The admixture of clonidine or epinephrine to lidocaine for brachial plexus block was studied with regard to duration of block, postoperative analgesia, and plasma concentrations of lidocaine. Thirty-three patients of ASA physical status I and II received an admixture of either clonidine (150 micrograms; n = 15) or epinephrine (200 micrograms; n = 18) to 40 mL of 1% lidocaine in a randomized, double-blind fashion. Bone surgery predominated in those patients receiving clonidine and soft-tissue surgery in those receiving epinephrine (P less than 0.05). Onset and duration of block were not different between the groups. With the admixture of clonidine, fewer patients were completely pain free for greater than 12 h (13.3%) and pain scores (visual analogue scale 0-10) were higher 6 h after the block (median 4; range 0-6) than with epinephrine (61.1%; median 2; range 0-7, respectively; P less than 0.05). In patients who had received clonidine, peak plasma concentrations of lidocaine were higher (10.29 +/- 2.96 mumol/L) and occurred earlier (23.7 +/- 9.3 min; mean +/- SD) than in those treated with epinephrine (6.9 +/- 1.71 mumol/L; 72.5 +/- 56.2 min; P less than 0.05). This indicates the absence of a local vasoconstrictor effect of clonidine and implies a reduced margin of safety with regard to local anesthetic toxicity. Although clonidine does not offer advantages compared with epinephrine, it may be a useful adjunct to local anesthetics in those patients in whom the administration of epinephrine is contraindicated.

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Two families of isogenic Xenopus and the progeny from one individual of each family were immunized with dinitrophenylated keyhole limpet hemocyanin. Antisera were raised in mice and in guinea pigs against purified antibodies from one individual of the first generation of each family. These were rendered anti-idiotypic by absorption with immunoglobulins of unimmunized isogenic frogs. In the first generation, antibodies from individuals of each family exhibited a high degree of idiotypic cross-reactivity. Antibodies from individuals of the second generation displayed idiotypic cross-reactivity, but to a lesser extent. Some idiotypic cross-reactivity was seen between members of one family with members of the other family: no sharing of idiotypic specificity was detected among anti-DNP antibodies isolated from individual outbred frogs. Isoelectric focusing (IEF) patterns of the anti-DNP antisera showed a high degree of restriction and overlap within members of each family and across two generations. Furthermore, the N-terminal sequence of the L chains from X. laevis anti-DNP antibodies was unique, and there was a low degree of structural heterogeneity in the H chain N-terminal region. A correlation between the IEF banding pattern and idiotypic reactivity was apparent. The data suggest the inheritance of variable region genes through two generations of isogenic Xenopus.

Intestinal calcium absorption from milk containing lactose (+) and from another containing glucose (-) was studied in eight patients with normal lactase (NL) and seven lactase-deficient (LD) subjects to determine if lactase deficiency is implicated in Ca absorption. The results were compared with data obtained from Ca ingestion in a water solution. Ca absorption was measured by a double-isotope technique and the kinetic indices were obtained by a deconvolution method. With (-), Ca absorption was identical in NL and LD subjects and slightly higher than with water solution (15%, NS). With (+), Ca absorption in NL subjects was identical with that from water solution; in LD subjects it increased (23%, p less than 0.02). These data indicate that: Ca is absorbed equally well from milk as from water solution; (+) favors Ca absorption in LD subjects, which suggests that milk ingestion might be encouraged in LD subjects to avoid Ca deficiency; and (-) should be a valuable alternative for lactose-intolerant patients.

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In the guinea-pig, it has been shown that homogenates of mucosa from the fundus contain an adenylyl cyclase system that is activated by histamine as well as by prostaglandins PGE1 and PGA1. The effects of burimamide, an H2-inhibitor, and mepyramine and chlorpheniramide, both H1-inhibitors, were tested. Both H1 and H2 inhibitors behaved kinetically as competitive inhibitors of histamine, but the Km derived for burimamide (2.5 - 4.1 . 10(-5)) was significantly lower than that for either chlorpheniramine (0.9 - 1.9 . 10(-4)) or mepyramine (1.3 - 1.4 . 10(-4)). On the other hand none of the three inhibitors influenced the cyclase activation by PGE1 and PGA1. These results suggest that there are at least two types of receptors in the preparation studied, one responsive to histamine and the other to the prostaglandins, and that the specificity of H1- and H2-receptors is not absolute in the broken cell preparation.

Endoscopic biopsies at the inferior duodenal flexure from 36 patients were assayed for disaccharidases. Comparative studies in 8 patients were carried out from this location and from the duodenojejunal flexure. 16 patients with lactase values under 20 U/g protein and normal histology also underwent a lactose tolerance test. Evidence is presented that the easily performed duodenal biopsies give the same information as those from the angle of Treitz, at a level about 40% under the latter. Tolerance to lactose was in close relation with the lactase level in 16 patients, the limit being at about 5 U/g protein.