Coronary artery aneurysms due to Kawasaki disease: diagnosis with ultrafast CT

Coronary artery aneurysms are the most serious complication of Kawasaki disease, and periodic screening examinations are necessary. Two-dimensional (2D) echocardiography represents the standard screening method; however, visualization of the distal coronary arteries is often limited. This report describes the complementary role of ultrafast computed tomography (CT) with 2D echocardiography in the evaluation of coronary artery aneurysms resulting from Kawasaki disease (mucocutaneous lymph node syndrome). Six pediatric patients with coronary aneurysms were examined with 2D echocardiography and ultrafast CT. Ten of 11 lesions were detected with ultrafast CT. The one missed coronary artery aneurysm was one of two contiguous aneurysms. Because of intersection thickness these two discrete aneurysms were interpreted as a solitary aneurysm. Ultrafast CT allowed detection of one aneurysm not initially visualized with echocardiography. In conclusion, ultrafast CT was found to be an effective complementary procedure with 2D echocardiography for noninvasively evaluating coronary artery aneurysms occurring as sequelae of Kawasaki disease.     

A profile of Chinese alcoholics in Singapore

Eighty-five Chinese alcoholics, referred consecutively to the psychiatric unit of a general hospital, were assessed with the Alcohol Problems Questionnaire (APQ) and the Severity of Alcohol Dependence Questionnaire (SADQ). There were 72 men (mean age 44.3, SD 13.9) and 13 women (mean age 36.7, SD 11.6). The common alcohol-related problems reported concerned physical health, finance, work, friends, depression and marriage. The SADQ score for men was 19.6 (SD 7.8) and women 15.6 (SD 8.4). Highly significant Pearson product moment correlations were found between the SADQ score and APQ subscales in physical health, depression and finance; but there was no correlation with children or legal (police) problems. The strongly positive correlation between the SADQ and APQ scores were independent of the quantity of alcohol consumption. Female drinkers had more depressive symptoms than males, but there was no significant difference in alcohol-related problems pertaining to physical health, work, marriage, finance or friends for male or female drinkers.     

Survey of patients on an alcohol in-patient unit in relation to group therapeutic factors

This study was prompted by the clinical research of Lovett and Lovett (1991) and Yalom's theory of group therapy (Yalom, 1985). The investigators examined perceptions of therapeutic factors in groups, in relation to outcome measures. Twenty-one patients admitted consecutively to an Alcohol Problems clinic engaged in a three-week programme, led by an interdisciplinary treatment team, including occupational therapy-led groups, were interviewed using an ‘important events’ questionnaire in the second and third week. A modified version of Yalom's therapeutic factor questionnaire was used at the end of the programme and patients were also asked if they had additional comments. Outcome factors were assessed at three months after discharge from reports by key workers and self-report. Results indicated that patients most valued existential factors, self-understanding, cohesiveness and catharsis. Existential factors were not identified as helpful by the group who were unchanged and continued to drink. The implications for occupational therapy in the treatment of alcohol problems were discussed.     

Gluteal artery occlusion: intra-arterial chemotherapy of pelvic neoplasms

Intra-arterial chemotherapy of pelvic tumors may be complicated by coincident flow to the buttocks. Transcatheter occlusion of both the superior and inferior gluteal arteries may have a role in directing the flow of chemotherapeutic agents away from the buttocks and toward the true pelvis. The results of flow studies using technetium-99m-labeled macroaggregated human serum albumin were compared in 12 consecutive patients examined before and after transcatheter arterial occlusion, and the best results were obtained by selective occlusion of those arteries that demonstrated increased flow to the buttock on the initial study. Without the preselection of patients in whom the initial flow went mainly to the buttock, the results were inconsistent. Because of the increase in the procedure time and the occurrence of minor complications, such as local pain during or after the occlusion procedure, in all patients, proper patient selection is important.     

A Cross-cultural Study of Alcohol Dependence in Singapore

This is a comparative study of alcohol dependence in Chinese and Indian patients admitted to a hospital in Singapore. There were 46 patients-21 Chinese and 35 Indians. In both ethnic groups there was a preponderance of male over female patients. There was no significant difference in the mean ages of the two groups but Indian patients started drinking at an earlier age and more of them had a family history of alcohol problems. Comparing the severity of alcohol dependence, Indian patients scored higher on the SADQ but no patients scored above 30 points.     

Histopathologic studies of the liver following intravenous colloidal 198Au therapy

Histologic studies of liver tissue from 27 patients given up to 395 mCi (cumulative) of intravenous colloidal 198Au showed no definite radiation injury and no correlation between hepatic abnormalities and dose. Demonstration of aggregates of colloidal gold in the Kupffer cells was inconsistent, suggesting slow removal or dispersion. Although the liver ordinarily receives the highest radiation dose, the critical organ is the marrow. Results support the recent introduction of 198Au to supplement teletherapy for certain neoplasms diffusely infiltrating the liver. Apparently the beta distribution minimizes endothelial injury in large vessels, which has been shown to be the cause of radiation hepatitis.