Prognostic classification of Hodgkin disease in pathologic stage III, based on anatomic considerations

Fifty-two patients with pathologic stage III Hodgkin disease were studied in an effort to determine whether location of involved abdominal nodes influenced survival. Treatment consisted of total nodal radiotherapy with or without subsequent combination chemotherapy. Th initial radiation field was the "extended mantle," which included supradiaphragmatic nodes, the splenic hilar area, and paraaortic nodes to the level of L2-L4. Subsequently, lower paraaortic and iliac regions were treated ("lower inverted Y"). Patients with disease limited to the spleen and/or splenic, celiac, or portal nodes ("anatomic substage" III1) had a more favorable 5-yr survival than did patients with involvement of paraaortic, iliac, or mesenteric nodes ("anatomic substage" III2): 93% versus 57%, respectively (p less than 0.05). The addition of combination chemotherapy to total nodal irradiation was associated with improved survival of patients in stage III2, but not of those in stage III1.

[Lysozyme levels in chronic inflammatory bowel diseases (author's transl)]

Lysozyme concentrations in serum and urine were determined in 101 patients with Crohn's disease and 26 patients with ulcerative colitis. Lysozyme was assayed according to the lysoplate method of Osserman against a standard of humam lysozyme. The mean serum lysozyme concentrations (+/- S.E.M.) for each group were as follows: controls 8.4 +/- 1.8 (n equals 38), Crohn's disease 8.2+/-2.6 (n equals 101), ulcerative colitis 8.7+/-3.0 (n equals 26). No significant differences were found in serum lysozyme levels of the various groups of patients (2p is greater 0.05). There existed no correlation (r equals 0.12, n equals 129, p is greater than 0.05) with the activity of the disease. Serum lysozyme levels were significantly higher in patients affected by Crohn's disease of the small and the large bowel than in patients with involvement of the small intestine only and operated patients (2p is less than 0.05). The discriminative value of these findings with respect to the clinical course of such patients is limited because no significant differences are found between the levels of patients with Crohn's disease and controls. Neither in case of Crohn's disease nor ulcerative colitis were the mean urine lysozyme concentrations increased. These findings show that the determination of serum and urine lysozyme levels is unsuitable in respect of the differential diagnosis of inflammatory bowel disease as well as of the assessment of activity and extent of the disease.

[Radiographic signs of colitis with consideration of angiographic findings (author's transl)]

Description of radiographic lesions in the various stages of ulcerative colitis as well as the deviating alterations of granulomatous colitis are represented. Radiographic signs are discussed with regard to their diagnostical importance. The value of angiography for the differential diagnosis of colitis is pointed out.

HL-A 27 antigen associated with uveitis and ankylosing spondylitis in a family

Uveitis and ankylosing spondylitis coexisted in a family. Tissue typing of the family revealed the HL-A 27 antigen in five members: two had uveitis; two had ankylosing spondylitis; and one was asymptomatic. These diseases did not coexist in any one member of the family.

Student drug use: attitudinal, parental relations, and sex differences--a pilot study

Student drug abuse and its relationship to attitudes held by the abuser, sex differences,and the abuser's relationship to his parents were studied. The Parent-Child Relations Questionnaire and four Smantic Differnetials regarding the "real" me, the perceived me, the immediate world and the drug addict were employed. Subjects were divided into present, past, and never users. Results indicated striking sex differences as well as differences between female present and never users with respect to all the attitudes investigated and the perceived relationship with the mother. It was hypothesized that the etiological factors surrounding female drug use may be psychodynamic in nature while the etiological factors for male drug use may be environmental.

Septic complications following gastric surgery: relationship to the endogenous gastric microflora

The microflora of the stomach is derived from both the ingestion of food and saliva and the reflux of proximal intestinal contents through the pylorus. Normally, this microflora is inhibited by gastric acid and normal gastric motility. In disease states, however, such as bleeding or obstructing duodenal ulcer, gastric ulcer or carcinoma, the level of gastric acid is reduced or the gastric motility is altered. Thus, endogenous microflora persists and often becomes the source of postoperative wound infections following gastric resection.

[Osteopathies and calcium absorption in chronic liver diseases]

Enteral calcium absorption was determined in 18 patients with non-obstructive liver disease (16 with liver cirrhosis, 2 with chronic hepatitis). There was no significant difference in comparison with healthy persons. Osteoporosis in patients with chronic liver disease probably is not due to impaired calcium absorption but to other complications of liver disease as immobility, muscle atrophy, chronic pancreatitis, alcoholism and malnutrition. Osteomalacia on the other hand, is a complication of long standing obstructive liver disease. In these cases vitamin D treatment is indicated.

The team approach in a psychogeriatric unit

The importance of a multidisciplinary team approach was recognized when a 14-bed short-term Psychogeriatric Unit was opened in a psychiatric hospital. The limited time available to the psychiatrist in charge placed a heavy clinical responsibility on the paramedical personnel who formed the team. Initially, role distinctions were kept vague and regarded as not overly important. Six months after the Unit opened, all the staff members filled out a questionnaire. They felt that communication within the team was good, that they could fulfill the role of primary therapist, and that they understood their own roles and those of others. All regarded the psychiatrist as the head of the team. The psychiatrist felt that he had the ultimate responsibility for over-all care of the patients, that any attempt ot blur roles caused problems, and that there had been a partial regression to more traditional patterns. Members of the Unit regarded themselves as a team, able to work together and pool skills in treating patients, and thus play a significant part in total care. This attitude proved more valuable than attempting to break away from the medical model or decrying the importance of roles.

[Soft contactlenses in general practice (author's transl)]

In contrast to the hard lenses the soft lens has enough permeability for oxygen and water-soluble substances, whereas high molecular substances, bacteria and virus cannot penetrate the soft lenses, so long as their surfaces are intact. The two principal production methods, the spin cast method and the lathe-turned method are compared. The duration of wearing of the soft lens depends on the deposits of proteins from the tears on the surface of the lens and the desinfection method. The daily boiling of the lenses shortens their useful life, while chemical desinfection causes besides bacteriolysis, damage of the corneal cell protein. The new cleaners on the base of proteolytic plant enzymes promise good results. For the optical correction of astigmatism with more than 1 cyl, soft lenses with conic outer surface are used or combinations of a soft and a hard lens (Duosystem). The therapeutic use of soft lenses has as aim: protection of the cornea against mechanical irritation, release of pain, protracted administration output of medicaments. Further indications for use: aseptic corneal inflammation and corneal defects.

Biochemical monitoring of the surgical patient

The need for prognostic and biochemical monitors of cellular function becomes increasingly evident with the further elucidation of the metabolic pattern secondary to disease. Thus far studies have shown that lactic acid may be one of these biochemical parameters. Investigations are now in the process of defining other biochemical indicators of cellular dysfunction.

The Mallard, Anas platyrhynchos, and Mallard-Black Duck, Anas superciliosa rogersi, Hybridization

The buildup of mallard and mallard-black duck hybrid populations in Australia has caused concern for the conservation of the black duck. Mallard populations are shown to be restricted in size and distribution in comparison to those of the black duck. Hybrids could not be confidently identified, other than those that showed obvious plumage characteristics of both species. Limited field studies in the Sydney district showed the stability of mallard and hybrid populations in comparison to those of the black duck, and there was evidence of restriction of pairing to intraspecific or intrahybrid matings and of poor hybrid breeding success. At present mallard hybridization per se does not pose a conservation threat to the black duck in Australia. This assessment might not apply under large-scale increase and perhaps husbandry of the feral mallard. In sufficient numbers mallard might threaten populations of the black duck by a different means, competition for refuge in times of drought.

Serum triiodothyronine determination by saturation analysis

An improved method for the determination of serum triiodothyronine (T3) has been developed. After addition of a tracer amount of the hormone, T3 was extracted from 1 ml serum under conditions of pH and ionic strength which favoured T3 extraction (89%) over thyroxine (T4) extraction (58%). Chromatography of the extracted material on Sephadex LH-20 separated T3 completely from residual T4. The T3 eluate was dried, then re-dissolved in 0.5 ml NaOH 0.04 n. To 0.2 ml duplicate aliquots, a standard amount of TBG was added for the competitive protein analysis. After one hour incubation at 4°C, separation of bound from free T3 was achieved on small Sephadex G-25 columns. Overall recovery was 67 ± 10.8% and correction for the loss was made. The solvent blank was 37 ± 27 (sd) ng/100 ml. Accuracy of measurement of known quantities of T3 added to serum was 98.4%. The coefficient of variation within the assay was 6.2% and between the assays it was 11.4%. The limit of detection (0.1 ng) corresponded to a concentration of 25 ng/100 ml. T4 added to serum did not interfere with T3 determination until high non-physiological values were reached. The mean ± sd serum T3 in 54 euthyroid subjects was 153 ± 58 ng/100 ml and in 24 hyperthyroid patients it was 428 ±186 ng/100 ml; 4 out of the 24 hyperthyroid values were within 2 sd of the mean euthyroid group. All the values found in the euthyroid group were well above the limit of detection of the method.

Serum thyroxine determination by saturation analysis: a new method and statistical approach

A new method for the measurement of total serum thyroxine (T4) by saturation analysis is presented along with technical details. Its main advantage over previously published methods is its sensitivity of 0.3 picomoles T4 (corresponding to 0.23 ng T4 or 152 pg iodine). It thus allows the measurement of serum thyroxine in very small volumes of human serum (7 μl) and, for the first time, in mouse serum. The use of Sephadex to extract thyroxine from the plasma gives more reproducible results and avoids the need to evaporate the extract to dryness, as in current methods.

A high speed digital computer was used for handling data processing. A new statistical algorithm was built into a code called REGSAT which is extensively described. This procedure allowed unskewed predictions of thyroxine levels in the samples and an estimate of the standard curves resolving power.