Creatinine related reference ranges for urinary homovanillic acid and vanillylmandelic acid at 6 months of age

The relationship between homovanillic acid (HVA), vanillylmandelic acid (VMA), and creatinine in the urine of 6 month old babies has been studied and reference ranges in the form of centiles constructed for HVA and VMA against creatinine. Over 10,000 urine samples were collected from babies in four health districts in the north of England. HVA and VMA concentration, either independently or when divided by creatinine concentration, were dependent upon the absolute concentration of creatinine in the sample. After adjustment for creatinine significant differences in the mean concentration of HVA were found between sexes. No such differences were found for VMA. HVA and VMA were also found to be age dependent. Centiles were constructed using a procedure which makes no distributional assumptions about the data. The net effect of utilising these centiles was to increase the predictive value of a positive screening test from 20% to 40% without any increase in the false negative rate.     

Computer graphics for digitally formatted images

The increasing use of digitally formatted imaging systems requires high-quality interactive gray-scale computer raster graphics systems for the management, display, and analog film recording of digital image and alphanumeric information. These systems are a combination of computer hardware and software and implement a set of graphics protocols. This paper describes a set of interactive graphics protocols that has been developed for clinical use.     

Studies on experimental mixed infection of Schistosoma haematobium and Schistosoma mansoni in the albino mouse

Swiss albino mice have been infected with S. haematobium and challenged with S. mansoni. No apparent disturbances as regards worm load and oviposition were observed. Yet certain deviations in the egg-distribution sites for both species were found. They were attributed to the possibility of earlier de-development of collateral circulation. Cross-pairing between the two species was met with, which might explain the extra number of S. haematobium eggs found in the small intestine. Although no major effect has been revealed, no conclusion at this stage could be put forward as regards complete absence of cross-immunity.     

Subjective Quality of Life of Community Living Sudanese Psychiatric Patients: Comparison with Family Caregivers’ Impressions and Control Group

Background: Researchers have paid scant attention to comparative studies of quality of life (QOL) issues among psychiatric diagnostic groups; the studies of patient – caregiver concordance ratings had small sample sizes; and the reports are rare from the African and Arab worlds. Objectives: to assess the subjective QOL of stable Sudanese outpatients, using the WHOQOL – Bref, compared with a general population sample; examine the caregiver–patient concordance; and assess the variables that impact on domains of QOL. Method: The responses of outpatients with schizophrenia (99), major affective disorders (120) and neuroses (81) (mean age 33.8) were compared with 211 controls and the impression of their family caregivers. Results: Patients were dissatisfied with life circumstances; the schizophrenia group and those with co-morbidity had significantly lower QOL scores; while the control group had higher QOL scores. There was no significant impact on QOL domains, of socio-demographic factors, duration of illness and treatment side effects. The schizophrenia group had least concordance with caregivers, but eight items were judged to be satisfactorily concordant for all groups. Conclusions: Psychiatric patients in stable condition can make reliable judgments of QOL, with relatives providing additional information. Differences in QOL and concordance of ratings reflect disease severity.     

Serum analysis after transplant nephrectomy reveals restricted antibody specificity patterns against structurally defined HLA class I mismatches

This study deals with HLA-mismatched kidney transplants that have been removed following rejection. Sera from 27 patients were screened for HLA-specific antibodies by direct complement-dependent lymphocytotoxicity with HLA-typed cell panels. Circulating donor-specific antibodies were detected in 3 cases (11%) before and in 26 cases (97%) after allograft nephrectomy. These findings demonstrate the production of donor-specific antibodies in patients with rejected transplants, but in most cases, they were undetectable before nephrectomy, because the graft had adsorbed them. With an HLAMatchmaker-based serum analysis program, we observed restricted antibody specificity patterns against amino acid triplet-defined epitopes on donor HLA-A,B antigens. Many donor triplets were non-reactive while others were apparently recognized by antibodies. In some patients, the donor triplet specific antibodies persisted for a long time whereas in many other patients, they became undetectable after a few months. The characterization of the antibody specificity profiles of post-allograft nephrectomy sera is clinically useful in defining criteria of HLA mismatch acceptability for sensitized patients awaiting another transplant. It provides also opportunities for determining the relative immunogenicity of mismatched triplets.     

Catheter-induced dissection of the left main coronary artery with and without extension to the aortic root: a report of two cases and a review of the literature

Catheter-induced left main coronary artery dissection is quite rare. We describe two cases of iatrogenic left main coronary artery dissection. In the first case, the aortic root was involved in the dissection process, and stenting of the entry point did not halt the progression of dissection. In the second case, the dissection did not involve the aortic root.     

Three-dimensional reconstruction of a rotational abdominal aortogram showing a renal artery aneurysm

This is a case of a 65-year-old woman with a history of coronary artery disease, who presented with hypertension that was poorly controlled by medical treatment. A rotational abdominal aortogram was done, followed by selective right and left renal artery angiograms. Imaging of renal artery aneurysms can be tricky, and some aneurysms might be misdiagnosed for a tortuous renal artery. In such cases, the physician needs to maintain a high index of suspicion towards this condition. Three-dimensional reconstruction allows for a better visualization of the aneurysm and its surrounding structures. It also guides the operator to the projection that best reveals the anatomical criteria of the aneurysm.     

Validation and reproducibility of computerised cell-viability analysis of tissue slices

Background

The identification of live cells using membrane integrity dyes has become a frequently used technique, especially with articular cartilage and chondrocytes in situ where tissue slices are used to assess cell recovery as a function of location. The development of a reproducible computerised method of cell evaluation would eliminate many variables associated with manual counting and significantly reduce the amount of time required to evaluate experimental results.

Methods

To validate a custom computerised counting program, intra-person and inter-person cell counts of nine human evaluators (three groups – unskilled, novice, and experienced) were compared with repeated pixel counts of the custom program on 15 digitised images (in triplicate) of chondrocytes in situ stained with fluorescent dyes.

Results

Results indicated increased reproducibility with increased experience within evaluators [Intraclass Correlation Coefficient (ICC) range = 0.67 (unskilled) to 0.99 (experienced)] and between evaluators [ICC = 0.47 (unskilled), 0.85 (novice), 0.93 (experienced)]. The computer program had perfect reproducibility (ICC = 1.0). There was a significant relationship between the average of the experienced evaluators results and the custom program results (ICC = 0.77).

Conclusions

This study demonstrated that increased experience in cell counting resulted in increased reproducibility both within and between human evaluators but confirmed that the computer program was the most reproducible. There was a good correlation between the intact cell recovery determined by the computer program and the experienced human evaluators. The results of this study showed that the computer counting program was a reproducible tool to evaluate intact cell recovery after use of membrane integrity dyes on chondrocytes in situ. This and the significant decrease in the time used to count the cells by the computer program advocate its use in future studies because it has significant advantages.