Initial studies on the penetration of spirohydantoin mustard into the cerebrospinal fluid of dogs

The possible correlations between unipolar endocardial electrogram amplitudes and voltage threshold stimulation were tested with electrodes having metallic tips of two different areas. The threshold measurements were always studied with the same pulse characteristics. The data were analyzed through five mathematical functions (linear, exponential, potential, hyperbola and translate hyperbola). The results show a significant correlation, mainly by hyperbolic and exponential functions. Consequently, we could deduce a parameter value since we already knew the other one. This was possible not only during the first implantation, but also later on.     

Breast reconstruction for malignant or premalignant disease

In ten patients breast reconstruction was done after surgical treatment for a premalignant or malignant breast disease. In six of these, prophylactic subcutaneous mastectomy and implant reconstruction were carried out, and in the remaining four reconstruction was done after simple or modified radical mastectomy. It is suggested that these procedures should be considered by those physicians and surgeons who undertake evaluation and treatment of breast disease in women. Breast reconstruction should be considered and offered to patients who suffer from the severe personal and emotional trauma attendant to surgical operation for breast disease.     

Esophageal perforation following use of esophageal airway

The esophageal airway has gained increasing acceptance in airway management during cardiopulmonary resuscitation, and its enthusiastic advocates are urging expansion of its use. A fatal case of esophageal perforation following the use of an esophageal airway is presented. Possible contributing factors are discussed. A modified esophageal airway which seems safer and more versatile, effective, and economic is described.     

Patterns of ambulatory health care in five different delivery systems

Few empirical investigations permit systematic comparison of the impact of widely-varying delivery systems within a single population sample. This study provides such a comparison, describing patterns of ambulatory care among patients using five different systems in Washington, D.C. as a regular source of health care: solo practice, fee-for-service group practice, prepaid group practice, public clinics, and hospital outpatient departments or emergency rooms. Comparisons are adjusted statistically to account for major patient group variations, and the results reveal substantial differences among the five systems. Sources used primarily by the poor--hospital outpatient departments, emergency rooms, and public clinics--contained important structural and financial barriers, and had the lowest rates of patient-initiated use. The prepaid system, in contrast, maximized patient's access to both preventive care and symptomatic care, and did not seem to inhibit physician-controlled follow-up care. The results suggest some perverse effects of fee-for-service payment: patients, especially poor patients, appeared to be deterred from seeking preventive and symptomatic care, while physicians were encouraged to expand follow-up services. Moreover, services in fee-for-service systems were distributed less equitably relative to both income and medical need than in the prepaid system. These findings have direct implications for policy decisions concerning organizational and financial arrangements for the delivery of ambulatory care.     

Use of rat glomerular basement membrane (GBM) as antigen in indirect imunofluorescence test for detection of human anti-GBM antibodies (author's transl)

The purpose of this paper is to verify if we may use the rat glomerular basement membrane (GBM) as antigen, in indirect immunofluorescent test in isolated GBM (IIT-BGM) to detect human anti GBM antibodies. Rabbit anti-human GBM serum (A-H-GBMS) were obtained by rabbit's immunization with human GBM or rat GBM respectively. The content of anti-GBM antibodies in rabbit's sera was determined in IIT-GBM. The titer of the A-H-GBMS was 1/10 when determined in IIT-GBM performed in human GBM and only weakly positive in IIT-GBM performed in rat GBM. The titer of A-R-GBMS was 1/60 and 1/20 when determined respectively in rat GBM and in human GBM. All the reactions performed with sera absorbed with autologous GBM were negative; the absorption of sera with heterologous GBM reduced sera titer. In conclusion: a) rat and human GBM have common and different antigenic components; b) to detect human anti-GBM antibodies we must not employ rat GBM in IIT-GBM.