Different fractionation schemes tested by histological examination of autopsy specimens from lung cancer patients

The biological effects of different fractionation schemes have been evaluated by the histological examination of bronchial carcinomas removed at operation or autopsy following radiotherapy. Radiation was given in daily, small fractions (200 cGy (rad)), large fractions (600 cGy (rad)) every fifth day, or a single high dose followed by daily low-dose treatment. The highest proportion of tumours free of viable cells was found in patients who had received small daily fractions in both operable and inoperable tumours. A hypothesis is put forward to explain this apparent change in radio-sensitivity with different fractionation schemes.     

Morphological studies on the formation of oxalate stones (author's transl)

The present paper deals with experimental and crystaloptical studies on synthetic and native Ca-oxalate. The findings are in favour of a uniform way of formation of Ca-oxalate stones from Ca-oxalate dihydrate crystals as primary crystallization product in urine, developing into the monochydrate phase by dehydratation. Rapid growth and a sufficiently high concentration of foreign ions (Mg) in the urine support the formation and stabilisation of dihydrate stones.     

Management of postoperative heparin rebound following cardiopulmonary bypass

Postoperative heparin rebound was investigated in 50 adult patients undergoing cardiopulmonary bypass with the use of the Hepcon heparin analyzer. Prior to bypass each patient received 2 mg/kg of heparin. During bypass, the activated clotting time (ACT) was utilized to assess the need for additional heparin to maintain the value between 300 and 400 seconds. The average amount of heparin given was 160 mg. Once cardiopulmonary bypass was terminated the Hepcon unit was employed to determine the actual amount of active circulating heparin and to calculate the dose of protamine sulfate. The average amount of protamine administered intraoperatively was 200 mg. The overall mean ratio of protamine-to-heparin was 1.25 : 1. Once hemostasis was achieved, no circulating heparin was measured with the Hepcon unit, and the ACT value had returned to its baseline, the incisions were closed and the patients were transferred to the intensive care unit. One hour later a blood sample was obtained and analyzed by the Hepcon unit for any heparin rebound. We found that 26 patients (52%) had circulating heparin and required an additional dose of protamine, averaging 70 mg. Drainage from the thoracotomy tubes averaged 400 cc in the first 24 hours, and a mean of 2 units of packed cells was infused. Three patients (6%) did not require any blood transfusions. The use of the Hepcon unit has produced a safe and expedient method of analyzing and neutralizing active circulating heparin in patients following cardiopulmonary bypass. It is a useful adjunct in blood conservation because it reduces excessive postoperative blood loss associated with heparin rebound.     

Clinical use and toxicity of intravenous lidocaine. A report from the Boston Collaborative Drug Surveillance Program

To determine the natural history of Meckel's diverticulum, 202 case records of proved disease of Meckel's diverticulum were retrieved, covering a fifteen year period, from all the hospitals of King County, Washington (population, 1,143,800). Using the figure of 2 per cent incidence of Meckel's diverticulum, we calculated that a Meckel's diverticulum has a 4.2 per cent likelihood of causing disease during a lifetime, decreasing to zero with old age. Using previously published mortality and morbidity figures, we calculated that to save one patient's life from the complications of Meckel's diverticulum, it would be necessary to remove approximately 800 asymptomatic Meckel's diverticula. This would be likely to incur a significant amount of postoperative morbidity from postoperative intestinal obstruction and infection. We suggest that the prophylactic removal of Meckel's diverticulum is rarely, if ever, justified.     

The physical state of alkali ions in a Halobacterium: some NMR results

The 46th case of known pregnancy-induced pancytopenia is reported. Pregnancy may play an etiologic role in this rare condition, but the specific mechanism is unknown. Maternal mortality is 63%, and fetal and neonatal wastage is 46%. The patient reported is a 24-year-old Oriental woman who delivered a healthy female infant. Her survival is attributed to conservative management with carefully timed packed cell and platelet transfusions.