Systemic toxicity from ocular homatropine.

Toxidromes are well known to emergency physicians. An unclear or incomplete history and subtle findings on physical examination make the diagnosis of poisonings challenging. This article reports a patient who had an acute onset of visual hallucinations, pressured speech, and mania.

A controlled clinical trial for stuttering in persons aged 9 to 14 years.

This paper presents the results of a controlled trial of child stuttering treatment. The aim of the study was, first, to compare the effectiveness of three viable treatments, and, second, to compare these three treatments to a no-treatment control composed of children who stuttered of a similar age and sex ratio who were on treatment waiting lists. The three treatments investigated included intensive smooth speech, intensive electromyography feedback, and home-based smooth speech.

Clostridium proteoclasticum sp. nov., a novel proteolytic bacterium from the bovine rumen.

A novel proteolytic bacterium was isolated from rumen contents of New Zealand cattle grazing fresh forage and was designated strain B316(T) (T = type strain). Strain B316(T) cells were straight to slightly curved rods (width, 0.4 to 0.

Occupational exposure leading to hantavirus pulmonary syndrome in a utility company employee.

Hantavirus pulmonary syndrome is a newly recognized rodent-borne zoonosis. We report a case of hantavirus pulmonary syndrome in an employee of a California utility company who was probably occupationally exposed to Sin Nombre virus. Environmental assessment and genetic comparison of the patient's hantavirus isolates to hantavirus isolates from rodents trapped at possible sites of exposure suggested that the patient contracted his infection at the work site.

Glucose-6-phosphate dehydrogenase from Saccharomyces cerevisiae is a glycoprotein.

A commercial preparation of glucose-6-phosphate dehydrogenase (G6PD) purified from Saccharomyces cerevisiae was subjected to PAGE analysis under both nondenaturing and denaturing conditions. The enzyme, identified by both activity staining and anti-yeast G6PD antibody immunoblotting, was shown to contain carbohydrate using the highly specific periodate-digoxigenin antidigoxigenin method which is diagnostic for glycoproteins.

An unusual presentation of cat scratch encephalitis.

Cat scratch disease is an infectious illness that has been recognized since the 1880s; however, our understanding and knowledge of it is still evolving (1). It was not until 1991 that the etiologic species, Rochalimaea, was finally confirmed (2,3). Only recently have the breadth of its clinical spectrum and the population at risk been appreciated.

A system of IAC neural networks as the basis for self-organization in a sociological dynamical system simulation.

This sociological simulation uses the ideas of semiotics and symbolic interactionism to demonstrate how an appropriately developed associative memory in the minds of individuals on the microlevel can self-organize into macrolevel dissipative structures of societies such as racial cultural/economic classes, status symbols and fads. The associative memory used is based on an extension of the IAC neural network (the Interactive Activation and Competition network). Several IAC networks act together to form a society by virtue of their human-like properties of intuition and creativity.

Colonic short chain fatty acids mediate jejunal growth by increasing gastrin.

Colonic infusion of short chain fatty acids (SCFAs) is trophic to rat jejunum and is associated with raised jejunal gastrin concentration. This study examined the hypothesis that the jejunal trophic effects of colonic SCFAs are mediated in part by gastrin. Forty six adult rats underwent caecectomy to reduce endogenous production of SCFA, ileocolonic anastomosis, and placement of a colonic infusion catheter.

Identification of proteolytic rumen bacteria isolated from New Zealand cattle.

The protease activities of 212 strains of rumen bacteria isolated from New Zealand cattle grazing pasture were measured. Thirty-seven per cent of strains had activity greater than or equal to the proteolytic rumen bacterium Prevotella ruminicola and 43 of these isolates were identified by morphology, carbon source utilization, Gram stain, biochemical tests and fermentation end-product analysis. Hierarchical Cluster Analysis showed that the strains formed four clusters: cluster A contained 26 strains and clustered with a reference strain of Streptococcus bovis; cluster C contained three strains and clustered with a reference strain of Butyrivibrio fibrisolvens, while clusters B (10 strains) and D (three strains) did not cluster with any of the remaining rumen bacterial type strains.

Carotid body tumors: a review of 30 patients with 46 tumors.

Minimal morbidity occurs with resection of most carotid body tumors (CBT). With larger tumors significant injury to the cranial nerves has been reported. In order to assess the operative sequelae rate, 30 patients with CBT were reviewed.

The implementation of a continuous quality improvement program in a pediatric peritoneal dialysis unit.

Continuous quality improvement (CQI) principles and practices were utilized to evaluate the outpatient peritoneal dialysis follow-up process and the routine monthly laboratory testing of chronic dialysis patients. CQI enabled us to reduce total clinic visit time from a mean of 161 min to 90.8 min.

Variations in oral glucose tolerance tests: the 100- versus 75-g controversy.

This study compared the results of a 75-g, 3-hour oral glucose tolerance test with those of a traditional 100-g oral glucose tolerance test. Thirty-two pregnant women participated in the study. Each patient served as her own control, undergoing both a 100- and a 75-g oral glucose tolerance test within 1 week.

Rabies in a vaccinated wolf-dog hybrid.

In March 1993, an 11-month-old neutered male wolf-dog hybrid with a 5-day history of progressive neurologic signs was determined to have rabies. The animal was currently vaccinated for rabies with a USDA-approved canine rabies vaccine. One month prior to becoming ill, the animal was observed carrying a dead skunk in its enclosure in a rabies-endemic foothills region of northern California.

Changing trends in the epidemiology of human brucellosis in California from 1973 to 1992: a shift toward foodborne transmission.

From 1973 through 1992, 426 cases of human brucellosis were reported in California, of which 98% were laboratory confirmed. Brucella melitensis was identified in 185 cases (78.7% of the bacteriologically typed cases).

Hydrogen exchange dynamics of the P22 virion determined by time-resolved Raman spectroscopy. Effects of chromosome packaging on the kinetics of nucleotide exchanges.

We describe the application of laser Raman spectroscopy to probe hydrogen isotope exchange dynamics of nucleic acid and protein constituents in a double-stranded DNA virus, the icosahedral bacteriophage P22. The Raman dynamic method employs a dialysis flow cell to control D2O efflux into an H2O solution of the virus sample while the rates of deuterium exchange of protons in the viral nucleic acid and protein molecules are measured spectrophotometrically in real time. The method provides structural and kinetic information about three different and distinct classes of exchangeable protons of the native virion: (1) labile imino (NH) and amino (NH2) protons of the bases which participate in Watson-Crick hydrogen bonding in the packaged genome; (2) pseudolabile purinic (8CH) protons that line the major groove of packaged P22 DNA; and (3) main-chain amide (NH) protons of viral subunits comprising the shell that encapsidates the DNA.

Induction of labor.

Labor is induced if pregnancy must be completed before the onset of spontaneous labor, usually for reasons of maternal illness, fetal distress or, most commonly, prolonged pregnancy. Although various mechanical methods are available for labor induction, pharmacologic methods are more commonly used. Oxytocin is the standard treatment.

Monarthric ankle pain. A diagnostic challenge.

A patient presented with monarthric ankle pain, which took 2 years to diagnose by numerous physicians and imaging and laboratory tests. A review of the differential diagnosis for monarthritic joint pain with guidelines for the work-up of the patient are presented.

The role of the automation development group in analytical research and development at Dupont Merck.

Laboratory robotics has been firmly established in many non-QC laboratories as a valuable tool for automating pharmaceutical dosage form analysis. Often a single project or product line is used to justify an initial robot purchase thus introducing robotics to the laboratory for the first time. However, to gain widespread acceptance within the laboratory and to justify further investment in robotics, existing robots must be used to develop analyses for existing manual methods as well as new projects beyond the scope off the original purchase justification.

Infections complicating pregnancy.

Common infectious disease problems that occur in pregnancy are outlined, including implications for pregnancy, appropriate diagnostic techniques, treatments, and methods for prevention of disease in mother and infant. Also included is general information about the use of immunizations and antibiotics in pregnancy.

Methohexital for orthopaedic procedures in the emergency department.

The past two decades have seen more and more orthopaedic procedures performed in the emergency department. Methohexital would seem to be a useful adjunct drug for the performance of these procedures because of its well-known attributes (eg, rapid induction and recovery, brief duration, and minimal hemodynamic changes). A search of the literature revealed no previous studies on the use of methohexital in the emergency department.

Efficacy of intravenously administered theophylline in children hospitalized with severe asthma.

Purpose: To determine whether intravenously administered theophylline, when added to frequently nebulized albuterol and intravenously administered methylprednisolone, benefits children hospitalized with severe asthma.

Design: Prospective, randomized, placebo-controlled, parallel-group, double-blind study.

Setting: Inpatient pediatric service at a tertiary-care teaching hospital.

Teaching family-centered perinatal care in family medicine, Part 2.

Pregnancy, childbirth, postpartum, and infant care are a continuum in the family life cycle for which the family physician is especially qualified to provide primary, comprehensive care. The purpose of this paper is to document and share the controversies, wisdom, and knowledge about caring for women and their families before, during, and after pregnancy. Family physicians can be leaders in developing an appropriate perinatal care system for the community.