The importance of toilet facilities and their proper use by the population of Melut, South Sudan.

Particularly in recent years one has recognized the great importance of hygienic removal of faeces in the prophylaxis of intestinal infectious diseases and parasitosis. Numerous models have been carried out in various areas and the World Bank has financed its own projects for this purpose. The models however, had to be suited to each country and district and also the living habits and conditions of the ground-water etc. The often desired water flushing toilets (or even chemical camping toilets) from certain people in the developing countries are at present to be carefully considered due to the insoluble drainage and fresh water problems.

The effect of intravenous infusion of Tebonin (Ginkgo biloba) on pial arteries in cats.

The dilatory effect of intravenously infused Tebonin (extract of Ginkgo biloba) on pial arterial vessels (less than 100 micron diameter), has been measured using a multichannel videoangiometer through a closed cranial window in cats. After 20 minutes there was a significant dilatation of 7% which increased to 21% by one hour. Results from 6 cats treated with 0.3 mg/kg/min. Tebonin were compared with a group of 6 control cats; the same blood gas "steady state" situation applying to both groups. Results imply a cerebral metabolic effect of Ginkgo biloba that induced a slow rise in cerebral blood flow.

Clinical factors associated with dementia in ischaemic stroke.

71 patients with an ischaemic stroke were studied. The patients were separated into two groups on the basis of the results of clinical investigation, computed tomography and psychological testing (WAIS). 40 patients showed an early dementia and 31 were without mental impairment. The mean age was 57 years in the demented group and 54 years in the non-demented group. The mean duration of the history of cerebrovascular disease was also not statistically different in both groups. The frequency of strokes was identical since 50% of the patients in both groups had more than one stroke. The history of neurological symptoms together with the neurological deficits seen on admission were distributed evenly. The dominant hemisphere was more often diseased in the demented group. Bilateral symptoms were also more common in the demented stroke patients. The WAIS showed a similar IQ in both groups but the deterioration index was significantly altered in the demented group. Hypertension was the only risk factor which differed between both groups. Cardiac disease, diabetes, viscosity and fibrinogen did not differ in both groups. The CT showed more normal scans in the non-demented group, the distribution of atrophy on its own and infarction in the left or right hemisphere were both inconclusive, whilst patients with bilateral infarcts were more common in the dementia group. Also, generalised atrophy in combination with an infarct was found more often in the demented patients.

Computer tomography in children with epilepsy.

Computer tomography investigations in 72 children with epilepsy showed 42 to be normal and 30 abnormal. An abnormal scan was more common children with partial seizures and in the presence of neurological deficits and/or mental retardation.

Measurement of regional cerebral blood volume using the EMI 1010 scanner.

Regional cerebral blood volume (rCBV) was measured in 14 patients with normal CT scans. An EMI CT 1010 scanner was used in combination with a computer subtraction technique. The mean CBV in the cortex was 5.0 ml/100 ml of tissue and 2.2 in the white matter. Regional differences were not significant and no difference was found between the right and left hemispheres.

[Effects of nicergoline on cerebral blood flow (author's transl)]. / Wirkung von Nicergolin auf die Gehirndurchblutung.

Cerebral blood flow (CBF) was measured before and after i.v. injection of the cerebral vasodilator 10-methoxy-1,6-dimethyl-ergoline-8 beta-methanol-(5-bromonicotinate) (nicergoline, Sermion) in 13 patients with cerebrovascular disease. CBF increased in seven. The possibility is discussed that the effect of the drug in the other patients may have been masked by a fall of CBF which occurs during sequential measurement of patients at rest. Nicergoline is an alpha-adrenergic receptor blocking agent which affects cerebral blood flow by reducing cerebrovascular resistance. The present study was undertaken to assess the acute effect of the drug on cerebral blood flow and blood pressure in patients with cerebrovascular diseases.

A correlation of clinical findings and CT in ischaemic cerebrovascular disease.

248 patients with an ischaemic stroke were investigated with computer tomography. A hypodense lesion was observed in 18% of TIAs, 76% of PRINDS and 95% of completed stroke patients. In the patients with TIA the hypodense lesions were mainly single ones, whereas completed stroke patients also had a significantly higher proportion of more bilateral lesions. Atrophy was present in 44% of TIA patients, 68% of PRIND patients and 82% of completed stroke patients. Atrophy was generalised in 60% of the patients and homolateral in only 16%. Contrast medium enhancement in a hypodense area occurred only in patients with PRIND and completed stroke and never in TIA aptients. Multiple lesions and atrophy were significantly more common in patients with dementia. The time course showed oedema initially in 47% of patients which fell to 25% after the 1st week. Contrast medium enhancement was present initially in 42% of the patients, rose to 70% until the 3rd week and then fell continuously until the 6th week. The change from an indistinct to a distinct outline of a lesion coincided with this.

Effect of nicergoline on cerebral blood flow.

Cerebral blood flow (CBF) was measured before and after intravenous injection of the cerebral vasodilator nicergoline in 13 patients with cerebrovascular disease. CBF increased in seven. The possibility that the effect of the drug in the remainder may have been masked by a fall of CBF which occurs during sequential measurement of patients at rest is discussed.

Cerebrovascular carbon dioxide reactivity and conductance in patients awake and under general anesthesia.

Paired cerebral blood flow measurements at two levels of arterial carbon dioxide (CO2) tension were made in 36 awake patients and 85 patients under general anesthesia to measure the percent change in flow per mm Hg change in PaCO2 (CO2 reactivity). CO2 reactivity was significantly greater in the generally anesthetized (5.96) than in the awake group (3.65). In both groups, a linear correlation was found between mean percent CO2 reactivity and conductance (the reciprocal of resistance), up to a level of conductance of 0.85 in awake and 0.95 in unconscious patients. When the CO2 reactivity of 18 awake patients and 59 unconscious patients was compared with that of respective control groups, only 11 patients were found to have abnormal CO2 reactivities for their conductance levels.

Computer subtraction in regional cerebral blood-volume measurements using the EMI-Scanner.

A computerized subtraction technique has been described to measure regional cerebral blood volume (rCBV) using the EMI-Scanner in a group of 13 patients. Sodium iothalamte was injected intravenously (1-75 ml./kg) to increase the absorption of X rays in the cerebral circulation. Significant regional differences in CBV were shown, values in the frontal and temporal regions being lower than the mean hemisphere value (4-9 +/- 0-7) and higher in the occipital region. The left hemisphere showed a significantly higher CBV when compared with the right. Measurements of CBV in the cortex showed no regional variation, but the mean cortical value of 6-0 +/- 1-8 was significantly higher than the hemisphere mean.

Cerebral blood flow in dementia.

Twenty-four patients of comparable age, blood pressure, and degree of dementia were classified by an "Ischemic Score" based on clinical features into "multi-infarct" and "primary degenerative" dementia. Regional cerebral blood flow (CBF) was measured by the intracarotid xenon 133 method. Both groups showed a decreased proportion of rapidly clearing brain tissue (largely gray matter). Cerebral blood flow per 100 gm brain per minute was normal in the primary degenerative group but low in the multi-infarct group. This suggests the blood flow is adequate for metabolic needs of the brain in patients with primary degenerative dementia but inadequate for those with multi-infarct dementia. There was no correlation between degree of dementia and CBF in the primary degenerative group but an inverse relationship existed in the multi-infarct group. Reactivity of blood vessels to reduction of arterial carbon dioxide pressure was normal in both groups.