Use of PABA test to check completeness of 24-h urine collections in elderly subjects.

The p-aminobenzoic acid (PABA) test has been successfully used as an indicator of completeness of 24-h urine collection in field studies of the general population. Our study was designed to investigate its validity for elderly people. Urinary excretion of fractionated oral doses of PABA was measured in 21 young control subjects (19-39 yr old) and 356 elderly (60-89 yr old) men and women. PABA excretion over 24 h was lower in elderly than in control subjects. Subjects aged greater than or equal to 70 yr had a lower recovery of the PABA dose than subjects aged 60-69 yr over the first 24 h, followed by a higher recovery over the next 24-48 h. The cumulative 48-h recovery was similar in all age classes of elderly subjects. However, 48% of the elderly subjects had a cumulative PABA recovery below the conventional cutoff for completeness (85%). These subjects also had consistently lower creatinine output and urinary volume. The lower 24-h urinary PABA recovery over 70 yr of age is interpreted to reflect the delayed renal clearance of the marker substance and indicates that the PABA test is unsuitable for this age group. The low 48-h cumulative recoveries found in all age classes of the elderly are thought to be caused by small unreported losses, which are recurrent in free-living populations.     

The use of microfluorometry to study DNA in nasopharyngeal carcinomas: a possible prognostic tool?

A microfluorometric method was used to determine the nuclear DNA content in the nasopharyngeal carcinomas (NPC) of 25 patients treated before 1983. Eleven patients are still alive with no evidence of disease (NED), while the rest died of their disease (DOD). All of the patients received a cycle of radiotherapy, while some also received chemotherapy or neck dissections. The neoplastic cells studied were taken from the original biopsy blocks, deparaffinized, isolated by enzymatic treatment and mechanical fragmentation, and then Feulgen-stained. The cytofluorometric measurement was carried out by a microphotometer equipped for fluorescence excitation and connected to a computer. This method allowed us to construct a histogram of the DNA content in the neoplastic cells. Different neoplastic classes were identified and represent the heteroclonality of the tumor, which can be expressed by the heteroclonality index (HCT). From the collected data it appears that the NED patients all had a low HTC (less than 1) and only 7 of the DOD patients had low HTCs (less than 1). Six of the DOD patients with a low HTC were in advanced stages of their tumor at the time of diagnosis, while the remaining patient did not complete his treatment. Our results show that the DNA analysis of the NPC cell population may offer a useful tool in predicting the biological behavior of this tumor and also improving its treatment.     

Some new clinical applications of rhinomanometry

Clinical applications of active anterior rhinomanometry of the oscillation type had been carried out for the purposes other than the conventional uses of rhinomanometry. 1. Effect of acupuncture upon the nasal resistance to airflow: Among 8 acupuncture points which were recorded in Chinese traditional medical literatures as effective for improving nasal breathing, Ingxiang point had been proved to possess definite effect of lowering the nasal resistance to air-flow in patients with congestion of nasal mucosa, whereas in other acupuncture points this effect was not certain. 2. The severity of snoring before and after treatment could be determined objectively by the measurement of nasal resistance to air-flow and the breathing pattern of the patient.     

Serious respiratory consequences of detergent ingestions in children

After ingesting or inhaling laundry detergent powder, eight children required hospital admission. The predominant symptoms were stridor, drooling, and respiratory distress. All but one patient underwent endoscopy of the airways and the esophagus, five children were admitted to the intensive care unit, and four children required endotracheal intubation. Laundry detergent ingestions are generally considered to have minor consequences, and there exists a paucity of literature on the subject. Evidence of significant morbidity incurred because of ingestion or inhalation of sodium carbonate-containing laundry detergent powder is presented, together with a review of the existing literature.     

Digoxin-like factor in infants of diabetic mothers not receiving digoxin therapy

Serum digoxin-like factor was detected in infants of diabetic mothers who were insulin-dependent or diet controlled. No statistical difference was found between the serum digoxin-like factor levels of the infants of diabetic mothers and the controls.     

Transplantability of human head and neck squamous cell carcinomas in athymic nude mice

Tumor material from 91 patients with squamous cell carcinoma of the head and neck was transplanted subcutaneously in athymic nude mice. In the first (man to mouse) passage, the calculated mean probability of tumor take in a single mouse was 11%. The probability of growth in the first passage was significantly better for moderately and poorly differentiated tumors than for well-differentiated tumors. Also, the implantation of lymph node material resulted in a significantly better tumor take rate than material taken from a primary tumor. Transplantability was not dependent on the following characteristics: localization, T or N stage of the tumor, or the sex of the patients. Once growth was established, all variables studied had no influence on the probability of growth in the subsequent mouse passages. A relationship between tumor growth in nude mice and patient prognosis could not be found. When transplanting head and neck squamous cell carcinoma in nude mice, it has to be recognized that some tumor characteristics will influence the success of tumor growth.     

Usher syndrome: clinical findings and gene localization studies

The issue of genetic heterogeneity is a critical problem in the localization of the gene(s) for Usher syndrome. Based on the data obtained on families studied to date, the differences between type I and type II Usher syndrome appear quite distinct with regard to auditory and vestibular function. Although the majority of families can be confidently diagnosed as typical type I or type II, clinical investigations revealed four families with findings that did not fit into either of the two more common subtypes. These findings emphasize the critical importance of an in-depth clinical analysis concomitant with the linkage investigation to assure accurate subtyping of Usher syndrome. Based on an analysis of only those families with definite type I or type II Usher syndrome, approximately 17% of the genome can be excluded as a potential site of the gene for type I, and 14% can be excluded as the site for the type II gene. This study will continue until the Usher gene(s) is successfully localized.     

Phonological disorders in children: changes in phonological process use during treatment

Unintelligible speech in childhood is often characterised by the use of unusual or deviant (i.e. non-developmental) phonological processes, e.g. initial consonant deletion. These processes are reported to appear at speech onset and to undergo little spontaneous change during the preschool years. The study reported here documents the changes that occurred in the phonological systems of seven phonologically disordered children during remediation that targeted unusual phonological processes. Qualitative changes in phonological process use were observed for all children. Six of the children made quantitative improvement in terms of the percentage consonants produced correctly in spontaneous speech. Individual differences in phonological learning strategy use are described.