Modulation of mild bleeding disorder during remissions and exacerbations of Graves' disease

A patient with Graves' disease had a symptomatic thrombocytopathy during periods of remission. When euthyroid, she noticed bruising, petechiae, and epistaxis. Hemostatic abnormalities included prolongation of the bleeding time by aspirin, reduced platelet retention (a second-phase defect), and abnormal thrombin-induced aggregation and serotonin release. When hyperthyroid, bleeding symptoms resolved, and platelet function returned to normal. These observations suggest that mild bleeding disorders may be influenced either directly or indirectly by thyroid hormone levels.     

Plasma tumor necrosis factor and mortality in critically ill septic patients

Tumor necrosis factor (TNF) cachectin has been implicated as an important host mediator responsible for shock and multiple organ failure (MOF) observed during sepsis. Using a sensitive enzyme-linked immunosorbent assay, we measured plasma TNF levels in 43 septic patients suffering from a broad range of diseases. Measurements were taken on the day that sepsis was diagnosed. Eleven patients had detectable TNF plasma levels ranging from 10 to 100 pg/ml (TNF-positive group); in 32 patients circulating TNF could not be detected (TNF-negative group). The groups did not differ significantly as to age, underlying disease, percentage positive bacteremia and bacteriologic profile, sepsis score, and extent of MOF. Eight (73%) of 11 TNF-positive patients died from sepsis during ICU stay, vs. 11 (34%) of 32 TNF-negative patients (p less than .05). This study demonstrates that sepsis is accompanied by detectable circulating TNF in 25% of the cases, and for these patients mortality is twice that for comparable TNF-negative patients.     

Medical and financial implications of discontinuing a statewide free insulin program involving 3,720 people

In 1981 a statewide program supplying free insulin to 3,720 patients of state health clinics was discontinued. We attempted to assess whether this action had an adverse effect medically and financially on those concerned. A computer randomized sample of 351 patients (9%) was studied by personal interview and questionnaire. Information obtained focused on certain events that occurred 18 months before and after the program ceased. Measurements used to determine medical impact were number of hospitalizations, emergency room and physician visits, changes in weight and glucose levels, and episodes of ketoacidosis. Financial impact was measured by cost of hospitalization and physician visits. Our results revealed no significant changes in any of the medical parameters studied except for fasting serum glucose levels above 300 mg/dl, which occurred less frequently after the free insulin program was discontinued. There were fewer hospitalizations, more visits to physicians, and no change in number of emergency room visits after discontinuance of the free program. The overall cost saving was estimated to be +883,558 for the 18-month study period, in addition to the +550,000 the plan had been costing the state.     

Ultrastructural investigation of substance P-, leucine-enkephalin- and 5-hydroxytryptamine-like immunoreactive terminals in the area of cremaster motoneurons of the male rat

Studies were made on whether substance P-, leucine-enkephalin- and 5-hydroxytryptamine (serotonin)-like immunoreactive fibers exert a direct influence on the cremaster motoneurons of the male rat by immunocytochemistry combined with retrograde tracing at the light- and electron-microscopic levels. Horseradish peroxidase was used as a retrograde tracer. Two days after injection of horseradish peroxidase into the genitofemoral nerves, its accumulation in the cremaster motoneurons was demonstrated by the diaminobenzidine-nickel method. On immunocytochemical examination of the same sections immunoreactive end-products were detected by the peroxidase-antiperoxidase method. Two different kinds of reaction products were distinguishable at both the light- and electron-microscopical levels. The horseradish peroxidase-labeled cremaster motoneurons at the L1 and L2 levels of the spinal cord were surrounded by abundant immunoreactive terminals. Examination at the ultrastructural level showed that substance P-like immunoreactive terminals formed synaptic contacts almost exclusively with the proximal dendrites of these horseradish peroxidase-labeled cremaster motoneurons. On the other hand, in the leucine-enkephalin- and serotonin-like boutons, significant numbers of axosomatic contacts with horseradish peroxidase-labeled cells were seen although axodendritic contacts with horseradish peroxidase-labeled cells were predominant. Occasionally, leucine-enkephalin-like immunoreactive fibers with synapses on horseradish peroxidase-labeled neurons formed axoaxonic contacts with other leucine-enkephalin-like axonal terminals. Thus, substance P-, leucine-enkephalin- and serotonin-like fibers clearly regulate the function of cremaster motoneurons monosynaptically. The varied synaptic contacts of these fibers according to the neuroactive substances involved suggest different actions of these substances on the cremaster motoneurons.     

Comparative evaluation of acute toxicity and antitumor activity of IF-XXV preparation and holoxan

The alkylating agent ifosfamide synthesized according to own method at the Institute of Pharmaceutical Industry, Warsaw, was compared in biological evaluations with Holoxan (Asta-Werke's ifosfamide). No significant differences between tested compounds were found in respect of acute toxicity and antitumor activity in experimental systems in mice.     

A simplified method of counting microorganisms in studying human autoflora

Formulae for the calculation of the count of microorganisms isolated from natural bacterial biocenoses of a child's body have been derived. The authors suggest a variant of simplified drip method for the computation of microorganism colonies in solid media. The described method helps cut down the nutrient media consumption at least 3-fold and is time-saving.