Fracture nonunion: CT assessment with multiplanar reconstruction

Nineteen patients with suspected or possible fracture nonunion underwent computed tomography (CT) with multiplanar reconstruction (MPR). Each case represented a difficult problem in fracture management in which clinical and conventional radiographic examinations had failed to provide a definitive diagnosis. CT with MPR demonstrated nonunion in 13 of 19 cases by delineating the lack of bone bridging across the fracture site in multiple planes. Variable amounts bridging were detected in six cases, indicating partial healing or delayed union. Evaluation of fracture healing with MPR was possible despite remaining metal hardware (ten cases), multiple operations (15 cases), or bone grafting (five cases). CT with MPR aided surgical planning and affected treatment options by providing a more detailed assessment of malalignment and angular deformities, the magnitude of the gap in bone, and the integrity of the adjacent weight-bearing joints in multiple projections. It is an important new modality for evaluating fracture nonunion.     

Pentose phosphate pathway inhibition in blood cells during anticonceptive hormone therapy

The transketolase activity (TKA) of the white and red blood cells of oral contraceptive users was studied in an unselected sample population. Compared with healthy controls of corresponding age, the white cell TKA in the oral contraceptive groups was lowered in about 30%. The red cell TKA was lowered in about 15% of the subjects studied. The most pronounced TKA inactivation was observed in the group taking pills that contained mestranol and megestrol acetate. The glucose tolerance tests were normal. Discontinuing the hormones normalized the white cell TKA.     

In vivo cell growth and pharmacologic determinants of clinical response in acute myelogenous leukemia

A predictable increase in the proliferative rate of malignant cells remaining after initial cytoreduction in vivo forms the rationale for timed sequential therapy (TST) with 1-B-D-arabinofuranosylcytosine (ara- C) for adult acute myelogenous leukemia (AML). The relationship between in vivo leukemic cell growth, intracellular ara-C metabolism, and clinical response to ara-C-containing TST was evaluated by comparing AML marrow cell growth kinetic and biochemical pharmacologic determinants obtained before therapy (day 0) and at the predicted peak of in vivo postdrug residual tumor proliferation (day 8). Serial measurements of DNA synthesis and net intracellular ara-C metabolism demonstrated marked increases in both determinants in day 8 residual tumor when compared with the pretreatment cells for newly diagnosed adults achieving complete remission but not for TST-refractory patients. The interrelationship of AML cell proliferation and biochemical pharmacology together quantitate cytotoxicity measured by both achievement and duration of remission and serve to predict eventual clinical outcome in response to TST with ara-C where both growth and favorable pharmacokinetics are intrinsic to the success of the drug schedule.     

Left azygos lobe

Left azygos lobe is much rarer than right azygos lobe, but cases have been reported. Computed tomography proved more reliable than plain radiography in the diagnosis of left azygos lobe in a 10-year-old girl.     

Correlation of scintigraphy and angiography for ventricular volume determinations using realistic cardiac phantoms: the unimportance of self-attenuation

The volumes of the left ventricle (LV) and right ventricle (RV) were determined by scintigraphy, radiography, and weight, using hollow, morphologically accurate cardiac phantoms that ranged from 99-415 ml (RV) and 72-364 ml (LV). Self-attenuation within these simulated ventricles appeared negligible in view of the nearly linear correlation between scintigraphic and weight determined volumes. Scintigraphy compared favorably with radiography for estimating clinically encountered volumes of the RV and LV.     

Reproducibility of a clinical screening method for assessing gingival inflammation, pockets and plaque retentions

The purpose of this study was to evaluate the reproducibility of the Periodontal Treatment Need System (PTNS), when plaque retentions were examined separately. A sample of 8000 persons was drawn to represent the Finnish population aged 30 yr and over. The first clinical examination (total sample) was made by a specially trained expanded-duty dental auxiliary (EDDA). During the second examination (2-6 months later), 20% of the total sample was reexamined by a dentist, and of those, every 6th patient was examined by the EDDA. Reproducibility of the PTNS was assessed as intra- and interexaminer agreement and was calculated using Cohen's kappa and weighted kappa. The intraexaminer weighted kappa values were 0.67 +/- 0.05 for the PTNS and 0.48 +/- 0.15 for plaque retentions. The interexaminer weighted kappa values between the PTNS registrations were 0.77 +/- 0.05 and 0.74 +/- 0.12 in plaque retentions when examinations were made within 1 day, and 0.53 +/- 0.05 and 0.37 +/- 0.07, respectively, when the interexaminer registrations were made with an interval of 2-6 months between them. The kappa values for intra- and interexaminer reliability reflect quite high reproducibility.