Use of sonography to evaluate carotid atherosclerosis in the elderly. The Cardiovascular Health Study. CHS Collaborative Research Group

Carotid sonography is being performed on more than 5,000 participants in the Cardiovascular Health Study, a prospective, multicenter study of cardiovascular disease in men and women aged 65 years and older. The sonographic methods used to examine and measure the extracranial carotid arteries are described. Initial validation studies were performed on 61 subjects with a mean age of 68.6 years. Analysis of within- and between-sonographer differences and between-reader differences were performed for selected variables. In general, the mean absolute differences for within- and between-sonographer comparisons were small, with even less variability between readers. Variability was less for the common carotid artery than for the internal carotid artery. These data suggest that carotid sonography is a reliable and reproducible method for use in the study of carotid atherosclerosis in population studies.     

Bilateral anterior cerebral artery infarction resulting from explosion-type injury to the head and neck

A 43-year-old woman suffered a blast-type injury to the head and neck. She subsequently developed bilateral internal carotid artery occlusion and bilateral anterior cerebral artery infarction not demonstrated by magnetic resonance imaging scan 24 hours after the explosion, but confirmed by a second scan 8 days after the explosion. In patients with blast-type injury to the head and neck who develop coma with a nonfocal neurological exam, the possibility of bilateral carotid artery occlusion and bilateral ischemic infarction should be considered.     

The General Practice Research Club.

The General Practice Research Club was established in 1969, and now has 120 members. A meeting of the club is held twice a year, at which various papers, from research ideas through to completed, published studies are presented. A survey of 40 individuals who had presented papers at meetings during the period 1984-89 showed that almost half (18) had presented papers on clinical topics. As a result of the presentation, 29 individuals had modified their research, with 11 undertaking major alterations. The meeting was rated most highly by those offering ideas and plans for research. Most individuals responded positively to the meetings, commenting that they valued peer review, found the meetings encouraging, and useful for focusing ideas. Lack of criticism and feedback was commented upon. The club has an important role to play in encouraging research by service general practitioners.     

Characterization of a model of malaria in the pregnant host: Plasmodium berghei in the white rat

This study characterizes a Plasmodium berghei white rat model of P. falciparum malaria in the pregnant human. Seventy-day-old and 114-day-old female rats, given an infecting inoculum at time of mating, had higher parasitemias and a more severe anemia than age- and sex-matched controls. Under these experimental conditions, the parasitemia went to crisis in all animals and there were no fatal infections. In contrast, all animals died when the infection was initiated 7 days after conception, a timing that brought a coincidence of peak parasitemia and term. Pregnancy during the post-crisis subpatent period did not cause recrudescence. At the time of delivery, the parasitemia was consistently higher in the placental (crush smear) blood than in the peripheral (tail) blood. This difference was greatest in animals giving birth shortly before or 1-2 days after the parasitemic crisis. Very young, compact parasite forms predominated in the placental blood, whereas trophozoites predominated in the peripheral blood.     

Leprosy in infants--report of two cases

Two infants, one 4 months old and the other 2 months old, having histologically confirmed indeterminate leprosy are reported. The route of infection, mode of transmission, and incubation period are discussed with reference to these two cases of infantile leprosy.     

Lithium inhibits human sperm motility in vitro.

Lithium is a widely prescribed drug used for the treatment of bipolar affective illness. Previous reports on its effects on sperm motility and male fertility are conflicting. The effect of lithium on human sperm motility was examined in vitro using the modified transmembrane migration method. This technique takes account of the dilution of lithium that occurs during the incubation. Lithium inhibits human sperm motility in vitro in concentrations comparable with those reported to be achieved in semen after oral administration.     

Myopathies of the lower extremities

The myopathies that can manifest themselves within the lower extremity are reported here and can serve as a guideline for clinicians in the early diagnosis of these disabling conditions. The classification of these disease entities based on signs and symptoms is significant if correlated with the age of the patient at the time of onset, the evolution and course, and the type of familial inheritance. This article can also aid the practitioner in assessing and planning the course of treatment for a particular patient.     

Characterization of unique ADTN-catecholamine binding sites in the iris root-ciliary body of rabbits

A binding site for tritiated 2-amino-6, 7-dihydroxy-1, 2,3,4-tetrahydronaphthalene (ADTN) has been partially characterized in the rabbit iris root-ciliary body. Binding of ADTN is proportional to protein content and requires at least 60 minutes to reach equilibrium. Binding is saturable, with a Kd of 27 +/- 1 nM and a Bmax of 2.1 +/- .3 pmol/mg protein (mean +/- SEM). Dopamine competes for this site with a Ki of 100 nM and apomorphine with a Ki of 180 nM. This site is not blocked by L-timolol, phenoxybenzamine, or by several DA1 and DA2 antagonists. It appears to be a new type of catecholamine binding site, of a type not observed outside the anterior eye. It is possible that some of the effects of dopamine on intraocular pressure are mediated through this binding site.     

Study of talc for pharmaceutical use. Trials of pharmacopoeias

A study has been carried out on the possible pharmaceutical use of spanish talcs following the normalized assays of the main european pharmacopoeia and other quantitative methods. Only the talc nr3, not processed, meets all the assays of pharmacopoeia. The samples 2 and 4 (crushed) exceed the highest tolerated content in chlorides. The talc 1 (also crushed) only meets the loss on drying. The measures of some of these assays by using quantitative methods lead to more correct results and even sometimes in opposition with those obtained by pharmacopoeia methods. The particle size estimated by shifting and sedimentation shows that the crushed talcs are silty, whereas the only talc not processed is sandy. Considering the medium sizes estimated by scanning microscopy, it can be said that the pulverization of the talcs 1, 2 and 4 is characteristic of a micronization.