Early and delayed imaging with123I- IMP SPECT in patients with ischemic cerebrovascular disease

Cerebral blood flow imaging with N-isopropyl (I-123) p-iodoamphetamine (IMP) was performed in 44 patients with ischemic cerebrovascular disease (CVD) at an acute or subacute stage less than 30 days from the onset. IMP imaging was obtained at 20 minutes (early scan) and 4 hours (delayed scan) after intravenous injection of 222 MBq of IMP. The region of interest (ROI) was selected in a slice compatible with the findings on the CT images, and the lesion to tissue ratio (L/T ratio) was calculated in a comparison with the unaffected side. The redistribution index (RI) was also calculated by dividing the difference between the L/T ratio in early and delayed image by the L/T ratio in the early image. The patients were classified into three groups (Grade 1, 2, 3) on the basis of the CT findings. The L/T ratio in the delayed images and RI was high in grade 1 and 2 groups and low in grade 3 groups both in early and delayed scans. The RI had tendency to grow high as the days after the onset became later. In the duration period from 4 to 7 days, 'reversed' redistribution was observed in 4 cases. Follow up examinations were performed in 6 cases in grade 3 group. The RI became higher in 3 cases and lower in 3 cases in the second examination. In conclusion, good redistribution was observed in grade 1 and 2 groups, and the prognosis was good. On the other hand, poor redistribution was observed in grade 3 group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Anatomical observation of the bony and ligamentous structures around the wrist--comparative study of the crab-eating monkey and the human

So far as we surveyed in the literature, no articles had been published on precise studies on the bony and ligamentous structures around the wrist joint in crab-eating monkey. The authors made an observation about these particular anatomical structures by careful dissection of the 40 crab-eating monkeys, and the results were compared with those of three fresh human cadavers. The most significant differences were that the monkey had nine carpal bones (os centrale in addition), quite different configuration of the pisiform bone, no radio-scapho-capitate ligament, hypoplastic or no radio-scapho-lunate ligament, and different structure of the triangular fibro-cartilage complex. We discussed these differences from the view point of functional anatomy.     

The spinal bone fracture of the aged women

The deformity or fracture of the spines, bone mineral density (BMD) of radius and spines by anterior-posterior scans and lateral scans, and metabolic bone markers were examined in the old women. The probability of fracture was less than 10% in women with L3 BMD over 0.786g/cm², and new fractures were not found during 12 months follow-up in these patients. Among the various metabolic parameters, bone Gla protein (BGP)/hydroxyproline (Hp) excretion ratio was one of the clinically useful indices if combined with BMD. The intensive therapy may not be necessary to patients with low BMD if they show high BGP/Hp ratio. Patients with low BMD and low BGP/Hp ratio should be treated intensively in the old women.     

Transmission of Staphylococcus aureus between healthy, lactating mothers and their infants by breastfeeding.

The authors have investigated Staphylococcus aureus transmission between healthy, lactating mothers without mastitis and their infants by breastfeeding using both bacteriological and molecular-epidemiological methods. They studied 8 healthy, lactating mothers without clinical signs of mastitis and their infants who were less than 3 months old. They collected samples of breast milk, swabs of the mothers' nipples, the infants' nares, and the infants' oral cavities. There was a 50% transmission rate between the pairs. As the result of 12 antibiotics' susceptibility, Methicillin-resistant S. aureus was isolated from 2 of the 4 pairs. Using pulsed-field gel electrophoresis, the authors determined chromosomal DNA restriction patterns of the S. aureus isolated from 4 mother-infant pairs. The DNA fragment patterns of the organism within a given mother-infant pair were indistinguishable or closely related. The results suggest that methicillin-resistant S. aureus or methicillin-sensitive S. aureus may be transmitted between healthy, lactating mothers without mastitis and their infants by breastfeeding.     

Non-marfan idiopathic medionecrosis (cystic medial necrosis) presenting with multiple visceral artery aneurysms and diffuse connective tissue fragility: Two brothers

Two brothers with multiple visceral artery aneurysms or dilatations and diffuse connective tissue fragility who did not have clinical features of Marfan syndrome are reported. One presented with retroperitoneal hemorrhage during angiography, and idiopathic medionecrosis was proved by resection of the aneurysms. These cases belong to the heterogeneous group of Marfan syndrome. The angiographical features (multiple dilation of visceral arteries) suggests fragility of connective tissue and is predictive of hazards during and after a catheterization and operation.     

The control of chemotherapy-induced nausea and vomiting

A growing interest has been shown in antiemetics with important advances in understanding the physiology of vomiting and the development of new anticancer agents having high emetic potential such as cisplatin. At present, high-dose metoclopramide, dexamethasone and butyrophenones have shown effective antiemetic action. In addition, antiemetic drug combinations that affect more than one neurotransmitter receptor have achieved improved emesis control. While improvements have been made in acute chemotherapy-induced emesis, anticipatory and delayed emesis is still a difficult problem. Further studies under well-designed trials are necessary to establish which of the available agents, doses, routes of administration, and schedules are best for reducing emesis depending on the chemotherapeutic drugs used.     

Phase II study of cis-diamminedichloroplatinum in patients with non-small cell lung cancer

A phase II study of cis-diamminedichloroplatinum (CDDP, 80 mg/m2, every 3 weeks) was performed in patients with non-small cell lung cancer (NSCLC). The overall response rate to CDDP was 14% (6/42). In patients without prior chemotherapy, the response rate was 20% (2/10), and in patients with prior chemotherapy, the response rate was 13% (4/31). The major side effect was gastrointestinal toxicity. It was concluded that CDDP at a dose of 80 mg/m2 every 3 weeks is effective against NSCLC.     

Arthroscopy for slipped capital femoral epiphysis.

Arthroscopy was performed in five hips with slipped capital femoral epiphysis (SCFE) before pinning in situ. Arthroscopy disclosed erosion of acetabular cartilage in the anterosuperior region and damage to the posterolateral aspect of the acetabular labrum. Cartilaginous erosion and transverse cleft were identified on the anterior surface of the femoral head. These findings support the hypothesis that all pathomechanisms of SCFE are caused by traumatic factors. Arthroscopy for SCFE is also clinically useful in reducing hip pain. Arthroscopy performed simultaneously with pinning in situ can permit early exercise of the joint.     

Adriamycin, cisplatin, and etoposide combination chemotherapy for small cell lung cancer

Twenty-three patients with small cell lung cancer (11 with limited disease and 12 with extensive disease) who had not received previous chemotherapy were treated with a combination of adriamycin (30 mg/m2, i.v., on day 1), cisplatin (80 mg/m2, i.v., on day 1) and etoposide (70 mg/m2, i.v., on day 1-5). This chemotherapy regimen was repeated at 3- or 4-week intervals for 3 to 5 treatment cycles. Among 22 evaluable patients, 5 showed complete response and 17 had a partial response (response rate 100%). The median response duration of 12 extensive disease patients was 21 months. There were 5 survivors for more than 2 years. Toxicity included moderate to severe hematologic toxicity, alopecia, nausea and vomiting. This combination chemotherapy appears to be optimal for the treatment of small cell lung cancer.     

Treatment of Adult T Cell Leukaemia by Extracorporeal Photochemotherapy

Four patients with chronic or smouldering type adult T cell leukaemia (ATL) were treated by extracorporeal photochemotherapy (photopheresis). From 4 to 8 months after starting photo-pheresis, skin lesions with ATL cell infiltration began to disappear. Cell surface markers in three patients showed improvement. In one patient, a serial decrease of soluble interleukin-2 receptor levels (950 U/ml to 620) in the serum was observed after 4 months. This pilot study suggests that photopheresis may be successfully applied in ATL. It is still necessary to continue follow-up observations in these patients and to treat a larger number of cases, before definite conclusions can be drawn in the future