Hospital and office practices of radiology groups.

To obtain information on the characteristics and practices of radiology groups in the United States, the American College of Radiology conducted a group practice survey in 1989; this report presents the main survey findings about the office and hospital practices of such groups. A questionnaire and one follow-up were mailed to all 2,591 radiology groups in the United States. Responses were weighted to reflect all groups. Hospital practices averaged 0.7 diagnostic radiologic procedures (including outpatient procedures) per patient day, with little variation by hospital type. Magnetic resonance (MR) imaging and angioplasty procedures were concentrated in teaching hospitals, but this was not true of other sophisticated procedures such as computed tomography and nuclear medicine. Offices averaged 15,000 diagnostic examinations annually, with less variation than expected according to group size. In both hospitals and offices, more than 90% of technologists were registered. Outsiders (most often, referring physicians and hospitals) had a financial interest in half of all offices. MR imaging and mammography grew faster than any other examinations, but only 44% of hospital practices accepted nonreferred patients for mammography.     

Tumor-associated antigens detected by autologous sera in urine of patients with solid neoplasms

Twenty-four-hour urine samples were procured from cancer patients and normal donors. The urine samples were processed and concentrated by centrifugation and ultrafiltration (10,000 MW cutoff). The processed urine samples were tested for the presence or absence of tumor-associated antigens by the complement-fixation assay. Autologous serum was used as the source of antibody. Ninety-two percent (55/60) of cancer patients were positive for the antigens in their urine. Within the cancer patient group, 86% (31/36) sarcoma patients, 100% (17/17) melanoma patients, and 100% (7/7) carcinoma patients were positive. In contrast, only 7% (2/27) normal donors were positive in this assay. Antibody activity of the sera reacting to the urine from cancer patients was removed by absorption with biopsied tumor specimens but not with normal skin or muscle suggesting that the antigens detected in urine of cancer patients were tumor associated.     

Alloreactive cytotoxic T lymphocyte responses to H-2 products on purified accessory cells.

Several purified accessory cell populations were examined for their capacity to stimulate allospecific cytotoxic T lymphocytes (CTL). A number of non-lymphoid accessory cells stimulated CTL directed against the whole H-2 region and to isolated Class I or Class II products of the major histocompatibility complex (MHC). The accessory cells which stimulated CTL expressed surface Ia. The generation of CTL to Class I MHC products could be inhibited by antisera directed at Class II molecules on the same accessory stimulator cell surface. These findings demonstrate the importance of Class II MHC products on heterogeneous accessory cells capable of stimulating alloreactive CTL.     

Comparison of the hypnotic activity of triazolam, flurazepam hydrochloride, and placebo.

Triazolam, 0.4 and 0.8 mg, flurazepam, 15 and 30 mg, and placebo were compared in a double-blind, randomized 5-night crossover study in 25 inpatient insomniacs. These patients all complained difficulty falling asleep; all said they usually slept less than 5 hr a nigh and woke up too early in the morning. Results of the patients' global evaluation of the medications shows that all of the treatments were rated significantly higher than placebo, with the exception of triazolam, 0.4 mg, which was not significantly different from flurazepam, 15 or 30 mg, or from placebo. In subjective evaluation of sleep onset, only triazolam, 0.4 and 0.8 mg, was rated faster than placebo. All 4 active medications increased duration of sleep. Triazolam, 0.8 mg, and flurazepam, 30 mg, were rated as providing deeper sleep than placebo while all treatments except flurazepam, 15 mg, decreased the number of awakenings below that on placebo. A significant dose-response curve was obtained with triazolam and flurazepam for some of the parameters. Very few adverse effects were reported. One patient reported feeling groggy and drowsy on 0.4 mg triazolam while 2 reported nightmares on placebo.     

Determination of incidence and partial characterization of tumor-associated antigens found in the urine of patients bearing solid tumors

Urine samples from patients with solid tumors and from donors without malignant disease were concentrated and tested for the presence of tumor-associated antigens. In the complement-fixation assay using serum from a source autologous with the source of the urine, 87.4% of cancer patients were positive, while only 6.9% of control donors were positive. When serum from an allogeneic source was used, 94.7% of cancer patients and 35.1% of control donors were positive. Absorption of a cancer patient's serum with autologous tumor cells removed antibody activity to autologous and allogeneic urine samples. Normal lymphocytes, skin, or muscle-cell suspensions were ineffective as absorbants. The excretion of antigen into urine is dependent upon the presence of tumor. Surgical removal of tumor resulted in cessation of antigen excretion. The urine remained antigen-negative as long as the patient remained disease-free. The antigenic activity was heat-stable and comprised molecules of > 1,000,000 daltons which could be dissociated into smaller molecular weight active fractions by treatment with 6 m urea.     

Health visiting in a well-baby clinic.

This article highlights the changes that were implemented after research was carried out into health visiting practice in a well-baby clinic. The study was the result of collaboration between practitioners and nurses working in the academic field.