摘要:

The past decade has seen an increasing awareness of the legal and ethical issues surrounding the human experimentation process. This paper discusses such issues and summarizes current federal policy governing institutional research involving human subjects. In addition, experience of a review committee at the New York University Medical Center is cited as an example of the policy's Implementation.

ISSN:0002-9629    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Fifteen patients who had been resuscitated following cardiac arrest were studied for coagulation abnormalities. A coagulation disorder was present in all subjects studied. Seven had clearcut evidence of disseminated intravascular coagulation and six had findings highly suggestive of this disorder. Findings in the remaining two patients were nonspecific. The severity of the coagulation defect did not appear to be related to the duration of arrest or the nature of the underlying disease. In those who survived long enough for follow-up, coagulation values returned toward normal spontaneously. Only one patient received anticoagulant therapy, consisting of two doses of heparin.Six patients recovered and were discharged from the hospital. Except for the one patient who received heparin, no patient had clinical signs which could be attributed to disseminated intravascular coagulation (ie, hemorrhage or thrombosis). Autopsies were performed on six of the nine patients who died. Examination of autopsy material failed to reveal evidence of disseminated fibrin deposition. It is concluded that cardiac arrest is frequently accompanied by laboratory evidence of disseminated intravascular coagulation. However, the patients do not show clinical signs of hemorrhage and/or thrombosis, nor do they require specific anticoagulant therapy.

ISSN:0002-9629    

出版商:OVID    

年代:1972

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

We have studied a 41-year-old man who had asymptomatic hypertension, hypokalemia, very low plasma renin, elevated plasma aldosterone, and elevated aldosterone secretion rate. These abnormalities persisted despite marked restriction of sodium intake, upright position, furosemide, DOCA injection, and angiotension infusion. These abnormalities are typical of primary aldosteronism due to adrenocortical adenoma. At surgery, however, no discrete adenoma was found. The adrenals were of normal size, and histologically revealed diffuse bilateral hyperplasia of the zona glomerulosa. Hypertension recurred postoperatively, but plasma renin and aldosterone returned to normal. This patient demonstrates that adreno-cortical adenoma and hyperplasia are presently indistinguishable causes of primary aldosteronism, and have a different prognosis.

ISSN:0002-9629    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

A 27-year-old man was given a course of stibophen therapy for schistosomiasis. Following the fourth dose of the drug he developed a severe hemolytic anemia which was due to the presence of an antibody which, in the presence of stibophen, agglutinated his own and normal red cells. In addition, he developed a severe bleeding diathusis and the coagulation studies were typical of those seen with disseminated intravascular coagulation (DIC). Although improvement in some of his coagulation studies was obtained after heparin therapy, he continued to bleed and suffered a fatal intracercbral hemorrhage. The DIC was probably the result of massive hemolysis and the mechanisms which may account for this are discussed. We believe this to be the first documented report of DIC associated with stibophen therapy.

ISSN:0002-9629    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Polymorphonuclear leukocytes from patients with chronic renal failure had an impaired ability to engulfBacillus subtillswhen compared with polymorphs from normal subjects. Serum from uremic patients killedEscherichia coliand two strains ofStaphylo-coccus aureusloss readily than normal serum. An unexpected finding was the increased killing ofB. subtilisby scrum from patients with chronic renal failure. L-forms ofStrepto-coccus faecaliswere equally susceptible to uremic and normal serum. Serum complement levels were not significantly different from those of normal persons. The findings are consistent with the increased susceptibility of uremic subjects to infections.

ISSN:0002-9629    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Two grams of tolbutamide in staculnrd tablets were administered to 17 chronic alcoholics and 18 matched nonalcoholic controls. Standardised low-calorie liquid meals were given a half hour and again at four hours after administration. Blood tolbulamide and plasma insulin levels were significantly lower and blood sugar levels significantly higher in the chronic alcoholics over a seven hour period. Peak tolbutamide concentrations occurred at three hours and were 19.8 ± 0.9 mg per cent in controls, compared with 15.4 ± 0.9 mg per cent in alcoholics. Maximal reduction in blood sugar was noted one hour after adminis-tration; mean reductions were 26 mg per cent for alcoholics and 41 mg per cent for controls. Peak elevation in plasma insulin concentration occurred at one hour, a mean increase of 130 μU/ml in controls compared with a mean increase of 92 μU/ml in alcoholics. The results show that the same oral doso of tolbutamide has decreased efficacy in chronic alcoholics when compared to nonalcoholic controls. Decreased absorption of active drug and rapid inactivation in the liver are possible mechanisms of action.

ISSN:0002-9629    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Patients with acute viral hepatitis were found to have decreased serum concentrations of total zinc, increased serum concentrations of diffusible zinc, and increased urinary zinc excretion. As the illness subsided serum concentrations of total zinc rose to normal, serum concentrations of diffusible zinc fell to normal, and urinary zinc excretion decreased. Total serum zinc concentration was related inversely to serum diffusible zinc and directly to plasma levels of retinol-binding protein (RBP) and total protein. Serum diffusible zinc was inversely related to plasma RBP and total protein and directly to plasma bilirubin and serum copper. The changes in serum and urinary zinc may be related to changes in the manner by which zinc is bound to serum proteins, particularly albumin. Total serum copper concentrations were normal in the early, acute phase of this clisease but increased to greater than normal levels as the illness subsided. This increase was accounted for entirely by increases in the concentration of ceruloplasmin copper.

ISSN:0002-9629    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

A patient with a hemorrhagic diathesis was found to have an acquired factor X deficiency associated with amyloidosis. The deficiency was correctablein vitrobut not invivo.Studies involving the interaction of soluble amyloid and normal plasmain vitroinconclusive. The possibility is raised that amyloidper semay not selectively adsorb factor X, and an alternative hypothesis is proposed. Since the majority of cases of acquired pure factor X deficiency in adults are associated with amyloidosis, the demonstration of such a deficiency suggests the underlying cause to be amyloidosis.

ISSN:0002-9629    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

A 29-year-old male with acute myelogenous leukemla and chloroma of the sternum who achieved hematologic remission and regression of the chloroma following chemotherapy is described; the addition of local irradiation eliminated the chloroma and with maintenance chemotherapy prolonged (one year) complete hematologic remission followed. An extensive literature survey and bibliography of chloroma of presented.

ISSN:0002-9629    

出版商:OVID    

年代:1972

数据来源: OVID