The Plasma Cells of the Bone Marrow in Myelomatosis Treated with Alkeran® (Melphalan)

The cytological appearance of the bone marrow was studied during Alkeran treatment of 46 patients with myelomatosis. The plasma cell count had decreased in 39 per cent, it remained unchanged in 48 per cent and was increased in 13 per cent. The plasma cell count seems to be of little value in the appraisal of the effect of treatment, especially compared with that of the concentration of the M component. The only qualitative change seen was a disappearance of the nucleoli from the plasma cells in 4 cases.     

Tinnitus in noise-induced hearing loss

Tinnitus was analysed in 94 patients with noise-induced hearing loss. Tinnitus of a pure tone character was most common followed by narrow-band noises, and a combination of these. A broad-band noise type of tinnitus was the least common finding. Tinnitus was most common at high frequencies. The suggested mean tinnitus level (in dBHL) corresponded well with the mean audiometric threshold for these patients. Most patients characterized their tinnitus as moderate to severe. Subjective tinnitus grading showed poor correlation to the audiometric threshold or to sensation level e.g. patients with a suggested tinnitus threshold corresponding to the hearing threshold could consider their tinnitus severe. The most common subjective discomforts were concentration difficulties, insomnia and decreased speech discrimination. In most cases residual inhibition was limited to 60 seconds.     

A radioimmunoassay of oestrone in plasma. Plasma levels of oestrone and oestradiol in oophorectomized Rhesus monkeys during treatment with subcutaneous implants containing oestrone.

A highly specific antiserum to oestrone was used to develop a sensitive radioimmunoassay. Plasma was generally analysed without prior separation of the oestrogens. A small amount of plasma (0.1-0.2 ml) was extracted once with diethyl ether. The above and previously described radioimmunoassays were used to estimate plasma levels of oestrogens in oophorectomized monkeys treated with subcutaneous oestrone implants. Three monkeys received a rod containing 40 mg of oestrone. The rods were kept in place for about one year. The release rates from the rods were calculated. The oestrone plasma levels were initially high (370-500 pg/ml). In about 3 months they had fallen to a level of 50-100 pg/ml which was maintained till the removal of the rods. A rise in the oestradiol plasma levels was also observed. It is concluded that rods are suitable for administration of oestrone.     

Visual testing with 'preferential looking' in mentally retarded children

In 21 out of 26 children and young adults with mental retardation visual acuity could be successfully examined with operant preferential looking. There was a good correlation in this group of patients between ocular abnormalities demonstrated in an ophthalmological examination and the visual acuity results.     

Imaging LTP of presynaptic release of FM1-43 from the rapidly recycling vesicle pool of Schaffer collateral-CA1 synapses in rat hippocampal slices

Recent studies using the styryl dye FM1-43 and two-photon microscopy to directly visualize transmitter release at CA3-CA1 excitatory synapses in the hippocampus have demonstrated that activity-dependent long-term potentiation (LTP) and long-term depression are associated with alterations in vesicular release. It is not known whether particular vesicle pools preferentially express these alterations or what second messenger cascades are involved. To address these questions, we selectively loaded FM1-43 into the rapidly recycling pool (RRP) of vesicles by use of a brief hypertonic shock to release and load the RRP. We demonstrate here that the induction of LTP can lead to a selective long-lasting enhancement in presynaptic release from the RRP, while reserve pool kinetics remain unchanged. LTP of RRP release was N-methyl-d-aspartate receptor-dependent and also required production of the intercellular messenger NO and activation of receptor tyrosine kinase. Measurement of FM1-43 stimulus-evoked uptake rates following induction of LTP confirmed that LTP produces more rapid recycling of vesicles released by electrical stimulation, consistent with an enhanced release probability from the RRP.     

Reduction of absorbed dose in storage phosphor urography by significant lowering of tube voltage and adjustment of image display parameters

Purpose: To investigate whether image quality in storage phosphor urography can be maintained when the X-ray tube voltage is significantly lowered to give a lower patient dose.

Material and Methods: Initial phantom studies were used to establish exposure settings at 53 kV that gave signal-to-noise ratios for contrast media structures equivalent to those obtained at the reference kilovoltage of 69 kV. Dose area product and image quality, assessed by image quality criteria and visual grading, were then recorded for 44 patients drawn at random to be examined by either the standard or modified technique.

Results: Absorbed dose could be reduced by more than 30% without any significant change in image quality in manually controlled exposures and by 13% in exposures controlled by AEC.

Conclusion: It might be possible to lower the tube voltage in digital examinations involving contrast media as a means of lowering patient dose. The image display parameters need to be adjusted to maintain image quality.     

The efficacy of ropivacaine as a dental local anaesthetic

The objectives was to investigate the efficacy of ropivacaine in dentistry. This open-labelled, parallel-group study included 41 subjects randomised to 1 ml or 2 ml ropivacaine 7.5 mg/ml and to maxillary infiltration or nerve block of the inferior alveolar nerve. Pinprick pain, electrical pulpal testing, and numbness were used as efficacy measures. Following onset, the duration was measured until baseline status was re-established or after a maximum of 6 h. A high frequency of anaesthesia was obtained. The pulpal anaesthesia mean onset time was 2.1 and 1.6 min after end of infiltration and 2.9 min and 4.5 min following end of nerve block injection for the 1 and 2 ml ropivacaine respectively. Pulpal anaesthesia mean duration was 0.4 and 1.3 h after infiltration and 3.7 and 4.3 h for nerve block respectively. The mean lip numbness duration ranged from 3.7 to 5.1 h for the upper lip and from 7.5 to 8.4 h of the lower lip. In conclusion 1 and 2 ml ropivacaine 7.5 mg/ml provided a high frequency of anaesthesia with short onset time and long duration following nerve block. Ropivacaine may be suitable for time-consuming oral procedures and/or when prolonged postoperative analgesia is desirable.     

Intrathecal and oral clonidine as prophylaxis for postoperative alcohol withdrawal syndrome: a randomized double-blinded study

In this study, we evaluated the effect of intrathecal and oral clonidine as supplements to spinal anesthesia with lidocaine in patients at risk of postoperative alcohol withdrawal syndrome (AWS). We hypothesized that clonidine would have a prophylactic effect on postoperative AWS. Forty-five alcohol-dependent patients (daily ethanol intake >60 g) scheduled for transurethral resection of the prostate were double-blindly randomized into three groups. All patients received hyperbaric lidocaine 100 mg intrathecally. The diazepam group (DiazG) was premedicated with diazepam 10 mg orally; the intrathecal clonidine group (Clon(i/t)G) received a placebo (saline) tablet and clonidine 150 microg intrathecally; and the oral clonidine group (Clon(p/o)G) received clonidine 150 microg orally. For patients diagnosed with AWS, the Clinical Institute Withdrawal Assessment for Alcohol, revised scale, was used. Twelve patients in the DiazG had symptoms of AWS, compared with two in the Clon(i/t)G and one in the Clon(p/o)G. The median Clinical Institute Withdrawal Assessment for Alcohol, revised scale, score was 12 in the DiazG versus 1 in the clonidine-treated groups. Two patients in the DiazG had severe delirium. Patients receiving oral clonidine had a slightly decreased mean arterial blood pressure 6-12 h after spinal anesthesia (P < 0.05); patients in the DiazG had a hyperdynamic circulatory reaction 24-72 h after surgery. In conclusion, preoperative clonidine 150 microg, intrathecally or orally, prevented significant postoperative AWS in ethanol-dependent patients. IMPLICATIONS: In this randomized, double-blinded study, clonidine 150 microg both intrathecally and orally prevented postoperative alcohol-withdrawal symptoms in alcohol-dependent men. The effect was superior to that with a single dose of diazepam 10 mg orally.