Exploring unconventional medical systems.

Exotic medical systems still exist in the world's developing areas. These systems often embrace a unique pharmacopaeia and remarkable human relationships. Here is a guide for your personal exploration and appreciation of health care systems unfamiliar to Western medicine. It has been developed from personal use, offering practical suggestions for the study of unusual medical beliefs and practice in the field--and it can be used, closer to home, to survey disease and treatment concepts found in alternative or complementary medicine.

A practical guide to creating compliance programs.

Regardless of size or corporate structure, all home care agencies will feel the heavy hand of the government's efforts to detect fraud and abuse in health care. By preparing ahead of time, agency owners can be confident that any investigation will have a satisfactory conclusion.

Clinical report on long-term bone density after short-term EMF application.

A 1984 study determined the effect of a 72 Hz pulsating electromagnetic field (PEMF) on bone density of the radii of post-menopausal (osteoporosis-prone) women, during and after treatment of 10 h daily for 12 weeks. Bone mineral densities of the treated radii increased significantly in the immediate area of the field during the exposure period and decreased during the following 36 weeks. Bone density determination of the radii of these women, remeasured after eight years, suggests no long-term changes. The bone density-enhancing effect of PEMFs should be further studied, alone and in combination with exercise and pharmacologic agents such as the bisphosphonates and hormones, as prophylaxis in the osteoporosis-prone postmenopausal woman and as a possible block to the demineralization effect of microgravity.

Baromedicine today--rational uses of hyperbaric oxygen therapy.

Compressed air, and more recently hyperbaric oxygen, have been used and misused in medical treatment for more than 300 years. Advances in physiology have led to rational protocols for hyperbaric oxygen use. Hyperbaric oxygen will enhance wound healing by fibroblast and capillary proliferation, suppress infection, reduce edema, reverse CNS damage from carbon monoxide and cyanide poisoning, and reduce clostridial alpha toxins. Monoplace and multiplace chambers are used for treatment during which EKG and oxygen tissue monitoring, as well as hemodynamic and respiratory support, can be continued, iatrogenic air embolism and diving decompression sickness demand immediate treatment. Investigative uses of adjunct therapy for several other clinical problems include treatment of MS, acute spinal cord injuries, and acute MI. Specific indications agreed on by the Undersea and Hyperbaric Medicine Society are recognized by most third-party payers including Medicare, Champus, and HMSA. Hyperbaric medicine remains a fertile area for basic physiologic investigation and outcomes research.

Enhanced mutagenic effect of a 60 Hz time-varying magnetic field on numbers of azide-induced TA100 revertant colonies.

Forty-eight hours exposure to a two Gauss (0.2 mT) rms 60 Hz time varying sinusoidal electromagnetic field increased the number of azide induced TA100 revertant colonies of Salmonella typhimurium 14% as compared with controls in the ambient < 2 milli-Gauss 60 Hz field. In the absence of the electromagnetic field, the numbers of mutant colonies grown within and outside the non-energized coil were nearly identical. Without azide, the number of "spontaneous" mutant colonies forming in the experimental field was not statistically significant from numbers of colonies not exposed to field effects. Experimental temperature variation of 2 degrees C had little effect on colony formation, and the enhanced production of revertant colonies in the presence of the magnetic field was maintained during continued culture for 5 additional days.

Electromagnetic fields: biological and clinical aspects.

Our entire biosphere is immersed in a sea of man-made electromagnetic fields (EMF). Occupational and public health data suggest that these fields may be a health hazard, possibly involving cancer and fetal loss. This paper reviews the history and pertinent physics of electromagnetic fields and presents evidence from the authors' work, and that of others, of biological interaction with living systems. Epidemiological data suggesting EMF hazards are reviewed including a discussion of possible risks associated with Hawaii's Lualualei transmitter site, TV and FM antennas in high-density population areas, fields surrounding electric power transmission and computer terminals, and the plan to route a major highway through the near-field of an operating Omega signal-source. In the face of current public fear and controversial research reports about long-term EMF exposure, suggestions are presented for public policy about these local sources of concern, as well as for the EMF risks common to any similarly developed areas.

Bone density changes in osteoporosis-prone women exposed to pulsed electromagnetic fields (PEMFs).

To determine the effect of a 72 Hz pulsating electromagnetic field (PEMF) on bone density of the radii of osteoporosis-prone women, the nondominant forearms of 20 subjects were exposed to PEMF 10 h daily for a period of 12 weeks. Bone density before, during, and after the exposure period was determined by use of a Norland-Cameron bone mineral analyzer. Bone mineral densities of the treated radii measured by single-photon densitometry increased significantly in the immediate area of the field during the exposure period and decreased during the following 36 weeks. A similar but weaker response occurred in the opposite arm, suggesting a "cross-talk" effect on the nontreated radii, from either possible arm proximity during sleep or very weak general field effects. The data suggest that properly applied PEMFs, if scaled for whole-body use, may have clinical application in the prevention and treatment of osteoporosis.

Ethanol vapour modulation of Lewis lung carcinoma, a murine pulmonary tumour.

Pure ethanol in experimental animal studies, may not primarily be carcinogenic, but secondarily it can act chemically and synergistically as a co-carcinogen via its endogenous metabolites and associated dietary and exogenous factors. However, ethanol, being a small molecule and miscible with water and most lipids, can readily enter cell membranes and directly affect cell function. In an in vitro study where ethanol was added to the culture medium for Lewis lung carcinoma, a dose-dependent suppression of tumour growth occurred. In the in vivo study, sequestration of the Lewis lung carcinoma in the lungs followed tail-vein injection in C57BL/6 mice. Starting on the second day after tumour implantation, primary pulmonary exposure was carried out with inhalations of 0.4% ethanol vapour from an aerosol for 70 min daily, this was continued for 17 days. This resulted in a marked reduction of the pulmonary tumour growth. Exposure to 0.1% ethanol vapour did not significantly affect the growth of Lewis lung carcinoma tumour. The optimum ethanol aerosol applications may thus be tumoricidal. Whether any ethanol secondary metabolites are involved is as yet uncertain.

Simultaneous outbreaks of Guillain-Barré syndrome and Bell's palsy in Hawaii in 1981.

Simultaneous outbreaks of Guillain-Barré syndrome (GBS) and Bell's palsy occurred among residents of Hawaii during the three-month period June through August 1981. The outbreak of GBS (six cases) involved children, while the outbreak of Bell's palsy (22 cases) involved primarily adults. Four of the six patients with GBS had serological evidence of recent infection with cytomegalovirus (CMV) v none of 24 control subjects; no such association with CMV infection could be demonstrated for patients with Bell's palsy. The patients with GBS and Bell's palsy lived in widely scattered areas within the population centers of Hawaii, and no common exposures to specific places or events were identified. Testing for antibodies to respiratory pathogens suggested that a variety of antecedent viral infections, in addition to CMV infection, may have been associated with this unusual simultaneous cluster of illnesses.

Clinical experience with the Lillehei-Kaster valve prosthesis.

The Lillehei-Kaster valve was used in 215 patients over a 7-year period. The aortic valve was replaced in 81 of them. Hospital mortality was 21% (17 patients). Ten patients were lost to follow-up and long-term mortality was 5% (3 patients). The incidence of thromboembolism was 2.6 per 100 patient-years, and actuarial survival was 96% at 5 and 87% at 7 years. Mitral valve replacement was performed in 108 patients. Hospital mortality was 20% (22 patients), 24 patients were lost to follow-up, and long-term mortality was 13% (11 patients). The combined incidence of thromboembolism was 5.0 per 100 patient-years, and actuarial survival was 81% at 5 years and 75% at 7 years. In both groups, the majority of patients improved clinically. Fifteen patients had double-valve replacement, and 11 had coronary revascularization in addition to valve replacement.

Weak A.C. magnetic field effects: changes in cell sodium pump activity following whole animal exposure.

A biological system consisting of a cell membrane enzyme (Na+-K+)-ATPase responded to exposure to a weak A.C. magnetic field. Analysis of Na+ pump activity in normal mouse (A/J) tissue--(a) Kidney cortex and diaphragm after 11 days of exposure to a magnetic field of 55-60 gauss, 60Hz showed a significant reduction as did (b) liver tissue but at day 17 the levels had returned to the control values. Neuroblastoma cells (C1300) transplanted to A/J mice also showed a reduction in the (Na+-K+)-ATPase activity but this persisted at day 17.

Effects of gravitational and magnetic fields on transplanted neuroblastoma vascularity.

Transplanted neuroblastomas were subjected to altered neural influences and imposed gravitational and magnetic fields, either separately or in combination. In each case impaired vascularity, and greater extravasation of blood with associated tumor necrosis occurred in the experimental animals. The combination of both hypergravity and alternating magnetic field resulted in definite macroscopic but less marked microscopic changes than with either force alone. Neuroblastoma cells in vitro exposed to a magnetic field showed no definite growth changes, suggesting an effect of the field forces on the host. Exposure of a unicellular organism, not requiring a host for survival, to a similar magnetic field, did result in distinct cell division changes.

Effect of alternating magnetic fields (60--100 gauss, 60 Hz) on Tetrahymena pyriformis.

Tetrahymena pyriformis and neuroblastoma cells were studied following exposure to low intensity low frequency alternating magnetic fields. Tetrahymena showed cytomorphologic changes, with delayed and reduced cell division concurrent with increased oxygen uptake. The resulting dead cells appeared intact, as compared with dissolution characteristic of the control group. In contrast, magnetically exposed actively growing neuroblastoma cells showed no growth alterations in vitro, but were affected when exposed in vivo.

Effects of alternating magnetic field (12 gauss) on transplanted neuroblastoma.

Exposure of A/J animals bearing transplanted neuroblastoma (C1300) to a 12 Gauss, 60Hz magnetic field for 16 days, starting 3 days post transplant resulted in - (a) early slowing of tumor growth, (b) more free red blood cells in the tumor areas and (c) a tendency to focal tumor cell destruction suggesting that a small alternating magnetic field may affect transplanted tumor growth.