The clinical and physiological effect of whole-lung lavage in pulmonary alveolar proteinosis: a ten-year experience

We have utilized whole-lung lavage in the successful treatment of 18 patients with pulmonary alveolar proteinosis. Our ten-year experience includes serial evaluations of patients with disabling lung dysfunction who had a total of 49 whole-lung lavages under general anesthesia. Clinical and physiological responses were documented both before and after each lavage. There were no complications or deaths. All patients were radiographically, physiologically, and symptomatically improved within hours after the procedures. Five patients required from two to four repeat lavages one to three years later. The treatment of this disorder has included a wide variety of techniques. We attribute our results to the use of a lung lavage technique that includes: (1) unilateral whole-lung lavages at two to three day intervals; (2) isotonic saline as the lavage solution; (3) use of a mechanical chest percussor during lavage; and (4) measuring the total thoracic compliance of each side in the immediate postlavage period as a guide for extubation. We conclude that whole-lung lavage is a safe, highly effective, repetitively applicable treatment for pulmonary alveolar proteinosis.     

Acute cardiovascular toxicity of thallium (I) ions

The paper deals with: 1. the protein concentration in the perilymph (PL), the serum and the cerebrospinal fluid (CSF), 2. the protein pattern in the PL and 3. histological findings in the middle and inner ear in unilaterally ear-infected guinea pigs. The studies were performed 6 h to 21 days post infectionem (Fig. 1). The pathological changes in the middle ear, which, in most cases, were limited to the infected ear, were initially evaluated under the operating microscope and divided into 4 stages. The analytical and histological results were presented as functions of these stages. As the inflammation intensity increased, the protein concentration in the PL of the infected ears increased to a level exceeding that of the normal value more than ten times (Fig. 2). However, in the serum and in the CSF this concentration remained unchanged. Likewise, no significant protein increase in the PL of the contralateral ears was detectable in most cases. As the inflammation intensity increased, the number of the precipitation lines detectable immunoelectrophoretically increased in the PL of the infected ears (Fig. 3). An increase in the alpha1- and gamma-globulins and a decrease in Albumin was found by electrophoresis on cellulose acetate strips (Tab. 3). The histological findings correlated with initially established inflammatory stages of the middle ear mucous membrane (Tab. 4). As the inflammation intensity increased, the round window, too, was changed pathologically, so that in some cases of purulent otitis media middle ear secretion could enter the cochlea. The protein increase in the PL immediately after the infection is probably due to an increase in the blood vessel permeability in the inner ear.     

Bacteremia in a community hospital: spectrum and mortality

The problem of bacteremia was studied at our 500-bed community hospital during 1974-1975. All patients with positive blood cultures for clinically significant organisms were analyzed with respect to age, sex, host factors, type, dose, and time of institution of therapy with antibiotics, and mortality. Of 142 episodes of bacteremia, outcome according to underlying host factors showed that 12/15 died in the rapidly, fatal group, 12/24 died in the ultimately fatal group, and in the nonfatal group 25/103 died. Mortality for Gram-positive bacteremia was 37% (7/54) for Gram-negative bacteremia in the nonfatal group. In addition to underlying host factors, inappropriate antibiotic therapy also contributed to higher mortality in patients with gram-negative bacteremia.     

Cross-tolerance between inhaled cannabis and intraperitoneal injections of delta9-THC

Male and female rats were exposed to Cannabis smoke or placebo once every second day for 32 days. Following these 16 trials all animals were injected once intraperitoneally with 4 mg/kg THC. After every third inhalation trial and after the injection the rats were placed on a movement sensor for 3 min. Cannabis smoke significantly reduced activity, relative to baseline scores, during the first 10 inhalation trials but by the thirteenth exposure, tolerance was evident. When the animals were injected with THC, the male rats who had been exposed to Cannabis smoke significantly increased their activity whereas the females did not alter their activity relative to the last inhalation trial. In contrast rats of both sexes that had been exposed to placebo smoke significantly decreased their activity following the injection. This intermodal cross-tolerance is discussed in terms of the role of conditioning in the development of tolerance.     

Discovery of insect anti-juvenile hormones in plants.?2U

Two simple chromenes with anti-JH activity have been isolated and identified from the bedding plant Ageratum houstoianum. By contact and fumigation these compounds induce precocious metamorphosis and sterilization in several hemipteran species of insects. Certain holometabolous species are sterilized, forced into diapause, or both. Each of these biological actions is equivalent to removal of the corpora allata, which produce the JH's, and is reversible by treatment with exogenous JH. Thus, the action of these compounds is to stop the production or depress the titer of the JH's. To our knowledge, this is the first discovery of anti-JH, and we hope it will guide the way to the emergence of a fourth generation of safe and insect-specific pesticides.