Medical and surgical therapy in diverticular disease: a comparative study

The course of 132 patients with documented acute diverticulitis was analyzed: 99 patients treated medically and 33 patients treated surgically were followed for an average of 9.2 years. Seventy-three per cent of the medical group and 79% of the surgical group had no further symptoms or hospital admissions as a result of their diverticular disease once they were recovered from the acute episode. For three-quarters of the patients, therefore, acute diverticulitis occurred as a single episode that responded to either medical or surgical management. Considering the morbidity and cost to the patient, the treatment of the patient recovered from acute diverticulitis should be medical, with operation reserved for complications.     

Lymphocytic choriomeningitis from pet hamster exposure: a local public health experience

Eleven cases of hamster associated lymphocytic choriomeningitis occurred within a space of four months in Jefferson County, Alabama residents. A single Birmingham breeder was the source of the infected hamsters. Ten cases experienced an illness of one to three weeks duration with grippe-like symptoms being most frequent. Complaints of nine cases suggested meningeal involvement, and one was asymptomatic. All patients recovered uneventfully. Frequent hamster contact had occurred in most cases, although three individuals reported infrequent or room exposure to the animals. The holding of hamsters for observation prior to sale, random testing of all breeders' stock, and the distribution of printed information with each hamster sold are suggested as precautions against future outbreaks of this nature.     

Progressive spastic paraparesis and adrenal insufficiency

A 10-year-old boy with progressive paraparesis, personality change, and seizures had laboratory evidence of adrenal insufficiency. Pathologic study showed cerebral edema, but no loss of myelin. Notable pathologic changes were limited to the spinal cord, where the corticospinal and spinocerebellar tracts were demyelinated. Lipid analysis of the brain was normal apart from the finding that galactocerebroside contained a higher proportion than normal of alpha-hydroxy fatty acids. We suggest that this case represents a distinct disease, differing importantly from adrenoleukodystrophy. The underlying defect appears to be in the early enzymatic pathway before cholesterol synthesis, although it is also possible that the defect is at the cell membrane.     

Transillumination of the skull in premature infants

Transillumination of the skull in infants is a simple technique which can be used to detect several major abnormalities of the central nervous system. The usefulness of transillumination has been limited, however, by the lack of standard techniques for its performance and by the absence of normal values, especially in premature infants. In healthy premature infants, there is a progressive increase in transillumination with increasing gestational age over three sites--the anterior fontanelle, the frontotemporal fossa, and the parieto-occipital eminence.     

Calcium-sodium antagonism on the frog's heart: a voltage-clamp study

1. In double sucrose-gap voltage-clamped frog atrial fibres the influence of [Ca]o and [Na]o on membrane current and contraction was investigated. 2. The slow (secondary) inward current varied with [Ca]o but was almost insensitive to changes in [Na]o. In contrast, the phasic (transient) contraction initiated by the slow inward current was affected by both [Ca]o and [Na]o. 3. With moderate changes of [Ca]o and [Na]o from normal, the strength of phasic contraction at a given depolarization followed the [Ca]o/[Na]2o ratio approximately. This was best seen at membrane potentials near zero level. 4. Under the same conditions, tonic (sustained) contractions associated with prolonged depolarizations were strictly correlated to the [Ca]o/[Na]2o ratio at any potential. No interrelation between tonic tension and steady-state current was found. 5. With extensive changes in [Ca]o and [Na]o, the sensitivity of both phasic and tonic tension to the [Ca]o/[Na]2o ratio declined, the negative effect of [Na]o becoming smaller than was expected from this ratio. 6. In Na-free choline-Ringer, a strong contracture developed followed by a spontaneous relaxation. Starting from the relaxed state, application of depolarizing clamps gave rise to phasic contractions with a very slow relaxation while tonic contractions were apparently lacking. 7. The results are interpreted in terms of an energy-dependent carrier mechanism exchanging one Ca for two Na ions across the cell membrane. The model implies a strong asymmetry in the rate constants governing the chemical reactions on both sides of the membrane. The system is thought to operate close to equilibrium at any potential, thereby determining the steady level of myoplasmic Ca. The equilibrium itself is considered to shift upon depolarization. Assuming that [Na]i is constant, the steady level of [Ca]i is expected to be proportional to the [Ca]o/[Na]2o ratio, the scale factor being a function of membrane potential. 8. The carrier model suggests the occurrence of a depolarization-induced inward transfer of Ca which might be involved in the generation of tonic contractions. 9. The apparent lack of tonic contractions in the absence of external Na ions may be explained by a suppression of carrier-mediated Ca influx normally occurring upon depolarization. 10. The antagonistic effects of [Ca]o and [Na]o on phasic contraction are understood as being due to alterations of the Ca pumping system rather than changes in slow inward current.     

Canine bladder cancer: epidemiologic features

Significantly reduced immunoglobulins were found in 22 patients with phenylketonuria. Tests of cellular immune function which included delayed skin hypersensitivity, T rosettes and PHA transformation were normal. Escherichia coli antibodies and the booster response to tetanus toxoid were also normal.     

In vitro effects of urease inhibitors on rate of urea hydrolysis in soils

We studied the effect of urease inhibitors on the urea hydrolysis in some Sundanese soils belonging to the orders of Vertisol and Entisol. The hydrolysis showed a lag period of about 3 days and its rate (Y) per unit time (t) could be described by a two constants exponential equation of the general form Y = K₁t^K ₂. Statistical analysis showed that the intercept K₁ (rate of urea hydrolysis) was significantly affected by soil type rather than treatment. It seems that K₁ is associated with the soils' initial urease activity as it closely correlates with the Michaelis constant (km).The gradient, K₂, being significantly affected by soil type as well as treatment is probably associated with the induced urease activity with time and it, therefore, varied with variations in soils and treatments. Of the so-called urease inhibitors used in this study Ca(OH)₂, p-benzoquinone (PBQ) and orthophosphoric acid (OP) only PBQ reduced urea hydrolysis while the other chemicals have effects possibly related to modifying the soil pH. Inhibitor treated soils had substantial amounts of unacounted for N which was believed to be present, presumably, in the form of carbamate.Contribution from the Department of Biochemistry and Soil Science, Faculty of Agriculture, Shambat, Sudan.