Utility of multidetector CT and virtual bronchoscopy in tracheobronchial obstruction in children

Purpose: The aim of this study was to evaluate the potential use of multidetector CT (MDCT) and virtual bronchoscopy (VB) in the evaluation of tracheobronchial patency in children with suspected bronchial obstruction and to compare its findings with fibreoptic/rigid bronchoscopy or surgery. Patients and methods: A total of 43 children (15 girls, 28 boys) with clinically suspected bronchial obstruction underwent contrast enhanced MDCT, using an age‐ and weight‐ adjusted low dose protocol. Post‐processing was performed and VB and multiplanar reformations (MPR) were obtained at the same sitting. Findings obtained at MDCT and VB were compared with fibreoptic/rigid bronchoscopy and surgery. Results: Obstructive pathology was found in 26 children, which included endoluminal foreign body, mucus plugs in 13 children, endobronchial tumour in three children and extrinsic compression (lymph node, aberrant Vessels, mediastinal cysts/tumours) of the tracheobronchial tree in 10 children. In 17 children, no obstructive lesion was identified. Excellent positive correlation was obtained, between MDCT‐VB and bronchoscopy/surgery, however, in one child with endobronchial obstruction caused by tracheitis, low dose MDCT‐VB was normal, but bronchoscopy revealed granularity and plaques. Conclusion: MDCT‐Virtual bronchoscopy is useful in evaluating bronchial stenosis and obstruction caused by both endoluminal pathology and external compression and has the advantage of looking beyond stenosis. Its main application lies in providing the exact location of suspected foreign body, prior to bronchoscopy. However, it fails to disclose exact nature of obstructing pathology.     

Lack of degradation of dietary and endogenous sterols in gastrointestinal tract of man

Nine hyperlipidemic subjects consuming their habitual solid diets were investigated by sterol balance techniques to see if there was any degradation of the steroid nucleus by the intestinal microflora. After the subjects had been equilibrated on their controlled habitual diets, 3-day fecal pools were collected first in a steady state for 9–12 days and then for another 12–15 days during the treatment with clofibrate and nicotinic acid. The amounts of cholesterol, β-sitosterol, and their microbial metabolites were estimated from each fecal pool. They were corrected for fecal flow and methodological losses. There was a modest variation in the recovery of the dietary β-sitosterol from pool to pool within a given subject. The mean variation was 9 ± 7%. The mean recovery of dietary β-sitosterol in nine subjects was 94 ± 5% with a range between 89 and 104%. If the absorption of β-sitosterol is assumed to be 5%, these results rule out significant degradation of the steroid nucleus in the gastrointestinal tract. This was true even when the subjects were given clofibrate or nicotinic acid. The mean recovery of β-sitosterol during this period was 96 ± 6%. The proportions of microbial conversion products (stanone and stanol) of cholesterol and β-sitosterol were similar. Clofibrate treatment did not significantly influence these proportions. However, in response to the treatment with nicotinic acid, significant increases in the stanol derivatives of both cholesterol and β-sitosterol were seen, but the changes were identical for the two sterols.     

Release of protein bound sialic acid from fibrosarcoma cells after cis-dichlorodiammine platinum (II) treatment: the possible role in tumor regression

Cis-dichlorodiammine platinum (II) (cisplatin) has been successfully used in experimental immunotherapy of syngeneic transplantable fibrosarcoma in mice. Incubation of fibrosarcoma cells with cisplatin in vitro causes release of sialic acid from tumor cells. The estimation of sialic acid in the supernatant have shown a difference in the release of sialic acid from the tumor cells with different concentrations of cisplatin. The removal of sialic acid from fibrosarcoma cells after cisplatin treatment suggests a possible exposure of certain antigenic sites on the tumor cell surfaces. Such membrane changes may be responsible for the increased antigenicity of fibrosarcoma cells.     

Multiple sclerosis with clinical and radiological features of cerebral tumour

Three cases of multiple sclerosis, all confirmed pathologically, are described in whom both the unusual clinical features and the CT scan appearances suggested cerebral tumours. The failure of mass effect reliably to differentiate plaques and tumours on a CT scan is stressed and the literature relating to CT scanning in multiple sclerosis is reviewed.