Gluteal artery occlusion: intra-arterial chemotherapy of pelvic neoplasms

Intra-arterial chemotherapy of pelvic tumors may be complicated by coincident flow to the buttocks. Transcatheter occlusion of both the superior and inferior gluteal arteries may have a role in directing the flow of chemotherapeutic agents away from the buttocks and toward the true pelvis. The results of flow studies using technetium-99m-labeled macroaggregated human serum albumin were compared in 12 consecutive patients examined before and after transcatheter arterial occlusion, and the best results were obtained by selective occlusion of those arteries that demonstrated increased flow to the buttock on the initial study. Without the preselection of patients in whom the initial flow went mainly to the buttock, the results were inconsistent. Because of the increase in the procedure time and the occurrence of minor complications, such as local pain during or after the occlusion procedure, in all patients, proper patient selection is important.     

Caffey award: cranial sonographic findings in meningomyelocele

Children with meningomyeloceles have problems involving several organ systems and often require repeated radiologic examinations. They have multiple cranial defects, particularly the Arnold-Chiari II malformation and associated hydrocephalus. Cranial sonographic findings in 29 patients included hydrocephalus with pointing of the frontal horns, asymmetry of the lateral ventricles, and relative enlargement of the occipital horns compared with the frontal horns. Partial absence of the septum pellucidum, abnormalities of the third ventricle including a prominent massa intermedia, prominent anterior commissure, and prominent suprapineal recess were also seen. A V-shaped tentorium cerebelli was demonstrated on axial scan as well as low position of the tent on coronal scan. The posterior fossa pseudomass was demonstrated. A prominent interhemispheric fissure was also seen in some patients. Sonography is an excellent method for following ventricular size and shunt function since repeated examinations can readily be performed.     

A Cross-cultural Study of Alcohol Dependence in Singapore

This is a comparative study of alcohol dependence in Chinese and Indian patients admitted to a hospital in Singapore. There were 46 patients-21 Chinese and 35 Indians. In both ethnic groups there was a preponderance of male over female patients. There was no significant difference in the mean ages of the two groups but Indian patients started drinking at an earlier age and more of them had a family history of alcohol problems. Comparing the severity of alcohol dependence, Indian patients scored higher on the SADQ but no patients scored above 30 points.     

Cervical spine injuries. Diagnosis and classification.

Roentogenographic techniques in the evaluation of the patient with a cervical spine injury entail several considerations that should be respected in defining and classifying the lesion according to the mechanism of injury. Unilateral or bilateral facet dislocation with separation of posterior elements usually implies disruptive flexion injury. Anterior wedging of a vertebral body indicates flexion with some degree of compression. Comminution of the vertebral body indicates a predominant compressive element to the injury. An anterior-inferior marginal fracture indicates extension injury. Impaction of the inferior articulating processes or fracture of the pedicle producing a more horizontal appearance of the facet indicates disruption of interspinous ligaments and the probability that significant instability exists. Studies should not be terminated until complete visualization of all cervical segments has been obtained, including the cervico-thoracic junction.     

Effects of oral zinc loading on zinc metabolism in humans—I: Experimental studies

The effects of oral zinc on distribution, retention and excretion of orally administered ⁶⁵Zn were studied in 50 patients with taste and smell dysfunction. The study was conducted in three phases. In the first phase all patients were studied for 21 days after receiving 3–18 μCi of ⁶⁵Zn as ZnCl₂ orally after an overnight fast. In the second phase, started after 21 days and continued for 290 to 440 (mean 336) days, all 50 patients received placebo for ZnSO₄. In the third phase 14 patients continued on placebo while 36 received ZnSO₄ (100mg/day Zn⁺⁺) for 112 to 440 (mean 307) days. Phases two and three were a controlled clinical trial of the effects of zinc on retention of ⁶⁵Zn tracer. Total body retention and activity in plasma and red blood cells were measured for all patients throughout the study. Ten of the 36 patients treated with ZnSO₄ had additional measurements of ⁶⁵Zn activity in liver and thigh made using external detectors. Total body retention during the second phase placebo period was not significantly different (p > 0.25) for the 36 subjects subsequently treated with ZnSO₄ (biological half-time (T_b) 378 ± 12 days) (mean ± SEM) and the 14 who were continued on placebo through the third phase of the study (T_b = 384 ± 8 days). During the third phase patients receiving ZnSO₄ showed an accelerated loss of total body ⁶⁵Zn (T_b = 235 ± 8 days) which was significantly different (p < 0.001) from half-time values during placebo treatment. Accelerated loss of ⁶⁵Zn from the thigh was apparent immediately, while that from the liver began after a mean delay of 107 days. There was no apparent effect of zinc on loss of mean ⁶⁵Zn activity from red blood cells.