The spleen in Hodgkin disease: diagnostic value of CT

Findings of CT of the spleen were compared with those of histologic examination in 35 patients who had Hodgkin disease. CT provides a simple way to calculate splenic size. This index is also of value in the assessment of the histologic state of the spleen. An accuracy rate of 91%, specificity of 94%, and a sensitivity of 89% in diagnosing splenic localization of lymphoma was found in this study.     

Frequency of glove puncture in the post mortem room.

The post mortem room is a potential source of danger from contamination caused by glove punctures. The objective of this study was to assess the incidence of hand injury and hand contamination during post mortem examinations. A prospective study of injury and glove puncture rate was conducted during post mortem examinations performed in 1990 on adults in Northwick Park Hospital mortuary. Four pathologists and two assistants performed a total of 44 post mortem examinations on adults. All participants completed a questionnaire after each examination, recording the total number of gloves used and the number of hand injuries and glove perforations sustained. Just over 8.3% of gloves were punctured; 31.8% of these punctures went unnoticed. Evisceration was the procedure most likely to result in hand contamination. The study highlights a significant risk which could be reduced by more care, frequent glove changes, and hand washing during post mortem examinations. In particular, gloves should be changed and hand washed when evisceration has been completed.     

A comparison of several calcium antagonists on uterine, vascular and cardiac muscles from the rat.

An assessment was made of the potencies of nifedipine, gallopamil, diltiazem, cinnarizine and salbutamol as inhibitors of tension development by the uterus and cardiovascular tissues from the term pregnant rat. The rank order of potency was nifedipine greater than gallopamil greater than diltiazem for those preparations on which these compounds were potent, viz. spontaneous and oxytocin-induced tension development of the uterus, spontaneous tension development of hepatic portal vein, potassium chloride (KCl)-induced pressure rises of perfused mesenteric bed and electrically-stimulated (0.5 Hz) ventricular muscle. The rank order of potency of nifedipine, gallopamil and diltiazem was different for those preparations on which they exhibited low potency, viz. noradrenaline-induced pressure rises of perfused mesenteric bed and tension development of aorta. Gallopamil and diltiazem, but not nifedipine, were more potent against tension development by ventricular muscle stimulated at 2.5 Hz than at 0.5 Hz, suggesting that nifedipine interacts at a different site from the other compounds. Cinnarizine was less potent than the other calcium antagonists on the uterus and portal vein, was the second most potent compound against KCl-induced pressure rises of the mesenteric bed and was equipotent against responses to noradrenaline and KCl of the mesenteric bed (unlike the other compounds). This suggests that the site of action of cinnarizine differs from that of the other calcium antagonists. Nifedipine, gallopamil and diltiazem, like salbutamol, exhibited selectivity for inhibition of tension development by the uterus relative to the cardiovascular tissues.     

Immunoglobulin and T cell receptor gene rearrangements in human lymphoma and leukemia

DNA samples from blood leukocytes or tumor biopsies of 45 patients with phenotypic B or T cell neoplasms were analyzed for rearrangements of the immunoglobulin (Ig) or T cell receptor (TCR) genes by Southern blot hybridization analysis. Rearrangements of the Ig heavy chain joining region genes (JH) were present in DNA from each of 28 B cell lymphomas and leukemias; 14 of 21 of these tumors also had rearrangements of the Ig kappa light chain joining (JK) or deleting element (KDel) genes. Conversely, 16 of 17 T cell lymphomas and leukemias had rearranged TCR beta chain genes. One B cell and one T cell tumor had rearrangements of both Ig and TCR genes. There was a strong correlation between the rearrangements of specific genes and the immunophenotype of the tumor: JH rearrangement without TCR beta chain rearrangement occurred only in B cell tumors; TCR beta chain rearrangement with or without JH rearrangement occurred only in T cell tumors, with one exception; and JK and KDel rearrangements were found only in B cell tumors. Thus, rearrangements of the Ig heavy and light chain genes and the TCR beta chain genes were found to be highly sensitive markers of monoclonal human lymphomas and lymphoid leukemias, with the type of gene rearrangements well correlated with the cell lineage of these neoplasms.     

Frequency and patterns of abnormality detected by iodine-123 amine emission CT after cerebral infarction

Single photon emission computed tomography (SPECT) was performed in 31 patients with cerebral infarction and 13 who had had transient ischemic attacks, using iodine-123-labeled N,N,N'-trimethyl-N'-(2-hydroxyl-3-methyl-5-iodobenzyl)-1,3-propanediamin e (I-123-HIPDM) as the radiopharmaceutical. SPECT scans were compared with computed tomographic (CT) scans. SPECT was as sensitive as CT in detecting cerebral infarction (94% vs. 84%). The abnormalities were larger on the SPECT scans than on the CT scans in 19 cases, equal in seven, and smaller in five (SPECT abnormalities greater than or equal to CT abnormalities in 86% of cases). Fifteen of 30 patients with hemispheric infarction had decreased perfusion (decreased uptake of I-123-HIPDM) to the cerebellar hemisphere contralateral to the cerebral hemisphere involved by the infarction (crossed cerebellar diaschisis). Nine of these 15 patients had major motor deficits, while only one of the 15 without crossed cerebellar diaschisis had a major motor deficit.     

Data collection from road traffic accidents.

A method of improving information about injuries sustained in road traffic accidents is described. It was achieved by combining data from the police with that from the accident and emergency department in such a way that patient confidentiality was preserved. This improved data base shows that present estimates of the number of injuries sustained on the road are too low and that assessments of their severity are probably inaccurate.     

Angiomyolipomas in tuberous sclerosis: subselective embolotherapy with alcohol, with long-term follow-up study

The use of subselective renal artery embolotherapy with absolute alcohol, using balloon occlusion to prevent backflow, is described in treating three hemorrhaging angiomyolipomas in two patients with tuberous sclerosis. Embolotherapy was chosen to treat the extensive hemorrhage and to spare the normal renal parenchyma. Literature reports of this treatment are reviewed, indicating it is one of the best methods for achieving a safe, permanent, and complete ablation.