Glioblastoma: catheter techniques for isolated chemotherapy perfusion

Techniques have been developed for isolated perfusion of chemotherapeutic agents in patients with glioblastoma. Three catheters that facilitate crossing the carotid siphon have been developed; two are based on an everting or toposcopic principle, and one uses microjets for deflectability and improved mixing. Blood from the ipsilateral jugular vein is aspirated at high volumes (300 ml/min) for extracorporeal circulation through an adsorption column (for recovery of carmustine) or dialysers (for recovery of cisplatin). Preliminary experience in 10 patients suggests that high doses of chemotherapeutic agent can be administered using these catheters, with reduced retinal and systemic toxicity.     

High-energy electrons used to inhibit experimental intraocular proliferation and detachment

Irradiation of rabbit eyes with high-energy electrons was used to test the inhibition of experimental intraocular proliferation and retinal detachment, produced by intravitreal implantation of 250,000 homologous fibroblasts. After irradiation with 2,000 rad, started 5 days after implantation, 45% of eyes (9 of 20) still manifested traction detachment. When the dose was increased to 3,000 rad and radiation treatment was started 1 day after implantation, proliferation and traction detachment were observed in only 10% of eyes (2 of 20). No acute damage to retinal tissue or nerve fibers was observed. Because it is easily available, simple in application and dose adjustment, and without toxic side effects, radiation therapy should be considered as an effective alternative to drug treatment for the inhibition of intraocular proliferation and detachment. Statistically significant results of this investigation suggest its use combined with surgery in certain reproliferative cases in man.     

Early child health in Lahore, Pakistan: VIII. Microbiology

The causative agents of acute diarrhoea were investigated in children under the age of five years from 1985–1991 in three socio-economically different areas in Lahore, Pakistan. The aim was to determine the frequencies of the most common enteropathogens in faeces. The total isolation rate was 73.4%; two thirds (53.5%) were of bacterial and one third (19.9%) of viral origin. ETEC-LT (23.4%), Rota virus (19.9%), EPEC (15%) and Campylobacter (12%) were the single most frequent pathogens in all age groups and areas of living. The positivity of Campylobacter increased from 1.6% to 12% after the change of isolation technique. Shigella was isolated significantly ( p >0.001) more in children over than under one year of age. The incidence of bacterial infections was high during all seasons, while in certain years Rota virus was relatively low in the summer compared to the cooler months. The prevalence of ETEC-LT diarrhoea was higher in the periurban slum as compared to the village and the urban slum. The study is the first of its kind in Pakistan, and the results are similar to other comparable studies. It is thus possible to establish a well functioning and reliable microbiological laboratory in developing countries in a setting with restricted trained personnel and material resources.     

Follow up of victims of fabricated illness (Munchausen syndrome by proxy)

Fifty four children were studied 1-14 (mean 5.6) years after fabrications of illness had been identified. Thirty of the 54 children were living in families with their biological mothers and 24 were with other family members or in substitute families. Further fabrications were identified for 10 children who had been living with their mothers and there were 'other concerns' for a further eight children. Thirteen children residing with mother and 14 not residing with mother at follow up had a range of disorders including conduct and emotional disorders, and problems related to school, including difficulties in attention and concentration and non-attendance. Overall, 20 children (49% of those successfully followed up) had outcomes that were considered to be unacceptable.     

PREVALENCE OF ENDEMIC GOITRE IN SCHOOL CHILDREN: SHIRUR (DIST. PUNE,MAHARASHTRA)

A survey for estimation of goitre in school children in the Rural Health Training Centre, Shirur area was undertaken. A total of 4664 students from 17 schools were surveyed. The goitre prevalence was found to be 59.8% with visible goitre rate of 6.2% in pre- and peri-adolescent (10–19 years) age group. Thus a highly endemic goitre focus was located in Shirur, area in Pune District (Maharashtra). This area is located on the eastern tail-end slopes of Sahyadri Hills in Balaghat ranges, situated at an altitude of 533 metres. The area is generally drought prone and receives scanty rain, with poor agricultural practices. Environmental deficiency of iodine was found to be the main cause for this high prevalence of goitre.KEY WORDS: Goitre endemic, Iodine     

Pixel overflow artifacts in SPECT evaluation of the skeleton

The successful application of single photon emission computed tomography (SPECT) techniques to radionuclide evaluation of the skeleton depends on strict quality control measures, recognition of potential artifacts, and the selection of appropriate cases for specific reprocessing techniques. The application of simple image-processing routines to problems of "hot spot" and bladder pixel overflows facilitated a reduction in the technical inadequacy rate from 19% to 2% for SPECT evaluation of 100 hips, as well as improvement in diagnostic image quality in a variety of additional cases.