Episodic dermatolymphangioadenitis (DLA) in patients with lymphedema of the lower extremities before and after administration of benzathine penicillin: a preliminary study

Dermatolymphangioadenitis (DLA) is a common and serious complication of obstructive peripheral lymphedema. The clinical characteristics of acute DLA are local tenderness and erythema of the skin, sometimes red streaks along the distribution of the superficial lymphatics and enlarged inguinal lymph nodes. Systemic symptoms include malaise, fever and chills. In its subacute or latent form, only skin involvement is observed. Each episode of DLA is commonly followed by worsening of leg swelling. Numerous clinical studies suggest that administration of antibiotic drugs interrupt the acute episodes and prevent their recurrence. We investigated the clinical course of lymphedema with respect to the prevalence of DLA in patients receiving injections of long-acting penicillin (benzathine penicillin). Forty-five randomly selected patients with obstructive lymphedema of the lower limbs were included in an open clinical trial. The inclusion criteria was stage II-IV lymphedema of postsurgical, posttraumatic, and postdermatitis type with at least 3 previous episodes of DLA. Benzathine penicillin (PCN) was given after the last presenting episode of DLA in a dose of 1,200,000 u, intramuscularly at 3-week intervals, for at least one year. Each patient was reevaluated at 3-month intervals. They were instructed in early diagnosis of DLA and reported promptly to the responsible senior surgeon with prodrome symptoms of recurrent DLA. The duration of lymphedema before initiation of therapy was 7 months to 40 years and the frequency of DLA was 1-6 episodes per year. PCN administration lasted for at least one year but was extended in all patients because of the tendency for recurrence of DLA after cessation of PCN injections. In 26 of these patients, PCN administration extended to over 5 years and in 2 over 10 years. Recurrent episodes of DLA occurred in the PCN-treated group during one year follow-up in only 4 of the 45 patients (9%). The frequency episodes in 3 patients with recurrent DLA was 1-2/year; in one patient, no positive effect of PCN therapy was observed. There were no apparent side effects of long-term PCN therapy. These data, although evaluated without a placebo group, suggest that long-term PCN administration decreases the frequency of DLA attacks and furthermore provide justification for carrying out a double-blind randomly placebo-controlled clinical trial of the efficacy of prophylactic antibiotic drug treatment in forestalling DLA episodes.     

RAPID PYROLYSIS OF EASTERN CANADIAN COALS BY FREE FALL REACTORS

The effect of temperature was investigated on the rapid pyrolysis of Prince, Lingan and No. 26 coals in the temperature range of 525^° to 750^°C using a 600 cm high stainless-steel free fall reactor at atmospheric pressure.

The yields of char, condensibles and gaseous products were determined at 25^°C intervals. Gaseous products were analysed for H₂, CO, CO₂, CH₄ and C₂+.

Volatile product (condensible and gas) yields exceeded the volatile product in the A.S.T.M. methods at and above 700^°C.

Some experiments using Prince coal were repeated at reduced pressure (50 mm mercury) in both the 600 cm height stainless-steel and a 140 cm height quartz reactor in order to find out the effect of pressure and retention time.

The experimental results indicated that the condensable yield was higher at the lower pressure and at the shorter retention time. The effect of retention time was far more pronounced.     

Social utility Functions-part II: applications

Social utilities account for agent preferences and, thus, can characterize complex interrelationships, such as cooperation, compromise, negotiation, and altruism, that can exist between agents. Satisficing game theory, which is based on social utilities, offers a framework within which to design sophisticated multiagent systems. Key features of this approach are: a) an N-agent system may be represented by a 2N-dimensional Bayesian network, called a praxeic network; b) the theory accommodates a notion of situational altruism (a willingness to defer to others in a controlled way if so doing would actually benefit others under the condition that others wish to take advantage of such largesse); and c) satisficing games admits a protocol for effective negotiation between agents who, though interested in their own welfare, are also willing to give some deference to others. Three applications are presented. The first two involve well-known two-person games: the Prisoner's Dilemma and the Battle of the Sexes, and the third is a simulated uninhabited aerial vehicle scenario.     

A rapid and sensitive method for determination of theophylline in plasma and saliva by high pressure liquid chromatography

A fast and sensitive high pressure liquid chromatographic method for the monitoring of theophylline concentrations in plasma or saliva was developed. Each sample requires only about 15 minutes for the completion of the assay after receiving the plasma or saliva sample. Only 0.1 ml of sample is required, and concentrations as low as 1 mcg/ml can be accurately measured.     

Serial measurements of left ventricular ejection fraction by radionuclide angiography early and late after myocardial infarction

1-Acyl-2-succinyl glycero-3-phosphorylcholine (GPC) was synthesized and its properties described. Although 1-acyl-2-succinyl GPC is a good substrate for succinate dehydrogenase, experiments on the incorporation of [2,3-14C] succinate into mitochondrial lipids gave no evidence to indicate that it is an intermediate in the enzymic oxidation of succinate to fumerate, as has been suggested earlier.     

Frequency of the carrier state for X-linked chronic granulomatous disease among females with lupus erythematosus

Carriers for chronic granulomatous disease (CGD) and patients with lupus erythematosus (LE) share several characteristics: They are mostly females, they reduce nitroblue tetrazolium (NBT) poorly in their neutrophils, and, in some cases, they have similar skin lesions. We thus investigated 19 female LE patients for the presence of laboratory findings characteristic of the carrier state for CGD. None of these patients turned out to have the combined abnormality of neutrophil bactericidal activity and neutrophil NBT-reduction that is diagnostic of CGD carrier state in the X-linked form. An increased frequency of CGD carriers among female LE patients thus appear to be unlikely. Why some CGD carriers develop skin lesions typical of LE remains unexplained.     

Nuclear estradiol receptor in the adult rat uterus: a new exchange assay

A protamine exchange assay has been developed to measure uterine nuclear estrogen receptor in mature rats exposed to estradiol (E). After ovariectomized-adrenalectomized mature rats are injected with E, estrogen receptor (RnE) is extracted from uterine nuclei with 0.6 M potassium chloride, diluted, and quantitatively precipitated with protamine sulfate. The precipitate is subjected to a ligand exchange with radiolabeled estradiol (E), with or without unlabeled diethylstilbesterol, to determine nonspecific binding. At 37 degrees C complete exchange of E for E in RnE is observed at 2.5 h; virtually no receptor degradation occurs up to at least 5 h. Exchange does not occur at 4 degrees C. Using the protamine assay, the depletion of cytoplasmic estrogen receptor (Rc) and the accumulation of RnE were studied at various doses of E at specific time points. Increasing doses of E result in a decrease of Rc with an equal increase of RnE. At the highest dose of E (10 mug) Rc is completely depleted within 10 min, by 6 h it is 25% replenished, and by 24 h returns to slightly above control levels. Within 10 min after the injection, RnE increases to 80-90% of the original cytoplasmic level of receptor (approximately 2-3 pmol/mg of DNA or approximately 1.5 pmol/100 mg of uterus). At 6 h RnE is 75% depleted and it is completely absent at 24 h. The protamine assay permits precise quantitative studies of nuclear estrogen receptor and avoids the problems of receptor degradation and excessive nonspecific binding often found in exchange reactions at elevated temperatures.