Isolated tear of the anterior cruciate ligament: 5-year follow-up study

During the period 1967 to 1971, 64 cadets at the United States Military Academy, West Point, New York, had surgical repair for isolated tear of the anterior cruciate ligament. In a 5-year follow-up study to determine the functional impairment, present disability, and reinjury to the knee, 32 of the 64 patients were located and evaluated by radiographic examination and either by interview or by questionnaire. Twenty-two were commissioned to full duty. 23 had attended ranger or airborne school, and 16 had been in combat. Impairment of ordinary activities was noted by 12 and impairment of athletic endeavors by 24; pain by 71%; swelling by 66%; stiffness by 71%; and instability by 94%. Seventeen of the 32 had had a significant reinjury after the repair of the anterior cruciate ligament. Clinically, we can diagnose the isolated tear of the anterior cruciate ligament by four essential ingredients--a pop at time of injury, inability to continue participation, gross swelling of knee, and maximal swelling within 12 hr. The mechanism of injury is usually deceleration and change of direction, not contact with another player. The follow-up study on this small series indicates that the patients have progressive deterioration of the knee.     

Effect of the Milwaukee brace on vital and ventilatory capacity of scoliotic patients

The vital capacity (VC) and the maximal voluntary ventilation (MVV) were studied in 29 patients with scoliosis (predominantly idiopathic). The results obtained confirmed earlier observations that scoliotic patients have decreased VC and MVV. The immediate effect of the application of the Milwaukee brace was a slight though statistically significant decrease in MV, whereas there was no significant effect on VC. Treatment with the Milwaukee brace for a mean period of 15 months did not appreciably influence the VC or MVV, as a percentage of the predicted normal values of the patients, when measured without the brace applied.     

Effect of exercise on cardiac output and distribution of uterine blood flow in pregnant ewes

This study was designed to determine what effect physical training has on heart rate and stroke volume responses to exercise stress and to determine if exercise altered the distribution of uterine blood flow. Measurements were made in ten pregnant ewes at rest and immediately following exercise on a treadmill. Five ewes underwent physical training for 3 wk prior to measurement. An increase in heart rate with no change in stroke volume was observed following exercise in both trained and untrained ewes. Total uterine blood flow was not changed following exercise, but distribution was altered in favor of the placenta. Blood flow was evenly distributed within the placenta before and after exercise. The redistribution of flow to the placenta that occurs after exercise. tphe redistribution of flow to the placenta that occurs after exercise might represent a compensatory mechanism for the fetus.     

Laboratory evaluation of 3-(5-tetrazolyl) penam, a new semisynthetic beta-lactam antibacterial agent with extended broad-spectrum activity

In the new agent 3-(5-tetrazolyl)penam, hereafter referred to as CP-35,587, the carboxyl function at C3 in the penicillin nucleus has been replaced with the 5-tetrazolyl moiety. Marked changes in spectrum and resistance to gram-negative beta-lactamases, particularly with regard to Klebsiella pneumoniae isolates, were conferred by this modification. The anti-Klebsiella activity clearly distinguishes the antibacterial spectrum of CP-35,587 from any known broad-spectrum penicillin. Compared to orally active cephalosporins, the spectrum advantage of CP-35,587 encompasses Enterobacter, Serratia marcescens, Citrobacter, Providencia, Haemophilus influenzae, and Streptococcus faecalis, both in vitro and in murine infections produced by many of the above-named microorganisms. Thus, CP-35,587 combines and extends the antibacterial activity of broad-spectrum penicillins and orally active cephalosporins.     

Continuous dynamic monitoring of pressure and flow patterns during assisted ventilation

On curettage, done in a 39 year old patient because of metorrhagia, a peanut-sized nodule was scraped away from the endometrium. Histologically it consisted of a jumble of irregularly shaped portions of normal appearing embryonal cartilage, of tortuous thick-walled vessels, of twisted bundles of nerves of ducts of respiratory and intestinal epithelium, and of sheets of hornifying skin. The haphazard disarray of tissues supported the notion that the lesion was not a remnant of a malformed embryo. Step-sections through the lesion revealed no traces of placental villi or decidua in the surrounding endometrium. The following were considered as possible origins of the teratoma: 1. displaced germinal cells, 2. retention of pluripotent müllerian epithelium, 3. overaged or blighted ovum. The latter seems most compatible with the histological findings.     

Sarcoidosis with salivary gland involvement: biochemical studies on parotid saliva

Parotid saliva from a patient suffering from sarcoidosis with salivary gland involvement has been shown to have a decreased level of alpha-amylase but increased levels of albumin and lysozyme. These observations suggest that in addition to impaired gland function, gland damage as a result of inflammation had occurred which permitted increased passage of constituents from serum into the gland secretion.