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Elastic scattering of electrons has been used to extract the nuclear charge distribution parameters of the N = 50 isotones; 89Y, 90Zr and 92Mo. The momentum transfer range studied is from 0.25 fm-l to 1.15 fm-l. A comparison of the differences in the charge distributions is made with the shell model predictions.

A high-performance liquid chromatographic (HPLC) method is described which determines ibuprofen in human capillary or venous plasma. Ibuprofen plus the internal standard, flurbiprofen, were extracted from acidified plasma with pentane-ether, back-extracted into base, and then extracted into the pentane-ether solution after acidification of the aqueous phase. A reverse-phase octadecylsilane column with acetonitrile-water-phosphoric acid as mobile phase and UV detection provided a quantifiable peak for 1 microgram/mL of ibuprofen in 0.1 mL of plasma. Capillary and venous plasma level curves were virtually superimposable after administration of 400 mg of ibuprofen to four normal volunteers. No ibuprofen was detected in the saliva of the subjects.

The differences in the mean square nuclear charge radius delta (r2) of the even cadmium isotopes 100

Construction of apparatus for a free electron laser experiment is being undertaken by a collaboration involving principally groups at the Heriot-Watt and Glasgow Universities and at the SERC Daresbury Laboratory. The experiments will be centred on 10.6 ?m but a tuning range of at least 2-20 ?m will be investigated. The gain has been optimised in a regime of large linewidth broadening arising from the electron beam and wiggler magnet properties. The performance of the electron linac source is being improved and a new beam line is under construction. A periodic magnet design utilising samarium cobalt blocks has been chosen and will be assembled and tested shortly. Following electron beam commissioning tests it is planned to start a comprehensive study of FEL characteristics late in 1983.

A retrospective survey of 135 posterior dislocations and fracture-dislocations of the hip was carried out in order to define the pattern of associated knee injuries. Thirty-five patients had sustained a significant injury to the knee, of which twenty-five were clearly attributable to a direct blow on the front of the knee (fractured patella, traumatic chondromalacia, fractures of femoral and tibial condyles) and ten were compatible with valgus, yams or rotational forces (medial, lateral and cruciate ligament tears). The second type of injury has not been widely recognised but it is important that it should not be overlooked.

The ‘ascending and descending audiogram’ is a simple pure tone hearing test that exposes with a high degree of reliability those who are feigning bilateral deafness. The normal person has a marginally better pure tone audio-metric threshold when the stimuli are presented in descending levels of intensity, as compared to ascending intensities. The reverse situation applies with the malingerer where there usually is a 20-30dB difference between the audiometric graphs, with ascending levels of intensity indicating a better hearing threshold.

The RMS radii (r2)1/2 of the charge distributions of the even isotopes 110

The influence of injection volume on the absorption and bioavailability of medroxyprogesterone acetate (MPA) was studied. A single i.m. injection of MPA 400 mg was administered to 24 healthy men; 12 of the subjects received 4 ml of a 100 mg/ml suspension of the drug, and the other 12 subjects were given 1 ml of a 400 mg/ml suspension. Blood samples for MPA determinations were collected periodically during a 202-day period after drug administration. Mean steady-state serum concentrations of MPA were simulated from single-dose data to reflect those achieved after standard dosage regimens. Values for area under the serum concentration-time curve and time required to reach peak serum concentrations were compared between subjects receiving different injection volumes of MPA. Mean peak serum concentration were significantly higher and occurred significantly sooner in subjects receiving the 4-ml injection of MPA than in those given the 1-ml injection. No significant differences in areas under the serum concentration-time curve were noted in subjects receiving different injection volumes. The rate but not the extent of absorption of injectable MPA suspension is enhanced by increasing the injection volume of equivalent doses from 1 ml to 4 ml.

The relative bioavailability of an orally administered aqueous suspension of medroxyprogesterone acetate (MPA) intended for intramuscular injection (Depo-Provera) was determined in relation to orally administered tablets. Serum levels of MPA were determined by radioimmunoassay following the administration of 400-mg doses to 19 adult male volunteers in a crossover design after an overnight fast. The two treatments were judged bioequivalent based upon a comparison of the resultant MPA serum levels and the derived bioavailability parameters. Hence, the intramuscular suspension administered orally offers an alternative means of achieving optimal serum levels of MPA in patients requiring high dose therapy.

Summary A case of haematogenous osteomyelitis of the medial first metatarsal sesamoid is presented and the differential diagnosis discussed. Review of the literature suggests that the condition is rarely seen and tends to present in childhood and adolescence. This contrasts with metatarsal sesamoid osteomyelitis due to direct spread of infection, which occurs in the elderly as an important complication of the diabetic foot.

Postoperative chest infection was studied prospectively in 73 patients in order to evaluate standard laboratory methods of sputum examination and to relate the results to the patients' clinical state and to antibiotic therapy. When a culture medium selective for haemophilus was used in addition to unselective media, homogenisation of the specimen gave no advantage. Laboratory and clinical findings usually corresponded well. Profuse growths of Streptococcus pneumoniae or Haemophilus influenzae were clearly associated with clinical evidence of chest infection but other Gramnegative bacilli and Staphylococcus aureus much less so. Coliforms were more prominent after antibiotic therapy.

The simplest three pharmacokinetic models which apply in cases of reversible metabolism are described. Area under the curve (AUC) relationships are described which allow one to make a choice of which one of the three models may apply in a particular case. Expressions for clearances and other pharmacokinetic parameters are given. It is shown that biexponential time courses are expected after bolus intravenous administration although distribution is not involved in the models. In some cases dose/AUC or infusion rate/steady-state concentration yield simple clearances, while in other cases they are complex. AUC data obtained following oral administration of 5 mg doses of prednisone and prednisolone to 16 normal volunteers were analyzed with the new concepts and one of the models was found to apply. This new interpretation of such data results in some significant changes from application of classical pharmacokinetics.

The presentation and outcome of 61 cases of nontuberculous spinal osteomyelitis were reviewed. Although the commonest presentation was subacute, with back pain predominating, 10% had septicaemia and 7% paraperesis or paraplegia. Most infections were caudal to the fourth thoracic vertebra. One third were associated with preceding urinary, respiratory, dental or abdominal sepsis. Staphylococcus aureus was the infecting organism in 85% of isolates. Delay in diagnosis was frequent. There were four deaths, and seven individuals remained severely disabled: outcome was otherwise satisfactory. An algorithm for the investigation and management of this uncommon but serious condition is proposed.

Acute urinary tract infections in young women attending a clinic for sexually transmitted diseases were caused by the same bacteria, in the same proportions, as those that caused infections in women students. Staphylococcus saprophyticus biotype 3 (formerly called Micrococcus subgroup 3) was the commonest organism after coliform bacilli and caused about 30% of the infections. It was uncommon in women over 25 years of age and rarely caused asymptomatic bacteriuria in pregnancy. Most infections, irrespective of the causative organism, started soon after sexual intercourse, but neither the staphylococci nor the other organisms were associated with promiscuity, as judged by numbers of sexual partners or the incidence of sexually transmitted diseases. There was no evidence that the staphylococci were sexually transmitted. The reasons for the virulence of Staph. saprophyticus and its predilection for the urinary tract of young women remain unknown.

SUMMARYIn a maternity hospital in which the umbilicus and trunk of healthy newborn infants were treated with 0·33% hexachlorophane dusting powder, the hexachlorophane content of blood was measured in mothers before delivery, in infants' umbilical samples at birth, and at 8 days of age in capillary blood samples. One mother and her baby had rather high blood concentrations of hexachlorophane, probably derived from a toilet preparation used before admission to hospital. Hexachlorophane was absent or barely detectable in the other mothers' blood and in the infants' umbilical blood. The hexachlorophane concentrations in the blood of 8-day-old infants ranged from nil to 0·166μg./ml. (mean 0·066μg./ml.). These were much less than the concentrations reported to be toxic in animals.In a previous trial now reported here, a dusting powder containing chlorhexidine instead of hexachlorophane was found to delay the separation of the umbilical cord.

The protective effect of treating the skin of newborn infants with powders containing 1% chlorhexidine or 0.33% hexachlorophane was compared. Each was equally effective in preventing colonisation and infection by Staphylococcus aureus. In contrast, the skin became profusely colonised by coagulase-negative staphylococci, irrespective of the powder used. Venous blood concentrations of chlorhexidine were low or undetectable in the few infants whose blood was analysed.

The prospect of the application of scientific techniques of physiology and movement science to dance promises to enhance not only the performance but also the safety of ballet dancing. The scientific analysis of nutrition, strength, and cardiovascular and movement demands of elite athletes in a great variety of competitive sports has increased our understanding of the stresses placed upon the body in these sports and in so doing has improved training techniques, enhanced performance, and helped to decrease the incidence of injuries. The application of these scientific analysis techniques to dance may reap similar benefits. Although the classical ballet teacher may, at first glance, be horrified by a computer analogue analysis of a grand jete, the information obtained from such studies may help him or her to decide when a young dancer is ready for such a technique or demonstrate a technical deficiency in the performance of such a technique. Similarly, the often debated question of when a young dancer should attempt pointe may become less subject to a teacher's intuition or parental pressure if research on the strength of muscles, bones, and ligaments teaches us the specific levels needed before this technique should be attempted.

In a clinical and microbiological study of women with urinary frequency and dysuria (excluding those with bacterial cystitis), 41 patients were compared with 42 control subjects. No difference was found between patients and controls in the incidence of infection by Chlamydia trachomatis or other sexually transmitted organisms. The numbers of lactobacilli and other fastidious organisms in the urine of patients with either mild or severe symptoms were similar and did not differ from the numbers in the urine of control subjects. The numbers of leucocytes in urine were also similar in both patients and controls. Our findings support the view that the urethral syndrome is not caused by bacterial or chlamydial infection.

Albright in 1944 described a syndrome of hypercalcaemia in patients immobilized following fractures through bones affected with Paget's disease. This paper reports a further two cases in which this syndrome was considered the cause of hypercalcaemia with fatal outcome. Both patients had parathyroid adenomata. The literature is reviewed, and it is argued that no firm evidence for the existence of this syndrome has ever been put forward. The finding of hypercalcaemia in Paget's disease of bone should prompt an exhaustive search for its cause.

Acute exercise enhances fibrinolytic (FA), factor VIII coagulant and factor VIII ristocetin cofactor activities, and increases the concentration of factor VIII-related antigen. Little is known concerning the mechanisms of these changes. To investigate possible relationships between exercise-induced changes in blood lactate, 2,3-diphosphoglycerate (DPG), and the hemostatic variables, a branching multistage treadmill protocol was used to exercise male volunteers to a maximum effort. Blood samples were drawn before, immediately post-, and 8 min postexercise. All hemostatic variables were significantly (P less than 0.05) increased postexercise. Highest values for factor VIII coagulant, factor VIII-related antigens and factor VIII ristocetin cofactor were observed at 8 min postexercise. Significant (P less than 0.001) correlations were found postexercise for lactate with factor VIII coagulant (r = 0.64), while no association between pre-, post-, or 8 min postexercise. Postexercise lactate demonstrated a significant correlation (r = +0.81), which was strengthened by including the preexercise high-density lipoprotein (HDL) concentrations (r = +0.87). Consequently, the expected postexercise FA may be calculated from the observed values for postexercise lactate and preexercise HDL. The correlations of lactate with postexercise FA and with postexercise factor VIII coagulant may reflect a common stimulus for these exercise-induced changes.

The results of the treatment of 168 children with acute osteomyelitis in Auckland between 1951 and 1955 were reviewed with a particular interest in late recurrence. The early failure rate of 20 percent is comparable with other recent series. Follow-up of the 134 apparent cures revealed five late recurrences, an incidence of 3.0 percent but follow-up was incomplete (44 cases) and the late recurrence may be higher.

Data on the hospital incidence of acute haematogenous osteomyelitis in New Zealand children between 1965 and 1973 are presented. The incidence in Maori children is four times that in European children. The condition is more common in the North Island than the South Island, but this difference is mainly due to the distribution of the Maori people. Admissions to hospital are common in late summer and autumn. The relationship of osteomyelitis to skin and ear sepsis and some possible reasons for ethnic difference, are discussed.

Experience of the first two years of an orthopaedic geriatric rehabilitation unit is described. There were 325 admissions comprising 271 females and 54 males. The predominant diagnosis was fracture of the proximal femur. Average length of stay in the unit was 43 days for males and 36.7 days for females. 75.9% of patients admitted from home returned there and 66.1% of patients admitted from residential care returned to similar accommodation. In the first year there was a fall of 13.5 days in the average length of stay for elderly females with proximal femoral fracture, resulting in 2175 less bed days for this diagnosis. This improvement has continued.