Neural control of the canine pylorus

After atropine administration the anesthetized dog exhibits significant spontaneous pyloric contractile activity and an inhibition-relaxation response upon electrical vagal stimulation. This inhibition-relaxation response was completely blocked by tetrodotoxin administration and by transection of the intraabdominal vagal nerves. In addition, tetrodotoxin administration caused a dramatic increase in spontaneous pyloric motor activity. The histaminergic receptor antagonists diphenhydramine and cimetidine did not block the inhibition-relaxation response. The octapeptide of cholecystokinin (CCK-OP) caused a dose-dependent increase in antral and pyloric motor activity which was significantly decreased by atropine administration. Therefore, histamine and CCK do not appear to play a significant role in the vagally mediated inhibition-relaxation response of the canine pylorus or in the atropine-resistant spontaneous pylorip motor activity.     

Renal function in acute Asiatic cholera

Acutely dehydrated cholera patients in shock were treated with one of two intravenous solutions to determine whether the composition of the replacement solution had an effect on restoration of renal function. Rapid rehydration was with either the Dacca solution (Group I) or normal saline (Group II), while maintenance was always with the Dacca solution. The Dacca solution contains, in addition to sodium and chloride, potassium and bicarbonate. It was found that the delay in correction of acidosis and potassium deficiency in Group II did not alter the rate of improvement of creatinine clearance to recovery levels. This level was reached in both groups at approximately 6 hours after admission. The patients rehydrated with normal saline excreted a large per cent of filtered water and sodium and a larger absolute amount of hydrogen ion. It was concluded that the return to normal renal function in cholera depends primarily upon rapid restoration of extracellular fluid volume.     

Increased leukocyte alkaline phosphatase activity following transfusion of leukocytes from a patient with chronic myelogenous leukemia.

Neutrophils from a patient with chronic myelogenous leukemia and typically low leukocyte alkaline phosphatase (LAP) activity markedly increased in LAP content following transfusion to and circulation in an infected neutropenic recipient. Incubation of the recipient's serum and plasma with normal neutrophils failed to alter their LAP activity. This observation suggests that LAP activity is inducible by as yet unknown "environmental" factors, and possible mechanisms for this are discussed.     

Mechanism of the repetitive ventricular response in man

The electrophysiologic characteristics of the repetitive ventricular response that followed an electrically induced single premature ventricular complex were evaluated to determine its mechanism during atrial pacing or sinus rhythm in 30 patients. Seven patients had preexisting bundle branch block. His bundle or right bundle branch deflections did not precede the repetitive complex in 29 of the 30 patients, which implies that the proximal His-Purkinje system was not involved in the reentry circuit. In 24 of 30 patients the QRS axis of the repetitive complex was divergent 45 ° or more from the stimulated complex. In 22 of 30 patients the repetitive complex had a right bundle branch block configuration. In 14 of 18 patients with two or more repetitive complexes, the QRS pattern changed from beat to beat, which implies that either the reentry pathway or conduction was changing. Thus, the repetitive ventricular response, which can be associated with clinically important ventricular arrhythmias, probably represents intraventricular rather than proximal His-Purkinje system reentry.     

Prolongation of cardiac conduction times by intravenous aprindine in man

The acute electrophysiologic effects of intravenous aprindine were evaluated in 48 patients to assess the effect on conduction times and refractoriness in patients with severe cardiac disease and arrhythmias. The patients had not responded to conventional antiarrhythmic medications or had been unable to tolerate effective doses of conventional medications because of side effects. Eleven patients had an abnormal H-V interval, 9 had prolonged QRS duration and 22 had evidence of severe left ventricular dysfunction. Aprindine prolonged conduction transiently in the atria, the atrioventricular (A-V) node, the His-Purkinje system and the ventricles. The refractory times of the atria, the A-V node and the ventricles increased insignificantly, both functionally and statistically. Atrioventricular block did not develop in any patient, and side effects were minor. Thus, aprindine can be safely administered intravenously (10 to 15 mg/min) to severely ill patients with arrhythmias that are refractory to other medications even in the presence of underlying conduction system and myocardial disease.     

Infections in 92 splenectomized patients with Hodgkin's disease. A clinical review.

Infections that occurrred in 92 previously untreated patients with Hodgkin's disease were reviewed from the time of laprotomy and splenectomy. Pneumonias occurred in nine patients with urinary tract infections in twelve during the immediate postoperative period. Severe bacterial infections did not occur in any patients during initial radiation therapy, adjuvant chemotherapy (stages I through IIIA), initial intensive chemotherapy (stages IIIB and IV) or during remission. Severe infections occurred in eight profoundly granulocytopenic patients with recurrent Hodgkin's disease. Streptococcus (Diplococcus) pneumoniae and Hemophilus spp infections were distinctly uncommon during the remission period. Herpes zoster, however, was very common developing in 22 of 92 (24 per cent) patients. Predisposing factors to herpes zoster included sex (female more than male), therapy (radiation plus chemotherapy more than chemotherapy alone), and age (less than 30 years of age more often than 30 to 50 years of age). Severe infection was uncommon in these patients except in ascociation with specific predisposing factors such as the immediate postoperative state of prolonged granulocytopenia associated with recurrent Hodgkin's disease or its therapy. Splenectomy per se did not affect either the incidence or the severity of infection during this period of 12+ months of observations per patient.