Thoracic empyema: a study of 56 patients

Fifty seven children with thoracic empyema (37 boys and 20 girls) aged less than 12 years were seen at the University of Port Harcourt Teaching Hospital between January 1989 and December 1991. Staphylococcus aureus was the most common organism isolated from the pus of these patients (36 (63%) patients). Pseudomonas aeruginosa, the next most common organism, was isolated in 10 (18%) patients. The most common symptoms at presentation were acute illness with fever and cough (51 (89%) patients). All the patients were treated with closed intercostal tube drainage and appropriate antibiotics. Decortication was resorted to in only one patient. There were two deaths and the overall survival rate was 97%.     

Relationship of Auer rods and chromosome findings to outcome in eighty-nine adults with acute nonlymphoblastic leukemia

We performed cytogenetic analyses using banding techniques on 89 adults with acute nonlymphoblastic leukemia prior to receiving protocol chemotherapy. The relationships of cytogenetic findings both to outcome and to other pretreatment variables (particularly the presence or absence of Auer rods) were analyzed. Patients were followed up to 90+ months. When patients were grouped according to cytogenetic findings (NN: all normal metaphases; AA: all abnormal metaphases; AN: both normal and abnormal metaphases; F: no evaluable metaphases; I: insufficient (less than three) metaphases) no significant differences were noted with regard to age, sex, terminal transferase positivity, complete remission rate, remission duration or survival. The marrow aspirates of patients with only normal (69%) metaphases or no evaluable metaphases (64%) were more likely to display Auer rods than specimens from individuals with only abnormal (26%) or a mixture of normal and abnormal (42%) metaphases (p = 0.03). The presence of Auer rods in the pretreatment marrow aspirate was associated with an increased complete remission rate (71% vs 41%, p = 0.004), median remission duration (12 months vs 9 months, p = 0.02), and median survival (13 months vs 4 months, p = 0.01). Using multivariable analyses, the presence or absence of Auer rods was the pretreatment factor that most significantly predicted response and survival in this group of patients. The presence of a normal karyotype in the initial cytogenetic preparation is associated with the presence of Auer rods. The finding of Auer rods in the initial bone marrow predicts greater response and longer survival in acute nonlymphoblastic leukemia.     

Exchange transfusion treatment of methylmercury-poisoned children

Three children, ages 6 months, 13 months and 10 years were treated by exchange transfusions following exposure to methylmercury in the Iraq outbreak in 1971-72. Two had severe signs of poisoning and the other was clinically normal but had a high blood mercury concentration. Exchange transfusion resulted in clearance of mercury not only from blood but also from other tissues. The average amount of mercury removed in a two hour exchange was estimated as 6% of the body burden as compared to 1% of the body burden removed by normal excretion processes in 24 hours. No dramatic improvement in the clinical condition of the two poisoned patients occurred. Some improvement in motor power and function was observed during follow-up visits to their houses.     

Spider monkeys (Ateles sp.) as animal models for atherosclerosis research

Spider monkeys (Ateles sp.) were evaluated for their usefulness in research on atherosclerosis. These animals became only slightly hypercholesterolemic (increase from control serum cholesterol concentrations of about 200 mg/100 ml to about 290 mg/100 ml) when fed diets containing 1 mg of cholesterol/kcal (diets shown previously to produce marked hypercholesterolemia in most species of nonhuman primates).Both control and experimental monkeys had aortic fatty streaks and occasional lesions of the major branches of the coronary arteries. Cholesterol feeding for up to 48 months exacrebated the lesions only slightly.Biochemically, the atherosclerotic lesions of spider monkeys, as compared with other primates, have relatively less cholesterol ester and markedly more phospholipid.