Assessment issues involving the families of trauma victims

This paper reviews the empirical literature on the clinically significant problems found within families containing a member with post-traumatic stress disorder. Recommendations are made regarding specific instruments that can be useful for evaluating marital and familial adjustment. Assessment issues concerning the need to weigh historical relationship factors vis-á-vis the influences of a traumatized family member are discussed. A multiple-gating model is presented for assessing different aspects of family dysfunction, and suggestions for future research and clinical directions are offered.     

An audit of MRI for bone and soft-tissue tumours performed at referral centres

AIM: Magnetic resonance imaging (MRI) is essential in the pre-operative staging of suspected primary bone and soft-tissue sarcomas. Such lesions are ideally managed in specialist centres but it is becoming increasingly common for patients to undergo MRI before referral. The aim of this study was to assess the adequacy of such studies. MATERIALS AND METHODS: Fifty patients (30 men, 20 women; mean age 39 years, range 9-89 years) were included over a 1-year period. Tumours included 31 suspected primary bone tumours and 19 soft-tissue tumours. RESULTS: The total number of sequences used was 225 (mean 4, range 2-8). Enhancement was used in 19 cases. The commonest mistake was the failure to image the whole bone for 'skip' metastases in 50% of appropriate cases (high-grade malignant lesions of bone). Reports were available in 40 cases. Specific information regarding precise intraosseous and extraosseous extent of tumour and relationship to the neurovascular bundle and adjacent joint was commonly not included. CONCLUSIONS: This audit indicates that a greater awareness is needed amongst general radiologists of the MR imaging and reporting requirements for musculoskeletal tumours. In particular, all important axial imaging is sometimes omitted.Saifuddin, A. (2000). Clinical Radiology 55, 537-541.     

Image-guided endoscopic sinus surgery

This paper has described a new technique of image guided endoscopic sinus surgery. Being able to define the exact location within the sinus using CT scan while in surgery with the patient has the potential to enhance the procedure's utility and decrease the overall potential complication rate. Use of this technology, however, is not a substitute for a thorough knowledge of the anatomy of the paranasal sinuses or experience in performing endoscopic sinus procedures. Further evaluation of this image-guided technology and experience with it will further define usage parameters in the future.     

Radiologically placed temporary hepatic artery catheter for treatment of liver cancer

Hepatic artery infusion (HAI) chemotherapy is associated with higher response rates compared to systemic chemotherapy in those patients with unresectable liver malignancies. Operative hepatic artery catheter (HAC) insertion has significant morbidity and mortality, especially in patients with high‐volume disease, some of whom may not respond to HAI chemotherapy. We report our experience in 45 patients with high‐volume liver disease who were initially treated with HAI chemotherapy via a radiologically placed temporary HAC to try to select the responders who then went on to have an operative HAC. In these 45 patients who had 62 radiologically placed HAC, we found very few major complications, and certainly no complications such as cholecystitis, vascular or malperfusion problems.     

Aminotetralins as selective beta-adrenergic agonists.

Aminotetralin derivatives M-8 and JOD-176, were studied in relation to isoproterenol for beta-adrenergic activity. M-8 and JOD-176 were found to be very weak in activating cardiac beta-receptors. These compounds were also found to be considerably more active in uterine and bronchial smooth muscle. Because these compounds were also shown to be very inactive in vascular smooth muscle, the possibility that beta-receptors in different smooth muscle types may also differ was suggested.