A procedure for infusion-transfusion therapy and autohemodilution in severe trauma and shock (apropos the article by B. N. Salamatin et al., The use of the "internal autotransfusion" method in complex shock-control measures at the prehospital stage)]

The infusion of hypertonic solution is thought by the authors to be effective due to its reflectory action for treatment of patients who are in the state of anaphylactic and cardiogenic shock. This method seems to be expedient for massive blood loss under conditions of prehospital medical aid to victims with very low level of arterial pressure, with craniocerebral trauma and critical trauma of the chest.     

Bronchial hyperresponsiveness to methacholine in patients with primary Sj?gren's syndrome.

The prevalence of bronchial hyperresponsiveness (BHR) to methacholine inhalation in a consecutive series of 21 patients with primary Sjögren''s syndrome was studied prospectively. Slight to severe BHR was seen in 12/20 (60%) of the patients. Ten of 12 patients with BHR (83%) had a non-productive cough, wheezing, or intermittent breathlessness. Bronchial hyperresponsiveness was more common in patients with extraglandular symptoms (10/14, 71%) than in those with only glandular symptoms (29%). Spirometrically 29% (6/21) of the patients had ''small airways'' disease'', and all those had BHR. Of 6/21 (29%) who had diffuse interstitial lung disease, two had BHR. Three of the four patients with obstructive lung function were challenged with methacholine and two of them had BHR. Only two patients with BHR had normal spirometry findings. The data showed that respiratory disease--mostly mild or moderate but even severe bronchial hyperresponsiveness--is commonly seen in patients with primary Sjögren''s syndrome.     

Segmental aortic wall stiffness from intravascular ultrasound at normal and subnormal aortic pressure in pigs.

Segmental aortic wall stiffness was calculated from intravascular ultrasound images and intravascular pressures in six pigs at normal and subnormal aortic pressures (21 sequences of pressures and areas before and after boli of intravenous nitroglycerin). The wall stiffness was expressed as the pressure-strain elastic modulus (Ep). The Ep was calculated from the formula: Ep = delta PR delta R-1 (P, pressure; R, radius) in two different ways. First from maximal and minimal values of pressure and area. Second as the slope of linear regression line of delta PR as a function of delta R from 29 simultaneous recorded pressures and images. The average Ep value for all sequences in the different segments was 0.58 +/- 0.55 10(5) Pa (Method 1) and 0.50 +/- 0.40 10(5) Pa (Method 2). Ep increased with the distance from the heart at normal aortic pressures. At subnormal aortic pressures after intravenous nitroglycerin this relationship was not so evident. At subnormal aortic pressures the calculated Ep values were significantly reduced in the lower half of the abdominal aorta. The phase lag, i.e. hysteresis, between pressure and diameter was demonstrated. Our study shows the applicability of intravascular ultrasound as a tool to evaluate arterial wall stiffness.     

Glucose and ketone body turnover in fasting grey seal pups

Concentration and metabolic replacement (turnover) rate of glucose and ketone bodies were determined at intervals during a 52 day postweaning fast in five grey seal (Halichoerus grypus) pups, using bolus injections of radiotracers. Blood glucose was maintained at a high level throughout the fast, while beta-hydroxybutyrate increased 26 times from day 3 to day 37, whereafter it by and large was maintained. Glucose replacement rate decreased to 56% of the day 9 value at day 37 and dropped further to only 32% of the day 9 level at day 52 in two seals, while in another 2 seals it increased at this late stage. The average ketone body replacement rate ranged between 8.6 and 13.8 mumols min-1 kg-1, but did not change significantly (P greater than 0.05) during the fasting period. These results suggest a reduced gluconeogenesis from protein and increased production of ketone bodies, which may in part replace glucose as energy source during fasting.     

Endovascular repair of a presumed aortoduodenal fistula.

This report describes the use of transluminal endovascular grafting for the treatment of a presumed aortoduodenal fistula. The patient was a 71-year-old man who had undergone resection and graft replacement for an abdominal aortic aneurysm. Three years after operation, melena was caused by perforation of the duodenal wall by a pseudoaneurysm at the proximal graft anastomosis. The pseudoaneurysm was treated by transluminal endovascular grafting. The pseudoaneurysm was subsequently thrombosed and absorbed. The ulcer-like lesions at the site of the duodenal wall perforated by the pseudoaneurysm also resolved. Endovascular stent-grafts may have a role to play in management of aortoduodenal fistula.     

Associations of personality variables with smoking behavior and pulmonary function

Interindividual variability of lung function responses to smoking is unexplained. The aim of the present study is to inquire about a possible role of personality factors for an explanation of interindividual differences of lung function responses in smokers of both sexes. The results of canonical correlation analyses showed that there are no substantial correlations of personality with smoking behavior and also no significant associations of smoking behavior with pulmonary function in a healthy sample of smokers. In males only, personality factors were related to breathing frequency, but not to static and dynamic lung volumes.