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Coronary arterial vasodilator effect of ibuprofen.
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The effect of ibuprofen, a nonsteroidal anti-inflammatory agent, on coronary vascular resistance in isolated perfused rabbit heart was studied. Ibuprofen had coronary arterial vasodilatory activity. An arterial concentration of 50 microgram/ml produced a half-maximal coronary vasodilator response. An ibuprofen concentration of 140 microgram/ml produced a coronary vasodilation, equal to that caused by hypoxia. A level of 280 microgram/ml depressed contractile function. The change in coronary vascular resistance did not appear to be physiologic autoregulation of coronary tone because determinants of myocardial oxygen demand were not significantly affected and myocardial oxidative metabolism was not significantly impaired, as reflected by myocardial lactate extraction, which was not significantly affected during the ibuprofen-induced coronary dilation. These results suggest a direct effect of ibuprofen on coronary vascular resistance.
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10,000,502
Influence of the dietary potassium intake on the natriuretic effect of hydrochlorothiazide in rats.
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10,000,503
Hydrochlorothiazide (HCTZ)-induced Na requirement was examined in rats fed a standard diet containing 250 mg of HCTZ per kg of food and given a free choice between water and 0.46 M NaCl. HCTZ treatment led to a persistent 8-fold increase of NaCl intake. An increase of the K content of the food from 100 to 600 mmol/kg reduce the NaCl intake by 75%. Maintenance on a high K diet prevented the HCTZ-induced requirement for extra Na and diminished HCTZ-induced loss of body weight and urinary loss of Na. Determinations of lithium clearance (CLi) in unanesthetized rats by using nontoxic doses of lithium was used as a measure of Na clearance at the end of the proximal tubules (CNa prox). The urinary sodium clearance divided by the urinary lithium clearance (CNa/CLi) was used to express the fractional escape of Na from distal reabsorption. In HCTZ-treated rats, maintenance on a high K diet reduced CNa and CNa/CLi. A high potassium intake increased CNa prox, but this effect was least in HCTZ-treated rats. The results show that a high K intake reduced the natriuretic effect of HCTZ. The renal mechanism is presumably a potassium-induced compensatory increase of the reabsorption of Na delivered from the proximal tubules.
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10,000,504
Effects of various calmodulin antagonists on contraction of rabbit aortic strips.
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10,000,505
Effects of N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide (W-7), chlorpromazine, prenylamine and N2-dansyl-L-arginine-4-t-butylpiperidine amide on vascular smooth muscle contraction were compared by using helically cut strips of rabbit aorta. These compounds are reported to be calmodulin antagonists, in vitro. W-7 at a concentration of 1 x 10(-4) M significantly antagonized the contractile responses of aortic strips to the same extent as seen with norepinephrine, serotonin, histamine, prostaglandin F2 alpha, angiotensin II and KCl. On the other hand, the addition of 1 x 10(-4) M N-(6 aminohexyl)-1-naphthalenesulfonamide, an analog of W-7 which has no chloride molecule in the structure and possesses a lower affinity for calmodulin than W-7, did not antagonize aortic contractions. Chlorpromazine at a concentration of 1 x 10(-6) M specifically antagonized the norepinephrine-, serotonin- and histamine-induced contractions, but did not antagonize the prostaglandin F2 alpha-and angiotensin II-induced contractions. Inhibition of prenylamine of the contractile response of aortic strips to KCl was marked compared with the inhibition by this drug of the responses to other agonists. N2-dansyl-L-arginine-4-t-butylpiperidine amide selectively antagonized the serotonin- and KCl-induced contractions at a concentration of 1 x 10(-5) M, however, at this concentration, the responses to norepinephrine, histamine and prostaglandin F2 alpha were not affected by the drug. Thus, each calmodulin antagonist tested has a different spectrum of action and of these only W-7 has a specific interaction with calmodulin.
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10,000,506
A comparative study of the acute effects of ethanol on the cholinergic system in hippocampus and striatum of inbred mouse strains.
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10,000,507
Postjunctional supersensitivity in young rat heart produced by immunological and chemical sympathectomy.
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10,000,508
Postnatal changes in sensitivity to norepinephrine (NE) were studied in normal and sympathectomized rat hearts. The sensitivity of left atria to NE was highest at birth, after which it declined, reaching the adult level by 2 weeks of age. Developmental changes in NE sensitivity of the left atria seemed to be related to the density of sympathetic innervation, and the high sensitivity at birth was most likely due to the lack or immaturity of the uptake function of the nerve endings. In contrast to the atria, right ventricular papillary muscle did not change in NE sensitivity with age. Immunological and chemical sympathectomy was performed by repetitive administration of antiserum to nerve growth factor and 6-hydroxydopamine, respectively. Both atria and papillary muscles from immunologically and chemically sympathectomized rats were supersensitive to NE at all ages tested. Inasmuch as the supersensitivity to NE was most marked at the 4th week of age, atria of this age were used for the study on the mechanisms of supersensitivity. Left atria from sympathectomized 4-week-old animals were also supersensitive to isoproterenol and phenylephrine. Because isoproterenol and phenylephrine are not taken up into sympathetic nerve endings, it was concluded that the postjunctional mechanisms were involved in the genesis of the denervation supersensitivity of left atria.
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10,000,509
Paradoxical resistance to adrenolytic agents of field-stimulated bladder base of rabbit.
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10,000,510
Isolated circulatory or longitudinally oriented strips from anterior or posterior rabbit bladder base were tested for responsiveness to agonists and sensitivity of field stimulation-induced responses to antagonists. Results were compared to the regional distribution of adrenergic and cholinergic nerves determined histochemically. Greater norepinephrine-induced responses in posterior than in anterior strips reflect denser noradrenergic innervation in posterior base. Longitudinal strips responded better to carbachol than circular strips, but no orientation-related differences in cholinergic nerve density or muscle mass were noted. Field stimulation-induced contractions were largely resistant to phenoxybenzamine (0.03 microM) and guanethidine (100 microM) and slightly reduced by phentolamine (2.6 microM). Atropine (0.4 microM) reduced maximum responses by 25 to 75%. The resistance to guanethidine suggests that the ineffectiveness of phenoxybenzamine is not due solely to atypical post synaptic receptors. Inaccessibility of the synaptic cleft to guanethidine is unlikely because the vas deferens, which possesses close contacts, was sensitive to guanethidine. Neurotransmission in bladder base may be partially noradrenergic, noncholinergic in nature. A question arises concerning the functional significance of the noradrenergic nerves in bladder base.
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10,000,511
In vitro metabolic activation of the pulmonary toxin, 4-ipomeanol, in nonciliated bronchiolar epithelial (Clara) and alveolar type II cells isolated from rabbit lung.
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10,000,512
The metabolism and covalent binding of 4-ipomeanol (IPO), a pulmonary toxin, were investigated in pulmonary cells isolated from rabbit. 3H-labeled IPO was incubated with freshly, isolated, intact alveolar type II cells (83% purity), nonciliated bronchiolar epithelial (Clara) cells (77% purity) and alveolar macrophages (greater than 90% purity). Covalent binding of radioactive material to type II and Clara cells was observed by autoradiography and by a biochemical method. IPO binding to cells was almost totally prevented by 1 mM piperonyl butoxide, an inhibitor of the cytochrome P-450-dependent metabolism of IPO. No covalent binding was observed with alveolar macrophages in the presence or absence of piperonyl butoxide. The maximal rates of enzyme-mediated covalent binding of IPO to protein were greater in the Clara cells (135 pmol/10(6) cells/min) than in the type II cells (13 pmol/10(6) cells/min). Incubation of either sonicated Clara or type II cell fractions with [3H]IPO, glutathione and NADPH (20 min, 37 degrees C) resulted in the formation of two distinct radiolabeled glutathione conjugates.
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10,000,513
Comparative actions of phenytoin and other anticonvulsant drugs on potassium- and veratridine-stimulated calcium uptake in synaptosomes.
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10,000,514
The actions of phenytoin and several anticonvulsants drugs on veratridine-stimulated (Na-dependent) and K-stimulated (Na-independent) Ca uptake were studied in isolated nerve terminals (synaptosomes) from rat cerebral cortex. Phenytoin inhibits both veratridine- and K-induced Ca uptake but is more potent against veratridine. Inhibition of veratridine-stimulated Ca uptake by phenytoin appears to be a competitive relationship, whereas the interaction between K and phenytoin is noncompetitive. Hydroxyphenyl-phenylhydantoin, mephenytoin and ethylphenylhydantoin have actions similar to phenytoin but all are substantially less potent. Carbamazepine, phenobarbital, diazepam and lidocaine also inhibit veratridine- and K-stimulated Ca uptake, but ethosuximide and valproic acid are ineffective. Only carbamazepine and lidocaine have a relatively selective action against veratridine which is similar to phenytoin, and only these three drugs are active at concentrations which approximate their clinically effective anticonvulsant blood levels. The results of this study, in conjunction with reported data, suggest that phenytoin inhibits Na and Ca conductances in nervous tissue by separate and probably independent mechanisms. The present data also lead to the hypothesis that inhibition of Na uptake (perhaps associated with inhibition of Ca uptake) in nervous tissues is a mechanism of action responsible for some of the selective antiepileptic effects and/or analgesic effects of phenytoin, carbamazepine and lidocaine.
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10,000,515
The kinetics of ethylmorphine N-demethylation in isolated hepatocytes: the effect of drug transport and oxygen concentration.
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10,000,516
In previous studies we have observed that the Km for ethylmorphine N-demethylase was only 50 to 100 microM in the isolated hepatocyte as opposed to 250 to 340 microM in isolated microsomes. These data suggested that either the drug is actively transported into the cell or that the enzymes in the cell had a reduced turnover number. Our current study indicates that ethylmorphine is transported into the hepatocyte with a Km of 250 microM and Tm of 20 nmol/min 10(6) cells. On the basis of temperature and inhibitor studies, this would appear to be active transport. When the turnover number of the ethylmorphine N-demethylase was decreased by reducing the oxygen from 20% of the gas phase to 5%, the activity was partially uncompetitively inhibited with the Km decreasing from 182 to 105 microM. The Vm decreased from 1.85 nmol/min 10(6) to 0.71 nmol/min 10(6) cells. These data suggest that the low Km we initially observed was probably due to active transport of the substrate into the hepatocyte. Further, our observations indicate that the effects of oxygen pressure on the kinetic parameters should be considered in predicting in vivo kinetics from in vitro studies.
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10,000,517
Inhibition of phrenic and sympathetic vasomotor neurons in cats by the serotonin analog 5-methoxy-N,N-dimethyltryptamine.
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10,000,518
5-Methoxy-N,N-dimethyltryptamine (20-200 microgram/kg) inhibits phrenic and sympathetic neural discharges and depresses blood pressure. The effects occur within seconds after injection. Complete recovery occurs, on the average, after 20 min. The inhibition of phrenic nerve discharges is prevented during hypercapnia and hyperthermia and reversed during 50 Hz electrical stimulation of the carotid sinus nerve. Cinanserin (2-4 mg/kg) antagonize the inhibition of phrenic nerve activity. Inhibition of sympathetic activity by 5MeODMT is also reversed during 50 Hz carotid sinus nerve stimulation, but is unaltered by hypercapnia, hyperthermia or cinanserin. High doses of 5MeODMT (200-700 microgram/kg i.v.) produce an initial apneustic discharge which is followed by inhibition of phrenic discharges. The inhibitory effects of 5MeODMT are attributed to a direct agonist action on central nervous serotonin receptors. The inhibition of phrenic and sympathetic neurons appears to be mediated by different types of serotonin receptors.
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10,000,519
Effect of superior cervical ganglionectomy on the sensitivity of rabbit ear artery and cerebral arteries of rabbit and cat to vasoactive agents.
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10,000,520
The effect of sympathetic denervation on the sensitivity of the rabbit ear and basilar arteries and the cat middle cerebral artery to vasoactive agents was examined in relation to the functional significance of the innervation. Fourteen days after superior cervical ganglionectomy, the catecholamine fluorescence disappeared and the norepinephrine content drastically decreased and transmural nerve stimulation ceased to elicit any response in all these arteries. In the rabbit ear artery, denervation resulted in a significant leftward shift of dose-response curves for norepinephrine (8.2-fold), serotonin (7.7-fold), histamine (2.9-fold) and potassium (1.2-fold). In contrast, there was no significant shift of dose-response curves to these drugs in the rabbit basilar and cat middle cerebral arteries. These results indicate that after chronic superior cervical ganglionectomy, postjunctional supersensitivity developed in the rabbit ear artery, but no pre- or postjunctional supersensitivity occurred in the rabbit basilar and cat middle cerebral arteries. The difference may be in part attributable to the reported closer synaptic cleft distance of the sympathetic nerve terminals in the ear than in the cerebral arteries examined. These results further suggest that the sympathetic adrenergic nerve exerts a tonic influence over the rabbit ear artery, but little or none in normal cerebral blood vessels.
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10,000,521
Sedative and anticonvulsant effects of adenosine analogs in mouse and rat.
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10,000,522
The behavioral and physiological effects of L-phenylisopropyladenosine, cyclohexyladenosine and 2-chloroadenosine were examined in mice and rats. These analogs of adenosine are agonists which bind with high affinity to putative central A1 receptors in vitro. Relatively low doses of these drugs administered i.p. produced marked sedation and hypothermia; higher doses resulted in an almost complete cessation of spontaneous motor activity as well as some ataxia. These analogs also antagonized seizures elicited by a variety of convulsants with different mechanisms of action. The differences observed in the anticonvulsant potencies of the analogs suggest that these effects are not produced by the interaction of these drugs with a single class of adenosine receptor. In particular, 2-chloroadenosine and cyclohexyladenosine appear to be more related to each other pharmacologically than to L-phenylisopropyladenosine. Because some of the anticonvulsant actions of L-phenylisopropyladenosine are not reversed by the adenosine antagonist theophylline, and are not shared by the other analogs, these may reflect actions mediated by other, perhaps nonpurinergic receptors. Although benzodiazepines also have sedative, hypothermic and anticonvulsant properties, responses to benzodiazepines can be clearly dissociated from responses to the adenosine agonists.
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10,000,523
A unique pharmacogenetic expression of the N-acetylation polymorphism in the inbred hamster.
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10,000,524
Liver N-acetyltransferase (NAT) preparations (105,000 x g cytosol) were obtained from both sexes of 26 strains of inbred hamsters. Liver NAT activity levels were determined for six arylamine substrates; isoniazid, p-aminobenzoic acid (PABA), p-aminosalicylic acid (PAS), sulfamethazine (SMZ), procainamide and 2-aminofluorene. The N-acetylation of isoniazid, SMZ, procainamide and 2-aminofluorene exhibited a monomorphic expression in the hamster as the genetic variation in NAT activity levels between hamster strains was only about 2-fold for each substrate. In contrast, the N-acetylation of PABA and PAS showed a polymorphic expression in the hamster. Two inbred hamster lines (Bio 1.5 and Bio 82.73) had over 400-fold lower PABA NAT and over 20-fold lower PAS NAT activity levels than did the other inbred strains. In addition, the genetically determined N-acetylation differences between the rapid and slow acetylator hamster strains were also demonstrated in vivo for PABA but not for SMZ. Comparison of Michaelis-Menten kinetic constants of PABA NAT activity in a rapid and slow acetylator strain showed a 20-fold lower Km in the rapid acetylator strain suggesting an intrinsic structural difference in rapid and slow acetylator hamster liver NAT. Thus, the pharmacogenetic expression of the N-acetylation polymorphism is quite unique in the inbred hamster, in that PABA and PAS are genetically polymorphic substrates, whereas isoniazid, SMZ, procainamide and 2-aminofluorene are monomorphic, in direct contrast to man and rabbit.
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10,000,525
Comparative accumulation of uric acid and hypoxanthine by slices of avian renal cortex.
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10,000,526
The purpose of the study was to compare the concentrative uptake processes of the 14C-labeled purines uric acid (UA) and hypoxanthine (HX) by slices of chicken renal cortex. It was found that both purines were accumulated by the slices and that, while UA was unaltered metabolically, HX was partially oxidized to UA during the incubation. Inhibition of the oxidation of HX to UA by use of the enzyme inhibitor allopurinol did not alter accumulation indicating that metabolism of HX did not drive accumulation. UA accumulation was eliminated by the presence of low concentrations of the organic anion transport inhibitors probenecid and 4-acetamido-4'-isothiocyano-stilbene-2,2'-disulfonic acid. However, HX accumulation was unaffected by probenecid and significantly decreased by 4-acetamido-4'-isothiocyano-stilbene-2,2'-disulfonic acid only at concentrations considerably in excess of those needed to eliminate UA accumulation. The lack of effect of probenecid is in contrast to its reported inhibitory action on HX excretion by the chicken in vivo, a difference which may reflect lack of luminal transport by in vitro slices. Neither was HX accumulation sensitive to the presence of high concentrations of the organic cations quinine and tetraethylammonium. Despite the insensitivity of the HX accumulation process to organic anions or cations, the process was blocked by cyanide and an N2 atmosphere indicating energy dependence. The results suggest that both UA and HX are accumulated by separable transport processes indicating that the renal tubules possess more than one system capable of contributing to purine excretion.
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-0.03199392557144165, 0.012139630503952503, 0.061937883496284485, -0.0010000837501138449, -0.01805739849805832, 0.005708485376089811, 0.0014554429799318314, 0.007151626981794834, 0.02750428020954132, 0.023498909547924995, -0.009392451494932175, -0.05016588047146797, -0.0023951935581862926, 0.055926378816366196, 0.025859521701931953, -0.09936246275901794, 0.007338975556194782, -0.054251592606306076, 0.07518454641103745, 0.05962768942117691, 0.014404748566448689, -0.031115876510739326 ]
10,000,527
Myocardial disposition and cardiac pharmacodynamics of verapamil in the dog.
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10,000,528
The disposition of verapamil was studied in anesthetized open-chested dogs following administration of intravenous doses of 0.5 mg/kg. The plasma and myocardial verapamil concentration-time data were fit to a three-compartment model to describe the disposition kinetics. The distribution equilibrium between myocardium and plasma was achieved rapidly and the concentration of verapamil decayed in parallel in these two tissues. The partition coefficient which describes the time averaged myocardial/plasma concentration ratio was 6.21 +/- 2.38. Examination of the relationship between the plasma and myocardial concentrations and the time course of the effect of verapamil, as defined as PR interval prolongation, revealed a hysteresis effect in some dogs. Despite this hysteresis, there was a linear relationship between plasma and myocardial concentrations of verapamil and the degree of prolongation of the PR interval. The results of this study indicate that the concentration in the plasma is in equilibrium with the myocardium and changes in plasma concentration are indicative of parallel changes in myocardial levels. The effect of verapamil on the atrioventricular node is related to the concentration in the myocardium and plasma, but there is substantial interanimal variability in the sensitivity to verapamil.
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10,000,529
Hospital personnel who handle anticancer drugs may face risks.
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10,000,530
Study suggests vaginal hysterectomy is safer.
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10,000,531
The ups and downs of disease rates and sex.
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10,000,532
Cholesterol and cancer.
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10,000,533
Management of acute epiglottitis.
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10,000,534
Timolol-induced bronchospasm.
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10,000,535
Effects of the sauna.
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10,000,536
Lhermitte's sign and cobalamin deficiency.
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10,000,537
Green urine.
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10,000,538
The argon laser for cutaneous lesions.
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10,000,539
Vitamin E.
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-0.07834813743829727, 0.008136269636452198, 0.009137898683547974, -0.06453078240156174, 0.01943899504840374, 0.049515146762132645, 0.08528221398591995, -0.042952898889780045, -0.0479465089738369, -0.020793020725250244, 0.002777369925752282, 0.03174585849046707, -0.002007093047723174, -0.05850638076663017, 0.007395841181278229, 0.0028989610727876425, -0.06022664159536362, 0.004537985660135746, -0.03315429389476776, 0.02788734808564186, -0.01032631192356348, 0.027550261467695236, 0.012634477578103542 ]
10,000,540
Adverse reactions to tetanus toxoid.
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10,000,541
A retrospective review of 740 charts of patients with a history of adverse reaction to tetanus toxoid immunization was undertaken. The most common reactions, by history, were local edema and tenderness (33%), fever (15%), and anaphylactoid response (33%). Three patients who had a vesicular eruption at the immunization site were found to have delayed hypersensitivity to mercury. Thirty percent of the patients had received tetanus toxoid within one year and 55% within five years of evaluation. Reactive responses to immediate skin tests were exceedingly rare (less than 1%). None of the challenge patients suffered an adverse reaction.
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10,000,542
Effects of sample selection on the coincidence of hypertension and diabetes.
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10,000,543
The occurrence of both hypertension and diabetes in patients at a general medical clinic at a university center and within a work-site community has been determined. In addition, the course of such patients for four years following presentation has been observed. The combination of hypertension and diabetes appeared more frequently, was expressed by greater severity, and coincided with a higher observed morbidity among the hospital clinic patients than among the work-site population. These findings regarding the prevalence and natural history of these coexistent diseases reaffirm that the source of a selected population can significantly affect the pattern of disease expression observed and, therefore, limit the capacity to extrapolate results from one population to another.
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10,000,544
Peripatetic plague.
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10,000,545
Cases of plague continue to occur in various parts of the world, including the western United States, where plague is endemic among the wild rodent population. In 1980, a case of plague acquired in New Mexico and hospitalized in Nebraska illustrated the problem of plague occurring in persons traveling from the state in which they become infected to another state. Nine cases of plague in travelers were identified among the 166 cases of plague reported in the United States from 1950 to 1980. Physicians should be aware of natural plague foci in the western United States and should obtain a travel history from patients with an illness clinically compatible with plague.
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10,000,546
Aspirin and analgesic nephropathy.
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10,000,547
To assess the effects of long-term aspirin ingestion on renal function, we studied all of the patients at the Massachusetts General Hospital Arthritis Clinic who had been taking aspirin continuously for ten or more years. Aspirin ingestion was documented by multiple, random, unannounced blood salicylate levels. Most of these 46 patients had seropositive rheumatoid arthritis. All creatinine and BUN levels were normal. Maximum recorded specific gravities were greater than 1.019 in 43 of 46 patients. These data suggest that long-term salicylate ingestion does not cause renal damage.
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10,000,548
Acute gouty arthritis. Special management considerations in alcoholic patients.
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10,000,549
Isolation of Mycoplasma hominis from the blood of men with multiple trauma and fever.
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10,000,550
Ocular myasthenia. Multiple recurrences and spontaneous remissions.
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10,000,551
The safety of treating rheumatoid arthritis with aspirin.
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10,000,552
Analgesic nephropathy in 1981: which drug is responsible?
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10,000,553
Corneal birefringence.
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10,000,554
Progressive antral narrowing in an adolescent.
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10,000,555
The new wave in medicine: nuclear magnetic resonance.
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10,000,556
Women in medicine.
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10,000,557
Computers in medicine.
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10,000,558
Postoperative compressive neuropathies.
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10,000,559
Exposure to cotton dust and respiratory disease.
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10,000,560
Mammographic parenchymal patterns. Risk indicator for breast cancer?
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10,000,561
Mammographic parenchymal patterns, originally presented as a new risk factor for breast cancer, have been prospectively studied in a large (27,157 examinations) consecutive screening population. Although there is a significantly higher risk of breast cancer in the so-called dysplastic breasts (P2 and DY pattern groups), the classification is of little practical value, as more than 72% of the cancers in the prevalent population were found in the so-called low-risk breasts (N1 and P1 pattern groups). A similar trend occurred at repeated screening of younger women, in which most of the "incident" cancers were found in the "low-risk" breasts. These patterns should not be used to influence patient management or screening programs.
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10,000,562
Percutaneous radiographically guided catheter drainage of abdominal abscesses.
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10,000,563
We performed computed body tomography and ultrasound-guided percutaneous catheter drainage in 45 cases of abdominal abscess. Evacuation of the cavity was achieved in 40 cases (89%), eliminating the need for surgery in 34 patients. There were six recurrent abscesses, all due to fistulous communications or recurrent infected tumor. Major complications were a lacerated mesenteric vessel and a small-bowel fistula. Drainage catheters were removed an average of seven days after insertion. In many cases, guided percutaneous radiological drainage is an effective alternative to operative therapy, especially in severely ill patients.
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10,000,564
Rubella antibody persistence after immunization.
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10,000,565
A comparative field trial of three live, attenuated rubella virus vaccines (Cendehill, HPV 77 DE-5, and HPV-77 DK-12) was initiated in 1969 on the islands of Kauai and Hawaii in the state of Hawaii. Following initial seroconversion rates of more than 98%, periodic serological testing of the study population was conducted to assess the durability of vaccine-induced immunity. In February 1980, ten years after the initiation of the study, 741 of the 5,153 original susceptible vaccinees were still enrolled in the study. After a drop of approximately 50% in mean hemagglutination-inhibition (HI) titer for each of the vaccine groups during the first four years following vaccination, the HI titer levels for all three groups have been generally stable between years 4 and 10. The frequency of reversion to an HI titer of less than 10 has remained less than 0.5% per year. A measurable HI antibody level has persisted in more than 97% of all vaccines over the ten-year period. This study indicates that when potent rubella vaccine is administered properly, a high seroconversion rate and a high rate of antibody persistence should be expected.
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10,000,566
Leg ulcer. Conservative management or surgical treatment?
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10,000,567
In a specific indigent socioeconomic setting, the nonsurgical management of 65 patients with chronic leg ulcers resulted in 59 cures. There were 42 patients (67%) with postphlebitic syndrome. Twenty-two patients (33%) had varicose veins (eight had postoperative vein stripping), 14 (22%) had deep-vein thrombosis, and 11 (15%) had associated neurological problems. Fifty-six patients (86%) were treated with pressure dressings that were changed once a week in an outpatient clinic, seven patients wore skintight plaster casts for variable periods of time, and two patients had split thickness skin grafts plus lumbar sympathectomies. In more than two thirds of the patients, the ulcers healed. In another 17 patients (26%), a satisfactory response to treatment was observed. In only six patients did therapy fail. Failures were attributed to the multiple medical and surgical problems of the patients or their lack of cooperation. Nonsurgical treatment of venous stasis ulcer is inexpensive and effective.
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10,000,568
Medical schools, clinical faculty, and community physicians.
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10,000,569
In vivo comparison of levothyroxine preparations.
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10,000,570
Cefoxitin falsely elevates creatinine levels.
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10,000,571
Cefoxitin sodium has been found to act like creatinine in assays for creatinine used by many hospitals. Our in vitro results show that cefoxitin causes an apparent rise in the serum creatinine level; the magnitude of the increase depends on the assay method and the concentration of cefoxitin. Results varied from 1.5 to more than 8.5 times the normal serum creatinine level. Published data from studies of human volunteers show the same effect. In patients with normal renal function, the serum creatinine test is reliable two to four hours following cefoxitin infusion and in mild to moderate renal failure (glomerular filtration rate greater than 30 mL/min), six to eight hours. In severe renal failure, the serum creatinine determination is unreliable. Measurement of urinary creatinine employs similar assays, thus making estimation of creatinine clearance unreliable when the patient is receiving cefoxitin.
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10,000,572
Cough variant asthma in children.
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10,000,573
The patient with multiple alloantibodies. One possible answer to meeting blood needs.
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10,000,574
Mammographic parenchymal patterns: more controversy.
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10,000,575
Changing patterns of graduate medical education.
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10,000,576
Postgraduate medical education underwent substantial change during the 1970s: medical-school classes grew, the internship year was eliminated, and the numbers of M.D.s entering primary-care specialties increased. The purpose of this study is to develop a planning model of graduate medical education that can project the impact of these and other changes on the numbers and specialty mix of physicians completing training. The model is applied to an analysis of trends in graduate medical education and to the probable consequences of policy recommendations made by the Graduate Medical Education National Advisory Committee (GMENAC). The results show that the trend toward increasing percentages of M.D.s entering primary-care specialties from 1970 to 1976 changes to no increase from 1976 to 1980. Thus, the GMENAC policy recommendation to increase primary care further is not likely to occur spontaneously in the near future.
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10,000,577
Brain death with prolonged somatic survival.
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10,000,578
Failure of oral trimethoprim-sulfamethoxazole prophylaxis in acute leukemia: isolation of resistant plasmids from strains of Enterobacteriaceae causing bacteremia.
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10,000,579
Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 1-1982. A 42-year-old woman with longstanding heart block.
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10,000,580
A QRS scoring system for assessing left ventricular function after myocardial infarction.
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10,000,581
A QRS scoring system for estimating the size of a myocardial infarct was evaluated in 55 patients who did not have left ventricular hypertrophy or conduction abnormalities. Serial 12-lead surface electrocardiograms were scored according to a 29-point system based on the duration of Q and R waves and on the ratios of R-to-Q amplitude and R-to-S amplitude. The scores were proportional to the severity of wall-motion abnormalities, which was determined by radionuclide blood-pool scanning and which correlated inversely with the radionuclide-determined left ventricular ejection fraction (LVEF). A score less than 3 was 93 per cent sensitive and 88 per cent specific for both severe regional dyssynergy and major depression of the global LVEF. The following equation was used to estimate the LVEF from the QRS score: LVEF (%) = 60 - (3 x QRS score). After acute myocardial infarction, an electrocardiogram can provide important indirect quantitative information about left ventricular function.
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10,000,582
Better service for our overseas subscribers.
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10,000,583
Perils of prophylaxis.
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10,000,584
Aminoglutethimide vs. surgical adrenalectomy in breast cancer.
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10,000,585
Clonidine-suppression test for diagnosis of pheochromocytoma.
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10,000,586
Jogging and suppression of ovulation.
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10,000,587
Autopsy: a further suggestion for its revival.
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10,000,588
Percutaneous catheter drainage of abdominal abscesses.
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10,000,589
Avoiding sphygmomanometer-cuff "hypertension".
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10,000,590
Unsuspected benzyl alcohol hypersensitivity.
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10,000,591
Sputum for cytologic diagnosis of lung cancer.
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10,000,592
Biguanides and the erythrocyte insulin receptor.
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10,000,593
Virus-specific IgE and histamine release in nasopharyngeal secretions.
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10,000,594
Case 35-1981: parainfectious encephalopathy.
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10,000,595
Isolation of Chlamydia trachomatis from the liver capsule in Fitz-Hugh-Curtis syndrome.
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10,000,596
Clinical drug information: a case of misinformation.
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10,000,597
OPEC otitis.
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10,000,598
Health policy report. Health care and American business.
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10,000,599
Hemodynamic characterization of tolerance to long-term hydralazine therapy in severe chronic heart failure.
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