AN INVESTIGATION OF THE ETIOLOGY OF MUMPS

1. From four out of six specimens of saliva from six cases of mumps in the early stages of the disease, a filterable cytotropic virus has been obtained which induces in M. rhesus monkeys, following inoculation of the parotid glands through Stensen''s duct, an acute, non-suppurative parotitis analogous to mumps. 2. This virus has not been found in normal saliva, nor does it correspond to any known virus with which we are familiar. 3. The virus is free of demonstrable microorganisms including spirochetes. 4. It is judged that this virus is the causative agent of mumps.     

AN AUDIT OF THE USE OF SPHYGMOMANOMETERS

SUMMARY This survey assessed the measurement of blood pressure and use of sphygmomanometers by general practitioners in Humberside and Yorkshire in 1988. All registered practitioners were sent a questionnaire — 1223 (58%) returned it completed. Their responses showed that 269 (22%) had an aneroid sphygmomanometer only, and that 120 (10%) had a random zero sphygmomanometer; 700 (57%) had special cuffs for obese patients, and 558 (46%) had special cuffs for children; 228 (23.5%) had never had their sphygmomanometers serviced (‘never’ corresponding to a mean time of 5.75 years), while 23% had patients who measured their own blood pressure. These findings suggest that the British Hypertension Society's recommendations on servicing and cuff use are not always applied. A formal audit of the use of different types of sphygmomanometer in general practice may encourage and improve accuracy and uniformity in blood pressure recording.     

AN IMMUNIZING STRAIN OF THE VIRUS OF POLIOMYELITIS

In this communication we have described a strain of the virus of poliomyelitis derived from a rapidly fatal human case, which exhibits mild degrees of infective power and marked degrees of protective effect for the monkey. While Macacus rhesus displays perceptible differences in suceptibility to the attenuated virus, nearly all individuals respond to the inoculation and none succumbs to the infection induced. As compared with previously described examples of experimental poliomyelitis, the modified disease described in this paper is distinguished by its relatively benign nature and its tendency to end in recovery rather than, as with the earlier observed instances, in death.     

AN OVERVIEW OF FORENSIC PSYCHIATRIC CARE OF THE ADOLESCENT

The field of forensic psychiatric nursing is a relatively recent addition to the specialty of psychiatric nursing. This paper provides an overview of forensic psychiatric care of adolescent patients. It describes the juvenile justice system, identifies various theoretical models useful for understanding youthful offenders, and explores risk and protective factors. Psychiatric comorbidities and treatment considerations also are presented.     

AN ESTIMATE OF THE TIMBER RESOURCES OF NEW BRITAIN

Mechanical thinning of mountain ash regrowth stands in southern Australia offers the potential for harvesting substantial amounts of pulpwood for industry. In 1988/89 a trial operation using feller-buncher, processor, and forwarder demonstrated the general feasibility of this. The present study examined the productivity of an improved operation developed from the initial trial and conducted during 1990/91, with subsequent site follow-up. Two stands of regrowth ash species (Eucalyptus delegatensis and E. regnans) were thinned using a feller-processor and forwarder under rules prescribed by the managing forestry agency. The stands were 18–19 years of age and located near Toolangi (Victoria). The study derived considerable information on rates of production, damage, and cost. It showed there were relatively few environmental effects associated with the felling and processing, but that forwarding could impose a considerable number of machine passes on the soil. Major problems in the operation were the amount of residual hardwood debris from past logging, and keeping damage to retained stems below acceptable levels. Changes in the operating rules have the potential to reduce costs from $38 m^?3 to $27 m^?3 These involve allowing the feller processor to work during wet weather, allowing accumulations of wood stored within the forest and at landings, and concentrating both forwarding and trucking at times of good weather. These changes reflect the low impact of the felling-processing and the high productivity of the forwarders. The study showed that it was not economic to take material of less than 150 mm dbh, and if such trees are to be felled on silvicultural grounds it is more economic to thin to waste.     

AN ELECTROCARDIOGRAPHIC STUDY OF THE ANAPHYLACTIC RABBIT

Electrocardiographic examination of rabbits during the anaphylactic reaction revealed marked and various changes of the heart''s activity in twenty-two out of twenty-four animals. Changes occurred in fatal as well as in non-fatal cases, after the vagi were cut as well as when they were intact. Cardiac disturbances are thus a practically constant result of serum anaphylaxis in the rabbit. It therefore is possible that anaphylaxis plays a role in the causation of certain cardiac derangements in man.     

ON THE GREATER SUSCEPTIBILITY OF AN ALIEN VARIETY OF HOST TO AN AVIAN TUMOR

A transplantable sarcoma of the fowl, known as Chicken Tumor XVIII, in our series, succeeds better in chickens of an alien breed (Plymouth Rock) than in those of the variety in which it originated (brown Leghorn). This is not due to gross physical differences in the two breeds but to some more subtle factor and one which perhaps acts by influencing the agent causing the tumor. It would seem that Chicken Tumor XVIII, as it occurred in nature, was an instance of a disease appearing spontaneously in an animal of relatively insusceptible variety.     

AN ULTRASTRUCTURAL STUDY OF THE MECHANISMS OF PLATELET-ENDOTOXIN INTERACTION

Electron microscopy has confirmed previous studies and has provided much new information on the mechanism of endotoxin-platelet interaction. The Boivin lipopolysaccharide preparation is particulate, and on electron microscope examination appears as a three-layered structure, morphologically similar to bacterial cell wall. In vitro and in vivo experiments have demonstrated that these endotoxin particles adhere to platelets. In some species, particularly the rabbit, this is associated with loss of platelet contents, due to lysosomal and cell membrane lysis, resulting in platelet sphering and apparent cell death. Serial observation of degranulating platelets and metabolic studies indicate that although some platelet engulfment of endotoxin occurs, degranulation is not dependent upon phagocytosis. Several observations suggest that these endotoxin effects are mediated through immune mechanisms: (1) Inactivation of complement in the suspending plasma by heating to 56°C, anticoagulation with EDTA, a reaction temperature of 5°C, ammonium hydroxide incubation, and adsorption with either zymosan or washed antigen-antibody complexes, inhibits both endotoxin adherence and platelet degranulation. (2) The reaction requires a plasma cofactor, possibly antibody, which can be adsorbed out by endotoxin. (3) Endotoxin adheres selectively to nonprimate platelets and primate red cells, a pattern conforming to immune adherence, a phenomenon requiring antigen, antibody, and complement. It is suggested that endotoxin-induced platelet damage is dependent upon the intimate contact provided by immune adherence. We have not established whether degranulation is an endotoxin or complement effect. The species variation in susceptibility to endotoxin also merits further investigation.     

THE STABILITY OF AN ORAL LIQUID FORMULATION OF CYSTEAMINE

A formula for cysteamine syrup is presented together with stability data obtained after analysis by high performance liquid chromatography.     

THE PULSE PRESSURE AS AN INDEX OF THE SYSTOLIC OUTPUT

On the basis of these facts we feel justified in making the following assertion: Under normal conditions and during various procedures (namely, stimulation of the vagus centrally and peripherally, of the saphenus nerve centrally, and of the annulus Vieussentis, intravenous transfusion of 0.7 per cent. sodium chloride solution, intra-arterial transfusion of strong carbonate, bleeding and asphyxia) the pulse pressure is a reliable index of the systolic output.     

口腔癌高温热疗的血液流变学机制探讨

为探讨口腔癌局部高温热疗的选择性杀伤机制，采用锥板粘度计测定了金黄地鼠血液在不同温度下的血液流变学参数，并采用扫描电镜观察了实验性口腔癌微血管构筑，结果发现：血液升温至４３℃时，血液流变各参数无明显变化．但当温度高于４３℃时，各参数随温度的升高发生明显改变，实验性口腔癌微血管观察发现毛细血管不规则狭窄、中断或极度扩张，可见铸型剂从血管内溢出，结果提示，肿瘤及其邻近组织血管构筑及血液流变特性的差异是口腔癌局部高温热疗选择性杀伤机制中的一个重要因素．     

JAUNDICE AS AN EXPRESSION OF THE PHYSIOLOGICAL WASTAGE OF CORPUSCLES

The jaundice that develops after obstruction of the common duct in the absence of complications, expresses the physiological wastage of corpuscles occurring from day to day; and the intensity of the bilirubinemia varies as does the total of functioning hemoglobin-containing tissue from which this wastage takes place. There is to be observed a constantly readjusted direct relationship between hemoglobin percentage, bilirubinemia, and, by corollary, bilirubinuria. Induced losses of red cells find expression at once in a lessened accumulation and excretion of bile pigment; and as the regeneration of hemoglobin takes place the amount of bile pigment increases pari passu both in plasma and urine. The jaundice of bile retention is far less pronounced during secondary anemia than when the individual is full blooded, other things being equal. During uncomplicated obstructive jaundice the intercurrent changes in bilirubinemia correspond closely with those in circulating hemoglobin even when tissue icterus is of long standing. The fact indicates the presence of a barrier to the distribution of bile pigment from the blood, and such a barrier is to be found in the walls of the vessels. Its influence is at once evident on comparing lymph specimens and blood specimens from the long jaundiced animal. The amount of bile pigment in the lymph is then seen to be negligible, relatively speaking. Tissue icterus should be thought of as, ordinarily, the highly imperfect secondary expression of a condition which tends to be localized to the blood pool. On occasion more pigment than usual may escape from this pool, as for example into the wheats of the yellow urticaria described by clinicians.     

医院临床用血现状调查分析

目的 了解医院临床用血合理性情况。方法 随机抽取本院2006～2008年有输血治疗的病历700份,其中外科病历500份,内科病历200份。依据《临床输血技术规范》中“手术及创伤输血指南”和“内科输血指南”对病例输血合理性进行分析评估。结果 700例病例中,合理用血占44％,部分合理用血占40％,不合理用血占16％。内科合理输血比例显著高于外科（χ^2=91．827,P〈0．01）。结论 不合理用血现象在医院中普遍存在,外科占有较大比例。     

AN EXAMINATION OF THE CYTOTOXIC EFFECTS OF SILICA ON MACROPHAGES

Effects of silica, diamond dust, and carrageenan on mouse macrophages were studied by phase-contrast cine-micrography, electron microscopy, histochemical techniques for lysosomal enzymes and measurements of the release of lysosomal enzymes into the culture medium. All added materials were rapidly taken up into phagosomes, to which lysosomes became attached. In all cases lysosomal enzymes were discharged into the phagosomes to form secondary lysosomes. Within 24 hr most of the silica particles and enzyme had escaped from the secondary lysosomes and lysosomal enzymes were found in the culture media. Most macrophages were killed by this time. With nontoxic particles (diamond dust, aluminium-coated silica, or silica in the presence of the protective agent polyvinyl-pyridine-N-oxide, PVPNO) ingested particles and lysosomal enzymes were retained within the secondary lysosomes for a much longer time, and cytotoxic effects were considerably delayed or absent altogether. It is concluded that silica particles are toxic because they are efficiently taken up by macrophages and can then react relatively rapidly with the membranes surrounding the secondary lysosomes. The particles and lytic enzymes can then escape into the cytoplasm, producing general damage, and thence into the culture medium. It is suggested that hydrogen bonding of silicic acid with lipid and protein constituents of the membrane accounts for the induced permeability. Protective agents such as PVPNO are retamed in lysosomes and preferentially form hydrogen bonds with silicic acid. Carrageenan is demonstrable within macrophages by its metachromatic reaction. It brings about release of enzymes from secondary lysosomes, but much more slowly than does silica. Silica released from killed macrophages is as cytotoxic as the original preparation. It is suggested that repeated cycles of macrophage killing in vivo leads to the mobilization of fibroblasts and fibrogenesis characterizing the disease silicosis.     

THE BLOOD CHEMISTRY OF AN ACUTE TRYPANOSOME INFECTION

The CO₂ capacity of the serum is markedly lowered early in infection with Trypanosoma equiperdum. The non-protein nitrogen and uric acid constituents of the blood are increased in the terminal stages. The kidneys also show terminal degenerative changes. The cholesterol remains unchanged throughout. Lecithin is markedly increased, most of the observations showing a 20 per cent to 50 per cent rise in this substance. Liver glycogen is lower than normal in the early stages and could not be demonstrated in the later stages of the infection. The blood sugar remains normal until a very late period in the disease.     

AN APPROACH TO THE QUANTITATION OF IMMUNOGENIC ANTIGEN

Using passively administered isotope-labeled anti-KLH to suppress the antibody response of rabbits to KLH, we have attempted to estimate the amount of antigen actually involved in stimulating antibody formation. Single and paired label tracer studies of passively administered anti-KLH IgG indicated that from 0.7 to 2.9 µg were utilized or involved by the antigen in the course of a 90% suppression of the response to 2 mg KLH. Tracer studies of labeled anti-KLH F(ab')₂ fragments revealed the retention of from 2 to 3 µg of these fragments in the entire rabbit during a 60% suppression of the response to 1 mg KLH. Based on previously determined ratios of mixtures of KLH and suppressive amounts of anti-KLH in adjuvant, the antibody utilization data were converted to the probable amount of antigen or immunogen involved. It appears that after an injection of 2 mg of KLH approximately 0.2–0.5 µg of antigen persisted and reacted with antibody given 24 hr later. Since all of this persisting, reactive antigen may not be immunogenic, the above estimate of immunogen is probably high, but may serve to establish upper limits for the amounts of immunogen involved in stimulating antibody formation and provide a meaningful frame of reference for antigen tracer studies.     

AN EXPERIMENTAL STUDY OF THE ARTERIES IN SHOCK

As a result of the experimental work here recorded, there can be no doubt of the fact that the rate of inflow in shock was faster than normally, and in my experiments the average increase was 36 per cent. It is concluded, therefore, that decreased vasomotor tone is an accompaniment of shock.