A comparison of nutrient-based and exchange-group methods of diet instruction for patients with noninsulin-dependent diabetes.

This study compared effectiveness of nutrient-based (Diet Guide) vs food-group (Exchange Lists) methods of diabetic diet evaluation in improving dietary compliance, glycemic control, and biochemical indicators of heart disease risk. Eighty-three persons with noninsulin-dependent diabetes were taught one of two diet-planning methods in a 3-session workshop. Both methods led to reductions in energy intake and percent of calories from fat and saturated fatty acids in 6 mo postworkshop. Reductions in fat intake were greater and more long lasting for persons using Diet Guide than using Exchange Lists method of diet planning. Despite dietary changes, neither diet-planning method led to significant decreases in weight or skinfold thickness. Few differences were seen in clinical measurements pre- and 6 mo postworkshop. Total and LDL cholesterol values were lower than preworkshop values for men in both groups. Suggestions are given for improving effectiveness of both diet-planning methods.

Treatment of a knee contracture using a knee orthosis incorporating stress-relaxation techniques.

The subject of this case report was a 67-year-old Caucasian woman who had undergone total knee arthroplasty of the right knee. Postoperative physical therapy and a new orthosis that utilizes principles of stress relaxation (constant displacement) and static progressive stretching were used to reestablish range of motion. The total treatment time (cumulative orthosis wear time) was 32.5 hours over a period of 29 days, and the patient obtained a 17-degree increase in active range of motion. Six months later there was no measurable loss in range of motion. The results of the treatment may be beneficial for some patients. Researchers and clinicians need to conduct studies to further evaluate this approach to knee contracture management.

Simultaneous isolation of xanthomegnin, viomellein, rubrosulphin, viopurpurin, and brevianamide A by preparative HPLC.

A method for the isolation of xanthomegnin, viomellein, rubrosulphin, viopurpurin, and brevianamide A from Penicillium viridicatum (DSM 2447) is described. After extraction, HPLC was performed with a preparative silicagel column, eluted with toluene / ethyl acetate / formic acid (27/9/1, v/v/v) and dichloromethane / acetic acid (9/1, v/v). The toxins were detected with a UV-monitor. It was possible to isolate them in an absolutely pure state. The described method is operationally simple and very efficient.

Cardiac contraction affects deep myocardial vessels predominantly.

To evaluate the roles of intramyocardial forces and systolic ventricular pressure in myocardial flow in the different layers separately, we measured myocardial flow in rabbit hearts during stable systolic contracture with left ventricular pressures of 60 (n = 5) and 0 mmHg (n = 5) and during stable diastolic arrest (n = 5). We also measured the number and size of the intramyocardial vessels after perfusion fixation (systolic arrest, n = 5; diastolic arrest, n = 5). In 25 rabbits, hearts were excised and perfused from the aortic root. Systolic arrest was achieved by perfusion of a low-Ca2+ Tyrode solution containing 2.0 mM Ba2+. Diastolic arrest was achieved by intraventricular injection of 700-1,000 mg pentobarbital sodium and was maintained by perfusion with St. Thomas cardioplegic solution. At perfusion pressure of 100 mmHg, subendocardial flow was lower than subepicardial flow during systolic arrest regardless of left ventricular pressure, whereas during diastolic arrest, subendocardial flow was higher than subepicardial flow. Subendocardial-to-subepicardial flow ratios for a physiological range of perfusion pressures were lower during systolic arrest with low rather than with high left ventricular pressure. Small arteriolar and capillary densities showed no difference between subendocardium and subepicardium. During systolic arrest, diameters of subendocardial terminal arterioles (4.6 +/- 1.3 microns) and capillaries (4.0 +/- 1.3 microns) were smaller than those in the subepicardium (8.8 +/- 1.7 and 7.1 +/- 1.6 microns, respectively; P less than 0.0001), whereas during diastolic arrest, diameters of subendocardial terminal arterioles (10.1 +/- 2.0 microns) and capillaries (7.6 +/- 1.8 microns) were slightly larger than those in the subepicardium (9.5 +/- 1.5 and 6.7 +/- 1.0 microns, respectively; P less than 0.01). We conclude that cardiac contraction predominantly affects subendocardial vessels and impedes subendocardial flow more than subepicardial flow regardless of left ventricular pressure.