Indomethacin in canine acute hemorrhagic pancreatitis

The effects of indomethacin administration on hemodynamics were investigated in canine acute hemorrhagic pancreatitis (AHP). Thirteen mongrel dogs were randomly divided into a fluid treatment group, an indomethacin prophylaxis group (IMP), and an indomethacin therapy (IM) group. Indomethacin (5 mg/kg) was administered as a bolus dosage 30 min before the induction of AHP in the IMP group. In the IM group, indomethacin was also given as a bolus (5 mg/kg) in 5 min starting 30 min after the induction of AHP. AHP was induced with a mixture of trypsin and sodium taurocholate infused into the pancreatic duct. Hemodynamics were monitored during the 4.5 h of surveillance time. Heart rate did not change significantly between the groups. Indomethacin prophylaxis maintained mean arterial pressure at a significantly higher level (P less than 0.05) and prevented the initial fall in blood pressure when compared to the fluid treatment or IM group. Indomethacin increased cardiac output (P less than 0.05) in the IM group, but did not differ significantly in the IMP group in comparison with the fluid treatment group. In conclusion, the inhibition of the initial fall in blood pressure by indomethacin in AHP suggests prostaglandins to play a role in hemodynamic changes and pancreatic shock to be "septic" as evaluated by hemodynamic changes.     

Refraction and accommodation in diabetic school children

Refraction and accommodation of 61 diabetic children (aged 9 to 16 years) and 92 non-diabetic children (aged 10 to 16 years) were studied. Myopia was found in 36.1% of the diabetic children and in 29.3% of the non-diabetic children. The difference was not statistically significant. In the diabetic children, the age of the onset of myopia and the progression of myopia were the same as in the usual myopia at school age. The refraction curve of the diabetic children was less peaked than that of the non-diabetic children; a greater number of low myopic refractions were observed, and the low hyperopic refractions were more evenly distributed in the curve of the diabetic children. The mean accommodation of the diabetic children was 9.9 D +/- 2.2, and in the non-diabetic children it was 11.8 D +/- 2.6. The difference was statistically significant. The accommodation of both the diabetic and non-diabetic girls was lower than that of the boys. The accommodation in the myopic diabetic children was statistically significantly lower than the accommodation in the hyperopic diabetic children.     

Corneal graft endothelial cell densities after preservation in M-K, K-sol and MEM tissue culture media. A clinical and specular microscopic study

The endothelial cell densities of corneal transplants of 30 keratoconus patients have been studied. All operations were performed by the senior author using the same technique. Preservation systems M-K medium, MEM-solution and K-sol were used; ten grafts in each group. The average endothelial cell density for all 30 transplants was 1815 +/- 869 cells/mm2. The mean cell density was the lowest (1128 +/- 587 cells/mm2) and the mean follow-up time longest (2 years and 9 months) in M-K medium stored grafts. K-sol is the newest preservation method used in our hospital. It gave the best graft endothelial cell densities (2302 +/- 938 cells/mm2). The mean follow-up time was shortest in K-sol (8 months). The mean endothelial cell density for grafts from MEM-solution was 2015 +/- 614 cells/mm2) with the mean follow-up time of 1 year, 4 months.     

Effects of the immunomodulator diacetyl-splenopentin on antigen-induced arthritis in rabbits

Long-term treatment with the immunomodulator diacetyl-splenopentin reduces the severity of chronic joint inflammation and cartilage destruction in rabbits with antigen-induced arthritis. The level of specific antibodies as well as specific and non-specific cell-mediated immune reactivities including the proliferative response of spleen lymphocytes to cartilage proteoglycans in treated animals are lower than in untreated arthritic rabbits. Moreover, suppressor cell activity, which normally decreases during the early phase of inflammation, is enhanced and hyperreactive helper cell potential is reduced. These findings suggest that treatment with diacetyl-splenopentin normalizes the immune regulation, which is disturbed in the early phase of inflammation. This might result in a depression of the hyperreactive immune system including the autoimmunity developed against cartilage. Lowered immune reactivity in the joint in turn reduces the severity of chronic joint inflammation.Preliminary results were presented at the 6th Halle Summer Colloquium on Modulation, Mediation and Inhibition of Inflammation (H. Bekemeier and R. Hirschelmann, eds.). Wiss. Beitr. Martin-Luther-Universität Halle-Wittenberg 1987/7. Halle (Saale) 1987.     

Can a clinician predict the technical equipment a patient will need during intensive care unit treatment? An approach to standardize and redesign the intensive care unit workstation

The technical equipment of today's intensive care unit (ICU) workstation has been characterized by a gradual, incremental accumulation of individual devices, whose presence is dictated by patient needs. These devices usually present differently designed controls, operate under different alarm philosophies, and cannot communicate with each other. By contrast, ICU workstations could be equipped permanently and in a standardized manner with electronically linked modules if the attending physicians could reliably predict, at the time of admission, the patient's equipment needs. Over a period of 3 1/2 months, the doctors working in our 20-bed surgical ICU made 1,000 predictions concerning outcome, equipment need, duration of artificial ventilation, and duration of hospitalization for 300 recently admitted patients. The interviews were made within the first 24 hours after admission. The doctors being interviewed were usually (i.e., in over 90% of cases) unfamiliar with the patient. Information concerning the patient's general state of health, special pre-ICU events, and complications was offered to the interviewed clinician because this information represents standard admission data. It was found that the equipment need (represented by two different setups, high tech and low tech) could be predicted most reliably (96.4% correct predictions) compared with a prediction on outcome of ICU treatment (94.5%), on duration of artificial ventilation (75.4%), and on duration of stay (43.4%). There was no significant (p>0.05) difference in the reliability of predictions between residents and consultants. Factors influencing the postoperative equipment need varied with surgical specialty. The general state of health, as indicated by the ASA classification (p<0.001), and the specific intervention (all multiple-valve replacements needed the high-level equipment standard) appeared to be most important in cardiac surgery, while a state of septicemia was important in general surgery (p<0.001). Our findings suggest that ICU workstations may be standardized into at least two types.     

The stability of the ecological distribution of the incidence of treated mental disorders in the city of Mannheim

Summary In 1965, Häfner et al. (1969) conducted an ecological study of the incidence of treated mental disorders in the industrial city of Mannheim. They found large variations in incidence rates in 20 urban areas: excess morbidity in the socially disorganized areas located mainly in the city center, and low rates in areas on the outskirts. This study incorporates additional data from the Cumulative Psychiatric Case Register established in Mannheim in 1973. It focuses on the short- and long-term stability of the spatial distribution of mental disorders comparing the year 1965 with the period 1974–80, and analysing the individual years from 1974–80. Despite marked changes between 1965 and the seventies (the increase in the number of guest workers; the development of extensive building and urban renewal programs; the establishment of the Central Institute of Mental Health and several community psychiatric services after 1975), the ecological correlation remained relatively high (r=0.79). Prior to the establishment of the Central Institute of Mental Health, the spatial distribution of mental disorders in the year 1974 was also very similar to that in 1965 (r=0.73). In general, the study revealed a highly stable ecological distribution of treated mental disorders not only on a long-term basis, but also for the individual years from 1974 to 1980.Revised version of a paper presented at the Symposium on Epidemiology and the Prevention of Mental Disorders 15–17 September 1987 - Reykjavik, World Psychiatric Association, Section of Epidemiology and Community Psychiatry     

Reciprocal interactions between α2-adrenoceptor agonist and neuropeptide Y binding sites in the nucleus tractus solitarius of the rat

Summary Interactions between a ₂-adrenoreceptor agonist and neuropeptide Y (NPY) binding sites have been studied in the rat medulla oblongata (MO) using biochemical binding techniques as well as quantitative autoradiography. Tritiated para-amino clonidine (³H-PAC; ₂-adrenoceptor agonist), idazoxan (³H-IDA; ₂-adrenoceptor antagonist) and iodinated neuropeptide Y (¹²⁵I-NPY) were used as radioligands. (1) Neuropeptide Y (NPY; 10^–8M) but not bovine pancreatic polypeptide (BPP) nor peptide YY (PYY 10nM) increased the K_D value of³H-PAC binding sites. However, intraventricular administration of a high dose of NPY (1.25nmol) did not change the³H-PAC binding characteristics in MO membrane preparations of these animals. (2) GTP 10^–4 lowered the affinity of³H-PAC binding. NPY (10 nM) had no additional effect, nor did NPYinfluence the GTP induced shift in potency of clonidine to displace³H-IDA from its binding sites. (3) In the autoradiographical experiments NPY (10nM) significantly reduced³H-PAC binding (2nM) in the nucleus tractus solitarius (NTS) area by 35%. (4) When clonidine, either given centrally in vivo (3.75nmol) or in vitro (10 nM) the binding of¹²⁵I-NPY was reduced (34 and 24%, respectively) in the NTS. When the monoamine receptors were irreversibly blocked in vivo by N-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline (EEDQ, 10 g i.e. 24h)¹²⁵I-NPY (0.5 nM) binding was increased by 137% in the NTS. This effect of EEDQ was prevented by pretreatment with the ₂-adrenoreceptor antagonist idazoxan.These results provide support for a direct intramembrane interaction between the ₂-receptor and the NPY receptor within the NTS and may be of importance in central cardiovascular regulation.