Performance of implanted biogalvanic pacemakers.

Seventeen unipolar cardiac pacemakers powered by hybrid biogalvanic cells were implanted in dogs. Long term clinical effects and electrical performance in vivo of the generators were investigated. The biogalvanic cells were designed to provide 50 years of generator operation. No systemic pathological changes which would be attributed to the generator or the biogalvanic cell were observed. Local reaction to implants was mild and not significantly different from the one observed in conventional pacemaker implantations to date. The electrical performance of the biogalvanic cells was very encouraging. Final steady-state cell voltage levels of .65V to .75V were reached in 100--150 days after implantation and remained constant in 3 units to date which represents over 36 months after implantation for each generator.     

Abnormalities of delayed hypersensitivity in systemic lupus erythematosus

Abnormalities of delayed hypersensitivity were found in patients with active systemic lupus erythematosus (SLE). The following immune responses were noted in 39 patients with SLE compared to 30 normal controls: (1) delayed hypersensitivity skin test responses to purified protein derivative (PPD) and trichophyton were significantly reduced in the patients with SLE, (2) in vitro lymphocyte transformation to PPD was normal, (3) the majority of patients with SLE had circulating antibodies to native deoxyribonucleic acid (nDNA), (4) these patients did not exhibit increased skin test responses or lymphocyte transformation to nDNA. The impairment in delayed hypersensitivity to PPD and trichophyton suggests that skin testing with PPD is inadequate to screen patients with SLE for tuberculosis. Furthermore, frequent infections which occur in some patients with SLE may result in part from their impaired cellular immune responses. The dissociation between skin response and lymphocyte transformation to PPD suggests that defects in cellular immunity may be selective. The dissociation between humoral and cellular immunity to nDNA suggests that control mechanisms exerted on one or both of these responses may be defective in SLE.     

The effect of fenfluramine on glucose tolerance, insulin, lipid and lipoprotein levels in patients with peripheral arterial disease

An investigation has been undertaken to determine the effects of fenfluramine on glucose tolerance, insulin, fasting lipid and lipoprotein levels, in a series of twenty-five patients suffering from peripheral arterial disease.     

Gastric mucosal resection in the treatment of peptic ulcers: a 1-10 year clinical follow-up.

The clinical results of gastric mucosal resection are reported after a 1-10-year follow-up in which 76 per cent of patients were followed up for more than 5 years. There were 3 postopertive deaths in 152 patients. Mucosal antrectomy with vagotomy for duodenal ulcer in 96 patients, and for recurrent ulcer in 9 patients, has not been followed by a single recurrence. Gastric mucosal resection alone for the treatment of gastric ulcer in 21 patients resulted in 1 recurrence. Although vagotomy combined with resection is currently out of fashion for the initial treatment of duodenal ulcer in Britain, mucosal gastric resection has technical advantages in combination with vagotomy for the cure of recurrent ulcers following duodenal ulcer surgery.     

Strong Linkage Disequilibrium between HLA—Dw2 and BfS in Multiple Sclerosis and in the Normal Population

An increased frequency of the S allele of Properdin factor B (BfS) was found amongst 162 patients with multiple sclerosis (MS) compared with 470 normal controls. This increase was shown to be due to a strong linkage disequilibrium (LD) between BfS and HLA-Dw2 in 77 patients typed for both systems (delta = 3.84%, P = .0002). The same LD was demonstrated amongst 100 normal controls (delta = 2.24%, P = .0049) and 31 patients with idiopathic demyelination of the peripheral nervous system (IDPN). A total of 70 haplotypes with HLA-Dw2 were encountered (40 MS, seven IDPN and 23 normal controls) and all contained BfS. In the MS patient group, a much weaker association was noted between BfS and HLA-B7 suggesting either that the Bf locus is musch closer to the HLA-D than the HLA-B locus or (and) that HLA-D and Bf products selectively interact (perhaps on the surface of B lymphocytes) with evolutionary advantage or disadvantage resulting from certain allelic combinations. Strong associations between BfS1 and HLA-Bw21 (P = .0000) and BfF1 and HLA-B18 (P = .0001), both previously reported, were confirmed in the current study. No increase in the frequency of a glyoxalase (GLO) allele was found amongst the MS patients and no LD was encountered between HLA-Dw2 and a GLO allele. The possibility that the HLA-Dw2, BfS disequilibrium has resulted from a selective advantage conferred on the general community but at the expense of increasing susceptibility to MS should be considered.