Prognostic value of isolation of L-forms of Mycobacterium tuberculosis

A procedure has been developed to detect antilysozymatic activity n L forms of Mycobacterium tuberculosis (MBT). A mode of predicting the course of a tuberculosis process in the lungs by the degree of antilysozymatic activity of MBT is outlined. Thus, when the level is 4 micrograms/ml or higher, progression or exacerbation of tuberculosis is predicted, when that of 0-3 micrograms/ml, a good prognosis is expected.     

The effect of change of position of the arm upon blood pressure

Position of the arm has a definite and uniform effect on blood pressure readings. The systolic pressure is lowest when the arm is hyperabducted, that is, when it is made to lie along the long axis of the body. The systolic pressure becomes higher as the arm is adducted and brought toward the side of the body in the horizontal plane. A neutral position of the arm, 45 to 90 degrees from the side of the body, is probably the optimum position for the estimation of blood pressure. Other positions may cause a marked discrepancy in blood pressure readings.     

Physiology of the Regulation of Platelet Production

Platelet production is stimulated by removal or destruction of platelets and is inhibited by hypertransfusion with viable platelets. It is not influenced by factors regulating red cell production, even in the absence of the spleen. Nephrectomy does not impair the response to platelet depletion. It is concluded that the regulation of platelet production is by a system entirely independent of that governing erythropoiesis.     

Treatment of the pruritus of cholestasis

Opinion statement The etiology of the pruritus of cholestasis is unknown. It is inferred that the pruritogen( s) is produced in the liver, excreted in bile, and as a result of cholestasis it accumulates in plasma. It may follow, logically, that the removal of the substance(s) that mediate pruritus leads to its resolution. The problem with this approach, however, is that the substance(s) is unknown; thus, it is not possible to reduce its serum levels specifically. Oral cholestyramine, a resin that is not absorbed, is associated with increased fecal excretion of certain substances, including cholesterol and bile acids. Many patients respond to treatment with cholestyramine with a relief of pruritus, which unfortunately may be temporary, but is well tolerated in general and it seems reasonable to prescribe it as an initial therapy. When pruritus is not relieved by resins, the use of opiate antagonists (eg, naloxone and naltrexone) is supported by data from controlled clinical trials. Butorphanol is an agonist at the kappa opioid receptor and an antagonist at the mu opioid receptor with minimal or absent abuse potential. The use of butorphanol spray in selective patients may be a therapeutic alternative. In uncontrolled observations dronabinol, an agonist at the cannabinoid B1 receptor, and sertraline, a serotonin reuptake inhibitor, have been reported to be associated with the relief of pruritus. The cannabinoidergic and serotoninergic systems participate in the mediation of nociception; therefore, there appears to be a rationale for the use of these drugs to treat pruritus. Data from controlled clinical trials on the use of dronabinol and sertraline, however, are not available at present.     

新生血管动物模型的构建

新生血管是指从已有毛细血管发展形成新血管,该过程受血管生成因子和血管抑制因子双重调控,是一个动态平衡的过程。新生血管是多种疾病的病理性改变,包括肿瘤、早产儿视网膜病变和糖尿病视网膜病变等,是严重的致残性病变。建立新生血管动物模型是研究这些疾病发病机制的重要前提,本文主要对主动脉环血管生成模型、基质胶栓动物模型、氧诱导视网膜病变模型、激光诱导脉络膜新生血管动物模型4种建模方法进行了综述。     

New aspects of the pharmacokinetics of ethanol

In the paper a survey on new results in the pharmacokinetics of ethanol is given. Resorption follows the rules of diffusion and is influenced by a lot of factors, this results in a high interindividual variation. Distribution is influenced by a first-pass-effect and the tissue contents of water. Metabolism is performed by alcohol dehydrogenase and microsomal ethanol oxidizing system. The kinetics of ADH is undependent on concentration, the MEOS is inducible. Results of acute and chronic ethanol treatment are discussed, clinical consequences are reviewed.     

Rate of evolution of a quantitative character

The rate of change of the mean of a quantitative character is evaluated exactly and also under the hypothesis of linear biparental regression. Generations are discrete and nonoverlapping; the monoecious population mates at random. The genotypic and environmental contributions to the character are additive and stochastically independent. The character is influenced by arbitrarily many multiallelic loci and has constant genotypic values; dominance, epistasis, and the linkage map are also arbitrary. The population is initially in linkage equilibrium, and there is no position effect. If the biparental regression is linear, then the regression coefficient is simply Vgam/V, and hence the single-generation change in the mean is deltaZ = (Vgam/V)S, where Vgam and V denote the gametic and total variances in the character and S designates the selection differential. The corresponding exact result is DeltaZ = (C/W) + (B/W2), where C, W and B represent the gametic covariance of the character and fitness, the mean fitness, and a correction term, respectively. If selection is weak, then DeltaZ approximately C/W. Furthermore, deltaZ = C/W if either there is no environmental contribution and the gametic effects are additive or the character is fitness itself. In the latter case, C is the gametic variance in fitness. Thus, even in linkage equilibrium, weakness of selection generally does not suffice to validate the linear-regression result. This conclusion holds even for additive loci.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Local treatment of carcinoma of the rectum

Conclusions Local treatment of carcinomain situ of the rectum is the procedure of choice. It is also preferable when there is a focal malignant change in a polyp with a pedicle that is not invaded by the cancer, and when a sessile carcinoma of low grade is less than 2 cm. in diameter. These indications may be extended in some cases when the general condition of the patient precludes a radical surgical procedure, when the patient, because of a poor mental condition, would not be able to manage the colostomy himself, and when a colostomy is refused. When a carcinoma of the rectum is inoperable, or when there is distant metastasis, local treatment may provide gratifying palliation. Read at the Canberra meeting of the Royal Australasian College of Surgeons. Canberra, Australia, November 28, 1964.     

Mode of action of chlorothiazide in the reduction of blood pressure in hypertension

The possibility that chlorothiazide affects the hypertensive process is a very real one since the effect on the blood pressure of long term treatment is to reduce peripheral resistance.

The means by which this is achieved is unknown. It cannot be shown to be due to loss of sodium since the level of exchangeable sodium returns to normal on long term treatment. The only change we have been able to observe is a fall in total body water which is believed to be due to a loss of cellular water.     

Endoscopic resection of small inflammatory fibroid polyp of the colon

Inflammatory fibroid polyp (IFP) is a solitary intestinal lesion of unknown etiology. Although IFP is benign, laparotomy for the resection of colonic IFP is performed in most cases because the polyp is usually large. We report a successful endoscopic resection of cecal IFP. It is considered that colonic IFP should be resected endoscopically if the polyp is small and is located submucosally.     

Regulation of the Expression of the N Gene of Bacteriophage Lambda

A quantitative assay for the N protein of bacteriophage lambda has been used to study the in vivo regulation of N gene expression. The assay makes use of the observation that in a cell-free protein-synthesizing system from Escherichia coli programmed with lambdaN(-) DNA the lambda endolysin is made only if N protein is added to the reaction.The rate of synthesis of N protein in vivo is negatively controlled by the products of the CI and tof genes of the phage. Furthermore, N protein activity is extremely unstable in vivo. During normal cell growth at 35 degrees , the half-life of N protein is about 2 min.     

Management of musculoskeletal complications of hemophilia

Prophylactic treatment from ages 2 to 18 years could prevent the development of hemophilic arthropathy if the concentration of the patient's deficient factor is kept from falling below 1% of normal. Early treatment is of paramount importance because the immature skeleton is very sensitive to the complications of hemophilia. Major hemarthrosis and chronic hemophilic synovitis should be treated aggressively to prevent hemophilic arthropathy. When advanced hemophilic arthropathy is present with severe disability, the aim should be to restore function while minimizing the risk to the patient. Joint debridement is an effective method to achieve this goal, especially around the elbow or ankle, and can be considered an alternative to knee replacement in the younger age groups. Proximal tibial valgus osteotomy is a reliable treatment method for painful genu varum of the mobile hemophilic knee. Supramalleolar tibial varus osteotomy is an attractive alternative to the more commonly used surgical option of arthrodesis. Finally, joint replacement can usually be relied on to restore both mobility and function in a diseased joint. The potential benefits of joint replacement must always be weighed against the long-term sequelae, however, especially loosening and consequent revision surgery.     

Clinical significance of sphincter of Oddi Dyskinesia

Sphincter of Oddi dyskinesia (SOD) is a functional disorder of the papilla region that can lead to clinical symptoms and functional obstruction of biliary and pancreatic outflow. Based on the severity of the clinical symptoms, the disorder is classified as one of three types (biliary or pancreatic type I-III). Diagnosis of SOD is hampered by the relative risk of endoscopic sphincter manometry to cause pancreatitis. Manometrically, SOD is characterized by increased pressure in the biliary or pancreatic sphincter segment and can be treated with endoscopic papillotomy. This review is an attempt to balance the arguments for invasive diagnosis with a pragmatic clinical approach in which papillotomy is performed if clinical suspicion and patient presentation support a dysfunction of the papilla. For patients with biliary or pancreatic type I, endoscopic papillotomy is the treatment of choice. In biliary type II, SO manometry may be helpful for clinical decision making; however, the ratio of risks to benefits is difficult to assess based on the present data. In type III SOD, patient selection and the low predictive value of manometry for treatment success raise questions about the clinical usefulness of SO manometry.     

肝肾综合征治疗进展

肝肾综合征（HRS）是严重肝病常见并发症,病死率高。发病机制尚不十分明确,临床表现主要为功能性肾衰竭,对其正确诊断非常重要。治疗主要是针对循环动力学改变及肾灌注不足等环节,选择具有较强的全身血管收缩作用,而对肾动脉无影响的血管活性药,加上血管扩张剂,以逆转高动力循环状态,并借助血液净化系统改善肾功能;针对门静脉高压环节给予经颈静脉肝内门-体分流（TIPS）治疗;最佳治疗是肝移植。HRS应采取积极预防措施。     

Staging of cancer of the pancreas

Staging of cancer of the pancreas is relatively reliable when based on pathological material obtained from operative specimens or at autopsy. At operation, the assessment of disease stage, and therefore of operability, is more difficulty-particularly in relation to the extent of lymph node involvement and liver metastases. Preoperative staging, which, clinically, is the most essential, is difficult and unsatisfactory at the present time.     

Methods of the elaboration of data of the cardiological importance

This paper deals with some introductory topics of signal processing and decision making in cardiology. In both instances the matter is referred to general schemes well suited to host different applications. Signal processing is divided in some phases: acquisition, storing, analysis and each of them is described with applications to specific signals. In a similar manner the methods for decision making have been simplified to a scheme including a "knowledge base" and an "inference method". The scheme is used to classify various implementations. Bayes analysis and expert systems have been introduced with some details.     

Management of intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease during pregnancy, characterized by otherwise unexplained pruritus in late second and third trimester of pregnancy and elevated bile acids and/or transaminases. ICP is associated with an increased risk of adverse perinatal outcomes for the fetus and the later development of hepatobiliary disease for the mother. Bile acids should be monitored throughout pregnancy since fetal risk is increased at serum bile acids >40 µmol/l. Management of ICP consists of treatment with ursodeoxycholic acid, which reduces pruritus. Early elective delivery is common practice but should be performed on an individualized basis as long as strong evidence supporting this practice is lacking. Mothers should be followed-up for normalization of liver function tests 6–12 weeks after delivery. Future research in large-scale studies is needed to address the impact of ursodeoxycholic acid and early elective delivery on fetal outcome.     

The characteristics of the circulation of the causative agent of opisthorchiasis in the tributaries of the Ob

Opisthorchiasis morbidity is reviewed in the area of the Vasyugan River, an Ob tributary. Intermediate hosts have been found in 3 settlements situated at various distances from the ostium. The infestation of intermediate and additional hosts with Opisthorchis larvae is investigated. The above data and the results of previous population surveys (establishing infestation and contamination) served the basis for elucidating the nature of helminth circulation on the territory along the Vasyugan River. The role of infected fish migration is discussed as a source of human infection in areas where helminth circulation is altogether absent or is at an extremely low level.     

Surgical treatment of osteoarthritis of the shoulder

Shoulder dysfunction is unusual in osteoarthritis and usually responds to conservative treatment. The primary indication for surgery is pain unresponsive to medical management. The procedure of choice for degenerative changes in the glenohumeral joint is hemiarthroplasty or total shoulder replacement depending on the condition of the glenoid. Shoulder fusion is rarely necessary for osteoarthritis and is recommended for chronic infection, flail shoulder, and failed total shoulder replacement not amenable to revision. Joint resection is reserved for infected joints with massive bone loss. The results of shoulder arthroplasty are good to excellent in 86 to 94 per cent of all patients. The results of shoulder arthrodesis are less predictable, but are usually satisfactory in approximately 75 per cent of patients with 10-year follow-up. The treatment of AC and SC joint arthritis is conservative with rest, local heat, and medication. Pain unresponsive to this regimen is an indication for resection of the joint. Good results with this procedure directly correlate with pain relief on injection of the joint with local anesthetic.