Sudden coronary death in Glasgow: the severity and distribution of chronic coronary atherosclerotic stenoses.

A detailed analysis of the extent of coronary artery atherosclerosis was made in 92 white subjects (66 men and 26 women) who died suddenly from ischaemic heart disease. Stenoses resulting in loss of greater than or equal to 75% of luminal cross sectional area (significant stenosis) were found in 90 subjects and these were more extensive in the proximal coronary tree than in the distal. Thirty nine per cent had triple vessel disease, 37% had double vessel disease, and 23% had single vessel disease. In addition one man had an isolated significant stenosis affecting the left main coronary artery. The frequency of significant stenoses in the left main coronary artery was greater in men than in women. The arteries that were least affected were the distal branches of the right coronary artery. A notable feature was the widespread nature of the coronary atherosclerosis: only 26 of the total of 1840 segments of coronary artery examined in the 92 victims could be described as having a normal intima (less than or equal to 10% loss of the area within the internal elastic lamina).     

Transient shock and myocardial impairment caused by phaeochromocytoma crisis

A patient admitted to hospital after injury to the abdomen was found to have transient hypertension which was followed by profound hypotension. ST elevation developed and extensive myocardial akinesia was seen at echocardiography, but coronary angiograms at this stage were normal. After treatment with intravenous fluids and dopamine he progressively recovered normal cardiac function. A partly necrotic catecholamine secreting tumour was later removed from the abdomen and it is likely that a kick to the abdomen had damaged the tumour and the consequent release of catecholamine had triggered a phaeochromocytoma crisis.     

Job characteristics and satisfaction of pharmacy technicians

Perceptions of job characteristics and job satisfaction of central-area technicians and drug-administration technicians at The Ohio State University Hospitals were analyzed. A questionnaire was administered to 79 pharmacy drug-administration technicians; 44 central-area technicians; 10 pharmacy residents, who served as objective raters (5 in the central area and 5 in the decentral area); 13 central-area pharmacists; and 17 decentral-area pharmacists. Perceived job characteristics were measured with the Job Characteristics Inventory; job satisfaction was measured by the Minnesota Job Satisfaction Questionnaire. The two groups of technicians differed significantly in their perceptions of task identity, task significance, and dealing with others. Significantly greater autonomy in technicians' jobs was perceived to exist by pharmacists and raters in both areas than by technicians. Significantly greater task identity was perceived by the central-area technicians than by their raters, and significantly greater task importance was perceived by both groups of technicians than by their pharmacists and raters. Friendship opportunities were perceived to exist to a significantly greater degree by decentral pharmacists and raters than by the drug-administration technicians. In the institution studied, both central-area and drug-administration technicians tended to be dissatisfied with their jobs. Central-area technicians' satisfaction was influenced most by the technicians' relationships with their supervisors and the feelings of accomplishment they gained. Drug-administration technicians were most satisfied if they believed they had opportunities to use their abilities. Efforts to increase job satisfaction among pharmacy technicians should focus on increasing feedback and task identity.     

Beta-adrenergic blockade increases the hepatic extraction of glucose in sepsis

To determine the relationship between hepatic glucose clearance and elevated epinephrine levels in sepsis, dogs with gangrenous cholecystitis were anesthetized and received either propranolol hydrochloride (mean dose, 0.29 mg/kg) or saline solution before intraduodenal glucose injection (2.5 g/kg). The amounts of glucose, insulin, and glucagon in the portal vein, the hepatic artery, and the hepatic vein were determined from the concentrations and the blood flows in these vessels over a two-hour period. Normal dogs served as controls. The amounts of glucose, insulin, and glucagon reaching the livers of both septic groups were the same. However, propranolol treatment increased the percent of glucose extracted by the liver without affecting the extractions of insulin or glucagon. Propranolol reverses the limitation of hepatic glucose extraction in sepsis by a direct effect. Whether the extracted glucose is utilizable as an energy substrate needs to be established.     

Effect of different levels of oral pyridoxine supplementation on plasma pyridoxal-5'-phosphate and pyridoxal levels and urinary vitamin B-6 excretion

Plasma pyridoxal-5'-phosphate and pyridoxal levels increased significantly (p less than 0.05) when single, oral bolus doses of pyridoxine were increased from 10 to 25 and from 25 to 50 mg in nine female volunteers. However, when the dose was increased to 100 mg, plasma pyridoxal-5'-phosphate levels did not differ significantly from those recorded after the 50 mg dose. Within 3 h plasma pyridoxal levels rose with a factor of 3.85 compared with the 50 mg dose but high pyridoxal levels were eliminated from the circulation. Renal clearance of pyridoxal remained a constant, low percentage (less than 2.0%) of each pyridoxine supplement in spite of the observed very high circulating pyridoxal levels. Pyridoxine supplementation is discussed in relation to circulating pyridoxal-5'-phosphate and pyridoxal availability for cellular metabolism.     

Delta hepatitis virus infection in China

To assess the prevalence, epidemiological features and prognostic implications of hepatitis D (Delta) in Sichuan Province, The People's Republic of China, 649 sera (515 from HBsAg positive patients and 134 from HBsAg negative subjects) were tested by radioimmunoassay (RIA) for antibody to the hepatitis D virus (anti-HD). Forty-seven sera (7.2%) showed some degree of reactivity. Serial dilutions of these sera indicated that prozoning was not responsible for the equivocal results. Thirty-four of the 47 sera were submitted under code to a second laboratory for independent analysis. According to those results anti-HD antibodies were detected in four of these sera. The overall prevalence of anti-HD in the HBsAg positive patients therefore was 0.8% (4/515). On the basis of clinical, biochemical and histological data 427 HBsAg positive sera were further divided into acute Type B hepatitis, chronic Type B hepatitis, healthy carrier state and hepatocellular carcinoma (HCC) subgroups. Two of 65 (3.1%) anti-HD positive sera belonged to the acute Type B hepatitis group; one of 104 (0.9%), the chronic Type B hepatitis group and one of 246 (0.4%), the healthy carrier group. No antibody was detected in sera from 12 HBsAg positive HCC patients. All HBsAg negative patients were negative for anti-HD antibody. The results of this study indicate that despite a high prevalence of hepatitis B virus infection, positive serology for delta virus is uncommon in Sichuan Province, The People's Republic of China.     

Radiation-induced meningioma. 3 cases

During the same year (1984), we have seen 3 cases of meningiomas following radiation therapy of the brain for previously diagnosed tumors. A causal relationship between irradiation and meningioma has been postulated. Nevertheless, the coincidental occurrence in same patient of two different histological lesions is possible. The neoplasms developed after irradiation are of mesenchymal origin; they are fibrosarcomas, osteogenic sarcomas and meningiomas.     

Guidelines for external fixation frame rigidity and stresses

Using results from FEM analyses and experiments as references, analytical methods are applied to develop simple approximate formulas to relate frame rigidity, maximal pin stresses, and peak pin-bone stresses in external fracture fixation (EFF) configurations in axial loading to the most important frame, pin, and bone parameters. It is found that, in a realistic range, the parameters can be adapted to vary the frame rigidity from about 13 N/mm to 17,000 N/mm, thereby reducing the maximal stresses in the pins and at the pin-bone interface by a factor of 140. In particular, when compromises have to be established in the frame characteristics in order to ensure a flexible configuration and limit the stress values at the same time, the formulas presented can provide useful guidelines. The side-bar separation and the pin modulus, in particular, can be adapted to decrease the rigidity, while only moderately increasing the stresses, thereby reducing changes for pin failure, pin-bone loosening, and pin-tract infection. A nomogram is presented for a quick reference to estimated relations between frame characteristics, rigidity, and stresses. It is believed that this material may be of use in EFF design and applications in clinical and animal experimental trials.