Computer-controlled sodium nitroprusside infusions in patients after cardiac surgery.

Postoperative hypertension, a common occurrence after cardiac surgery, is frequently controlled by sodium nitroprusside infusions. Computer-controlled administration of this drug has been shown to be superior to manually controlled systems for maintaining the patient's blood pressure within an optimal range. The impact of this technology on patients, nurses, and hospitals is discussed.

Blood flow asymmetry in carotid occlusive disease.

Patterns of anterior border zone (ABZ) and middle cerebral artery (MCA) cerebral blood flow (CBF) asymmetry were readily seen during both normocapnic room air (RA) and induced hypercapnic (CO2) inhalation using fluoro-methane and a multislice, high-resolution positron scanner. Wilcoxon two-sample rank testing showed symptomatic-over-nonsymptomatic CBF ratios for unilateral greater than 75% carotid stenosis patients (n = 8) to be 1.05 +/- 0.

Functional knee braces increase intramuscular pressures in the anterior compartment of the leg.

The effect of three different functional knee braces on intramuscular pressures in the anterior compartment of the leg was investigated in 8 healthy subjects. Pressures were recorded with the microcapillary infusion technique while the subjects were either supine, sitting, or standing. Pressures at rest in the anterior tibial muscle increased significantly following application of each of the three knee braces regardless of posture.

Lack of predictive value of the APACHE II score in hypoalbuminemic patients.

The APACHE II score predicts mortality in severely ill patients. This score does not account for the serum albumin level. Ninety-three patients (28 with serum albumin levels less than 2.

The calcar femorale. An anatomic, radiologic, and surgical correlative study.

In order to define the anatomy of the calcar femorale, a radiologic and surgical study was done on ten paired cadaver femurs. After radiography and computed tomographic (CT) scans, the specimens were subjected to medullary reaming by an experienced orthopedist, simulating total hip arthroplasty procedures. The imaging studies were repeated and compared with the prereaming studies.

Echinococcus infestation of the biceps brachii. A case report.

Echinococcus is a genus of tapeworm endemic in certain parts of the world but found only rarely in the United States. An extremely unusual case of an intramuscular infestation involving an extremity occurred in a 41-year-old man. Since the infestation closely resembled a soft-tissue tumor on clinical and roentgenographic examination, the patient was treated with an incisional biopsy of the mass, which consisted of a cystic cavity filled with clear fluid.

Serum factors influencing cultured hepatocyte exogenous and endogenous triglyceride.

Rat hepatocyte monolayer triglyceride content was increased modestly by incubations with apolipoprotein E-containing triglyceride emulsions or chylomicrons (exogenous) and was increased substantially by increasing media free fatty acid concentrations (endogenous). The secretion of both endogenous and exogenous triglyceride into media was enhanced by additions of serum and serum components. These additions not only enhanced hepatocyte triglyceride secretion but also, because of the absence of media lipolysis, more triglyceride was recovered in the system.

Prolonged neuromuscular blockade following vecuronium infusion.

Administration of vecuronium by infusion is an increasingly common technique, both in the operating room and in the intensive care unit (ICU), for patients requiring prolonged neuromuscular blockade and mechanical ventilation. The major advantage of vecuronium over older neuromuscular blocking agents is its rapid excretion and intermediate duration of action. Prior to the current case report, the longest reported continuous paralysis after the cessation of a vecuronium infusion was 90 hours.

In vivo 31phosphorus spectroscopy during transient cerebral ischaemia in the gerbil.

The depletion of the high energy phosphates; phosphocreatine and ATP, during cerebral ischaemia disrupts normal cellular function and can lead to cerebral infarction. Using in vivo nuclear magnetic resonance spectroscopy, the metabolic effects of the gerbil model of transient bilateral carotid artery occlusion were quantified. By examining the changes in the inorganic phosphate (Pi), phosphocreatine (PCr) and beta-ATP peaks, the PCr/Pi ratio, the PCr/beta-ATP ratio and intracellular pH (pHi) before, during and after an ischaemic insult were calculated.

Circadian distribution of proteins in urine from healthy young men.

Urine samples were collected at 3-hr intervals over a single 24-hr period from each of seven clinically healthy men who ranged in age from 21-25 years. Urines at each collection time were subsequently pooled using 20% of each volume and serially dialyzed against ammonium-barbituric acid buffer (pH 7.35 +/- 0.

Three-dimensional dynamic motion analysis of the anterior cruciate ligament deficient knee joint.

Dynamic three-dimensional motion analyses of 15 fresh human knee joints subjected to combinations of flexion velocity and moment, internal and external femoral torque, and horizontal shear before and after sectioning the ACL were performed. ACL deficient specimens demonstrated marked anterior instability without rotational instability. The pivot shift phenomenon occurred with an isolated ACL deficiency and was the result of anterior instability.

Spontaneous remission of acute leukemia after the termination of pregnancy.

A 28-year-old woman in the third trimester of her pregnancy was found to have acute myelocytic leukemia. The baby was delivered by Cesarean section and her leukemia underwent spontaneous remission. However, 3 months later, she presented with massive painful leukemic infiltration of the breasts as initial manifestation of relapse, followed by systemic symptoms of leukemia.

Lack of initiating activity of the peroxisome proliferator ciprofibrate in two-stage hepatocarcinogenesis.

The peroxisome proliferator ciprofibrate was examined for its ability to initiate hepatocarcinogenesis in rats. Ciprofibrate was fed in the diet at levels of 0%, 0.01% and 0.

Assessment of mucosal hemodynamics in normal human colon and patients with inflammatory bowel disease.

Reflectance spectrophotometry measures indices of mucosal hemoglobin concentration (IHB) and oxygen saturation (ISO2). In the rat colon, characteristic patterns of IHB and ISO2 are associated with ischemia with congestion (increased IHB and decreased ISO2) and ischemia without congestion (decreased IHB and decreased ISO2). Endoscopic measurements with acceptable interobserver variability was demonstrated in the canine stomach.

Sensory form of acute polyneuritis.

A patient presented with severe sensory loss and ataxia with total arreflexia, and elevation of CSF protein with pleocytosis. At autopsy there was extensive lymphocytic infiltration of nerves and posterior roots, sparing the anterior roots. Teased fiber preparation of nerve showed a demyelinating lesion.

Postoperative pancreatitis.

Our experience with 52 patients who had postoperative pancreatitis develop during a nine year period was reviewed to characterize this group, to determine the incidence of complications and to identify variables predictive of complications. Biliary tract procedures (n = 10), colectomy (n = 9) and intestinal resection (n = 9) were the most frequently performed operations preceding pancreatitis. Thirty of the procedures were near the pancreas.

The pathology of posttransplant lymphoproliferative disorders occurring in the setting of cyclosporine A-prednisone immunosuppression.

Posttransplant lymphoproliferative disorders (PTLDs) were diagnosed in 43 patients from the Pittsburgh-Denver series between June 1980 and March 1987. This constitutes a detection rate of 1.7%.

Brain ornithine decarboxylase activity following transient cerebral ischaemia: relationship to cerebral oedema development.

Ornithine decarboxylase (ODC) activity, the first and generally rate-limiting enzyme for polyamine synthesis, is stimulated in permanent focal cerebral ischaemia in areas of incomplete ischaemia which are developing ischaemic brain oedema. As polyamines are ubiquitous ornithine-derived molecules which are obligatory in cold-induced vasogenic oedema, we studied the effect of transient dense cerebral ischaemia with reperfusion on ischaemic oedema development and ODC activity. Fifty-nine Mongolian gerbils were anaesthetized with ketamine hydrochloride (160 mg/kg i.

Polyamine inhibition preserves somatosensory evoked potential activity after transient cerebral ischaemia.

We tested the hypothesis that the increase in polyamines observed after cerebral ischaemia is related to deficits in electrocortical function as measured by somatosensory evoked potential (SEP). Adult Mongolian gerbils were anaesthetized with ketamine and prepared for monitoring SEP, cerebral blood flow (CBF) in parietal and frontal regions by H2 clearance, and for bilateral carotid artery occlusion (BCO). Seven animals served as controls and received saline.

Hyperresponsiveness of arterial rings induced by renal prehypertensive rabbit plasma.

Vascular rings from normal rabbit renal arteries, when bathed in processed plasma from 3-day renal artery stenosis (RAS) rabbits, had greater contractile responses to norepinephrine than did matched rings bathed in processed plasma from sham-operated rabbits. This vascular hyperresponsiveness of the rings produced by 3-day RAS plasma was abolished by the angiotensin II (ANG II) antagonist [Sar1, Ile8] ANG II but not by [Sar1, Ala8] ANG II at a dose that completely blocked the contractile responses of the rings to ANG II. The addition of [Sar1, Ala8]-ANG II to rings bathed in normal rabbit plasma did not alter the contractile responses to norepinephrine, indicating a lack of agonistic action by this ANG II analogue.

Ocular syphilis in patients with human immunodeficiency virus infection.

We diagnosed ocular syphilis in three homosexual men infected with human immunodeficiency virus (HIV). Ocular inflammation included uveitis, optic neuritis, and retinitis. Dermatologic and central nervous system manifestations of secondary syphilis were also present.

Surveillance strategies: a primer.

A variety of acceptable surveillance methodologies have been described. CDC-type surveillance remains the standard, but a limited program may be most sensible for some. Surveillance by objective is an attractive concept and reports of its value are anticipated.

Lectin detection of renal glycogen in rats with short-term streptozotocin-diabetes.

Earlier histochemical findings from our laboratory have shown that a lectin (agglutinin) from Griffonia simplicifolia, which reportedly binds to terminal N-acetylglucosamine residues in glycoconjugate oligosaccharides also shows affinity for glycogen. In the present study, the lectin was conjugated to horseradish peroxidase and applied to paraffin sections of kidney from streptozotocin-diabetic rats, insulin-treated and untreated, and age-matched control rats. Griffonia simplicifolia agglutinin II detected glycogen in cortical ascending thick limbs of untreated diabetic rat kidneys as early as 24 h following injection of streptozotocin.