New radiological typing system for rhinosinusitis and comparison with existing system: Initial finding

The objective of this study was to determine whether the proposed Malan radiological sinusitis typing (RST) system facilitated a level of agreement and ease of use comparable with the Lund–Mackay (LM) system for chronic rhinosinusitis. Ten observers (one otolaryngologist and nine radiologists), in two separate centres (regional and tertiary), blinded to all clinical data, used these two systems to independently and randomly score and type 15 sets of scans, recording the time to score each film. Using unweighted kappa scores, both methods facilitated a moderate level of agreement, slightly better with the LM system. The Malan system is more time efficient. Preliminarily, this study shows that the Malan RST system is easy to apply with a comparable level of agreement. The Malan RST system is a focused attempt at classifying disease extent radiologically and correlating it to a surgical approach. It emphasizes that scoring systems are vulnerable and proves to be superior to the LM system as a surgical planning tool. To score sinus disease, a Quality‐of‐Life questionnaire in association with this typing method is more appropriate.     

A clinical study assessing the tolerability and biological effects of infliximab, a TNF-alpha inhibitor, in patients with advanced cancer

BACKGROUND: Tumour necrosis factor-alpha (TNF-alpha) is an important regulator of the chronic inflammation contributing to tumour progression. Infliximab, an anti-TNF-alpha monoclonal antibody was investigated in this trial of patients with advanced cancer. The primary objectives were to determine the safety profile and biological response of infliximab in a cancer population. Clinical response was a secondary objective. PATIENTS AND METHODS: Forty-one patients received infliximab at 5 mg/kg (n = 21) or 10 mg/kg (n = 20) i.v. at 0 and 2 weeks and then every 4 weeks. Post-treatment samples were measured for changes in plasma and serum TNF-alpha, CCL2, IL-6 and C-reactive protein (CRP). RESULTS: Infliximab was well tolerated with no dose-limiting toxic effects. At both doses of infliximab, neutralisation of serum TNF-alpha was observed after 1 h while plasma CCL2, IL-6 and serum CRP were decreased 24 and 48 h following infliximab administration. Seven patients experienced disease stablisation (range 10-50+ weeks). There was no evidence of disease acceleration in any patient. CONCLUSIONS: Infliximab treatment was safe and well tolerated in patients with advanced cancer. There was evidence of biological activity with baseline TNF-alpha and CCL2 being correlated with infliximab response.     

Acute renal failure in a neonate due to pelviureteric candidal bezoars successfully treated with long-term systemic fluconazole

Systemic candidiasis with renal involvement is a rare but well-recognized complication during intensive care treatment in very-low-birth-weight infants. We report a term neonate who developed anuria associated with bilateral bezoar formation in the renal pelvis and candidemia. The treatment consisted of placement of a nephrostomy tube in the left kidney, short-term irrigation with amphotericin B and iv, and later, oral administration of fluconazole.     

Development and validation of a photometric titration method for the quantitation of sodium chondroitin sulfate (bovine) in Cosequin DS chewable tablet

A photometric titration method was developed and validated to quantitate sodium chondroitin sulfate in raw materials and Cosequin DS chewable tablet(1). About 0.1% (w/v) cetylpyridinium chloride was used to titrate sodium chondroitin sulfate with photometric indication at wavelength 420 nm. The standard curves for sodium chondroitin sulfate showed linearity (r> or = 0.99) over the selected concentration range from 0.6 to 1.4 mg/ml. The chewable tablet was ground to fine powder and extracted with water and the resulting solutions filtered through a 0.45 microm membrane filter. Recovery between 97 and 103%,. The intra- and inter- day precision as indicated by the relative standard deviation (R.S.D.) were not greater than 0.33 and 0.78%, respectively. The method was found to be specific and with excellent linearity, accuracy and precision and is well suited for the quantitation of sodium chondroitin sulfate in raw material and Cosequin DS chewable tablet.     

Pituitary gland imaging in Cushing's disease

Specific MR techniques are required for optimal detection of adenocorticotropic hormone secreting adenomas responsible for Cushing's disease. Adequate MR sequences, high resolution coronal T1 and T2 - weighted images, dynamic MR imaging, post-gadolinium delayed images, dose of gadolinium adjusted for each sequence can routinely demonstrate pituitary adenomas less than 3 mm in Cushing's disease.     

Gadolinium in arteriography and interventional radiology: 39 patients

OBJECTIVE: To report the experience of using various Gadolinium chelates as contrast media in digital subtraction angiography in patients with relative or absolute contraindications for iodinated contrast agents. MATERIAL: and Methods. Forty-two arteriograms were performed in 39 consecutive patients using Gadolinium chelates (gadoteridol, gadodiamide, and gadopentetate dimeglumine). The vasculature of the brain, of the upper and lower limbs and the renal arteries were examined. Among these 39 patients, 17 were treated by various endovascular procedures. RESULTS: In 40 examinations out of 42, the angiographic result was satisfactory, allowing either a diagnostic evaluation or an endovascular therapeutic procedure. Clinical tolerance was excellent. In one case of renal failure that was reported after angiography, the patient had received both iodine and gadolinum-based contrast agents. CONCLUSION: Gadolinium appears to be an interesting alternative for arteriography in patients with absolute or relative contraindication to iodinated contrast agents, and also seems to demonstrate efficacy during endovascular therapeutic procedures.