Spironolactone and acute mountain sickness

Thirteen adults trekking in Nepal in 1974 to altitudes between 4,300 m and 5,500 m remained free from acute mountain sickness while taking spironolactone as a prophylactic measure. Two years previously five of these adults trekking at similar altitudes, but without treatment, had suffered from acute mountain sickness. The regime used was spironolactone in a dosage of 25 mg three times a day for two days preceding and during the periods spent at altitudes above 3,000 m.     

Permanent cardiac pacemakers in children: technical considerations

Placement of permanent cardiac pacemakers in children presents technical problems that are not encountered in the adult. Problems unique to pacemaker implantation in children are related to the patient's size, the relative bulkiness of pulse generators, the lack of subcutaneous tissue, and the child's growth and long life expectancy. Based on our experience with implantation of 27 permanent cardiac pacemakers in 13 children, we have found that the use of small pulse generators, placement of epicardial leads, insertion of properitoneal pulse generators, and use of recharabeable pacemakers are satisfactory methods in children.     

The great toe as a clinical problem in rheumatoid arthritis

Two hundred consecutive in-patients with rheumatoid arthritis were examined for pain or deformity of the feet, and of the great toe in particular. Some abnormality occured in 196 feet and the deformities observed are presented. The symptoms that arise from these deformities are mainly derived from ill-fitting shoes, and the need for suitable foot-wear is emphasized. Two hitherto un-named entities are described namely Hallux tortus and chisel toe, since they give rise to their own shoe-fitting problems.     

Circulatory changes in patients with coronary artery disease following thiamylal-succinylcholine and tracheal intubation

After introductory remarks concerning the Posner-Schlossman-syndrome (syndrome of glaucomatocyclitic crises) a case is reviewed. The concurrence with Addison's disease in this patient gives rise to speculations as to possible connections between the two conditions, but the conclusion is that the simultaneous occurrence of the two diseases at present must be regarded as coincidental.     

High-performance liquid chromatographic separation of C-15-epimers of 15-methylprostaglandin E2 methyl ester and 15-methylprostaglandin E2

A high-performance liquid chromatographic system that permits quantitation of 15-methylprostaglandin E2 and its methyl ester is described. Separation from the corresponding C-15 epimers is effected by adsorption chromatography on microparticulate silica with refractive index detection.     

Fractures of the femoral shaft: a prospective study of closed intramedullary nailing, modified open intramedullary nailing, and cast-bracing

One hundred twelve consecutive fractures of the femoral diaphysis were treated in a prospective study at Grady Memorial Hospital, a designated trauma center, during the three-year period 1978 through 1980. Fifty of these were treated by closed intramedullary nailing; all united. Of the rest, 20 were treated by modified open intramedullary nailing, and 42 by cast-bracing. Closed intramedullary nailing offered a significant reduction in hospitalization and healing times compared to the other two methods; however, the high cost of equipment, along with the added cost of reoperation to remove the nail, rendered cast-bracing economically superior. Fractures treated by modified open intramedullary nailing developed no infections, but these patients lost significantly more blood during operation than those treated by closed nailing. Because of the decreased hospitalization and healing times, we prefer the closed intramedullary nailing technic for use in selected femoral fractures treated during the acute phase by an experienced surgical team.     

Selftuning control of some pilot plant processes

This paper reviews the results of some experimental tests carried out to evaluate the performance of selftuning (ST) controllers for temperature control of a continuous stirred tank heater, composition control of a binary distillation column and pH control of an acidic effluent. All the pilot plant units have been controlled using a single variant selftuning control, and a newly developed multivariant ST controller was used for simultaneous control of the terminal compositions of the distillation column. The control performance of the units operating under ST control is compared to that obtained using very well tuned proportional plus integral (PI) or proportional plus integral plus derivative (PID) conventional controllers. Control of pH is shown using a technique of electrochemical neutralisation coupled with a single variant ST controller. The control algorithms have been programmed on a number of microprocessor- and minicomputer-based systems. Z80 for stirred tank heater control, LS1-11 for pH control and HP1000 distributed computer system for distillation control.