The utility of contrast echocardiographic techniques in the care of critically ill infants with cardiac and pulmonary disease.

In order to assess the utility of contrast M-mode echocardiography in an intensive care nursery population of critically ill newborns with cardiac and pulmonary disease and to validate contrast echo methods, we performed 200 serial contrast echoes on 40 infants via umbilical arterial or venous catheters which had been placed into these infants for clinical indications. The resulting contrast echoes recorded from the precordium or the suprasternal notch allowed the delineation of intra- and extracardiac right-to-left and left-to-right shunting patterns. Patterns identified and validated by cardiac catheterization (in cardiac patients) were: right-to-left atrial shunts, right-to-left ventricular shunts, and left-to-right patent ductus arteriosus shunts.

Diffuse eosinophilic fasciitis. A new syndrome or variant of Scleroderma?

Recently, attention has been drawn to a scleroderma-like illness, characterized by transient eosinophilia, which is commonly antedated by unusual physical exertion, is apparently free from significant systemic changes, and in which the primary pathological alterations, consisting of intense inflammation and thickening with or without eosinophils, occur initially in the fascia, not the skin. These patients are said to respond well to oral corticosteroids and an occasional one may undergo spontaneous resolution. Clinicopathologic study of a patient with this syndrome, suggests an even deeper tissue genesis than that recently proposed for some of the cutaneoindurative disorders.

[Management of early breast cancer (author's transl)].

The results of clinical trials for early cancer of the breast were assessed in terms of survival, morbidity, and the rate of local recurrance. Simple mastectomy appeared to be the operation of choice because survival following this procedure was equal to that following more radical operations, but the morbidity was less. Partial mastectomy was found to be an unsatisfactory method of treatment.

Screening for breast cancer.

The feasibility of mass population screening for breast cancer by clinical examination and x-ray mammography was studied. The results indicate that such a programme could be conducted effectively by non-medical staff and be safe from the dangers of irradiation. The response rate of women invited for screening suggests that such a service is acceptable to the general public.

Effects of derivatives of cyclic amp and cyclic gmp on contraction force of cat papillary muscles.

Right ventricular kitten papillary muscles were incubated with dibutyryl adenosine 3',5'-monophosphate (dbcAMP) at varying concentrations as low as 1 X 10(-4)M. A positive inotropic effect was observed with all concentrations of dbcAMP. Concomitant administration of 5 X 10(-4)M monobutyryl guanosine 3',5'-monophosphate (mbcGMP) and 1-2 X 10(-4)M dbcAMP prevented the inotropic response observed when dbcAMP was used alone.

Changes in cyclic nucleotide levels and contractile force in the isolated hypoxic rat heart during perfusion with glucagon.

Isolated rat hearts were perfused with hormonal concentrations of glucagon during a hypoxic perfusion to determine whether it would enhance recovery after reoxygenation. Rat hearts were divided into two groups: (1) those perfused with glucose-free Tyrode's solution and (2) those perfused with Tyrode's solution containing glucose. During 3 minutes of exposure to hypoxia both untreated hearts and hearts perfused with glucagon demonstrated a decrease in contractile force to 10-20% of control.

Biochemical changes during the initial stages of industrial lead exposure.

Biochemical measurements were carried out on 20 workers entering employment in a lead industry. Blood lead (Pb-B) urinary delta-aminolevulinic acid (ALA), and coproporphyrin (CP) levels were determined before entry and then at approximately weekly intervals for the first 12 weeks of employment. Levels of blood lead began to increase in all men within one week rising from an average pre-employment figure of about 1-1 mumol/l (22 mug/100 ml) to a value of about 2-9 mumol/l (60 mug/100 ml) at three weeks.

Failure of cyprohepatdine to inhibit vasopressin-stimulated cortisol release in a patient with Cushing's disease.

A case of a 21-year-old woman with Cushing's disease due to a pituitary tumor is described. The patient was treated with cyprohepatadine for 4 weeks immediately following pituitary alpha-particle irradiation. A standard vasopressin test to measure ACTH-mediated cortisol release was performed four times: prior to pituitary irradiation, after irradiation, after 4 weeks of cyproheptadine therapy, and off cyproheptadine for 2 weeks.

Effects of glucagon on cardiac cyclic nucleotides in the hypoxic heart.

Isolated rat hearts were perfused with a subinotropic concentration of glucagon during an hypoxic perfusion to determine whether glucagon would enhance recovery upon reoxygenation. Rat hearts were divided into two groups: 1) those perfused with glucose-free Tyrode's solution and 2) those perfused with Tyrode's solution containing glucose. During 3 min of hypoxic exposure, untreated hearts and hearts perfused with glucagon both demonstrated a dramatic decrease in contractile force regardless of whether glucose was included in the medium.

Protective effect of methylprednisolone on the heart during ischemic arrest.

Although corticosteroids have been shown to stabilize lysosomal membranes and prevent release of hydrolytic enzymes, the mechanism of membrane stabilization remains obscure. The few reports regarding the use of steroids in myocardial ischemia have been conflicting. This study was undertaken to determine if a pharmacologic dose of the glucocorticoid methylprednisolone would protect the heart during ischemic cardiac arrest.

The effect of the size of the gastric outlet on gastric emptying after vagotomy for duodenal ulcer.

Gastric emptying of isotopically labelled solid meals was studied in normal human subjects and in 30 patients who had had an operation for chronic duodenal ulcer. Each patient had a vagotomy of the whole stomach combined with either a Finney pyloroplasty to produce a large gastric outlet or a Heineke-Mikulicz pyloroplasty to produce a relatively small outlet. At 10-22 days after operation gastric emptying was equally and significantly slowed in both groups when compared with the normal controls.

Renal cyclic AMP accumulation and adenulate cyclase stimulation by erythropoietic agents.

The regional distribution of cyclic AMP in the kidney was determined following erythropoietic stimulation with hypoxia and cobalt. Following these stimuli, increases in renal cyclic AMP concentrations were restricted to the cortex. The basis for this localization in the case of cobalt treatment was found to reside in the stimulation of renal cortical adenylate cyclase activity in vitro by concentrations of cobalt similar to those found in vivo.

Feasibility of screening for breast cancer.

The feasibility of screening for breast cancer by clinical examination and X-ray mammography has been studied. The results suggest that a breast screening programme is safe from dangers of irradiation and can be conducted by non-medical staff. The response of women at risk suggests that the service is acceptable to the general public.