Frozen stored Leishmania tropica vaccine: the effects of dose,route of administration and storage on the evolution of the clinical lesion. Two field trials in the Israel Defense Forces

The first field trial of frozen vaccine against cutaneous leishmaniasis yielded a 100% take rate and a high ulceration rate at a dose of four million units. Two further trials were designed to investigate differences in response rates on the basis of duration of storage, sex of vaccinee, vaccination dose and method of administration.257 soliders (151 males and 106 females) were inoculated in 1978 with an isolate of Leishmania tropica major that had been stored at the temperature of liquid nitrogen for 11 months before use. Those inoculated with an intradermal jet injector and those receiving half a million units by conventional injection yielded very low take rates. For those receiving two million and one million units, no difference in response was demonstrated between males and females or between doses. The over-all take rate for these groups after six months of follow-up was 71·6% with an ulceration rate of only 23·7%.In a subsequent trial in 1979, 131 men were inoculated with one of two frozen isolates of L. tropica major that had been stored for 11 and 18 months, respectively, at doses of either two million or four million units. The take rate after 12 months of follow-up was 91% and 93% for the four and two million units dose, respectively. The corresponding ulceration rates were 39·5% and 25%. The lesions produced by the higher dose developed more rapidly than those produced by the lower dose. The ability of the parasites to produce lesions rapidly with high ulceration rates appears to decline during prolonged storage, even in the frozen state.     

Hepatic structure and function in Papua New Guineans with leprosy

Hepatic function, including plasma bromsulphthalein (BSP) clearance was studied in 20 Papua New Guineans with leprosy: 11 lepromatous (LL) (6 had erythema nodosum leprosum (ENL)) (group A), and 9 tuberculoid or borderline (BT or BB) (group B); 12 controls (group C) were also studied. Four of five with abnormal BSP results had significant complicating or additional factors (hepatic amyloidosis, pustular ENL, hepato-cellular carcinoma and a pyogenic abscess), compared with two of 15 with normal results (tuberculous osteitis and pyogenic osteomyelitis). In nine (five from group A, and four from group B) needle liver biopsy histology was assessed: foci of vacuolated phagocytes and histiocytes, and tuberculoid granulomata were the most frequent lesions; none had cirrhosis.Leprosy is not associated with impaired hepatocellular function unless a severe complication or coincident disease is concurrently present. In this limited study therapeutic agents were not associated with abnormal liver structure or function. When liver function is abnormal in leprosy, another cause (e.g. secondary amyloidosis, sepsis or malignancy) should be searched for.     

Epidemiological characteristics and clinical findings in patients with serologically proven toxocariasis.

The enzyme-linked immunosorbent assay (ELISA) using Toxocara canis larva-specific antigens was used to confirm a presumptive clinical diagnosis of visceral larva migrans in patients whose serum specimens were submitted to the Center for Disease Control. The clinical and epidemiological characteristics of patients with diagnostic ELISA titres (greater than or equal to log2 5) were compared with patients who had less or no detectable antibody. The typical patient with serologically confirmed toxocaral visceral larva migrans was about five years of age and resided in the southern half of the USA. Clinical findings were likely to include leucocytosis, eosinophilia, an increased anti-A or anti-B isohaemagglutinin titre, and an elevated serum IgG level. Pica, as ascertained by a physician questionnaire, was not a consistent finding and both sexes were nearly equally represented.     

Casual blood pressure: Its relationship to several cardiovascular risk factors in middle-aged men

The relationship between casual blood pressure and other cardiovascular risk factors in presumably healthy middle-aged men (in the age range of 50–60 years) was investigated in a cross-sectional study. It was found that people with high casual blood pressure (> 160 and/or > 95 mmHg) and who have no history of previous cardiovascular disease were older, heavier, had higher heart rates and blood glucose, smoked more and had more evidence of L.V.H. on E.C.G. than a control group who had normal or borderline casual blood pressure. It was concluded that even casually found hypertension in seemingly healthy individuals is associated with higher prevalence and degree of certain behavioral, physical and biochemical parameters frequently seen in people with ischaemic heart disease.     

The control of gonorrhea by obstetricians and gynecologists

A questionnaire was mailed to all specialists practicing obstetrics-gynecology in two geographically remote metropolitan areas of comparable size. In one city routine culture for gonorrhea was performed by less than one-fifth of respondents, over one-fourth of diagnosed cases were unreported to the health department, and two-thirds of diagnosed patients had symptomatic infection. In the second city, where the Public Health Department had instituted a program of free culture media and microbiologic identification, half of responding physicians routinely cultured for gonorrhea, 93% of identified cases were reported, and half of diagnosed patients had asymptomatic infection. In both cities inappropriate therapy was given by nearly half of the respondents, and epidemiologic treatment was routinely used by less than half of the respondents. Data support the use of public health programs for diagnosis, and indicate that further physician education regarding appropriate individual and epidemiologic management are needed.     

Modifying the snack food consumption patterns of inner city high school students: the Great Sensations Study

The Great Sensations Program is a nutrition-education project developed for high school students. It was designed to (a) decrease students' consumption of salty snacks and (b) increase students' consumption of fresh fruit snacks. The overall programs were designed following principles of social learning: informative instruction, participatory classroom activities, personal goal setting, feedback, and reinforcement. The program was delivered in six lessons during regular health-education classes. A parental involvement program consisted of mailers and telephone calls to parents to teach them to encourage changes in student snacking habits. A schoolwide program was designed to provide out-of-class peer support for student modifications in salty snack foods. The program was evaluated in one high school using a 2 X 2 design. A second high school served as a no-treatment control. Program assessments were made at both schools before and after the classes, at the end of the school year, and the following fall the next school year following summer vacation. The schoolwide media program was effective in decreasing consumption of salty snack foods and in increasing consumption of target snack foods. However, only those students receiving classroom instruction maintained those changes until the end of the school year. No changes were maintained across summer vacation. These outcomes suggest that school programs developed using principles of social learning may be effective in facilitating important behavior changes at home and at school.     

Social bonds in a healthy elderly sample: characteristics and associated variables

Social bonds were examined in 256 healthy, independent-living elderly men and women using the Interview Schedule for Social Interaction (ISSI). Multivariate techniques were used to test for relationships between six dimensions of social bonds, as measured by the ISSI, and demographic characteristics as well as scores from the Kellner-Sheffield Symptom Questionnaire, the Jacobs Cognitive Screening Exam, the Halstead Category Test and the Wechsler Memory Scale. The study participants reported involvement in a range of satisfying, supportive, interpersonal relationships. Significant associations were found between social bonds and income, marital status, work status and health status. Emotional status, cognitive functioning, and memory were found to be independent of social bonds in our statistical model.     

现代科技革命背景下的中药现代化

中医药在人类疾病的预防和治疗中占有重要地位.21世纪以生命科学、信息科学和物质科学为先导的科学技术正在不断地促进经济的繁荣和人类文化的变革.把它们的研究成果应用于中药的二次开发,加强创新中药的研究,走可持续发展的道路,将极大推动中药现代化的进程.     

肢体运动功能图像评价系统的研究

为提高对肢体运动功能检测和评价的精确性和规范性,我们用彩色ＣＣＤ摄像头,ＭＰ－１０００图像卡,一台５８６计算机及所编制的图像处理软件组成评价系统,研制了一套肢体运动工能图像评价系统。本系统对２６例患者进行临床评价的初步实验表明,该评价方法科学,精确,结果可信度高,操作简便,很有临床推广意义。     

A review of the carcinogenicities of nickel,chromium and arsenic compounds in man and animals

Increased incidences of cancers of the respiratory tract have been reported among (a) workers in nickel refineries; (b) industrial workers who have been engaged in production of chromates or in processing of chrome pigments; and (c) workers who have had diverse occupational exposures to arsenic compounds (metallurgical, chemical and agricultural workers). Human subjects who have developed clinical manifestations of arsenicalism as a result of environmental, occupational or iatrogenic exposures have been reported to have increased incidences of cancers of the skin and possibly of internal organs. Certain nickel and chromium compounds (e.g., nickel subsulfide and calcium chromate) that have been administered to rodents by parenteral or respiratory routes have induced cancers at the sites of deposition. Experimental induction of cancers in animals has not been reported as a consequence of administration of arsenic compounds.     

Hepatitis B virus (HBV) markers among patients with chronic liver disease in Kuwait

The prevalence of hepatitis B surface antigen (HBsAg), antibody to the hepatitis B core (anti-HBc) and to surface antigen (anti-HBs), was investigated, using sensitive radioimmunoassay (RIA) systems, among patients with different clinical entities of chronic liver disease in Kuwait, and compared to a control blood donor population. 81% of patients and 44% of the controls had at least one HBV marker. 24% of patients, but none of the controls had both HBsAg and a high titre of anti-HBc in the absence of anti-HBs, suggesting a chronic infection. 31% of our patients with hepatosplenic schistosomiasis, 20% with cryptogenic cirrhosis and chronic active liver disease and 60% with hepatocellular carcinoma had these two markers. HBV antigenaemia was significantly more prevalent among male than among female patients and was particularly high among those less than 35 years old. The high prevalence of the various HBV markers among our patients suggests that HBV is a major factor in the development of chronic liver disease in our area. Furthermore, in view of the high prevalence of antigenaemia in patients with hepatosplenic schistosomiasis, HBV infection must play a concomitant role in the development of a more serious form of chronic liver disease among such patients.     

Efficacy of cervical cytologic screening in the control of cervical cancer

Cervical cancer mortality in the U.S. has been declining, and this has been attributed to cervical cytologic screening. This report reviews data on the incidence and mortality of cervical cancer in order to evaluate the effect of cytologic screening. U.S. cervical cancer mortality has been declining consistently since 1946, with little change in the mortality trend after widespread cytologic screening. Incidence of invasive cervical cancer in specific geographic areas has also declined. However, the rate of diagnosis of carcinoma in situ has increased sharply and parallels increasing cytologic screening rates. A causal association of cytologic screening with the decreasing mortality and incidence of invasive cervical cancer cannot be established using current data, especially considering declining mortality prior to widespread screening and increasing removal of women from the population at risk by hysterectomy.     

Strategies for prevention using allied health professionals.

Preventive services which are directed at groups and individuals who are at high risk of some unfavorable outcome should be incorporated into the fabric of medical care practice. Allied health professionals have the required skills to provide preventive services with a greater sense of job satisfaction than do physicians. Experiences to date attest to the usefulness of allied health professionals in meeting the gaps in health care which are largely preventive in nature.     

Studies in community nutrition: Estimation of sodium output

A practical procedure for estimating dietary intake of salt would facilitate examination of the possible relationship between salt intake and hypertension and could provide feedback to aid persons in changing salt intake when such is recommended. This is a study with 19 subjects of a sampling procedure of estimating sodium output which requires less patient cooperation than that needed for a 24-hr urine sample. Each subject provided timed urine samples for portions of the entire 24-hr period for three consecutive days. Sodium excretion for any one of the entire 24-hr periods correlated well with the mean 24-hr excretion for the 3-day period. The mean sodium excretion of the three 9-hr overnight urine samples correlated equally well with the mean 24-hr excretion for the entire 3-day period. This latter procedure, which puts far less a burden of compliance on the subjects, is suggested as preferable to obtaining a 24-hr urine sample. For purposes of checking compliance with dietary suggestions, it is possible to replace the analysis for sodium with a simple titrator strip that measures chloride.