Sweet's syndrome—therapy with cyclosporin

We report the case of a 39-year-old female patient suffering from Sweet's syndrome after an upper respiratory tract infection. Cyclosporin A at a dose of 10 mg/kg per day was given as initial treatment. Skin lesions and general malaise resolved within 9 days. The cyclosporin dose was decreased within 21 days, without recurrence of the eruption. Cyclosporin is a potent inhibitor of T lymphocytes, but affects granulocyte and monocyte functions as well. Success of treatment in our case shows that cyclosporin represents an alternative to steroid treatment in patients with Sweet's syndrome.     

The examination of the heart and lungs by the cardiocairographic method

Cardiocairography is a method by means of which roentgenographic examination of the heart can be made at a particular phase of its cycle. The apparatus designed by Schwarzchild for making such exposures of the thorax (the cardiocairograph) synchronizes the roentgen exposure with the action currents of the heart. These currents are taken through the standard leads of the electrocardiograph. Since the peak of the R wave is attained 0.08 second before the actual beginning of cardiac contraction, a roentgenographic exposure of the thorax at this instant will reveal the shape of the heart and the character of the lung fields during diastole.Inasmuch as the time of occurrence of maximum systole is relatively constant, namely, about 0.20 second after the peak of the R wave, and is relatively independent of the pulse rate, and since the diastolic interval is that part of the cycle which varies most with the pulse rate, it becomes possible, by introducing into the circuit a delay mechanism, to obtain an exposure at the instant of maximum systole. Thus, roentgenograms of the chest may be obtained either when the heart is in maximum diastole or in systole.The advantages and disadvantages of each type of exposure are discussed. The importance of establishing standards for the cardiac shadow, both during systole and diastole, is discussed.In roentgenology of the chest, the motion of the pulmonary structures is the most important single factor influencing definition and sharpness of the images. The amount of blurring produced by movement varies with the rate of movement and with the duration of the exposure. Shortening of the exposure, even to $\text{1}\text{30}$ second, does not eliminate movements which arise from the impact of the pulsating heart against the lungs and the pulsations of the vessels. This motion varies in relation to the cardiac cycle and in different portions of the lungs, depending upon the proximity of the vessels to the heart. Whereas at the periphery, in certain parts of the lung, the movement may be minimal, it may be very marked in the basal portions of the lungs. The movement of the pulmonary structures is at a minimum at the instant when the ventricles are almost at the end of the diastolic phase. This, therefore, is the ideal time for roentgen exposure of the lung. Further, in stereoscopic examinations of the chest, perfect visual fusion is obtained only if the two roentgen images of the lungs are made at exactly the same phase of the cardiac cycle. This method gives a true stereoscopic pair of roentgenograms which possess maximum sharpness and detail.Cardiocairography may also be used to obtain kymograms in which the time scale begins at any predetermined phase of the cardiac cycle; this type of roentgenogram has been named the cairokymogram.Further, cardiocairography provides a simple method for combined electrocardiographic and kymographic examination; it is free from many difficulties because there is no shielding problem in this procedure.     

Computed tomography of complications caused by manufacturing defects in synthetic grafts

Two unusual cases of delayed synthetic graft complications resulting from manufacturing defects of knitted Dacron are presented. Computed tomography appears to be a suitable noninvasive alternative examination to angiography in this condition.     

Beta 2 transferrin application in otology.

The diagnosis and management of perilymphatic fistula has received considerable attention in recent years. Despite the use of sophisticated technology, the diagnosis of perilymphatic fistula continues to rest primarily upon clinical suspicion and the exclusion of other disorders. In addition, the confirmation of a perilymphatic fistula during surgical exploration is usually based upon the subjective observation of fluid pooling in niches of the middle ear. A sensitive and objective laboratory test for identifying perilymph in the middle ear would be a useful adjunct for the diagnosis and management of perilymphatic fistula. The objective of this paper is to demonstrate the potential utility of beta 2 (beta 2) transferrin assay in the diagnosis of perilymphatic fistula. To accomplish this objective, we confirmed that beta 2 transferrin is present in living human perilymph and is absent in the normal or inflamed middle ear. In addition, the utility of beta 2 transferrin assay in the diagnosis of cerebrospinal fluid otorrhea is presented.     

Preliminary investigation of respiratory self-gating for free-breathing segmented cine MRI.

Segmented cine MRI generally requires breath-holding, which can be problematic for many patients. Navigator echo techniques, particularly successful for free-breathing coronary MRA, are incompatible with the acquisition strategies and SSFP pulse sequences commonly used for cine MRI. The purpose of this work is to introduce a new self-gating technique deriving respiratory gating information directly from the raw imaging data acquired for segmented cine MRI. The respiratory self-gating technique uses interleaved radial k-space sampling to provide low-resolution images in real time during the free-breathing acquisition that are compared to target expiration images. Only the raw data-producing images with high correlation to the target images are included in the final high-resolution reconstruction. The self-gating technique produced cine series with no significant differences in quantitative image sharpness to series produced using comparable breath-held techniques. Because of the difficulties associated with breath-holding, the respiratory self-gating technique represents an important practical advance for cardiac MRI. , Inc.