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Oriental cholangitis is a poorly understood syndrome consisting of intrahepatic pigment stone formation with chronically recurrent exacerbations and remissions. Endemic to Asia, it is being encountered more frequently in the United States due to increased immigration of asians. Twenty-one patients with oriental cholangitis (9 men and 12 women), 19 to 84 years of age, all of whom immigrated from asian countries, were treated between 1970 and 1983. All had histories of episodic abdominal pain, most with jaundice, chills, and fever. Laboratory results were nonspecific but frequently included leukocytosis and hyperbilirubinemia. All patients were operated on with 15 having cholecystectomy, common duct exploration, and a bilioenteric anastomosis. E. coli was cultured from specimens obtained from the biliary tracts of all patients, and 13 patients had more than one organism. Four patients had a previous history of parasitic infection, and four different patients had parasites identified in the biliary tract intraoperatively. Early recognition and appropriate operation will decrease morbidity and mortality.

We describe a case of citrate intoxication and cardiac arrest that resulted from the inadvertent direct IV administration of citrate phosphate dextrose solution. Treatment included thoracotomy with open cardiac massage and CaCl administration. The patient was placed in a rehabilitation program for residual spacticity and weakness, and for psychiatric problems.

Prostacyclin, or prostaglandin I2 (PGI2), and thromboxane A2 (TXA2) are potent, endogenously produced, vasoactive substances that have been implicated as mediators in the pathophysiologic nature of septic shock. We investigated the contribution and production of PGI2 and TXA2 in sepsis and septic shock, using an intact rabbit model and an in vitro rabbit isolated cardiac perfusion model. Continuous hemodynamic monitoring of both experimental models, along with serial radioimmunoassays of the metabolites of PGI2 and TXA2, indicated that myocardial depression is a common finding in subjects with septic shock and that septic shock causes a suppression of PGI2 production while augmenting TXA2 production. In addition, PGI2 and TXA2 were mediators of some cardiovascular changes in septic shock but were themselves not the toxic factor(s) responsible for the associated myocardial depression.

Thirty cases of acute cholecystitis in pregnancy were identified during a 12-year period. Twenty-one patients were successfully managed with medical therapy alone. Nine underwent surgical intervention, four after failing medical therapy and five as the initial approach to therapy. Surgical therapy was complicated by preterm labor and delivery in two patients undergoing surgery during the early third trimester. One patient underwent cholecystectomy during the first trimester and subsequently aborted. There were no serious complications in patients undergoing surgery during the second trimester. These data suggest that conservative medical management can be successfully used in most patients with acute cholecystitis in pregnancy.

Liver lacerations are the most common intra-abdominal injury that leads to death, and control of hemorrhage remains the primary problem in lowering mortality from severe hepatic trauma. We retrospectively reviewed operative trauma cases in which liver packing and planned reoperation were used as temporizing measures in hemodynamically unstable patients. These cases were compared to patients closely matched for age, sex, type of trauma, and associated injuries but who did not undergo liver packing and planned reoperation. Preliminary data support our contention that liver packing and planned reoperation is a valuable adjunct for the management of hemorrhage from severe hepatic injury without incurring increased morbidity or mortality. This technique is useful for the experienced trauma surgeon to arrest hemorrhage and gain hemodynamic stability before attempting definitive care and for the community hospital surgeons who after gaining hemodynamic control would like to transfer the patient to a tertiary care facility.

Trauma physicians are frequently involved in the evaluation and treatment of patients who are victims of crimes or themselves criminals. These physicians usually have little or no training in the forensic aspects of emergency medical care and therefore necessary evidence may often be overlooked, lost, inadvertently discarded, or its admissibility denied because of improper handling or documentation. Criteria were developed to evaluate the forensic medical aspects of such trauma cases and to discern the magnitude of the problem. The majority of the cases reviewed demonstrated significant forensic medical deficiencies primarily in the areas of documentation and/or handling or securing of evidence. Trauma physicians have the responsibility and potential liability to insure that necessary evidence is properly secured and preserved while caring for their patients. Educational programs should be developed for this purpose.

Myocardial depression is a major but poorly understood component of septic shock. This study investigates the morphologic and biochemical abnormalities associated with septic shock. Myocardial cells are incubated in normal and septic plasma in a nutrient-, oxygen-, pH-, electrolyte-, and temperature-controlled environment. Cells and media are tested for basal- and epinephrine-stimulated cyclic adenosine monophosphate (cAMP), lactic dehydrogenase (LDH), and creatine kinase. Electron microscopic studies are done at the end of incubation. Septic LDH and creatine kinase levels in the media are increased substantially, and septic cAMP levels are reduced significantly. Septic cells beat irregularly and arrest along with exhibiting abnormal electron microscopic structure. Septic myocardial dysfunction occurs independently of previously postulated causes that are controlled for in this experiment and therefore may be due to endogenously produced or accumulated toxic factor(s).

To contribute to knowledge on the significance of B chromosomes in rye populations, a component of fertility has been estimated by a comparative study of germination and growth of pollen tubes in plants with and without B chromosomes. The highest percentage germination of pollen and mean speed of pollen tube growth was shown by 14 + 2B plants, followed by normal plants.Observations of first pollen mitosis indicated that in most cases the chromatid constitution of the tube nucleus was the same in 14, 14 + 1 and 14 + 2B plants. In contrast, the mean growth rate of pollen tubes differed significantly among the three cases. From these data it seems that the determination of germination ability and pollen tube growth depends on the sporophyte and is related to the number of Bs carried by the plant.

The meiotic behaviour of hybrids between Secale cereale carrying B chromosomes and S. vavilovii has been studied in order to estimate the effects of B chromosomes on hybrid meiotic pairing. The possible effect of Bs on the meiotic pairing of the offspring from backcrosses with S. vavilovii has been studied also. The results obtained clearly indicate that no detectable differences existed in chromosome pairing of hybrids with or without B chromosomes. The hypothetical existence of epistatic genes on cereale genome masking the effect of Bs has been rejected after the results obtained in backcrosses. Therefore, lack of qualitative genes controlling interspecific pairing on rye B chromosomes has been concluded. A quantitative effect of B chromosomes was detected only when they were in alien cytoplasm.

The present study was designed to contribute to our understanding of the factors that take part in the developmental transformation of the optic vesicle into the optic cup. The expansion and formation of this structure are dependent upon factors such as cellular proliferation, the space or zone occupied by the growing optic cup, and environmental influences. Our investigation in the chick embryo analyzes the relationship between retinal thickness and ventricular mitotic density. This relationship is shown in the study as PEI (proliferation-expansion index). That index varies in the superior, medial and inferior regions of the retina when the zones of the same stage are compared, as well as in the comparisons of values between the 13-14 stage and the 17-18 stage. These differences indicate a different behavior of the cells constituting the retinal regions. Also discussed is the influence of the retinal fissure on the morphological changes observed during optic cup development.

A strain of Myxococcus coralloides produces pigments with antibiotic activity. The pigments are non-diffusible and become detectable at the beginning of the autolytic phase. Red pigments produced by vegetatively growing cells were extracted by acetone treatment. The crude extract when chromatographed yielded several fractions, two of which were active against certain Gram-positive bacteria. Both fractions were partial purified in thin layer chromatography and can be differentiated according to colour, polarity and absorption spectrum. Production of active pigments is increased by nicotine and inhibited by diphenylamine. The pigments are also compared with the antibiotic produced by this bacterium.