Studies on pulmonary ventilation using digital subtraction radiography. A preliminary report

Digital subtraction radiography was used in 84 patients with suspected pulmonary embolism to obtain information about localized changes in ventilation of the lungs. Preliminary experiences in patients with carcinoma of the lung, emphysema and acute inflammatory diseases have also been obtained. Digital subtraction radiography is a simple, rapid and inexpensive method to obtain information about ventilation in the lungs. It is completely non-invasive and requires only minimal cooperation of the patient. The sensitivity appears to be as good as that of 133Xe radionuclide ventilation studies.     

Subclavian flap angioplasty with absorbable suture polydioxanone (PDS). An experimental study in growing piglets

The fate of the subclavian flap in aortoplasty was studied and a new synthetic monofilament, absorbable vascular suture (polydioxanone, PDS) was evaluated. In 11 piglets submitted to the aortic repair, the diameter of the aortic arch and descending aorta and the length and width of the subclavian flap were measured. The aortoplasty was performed with a continuous running suture of 6/0 PDS. All the animals survived and grew normally. They were sacrificed 6-26 weeks postoperatively, when the mentioned variables were reestimated. No aortic narrowing was found and no suture material was detectable in the lumen. The subclavian flap had grown uniformly in length and width. Histologic examination showed evening of the inner surface by intimal proliferation and healing of the anastomoses. There was no sign of flap destruction and tissue reaction to PDS suture was minimal, indicating normal growth and viability in all parts of the flap. The suture material was absorbed 26 weeks postoperatively. Continuous suture with absorbable PDS seems to be a good alternative for repair of aortic coarctation in early infancy.     

Monte Carlo calculations of scatter dose for small field sizes in a 60Co beam

Photon dose calculations are frequently based on the separation of primary and scatter dose components. For small field sizes it is difficult to make this separation from measured data. Such problems lend themselves to solution by calculational methods, which permit rigorous definition of primary and scatter dose. Using Monte Carlo methods, we verify an equation derived from O'Connor's scaling theorem relating scatter-primary ratios at small depths and field sizes to those at larger depths and fields. This equation may prove to be useful when separating primary and scatter dose components, and consequently in dose calculations involving irregular fields or inhomogeneities.     

Intraindividual variation in 6-mercaptopurine pharmacokinetics during oral maintenance therapy of children with acute lymphoblastic leukaemia

Summary Intraindividual variation in 6-mercaptopurine (6-MP) kinetics has been little studied. It has now been examined in 18 children with acute lymphoblastic leukaemia (ALL).On 2 to 4 occasions in each patient drug concentrations in plasma and red cells were followed for 4 h after administration by means of HPLC.The mean individual coefficient of variation (C.V.) in AUC was 57.9% and it was not related to dose or concentration. The variation was the same in plasma and in red cells.It is concluded that regular monitoring of 6-mercaptopurine concentration would identify periods when a patient deviates strongly from the mean range. Both undertreatment and concentration-dependent toxicity could then be corrected.     

Spontaneous correction of femoral torsion: Diaphyseal osteotomies studied in kittens

Inward or outward torsion of about 25 degrees was produced in the right femur of kittens by midshaft osteotomy and plate fixation. The left femurs served as controls. The anteversion angle of the femoral necks was measured in axial radiographs taken preoperatively and up to 58 weeks postoperatively. As the bones grew in length, the difference in the anteversion angle between matched femurs was gradually corrected.     

Improved hand function in a dental hygienist with neuropathy induced by vibration and compression: the effect of cutaneous anaesthetic treatment of the forearm.

We report a case of neuropathy induced by vibration and compression in the hand of a dental hygienist. Her hand function was improved considerably by repeated treatment during which EMLA cream (EMLA cream is a local anaesthetic agent containing lidocain 2.5% and priolocain 2.5%) was applied to the forearm to induce cutaneous anaesthesia.     

Cefepime as empirical monotherapy in febrile patients with hematological malignancies and neutropenia: a randomized, single-center phase II trial.

The purpose of this phase II trial was to evaluate the efficacy and safety of cefepime monotherapy in patients with neutropenia expected to last more than 7 days. Sixty-nine patients with neutropenia (<0.5 x 10(9)/1) were randomized during 94 episodes of fever to receive either cefepime monotherapy (n=76) or combination therapy with trimethoprim/sulfamethoxazole plus amikacin (TMP/SMZ plus AMI, n=18). A successful response to cefepime was seen in 31/76 (41%) episodes, with 10/36 (28%) in microbiologically documented infections, 3/4 (75%) in clinically documented infections and 18/36 (50%) in fever of unknown origin. No patient in either treatment group died due to the presenting infection. One patient in the cefepime group discontinued treatment due to a rash. Susceptibility testing of blood isolates by E-test strip showed low MIC values to cefepime for most isolates. It is concluded that cefepime monotherapy appeared both safe and effective as empirical therapy in patients with febrile neutropenia.