the end of the study was larger in the group treated with Cardiotensin. The influence on laboratory parameters was only minimal and without clinical relevance. Both preparations have generally been well tolerated and exhibited an equal duration of effect.

Post-clinical follow-up of spinal patients through domestic check-ups. (Koblenz model)

One hundred spine-injured patients have been visited at their homes, examined and questioned about their medical and social situation. The medical conditions have improved, compared with a former similar check-up. But the tendency to work has decreased and is lagging behind other countries. Possible reasons are pointed out.

[Conservative treatment of peripheral arterial occlusive diseases]

The therapeutical effect and tolerance of Defluina was studied in a selective open trial of 24 patients suffering from peripheral arterial diseases in Fontaine's stage I and II. All patients were treated with Defluina, 30 drops three times a day during a period of six weeks. From the statistically significant improvement of the different control parameters it can be concluded that peripheral arterial circulation has increased considerably in the course of the Defluina treatment. The preparation was always well tolerated, no side-effects were observed.

[Agreement between traditional and computer diagnosis in psychiatric outpatients (author's transl)]

Psychiatric diagnosis based on personal interviews with 100 clinic outpatients was made and the data thus obtained were documented in Spitzer's and Endicott's CAPPS (Current and Past Psychopathology Scales). Two clinicians and the computer program DIAL - a modification of the DIAGNO II program of the same authors - diagnosed the same patients independently of each other basing their diagnoses solely on the entries in the CAPPS. The diagnostic agreement between the different diagnoses was evaluated and results compared with earlier findings by Schmid et al. These authors had, however, used CAPPS data gathered from case histories and not from direct interviews of patients. The modification in the procedure of gathering the data resulted in a slight, but statistically insignificant improvement in diagnostic agreement. The possibility of improving diagnostic agreement by the use of another scale is discussed.

[On the mechanism of action of glutamate dehydrogenase from pea seedlings and the regulation of the activity by adenosine phosphates, the energy charge and ions]

The mechanism of action and the regulatory properties of glutamate dehydrogenase from pea seedlings (Pisum sativum, var. Späths Violetta) have been investigated by using a highly purified preparation of the enzyme. Kinetic experiments show that the binding of the coenzyme (NAD(+) or NADH) and the substrate (L-glutamate or α-ketoglutarate) is sequential. The formation of a quarternary complex with ammonia as additional substrate is questionable, as can be seen from the kinetic data. The anions of the ammonia source have a strong rate-regulating effect on the NADH reaction. The adenosinphosphates AMP, ADP, and ATP exert an inhibiting effect on both the reductive amination and the oxidative deamination reaction. The former reaction is inhibited half as much as the latter. Dead end inhibition offers a sufficient explanation for this effect. The glutamate dehydrogenase from pea seedlings is not regulated by the energy charge. Zn(2+) ions are strong inhibitors of the NADH-reaction; their inhibitory effect on the activity is indirect and can be reversed by addition of ATP. A reaction sequence is formulated.