Journal of the American Medical Association

During a measles epidemic in Panama, 453 persons with no previous history of measles were inoculated with a modified live-virus measles vaccine, and 356 others served as controls. About 70 to 80% of children under 5 years of age had some degree of fever, and about 50% of these developed a slight macular rash. During the following four and one-half months, three of the vaccinated group developed m…

The effectiveness of orally administered triamcinolone in 60% of the cases treated was first reported by Shelley and colleagues¹in a series of 60 patients with psoriasis. Of 21 of these patients who had skin tests in a psoriatic lesion with a 1% suspension of triamcinolone, 11 showed a zone of clearing at the injection site. Subsequently one of us (R. L. B.) with Cohen²demon…

Analysis of 157 cases of cardiac arrest led to the conclusion that in 50 of these the sole cause was massive transfusion of hyper-potassemic bank blood. The bank blood rapidly administered to these patients contained an average total of 77.7 mEq. of potassium. In an additional group of 18 of the 157 cases, transfusion contributed to the production of cardiac arrest. Serum potassium concentrations…

For several years the protease chymotrypsin has been among the available adjunctive treatments for traumatic injuries in which tissue hemorrhage and edema present a problem.¹The toxicity of this material has been studied, and it has been found to be relatively nontoxic.²However, being protein in nature it might be expected to elicit a sensitivity reaction in susceptible pers…

Open intracardiac operations, at the present time, can be done with a low risk and a minimum of complications. When complications do occur, they are related primarily to a reduction in cardiac output. Metabolic acidosis or the presence of complete heart block, although rare, can aggravate these states of low cardiac output. To combat such complications when they occur, accurate postoperative care…

A technique whereby a given strain of bacteria can be tested for sensitivity against 12 to 15 antibiotics simultaneously on a single plate was used in a study of resistance to drugs among staphylococci cultured from hospital inpatients and outpatients. Within the period 1955 through 1959, resistance to penicillin changed but little from the level of 60 to 80% previously attained. Resistance to st…

Unfortunately, wars have provided the greatest stimulus to advances in the treatment of wounds. Between wars, the basic principles of emergency treatment are frequently forgotten or are overlooked and have to be relearned at the expense of increased morbidity and mortality in the early phases of a new war. Medical officials of the 15 North Atlantic Treaty Organization (NATO) nations recognized th…

The complete effectiveness against tetanus of the active immunization of persons, as produced by a series of tetanus toxoid injections, was thoroughly established by the experience of the armed forces of the United States during World War II. The sole qualification which must be attached to this state, ment, however, is of the utmost importance today to the practicing physician who must treat an …

In the past six weeks we have observed two patients who have had an identical and unusual reaction while being treated with furaltadone (Altafur), which is a synthetic nitrofuran derivative. This reaction was manifested subjectively by diplopia and objectively by paresis of the lateral rectus muscle. In both cases the diplopia cleared with cessation of therapy. One patient was treated with antihi…

Leukocytic infiltration was found in 10% of the umbilical cords examined in a preliminary study. The present examination of the cords obtained from 1,000 consecutive deliveries made it possible to correlate the presence or absence of the infiltration with each of a list of maternal and fetal factors. Lymphocytic infiltration of the umbilical cord was most strongly associated with prolonged labor,…

Various dietary schemes intended to reduce high serum cholesterol levels to normal have met with various degrees of success. In this study of 51 patients with elevated serum cholesterol levels, comparisons of serum lipid values were made with data from 106 normal subjects, and the effects of low-fat diets were compared with those of vegetable-oil diets. The data indicated that patients can be cla…

This compilation is divided into four parts. Part 1 thoroughly reviews the problem of osteoporosis. The authors and chairman of this section do not agree as to the cause of the condition, but the vast amount of investigative research that is presented permits an intelligent clinician to attain a better understanding of the etiology of osteoporosis as well as a sound clinical approach. Part 2 cove…

Much has been written about lymphocytes, but relatively little is known about them. The same applies to a greater extent to mast cells. This monograph is an attempt to gather between the covers of a small book what has been written about these cells. The authors are well qualified for the task. They have been contributing to the subject individually and jointly for many years. The lymphocytes, pl…

The uses and advantages of a digital computer system in medical research were explored in a pilot study of 138 records from an outpatient clinic. Information was coded with the help of the Standard Nomenclature of Diseases and Operations, the Cornell Medical Index, and other aids, and it was found possible to punch a history of 195 questions on International Business Machine cards in 40 seconds. …

The pacemaker here described has been used in 66 patients to correct complete heart block. In most cases the block followed surgical procedures, but it also occurred in some nonsurgical patients. The pacemaker consists of three parts: a 9.4-volt mercury cell battery as the source of power; a transistorized oscillator transformer to generate the pulses needed to stimulate the heart; and a unipolar…

Free cancer cells can be identified in the circulating blood by removing the erythrocytes with a heparin-fibrinogen mixture, centrifuging the plasma, and examining smears made from the buffy coat. In a series of 179 patients with advanced cancer, one-half of the samples of peripheral blood studied in this way yielded recognizable tumor cells. These metastasizing cells with diameters of 10 to 30 μ…

Pregnancy is not a common complication in cancer. When it does occur, it often does not affect greatly the treatment of the malignancy, although it may change the prognosis. Occasionally, however, pregnant women with disseminated malignant disease are seen as candidates for palliative therapy with irradiation or chemotherapeutic agents. In such cases, the presence of the pregnancy may be a major …

Material from 116 human eyes infected with trachoma was used successfully for the isolation of viruses by culturing in the yolk sac of chick embryos. Five strains of virus were isolated. All five killed embryos on second passage, and all five fixed complement with both serum from patients with lymphogranuloma venereum and a guinea pig psittacosis antiserum. The virus thus made available for labor…

In the treatment of obstructive vascular diseases the use of drugs that inhibit sludging of erythrocytes is as logical as the use of anticoagulants. The antimalarial drug hydroxychloroquine sulfate is known to reduce the frequency of thrombotic and embolic phenomena in animals by a marked desludging action; it was administered to 44 human subjects in whom sludging had been noted in the bulbar con…

Because a marked diminution of tremor of hands and fingers was noticed in a diabetic receiving tolbutamide, the authors began to use tolbutamide in patients with paralysis agitans. The studies have been continued for a year and a half, and the results have been observed in 15 patients. Eleven of the patients showed considerable reduction of tremor or rigidity or both. In several there was a marke…