The radiology of intracranial tuberculosis in children.

Radiology provides valuable clues to the correct diagnosis of intracranial tuberculosis. Twenty-three children with this problem were reviewed. Fifteen had meningitis, 12 of whom had abnormal chest radiographs, nine of them suggestive of tuberculosis. Common neuroradiologic findings were minor suture separation, abnormal activity in the region of the sylvian fissure on brain scans, mild ventricular dilatation, and vasculitis. Among the eight patients with tuberculomas, abnormal chest radiographs were less common. Neuroradiologic abnormalities included evidence of increased intracranial pressure on skull radiographs, focal deep lesions on brain scans, and hydrocephalus and mass lesions on air studies. Most tuberculomas were calcified one year later.     

Marked individual variability in heart rate ‘normalization’ by ethanol

In order to test Kissin's (1974) concept of normalization by ethanol (deviant prealcohol parameter values becoming less deviant after alcohol) in nonalcoholics, data on unselected mice and nonalcoholic humans were analyzed. These data were on heart rates (HR) of 1055 HS mice and 24 young adults, measured before and after receiving a dose of ethanol (mice: 1.4g/kg, i.p.; humans: 1.3g/kg, oral). Both mice and humans, on the average, show marked normalization, initially low HR usually increasing after alcohol, and initially high HR usually decreasing. The correlation between (1) deviation in HR from the prealcohol mean and (2) change in HR after alcohol was-0.803 for mice and-0.538 for humans. There is very great individual variability, however, in the degree of this normalizing response, some individuals normalizing strongly and others not at all. Although first described in alcoholics, strong normalization by alcohol of several psychophysiological parameters is now known to occur in mice and seems likely to occur in some nonalcoholic humans. The possible relevance of these results to predisposition to alcoholism remains to be shown.     

Voice recognition for the radiology market

Voice recognition is an exciting technology that is only starting to catch on in radiology. By reducing training time from days to several minutes, today's voice recognition systems are more practical than their predecessors. Voice recognition systems will improve the productivity of radiologists, allowing them to spend less time dictating their findings and more time concentrating on their specialty. Ultimately, the major benefit is increased patient care. As more and more hospitals become automated, voice recognition systems are a natural fit in this process. Radiology departments will be able to have integrated systems that will allow everything from initial patient entry, procedure status and tracking, and report dictation with voice recognition, to electronic report signature, report archiving, and patient billing.     

Comparison of filters in an oversized vena caval phantom: intracaval placement of a bird's nest filter versus biiliac placement of Greenfield, Vena Tech-LGM, and Simon nitinol filters.

For patients with an oversized inferior vena cava (IVC) (diameter greater than 28 mm, corrected for magnification) who require vena caval filtration for prophylaxis against pulmonary emboli, the accepted treatment has been the biiliac venous placement of Greenfield filters. Because of its wide strut span, the Bird's Nest filter (BNF) has been successfully placed in patients having an oversized IVC. However, the effects of the BNF on caval blood flow and its clot-capturing ability in an oversized IVC are not clearly understood. The authors created a flow phantom simulating an oversized IVC with "iliac" tributaries of normal inner diameter to analyze flow turbulence, pressure gradients, and the clot-capturing ability of the BNF, tested within the "caval" segment of the phantom, and the Greenfield, Vena Tech-LGM, and Simon nitinol filters, tested in the "iliac" segments. All filters were tested for flow disturbances before and after clot capture. The authors' results demonstrate that within an oversized IVC, the BNF creates less flow disturbance and is less occlusive with clot capture than biiliac filters. The BNF displayed a clot-capturing ability equal to that of biiliac filters. Thus, for patients with an oversized IVC, these results suggest that placement of a single intracaval BNF is preferable to biiliac placement of filters.     

Marked increase of plasma hyaluronan after major thermal injury and infusion therapy

Hyaluronan (HYA) is an important structural element in skin and is presumably participating in regulation of the interstitial fluid volume. HYA is transported via the lymphatics from the tissues to the blood, where its concentration is normally very low. Fluid flux through the interstitium is markedly increased after thermal injury. The present study was performed to determine whether major thermal injury would affect plasma levels of HYA. In halothane-anesthetized sheep subjected to 40% BSA full-thickness scald burns, plasma HYA concentration increased from 116 +/- 19 (mean +/- SEM) to 172 +/- 18 ng/ml within 1 hr after injury (P less than 0.05). After 3 hr of fluid therapy plasma HYA concentration was further elevated to 10 times baseline (1417 +/- 322 ng/ml) (P less than 0.01). To clarify whether this rise represented an increased "washout" of interstitial HYA, attributable either to the burn injury or the subsequent fluid therapy, awake sheep were subjected to overhydration. Following a 3-hr infusion of lactated Ringer's 2.5 liter/hr, plasma HYA concentration increased to 2-3 times baseline. Lung lymph flow and its concentration of HYA increased, leading to an increase in the lymphatic flux of HYA to 10-20 times baseline. In peripheral lymph HYA flux increased 2-3 times baseline. Infusion of lactated Ringer's markedly increased lymphatic removal of HYA. However, plasma concentrations of HYA were 3 times higher after thermal injury than following fluid challenge alone, suggesting that thermal injury per se may also increase input of HYA into the systemic circulation.