Health care in Denmark

In Denmark, federal control of medicine began as early as 1890. Last year the American College of Medical Group Administrators studied the evolution of that country's health care system and found that it may well have predictive value for American health care planners.

Mal perforans and spina bifida occulta

A 26-year-old man had mal perforans pedis as the principal manifestation of spina bifida occulta with an associated intradural lipoma. Two lumbosacral dimples and a tuft of hair overlying the spina bifida led to the diagnosis. We include a review of the causes of mal perforans and a review of spina bifida occulta and associated abnormalities.

Experimental cryptorchidism in adult male rats: histological and hormonal sequelae

Mature male rats were rendered cryptorchid and followed for up to nine weeks during which serial blood specimens were obtained for multiple hormonal analyses; serial testicular samples were obtained as well. In contrast with control animals, cryptorchid rats showed transient rises in FSH which returned to normal at the end of the study; estrogen levels were high in the final weeks. Plasma testosterone levels were unchanged and LH levels changed little. Light and electron microscopic studies of testicular biopsy specimens showed prompt disruption of spermatogenesis which became more extensive with time. Sertoli cells underwent multiple changes including increased lipid storage and phagocytosis of spermatozoa. Comparisons are made between the sequence of hormonal changes and that of histological changes. In addition, questions are raised concerning the ways in which Sertoli cells are affected by experimental cryptorchidism.

The effects of fluoxymesterone administration on testicular function

Long term daily administration of fluoxymesterone (9alpha-fluoro-17alpha-methyl-11beta, 17beta-dihydroxyandrost-4-en-3-one) was associated with a modest suppression of sperm production and a profound suppression of testosterone levels in the absence of significant effects on plasma gonadotropin levels. Nine normal male volunteers took either 10, 20, or 30 mg of fluoxymesterone daily for twelve weeks. Plasma samples were obtained for testosterone, estrogen, LH and FSH levels at biweekly intervals before, during and for up to 12 weeks after fluoxymesterone treatment. Samples were obtained for dehydroepiandrosterone sulfate, testosterone binding globulin and free testosterone assays at representative times before, during and after treatment. Although lower sperm counts were observed at several points during both the treatment and follow up periods, significant consistent suppression of spermatogenesis could not be demonstrated. Reduced plasma testosterone levels were seen within 24 h after beginning fluoxymesterone, and further reductions were noted throughout the treatment period. Changes in plasma estrogen levels did not correlate with fluoxymesterone administration. Neither plasma LH nor plasma FSH levels were significantly altered by fluoxymesterone. A short term study utilizing a single dose of fluoxymesterone yielded similar findings. It is proposed that fluoxymesterone has a local effect on the Leydig cell which is not mediated by gonadotropins.

Testicular chromosomal mosaicism and infertility

A healthy young man with azoospermia and no other endocrinological abnormalties was shown to have chromosomal mosaicism with the cytogenetic errors found only in testicular tissue. Three clones of cells were identified in both meiosis I and meiosis II by cytogenetic analysis of direct testicular smears. Peripheral blood karyotypes and buccal smear preparations revealed no abnormalities. It is postulated that the gonadal cytogenetic defects account for this patient's azoospermia. In addition, it is hypothesized that this type of incomplete spermatogenesis nonetheless produces sufficiet feedback material ("inhibin") so that FSH levels are not affected.

The packing properties of moist bulk solids

The specific volumes of three bulk solids at moisture contents up to 50% w/w (dry basis) under various consolidating stresses have been shown to be dependent on the nature of the bulk solid. The values obtained can be related to the intraparticulate porosity and inherent cohesiveness of the dry materials. The influence of moisture on the packing properties and tensile strength of the three bulk solids is discussed in terms of the granulation process.

A gas chromatographic method for the determination of aldose and uronic Acid constituents of plant cell wall polysaccharides

A major problem in determining the composition of plant cell wall polysaccharides has been the lack of a suitable method for accurately determining the amounts of galacturonic and glucuronic acids in such polymers. A gas chromatographic method for aldose analysis has been extended to include uronic acids. Cell wall polysaccharides are depolymerized by acid hydrolysis followed by treatment with a mixture of fungal polysaccharide-degrading enzymes. The aldoses and uronic acids released by this treatment are then reduced with NaBH(4) to alditols and aldonic acids, respectively. The aldonic acids are separated from the alditols with Dowex-1 (acetate form) ion exchange resin, which binds the aldonic acids. The alditols, which do not bind, are washed from the resin and then acetylated with acetic anhydride to form the alditol acetate derivatives. The aldonic acids are eluted from the resin with HCl. After the resin has been removed, the HCl solution of the aldonic acids is evaporated to dryness, converting the aldonic acids to aldonolactones. The aldonolactones are reduced with NaBH(4) to the corresponding alditols, dried and acetylated. The resulting alditol acetate mixtures produced from the aldoses and those from the uronic acids are analyzed separately by gas chromatography. This technique has been used to determine the changes in composition of Red Kidney bean (Phaseolus vulgaris) hypocotyl cell walls during growth, and to compare the cell wall polysaccharide compositions of several parts of bean plants. Galacturonic acid is found to be a major component of all the cell wall polysaccharides examined.

Moisture uptake and tensile strength of bulk solids

An apparatus is described in which bulk solid handling properties can be examined over a wide range of humidities. It is shown that constant temperature and relative humidity can be maintained. The apparatus can also be used to study the effect of cycles of humidity changes. The rate of moisture uptake by loosely packed and tapped beds of six pharmaceutical materials was found to be dependent upon bed depth but independent of bulk density. The tensile strengths of the bulk solids changed when they were subjected to high relative humidities.

The flow of granular magnesia

Investigations of the flow rates of loosely packed magnesia have shown that the general equation developed by Jones & Pilpel (1966)

can be applied to single component and multicomponent mixtures in the size range 0·003 to >0·2 cm. The increase in flow rate caused by mixing coarse and fine particles has been related quantitatively to the size of the particles by the general expression

This can be used to calculate the composition for maximum flow in multicomponent mixtures. The mechanism of action of glidants is discussed in the light of the experimental results and a distinction is made between glidants which improve the flow of granulations and those which improve the flow of cohesive powders.

The flow properties of granular magnesia

Measurements have been made of the flow of granular magnesium oxide through circular orifices and the equation

has been derived. This is a particular form of a more general equation

which can be shown to apply to a wide range of materials, A and 1/n being functions of particle size and shape.

The equation has been employed for predicting the flow rates of binary and ternary mixtures of magnesia with an accuracy of 5%.

Some physical properties of lactose and magnesia

Anomalies in some of the physical properties of spray dried lactose and granulated magnesium oxide have been traced to the presence of fines. These are strongly adsorbed onto particles of about 1,000 μ diameter, being held in position by van der Waals’ and electrostatic forces. Although they are not displaced during sieving, they can be removed by washing the powders with organic solvents.