[Osmolarity parameter and kidney function of polytraumatized intensive care patients]

Improved possibilities in prediction of renal failure after polytrauma would possibly improve the survival rate of this severe posttraumatic complication. Our clinical investigation was carried out in 27 patients suffering from severe trauma. We intended to achieve early recognition of acute renal failure by osmolality measurements after polytrauma. Thus we investigated the daily concentration of blood urea, serum and urine creatinine, daily urine output, creatinine clearance, plasma and urine osmolality and the serum colloid osmotic pressure. Additional to important informations for fluid and electrolyte replacement the follow-up of osmolality changes in plasma and urine proved general and renal prognostic value. Early and clear decreases in urine-plasma ration, osmolar clearance and negative free water clearance were found in case of later reduction of renal function and acute renal failure. Consequently we advise regular osmolality measurements in the postoperative management of the polytraumatic patient.

[Blunt neck trauma--the danger of secondary respiratory insufficiency]

It is very difficult to properly assess a lesion of the kind represented by the contuse trauma of the neck, if such assessment has to be effected at the site of the accident. It is a characteristic feature of such a trauma that even hours or days after the accident, acute respiratory insufficiency may suddenly appear if there is an interruption of continuity of the respiratory tract. X-ray and endoscopic findings are mandatory directly after the accident even if it looks as though there are only few signs or symptoms. In case of indication of surgery, all the necessary measures must be taken before initiating anaesthesia to avoid any complications which may be due to hypoxia and aspiration. A case report is given to illustrate the possible discrepancy between the signs immediately after the accident and the findings made later.

[On the use of physostigmine in anesthesia and intensive care]

Physostigmine is an antidote in cases of overdosage with intravenous anaesthetics such as dehydrobenzperidol, benzodiazepines and ketamine. It is also useful in antagonizing drug induced comas of different origin particularly in cases of acute intoxication with tricyclic antidepressants and alcohol. We discuss our therapeutic observations in anaesthesiological and intensive care patients. We have not seen any side effects after physostigmine administration, but the possibility of undesired parasympathomimetic activity demands correct indication, well calculated dosage and continuous surveillance of the patient.

[Perioperative opiate analgesia (author's transl)]

22 patients undergoing gynaecological surgery were given general anaesthesia supplemented by epidural morphine during and after the operation. The fentanyl requirements during the operation were significantly lower than they were in a control group and postoperative administration of analgesics could be dispensed with. The method is particularly suitable for patients at risk because less anaesthetic agents are needed. Postoperative epidural opiate analgesia is also useful after epidural anaesthesia; doses of 3.0 mg of morphine produced no side-effects except pruritus.

Modification of the Method for Vitamin A in Foods and Feeds for Use with Margarine and Butter: Collaborative Study

An adaptation of the method for vitamin A in feeds and foods to margarine and butter was studied in 1977 and 1978. The principal change was the use of 2 extractions with an ether-hexane mixture instead of one with hexane. Results of the 1977 test were not good enough to recommend adoption. The 1978 analytical samples consisted of 4 margarines, including a known, and a butter. Data were reported by 11 analysts. Averages for vitamin A (μg/g) and coefficients of variation (%) were, respectively: A (known)—7.2, 5.7; 1—8.2, 11.1; 2—11.4, 3.9; 3—7.6, 10.7; butter—8.5, 13.3; and for carotene: A—5.6, 6.4; 1—6.0, 5.5; 2—0; 3—5.8, 3.8; butter—3.1, 11.8. Carotene results were grouped reasonably closely and tended to be distributed randomly, but vitamin A results had a less random trend. Trifluoroacetic acid was studied as an alternative colorimetric reagent for determining vitamin A, with overall satisfactory results. The modification for determining vitamin A and carotene in butter and margarine, and the use of trifluoroacetic acid as an alternative colorimetric reagent have been adopted as official first action.

[3H] 2-Amino-6,7-dihydroxy 1,2,3,4-tetrahydronapthalene (ADTN): a potential specific dopamine receptor ligand

The characteristics of [3H] 2-amino-6,7-dihydroxy 1,2,3,4-tetrahydronapthalene (ADTN) binding to calf striatal membranes were investigated. [3H]ADTN was observed to bind with high affinity and stereospecificity to a preparation of crude synaptic membranes. A number of dopamine agonists and antagonists were studied for their ability to displace bound [3H]ADTN. Dopamine agonists were found to be more potent inhibitors of ADTN binding than were dopamine antagonists. Kinetic analysis indicates that [3H]ADTN binds to dopamine recognition sites in a manner comparable to dopamine itself. Overall, the data suggest that ADTN may be a useful ligand for the characterization of agonist requirements for recognition by dopamine binding sites.

Bacteriology of the socket in patients with prostheses

Fifty-two unilaterally enucleated patients were studied for symptoms, signs, and actual presence of bacteria in the socket and fellow eye. The majority (85%) of asymptomatic sockets were found to have a mixed culture of pathogenic organisms. Sockets had a significantly (P = .001) greater frequency of pathogenic organisms than the fellow eye. Cross contamination does not appear frequently but is a definite possibility. We recommend culture and treatment of the asymptomatic socket before surgery on the remaining eye.

Initiation of parturition in the rabbit by maternal and foetal administration of cortisol: effect of rate and duration of administration: suppression of delivery by progesterone

Continuous infusion of cortisol at rates from 0·31 to 1·24 mg/h into pregnant rabbits from day 21 of pregnancy onwards induced delivery in approximately 72 h. Similar rates of infusion into the foetal amniotic sac induced delivery with a shorter latency. Maternal infusion of 1·24 mg cortisol/h produced parturition providing it was continued for at least 24 h. If after this period the infusion was terminated, delivery still occurred after a further 48 h (i.e. 72 h in all). Progesterone administration to the mother blocked the effect of cortisol administered by the maternal or foetal route.

Rate of disappearance of endogenous insulin from the circulation after removal of insulinomas

In two patients with insulinomas a rapid rate of disappearance of insulin from the circulation was found after the tumours had been removed. In a third case the rate of disappearance was slower but the insulin was not immunologically identical to normal human insulin standards, as it was in the other two cases.

The acute toxicity of barium sulfate administered intragastrically

Intragastric administration of barium sulfate to albino rats did not produce deaths until the dose reached 25% to 40% of body weight. Death was due to stomach rupture or to bowel obstruction followed by gastrointestinal hemorrhage and generalized arteriovenous thromboses which produced further toxic changes in many body organs. Barium sulfate does not appear to be a factor of significance in the acute toxicity of tannic acid-barium sulfate formulations used in diagnostic radiology.