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Abstract168 patients with bacteremia seen in 1965–1969 were studied with regard to mortality rate, age and sex distribution, sources of infection, predisposing factors and infecting organisms. Special attention was drawn to outside hospital originating bacteremia vis-á-vis hospital-acquired bacteremia. In general, the results obtained were essentially in agreement with earlier experiences elsewhere. The most striking observations were, firstly, the grave prognosis associated with hospital-acquired bacteremia and, secondly, the dominant role played by gram-negative bacilli.

Lumbar epidural analgesia with bupivacaine was given to 37 women for uncomplicated labor. After the blockade serial determinations of pH and bupivacaine concentration were made in fetal scalp blood and maternal venous blood and there was continuous monitoring of the fetal heart rate. Fetal scalp blood pH was within normal limits and no pathologic FHR tracings were elicited by the blockade, although a temporary decrease of the baseline fetal heart rate irregularity was seen in about one-fifth of the cases. Fetal drug concentrations were low and about one-fourth of corresponding maternal values. After reinjection of bupivacaine the degree of drug accumulation was fairly similar in fetal and maternal blood.

A method for the determination of bupivacaine in maternal and foetal blood during obstetric analgesia is described. The drug and the internal standard, 1-pentyl-2-(2,6-xylylcarbamoyl)-piperidine, are initially extracted into methylene chloride. Perchloric acid is added to retain bupivacaine and the standard as Perchlorates in the organic phase accomplishing a selective separation from less hydrophobic amines. Bupivacaine and the standard are then re-extracted into sulphuric acid, followed by a purification with methylene chloride. The aqueous extract is finally made alkaline and the compounds extracted into 10 μl methylene chloride. This extract is analysed by gas chromatography using a 3% OV-17 column. The standard deviation of the method at therapeutic concentrations is about 10% and the lowest level which can be determined with reasonable accuracy is 15 ng ml−1.

AbstractA retrospective study of age distribution, civil state and pregnancy in 2 large series of patients with infectious mononucleosis (I.M.) cared for at the departments of infectious diseases in Malmö and in Lund during the years 1950–65 is presented. In both series the peak of the age distribution appeared in the late teens. The number of married individuals was significantly lower than that in the normal Swedish population of the same groups. Epidemiological implications of the findings are discussed in the light of recent findings, by the Henle group, of antibodies against the herpes-like virus derived from Burkitt lymphoma in individuals who have had I.M. Only 3 pregnant women with I.M. were found in the 2 series, all of them in the first trimester. Their gestations were normal and their children have developed well.

Thirty-three full-term nulliparae and their babies were studied. Twenty-one received lumbar epidural analgesia with bupivacaine (Marcain-adrenalinr`) and twelve conventional obstetrical analgesia with meperidine (Petidinr`), chlorpromazine (Hibernalr`), nitrous oxide and a pudendal nerve block with prilocaine (Citanestr`). Glucose, lactate, potassium, sodium, chloride, total protein, haemoglobin and haematocrit were determined in fetal and maternal blood during labour and in neonatal blood after birth. This study revealed a high level of plasma sodium in scalp blood of both 'epidural' and 'control' series probably related to water loss during labour. Furthermore, administration of epidural analgesia to women in labour resulted in lower lactate concentrations in these women and their babies compared with those receiving conventional obstetric analgesia.

This paper reports a case of cytomegalovirus (CMV) infection complicating heart surgery in connection with extracorporeal circulation, transfusion of fresh blood and medication of corticosteroids. The clinical syndrome was different from that reported in a small number of cases with post-transfusion CMV complications. A longstanding fever with involvement in the infectious process of lungs, also possibly heart, liver, and spleen, dominated the clinical picture. The role of viral infections - and that of CMV in particular - as complication of surgery, transfusions and immunodepressive therapy is discussed. The frequency of CMV disease and of CMV carriers is supposed to be considerable.

Twenty-four full-term nulliparae and their babies were studied. Twelve received lumbar epidural analgesia with bupivacaine (Marcain-adrenalinr`) and twelve conventional obstetrical analgesia with meperidine (Petidinr`), chlorpromazine (Hibernalr`), nitrous oxide and a pudendal nerve block with prilocaine (Citanestr`). The acid-base balance was determined in fetal and maternal blood during labour and in neonatal blood after birth. The newborn infants were placed in incubators after birth and several clinical parameters were recorded during the first two hours. Epidural analgesia to the mothers resulted in a lower degree of metabolic acidosis than conventional obstetrical analgesia. The clinical and blood-chemical parameters recorded in this study indicated no harmful effects on the newborn infants after epidural analgesia to the mothers.

THE vascular responses in adipose tissue seem to depend on whether noradrenaline (NA) is released from the sympathetic nerve terminal system or whether it is reaching the receptors by means of the vasculature. Thus electric stimulation of adrenergic nerves to adipose tissue invariably causes α-receptor-mediated vasoconstriction, whereas infusion of NA intravascularly may induce β-receptor-mediated vasodilatation1–4. Likewise intravenous tyramine in monkeys causes vasoconstriction in adipose tissue whereas intravenous NA induces vasodilatation5. Since tyramine acts by releasing NA from the sympathetic nerve terminal system, these observations also indicate that NA produces qualitatively different effects depending on how it is delivered to the vascular adrenergic receptors. Our results indicate that the vascular adrenergic α-receptors only are located close to the adrenergic nerve terminal system, whereas the vascular β-receptors may have a different distribution, being farther away from the adrenergic nerve terminals. Consequently, the α-receptors may be affected primarily by NA released from the nerve terminals, whereas the β-receptors are primarily stimulated by circulating catecholamines.

CONVENTIONAL nonspecific precipitation methods sometimes depend on affinities which can be used in a more selective fashion by modern chromatographic techniques. The affinity of proteins for heavy metal ions, for example, may provide a basis for their purification and analysis. A highly flexible method based on such affinities is described here.