Successful resuscitation from sea water drowning.

A case of a 24-year-old male who survived a near drowning despite suboptimal pre-hospital management is reported. The case illustrates the value of continuing resuscitative efforts even in the apparently dead drowning victim.     

Structural periodicities observed in mammalian rod outer segments with Nomarski optics

Structural periodicities have been observed in isolated rod outer segments of several mammalian species using differential interference contrast (Nomarski) optics. The spacing among the observed structural inhomogeneities is somewhat variable. If these measured spacings are corrected for shrinkage, estimated by comparing ROS widths in unfixed cells to those in light microscopic autoradiographs, the mean values correlate well with published rates of ROS renewal in rats and dogs.     

RADIONUCLIDE PANCREATIC SCANNING: A RETROSPECTIVE ANALYSIS

Records of 346 patients were studied to determine the reliability and diagnostic value of pancreatic scanning. In 157 the pancreatic diagnosis was established subsequent to scanning. The scan was abnormal in 28 of 34 patients (82%) with pancreatic neoplasm, and in 21 of 26 patients (81%) with chronic pancreatitis. Of 71 with normal scans, 56 (79%) had a normal pancreas, and 15 had pancreatic disease (a false negative rate of 21%). Of the 86 with abnormal scans, the pancreas was diseased in 56 (65%), and of the others, 14 had extrapancreatic conditions known to be associated with a high incidence of scan abnormalities. In obstructive jaundice all 21 patients with pancreatic carcinoma had abnormal scans (and the scan accurately diagnosed all four cases of bile duct carcinoma). A normal scan reliably indicated that the cause of jaundice was outside the pancreas. In chronic abdominal pain an abnormal scan was unreliable, but a normal scan excluded pancreatic disease with reasonable accuracy.     

Quantitative assessment of low blood flow using an electromagnetic flowmeter

This study evaluated the behavior and reliability of an electromagnetic flowmeter for the quantitative assessment of low mean blood flow. Cuff-type probes with lumen diameters of 0.75, 1.0, 1.5, and 2.0 mm were used on excised canine vessels of external diameter less than 4.0 mm for in vitro calibrations. Flows ranged from 0 to 30 ml/min. Standard calibration plots were linear through zero with a mean error of ± 4.2%. Linear plots were significantly shifted by vascular constrictions of 50% and greater. Mechanical occlusion of the vessel for zero baseline determination was found to be important. To date, this report is the most extensive and accurate quantitative study of low blood flow with small transducers. We feel that the equipment can function as a valuable surgical tool.     

VIP modulates substance P-induced plasma extravasation in vivo

Substance P (SP), a putative mediator of neurogenic inflammation, has previously been shown to induce plasma extravasation when exogenously perfused over a blister base induced on the rat hind foot pad. Using the same animal model, we have studied the role of vasoactive intestinal polypeptide (VIP), one of the neuromodulators in primary afferent neurons, on SP-induced plasma extravasation. At all concentrations tested (2.5, 5 and 10 microM), VIP did not cause plasma extravasation by itself, however, it increased that due to 1 microM SP, in a dose-related manner. We have also studied the effect of VIP on the local blood flow in the blister base using a laser doppler-flowmeter. VIP was also found to increase the local blood flow in a dose-dependent manner. The present results provide evidence for the first time in vivo of a role for VIP in modulating a neurogenic inflammatory response induced by SP. The mechanism underlying this action is probably related to the vasodilator activity of VIP.     

Validation of the Edslab dual lumen oximetry catheter for continuous monitoring of jugular bulb oxygen saturation after severe head injury

Continuous jugular bulb venous oximetry has been validated previously for periods of up to 12 h after calibration. We assessed a new Edslab venous oximetry catheter in 15 patients with brain injury in the intensive care unit. After insertion into the jugular bulb, the catheter was calibrated using a laboratory co-oximeter. Subsequent comparisons were made at varying intervals (range 20 min to 100 h); 78 paired samples were obtained during periods of stable recordings. Estimation of haemoglobin saturation by the methods correlated well (r2 = 0.97, P < 0.0001). Mean difference (d) was small (0.28% (SD 2.35%)) and limits of agreement (d +/- (SD x 1.96)) were acceptable (-4.88% to 4.32%). There was no appreciable drift and there was negligible bias. This catheter did not suffer from problems of light intensity described with other systems, and it provided acceptable accuracy for clinical use for periods of up to and exceeding 24 h after calibration.      

THE TEMPERAMENT OF DOWN''S SYNDROME TODDLERS: A RESEARCH NOTE

A toddler temperament questionnaire was completed by the mothers of fifteen Down's syndrome children who had been assessed two years earlier with the Carey infant temperament questionnaire. The results suggest that infants who have been scored as showing signs of difficult temperament move towards the easier signs on the toddler scale. If these temperament questionnaires are biased by maternal perceptions, this move may reflect a reduced level of maternal anxiety.     

Methylcellulose for endothelial cell protection

A randomised trial of three types of endothelial cell protection for patients undergoing posterior chamber intraocular lens implant is described. The results confirm the superiority of a viscoelastic fluid over air as a form of endothelial cell protection. No statistically significant difference was found between sodium hyaluronate and hydroxypropylmethylcellulose (HPMC). As the cost of sodium hyaluronate is prohibitive, a manufacturing technique for HPMC is given.     

Treatment of scaphoid nonunion by volar inlay distal radius bone graft

Volar inlay corticocancellous bone grafting is an accepted method of treatment for symptomatic nonunion of the carpal scaphoid. Performance of this procedure with a radial graft without styloidectomy yields results comparable to those obtained with iliac grafting. This permits the operation to be performed through a single incision. The elimination of the need for iliac dissection avoids morbidity associated with the iliac exposure.