Congenital middle-ear deafness: CT study

Computed tomography (CT) was used to study 25 patients with congenital conductive hearing loss and normal external auditory canals. Deformities were subdivided according to ossicular, fenestral, and cholesteatomatous origin. Isolated ossicular deformities were found in 14 patients (five bilateral), cholesteatoma in eight, oval-window nondevelopment (with ossicular deformity) in one, and normal studies in two (congenital stapes fixation at the level of the annular ligament). Ossicular deformities may be subdivided into incudostapedial disconnections into incudostapedial disconnections (most common), malleoincudal fixations, and stapes fixations. Most are due to developmental anomaly of the first or second branchial arch. The stapes has a dual origin (second arch and otic capsule). A cholesteatoma is defined as congenital only if there is no history of otitis and the tympanic membrane is intact. In this series, six were in the middle ear proper, and two were within the attic beyond otoscopic view. Their CT appearance, with one exception, was essentially identical to that of acquired lesions.     

Hemagglutination inhibition of Cromer blood group antibodies with soluble recombinant decay-accelerating factor

BACKGROUND: Cromer blood group antigens are located on decay- accelerating factor (DAF, CD55), which contains four short consensus repeats (SCRs). Cromer system antibodies may be of clinical significance in blood transfusion. STUDY DESIGN AND METHODS: Soluble recombinant DAF (srDAF) constructs, consisting of all four SCRs or of only two SCRs, were expressed in the yeast Pichia pastoris. They are used in hemagglutination-inhibition tests with Cromer system antibodies and with DAF-specific monoclonal antibodies. RESULTS: The srDAF inhibited hemagglutination by all Cromer system alloantibodies in undiluted serum. Antibodies to antigens of other blood group systems were not inhibited by the srDAF. Hemagglutination-inhibition tests with domain-deleted srDAF showed that UMC is on SCR-4 and confirmed that Tca, TcaTcb, and WESb are on SCR-1; Dra is on SCR-3; and Cra is on SCR- 4. CONCLUSIONS: Hemagglutination inhibition with srDAF is useful in the recognition of antibodies that belong to the Cromer blood group system and facilitates pretransfusion testing. This use of domain-deleted srDAF provides an easy method of determining epitope location on DAF and is an aid to more precise identification of Cromer system antibodies.     

Superior mesenteric artery blood flow velocity and estimated volume flow: duplex Doppler US study of preterm and term neonates

To obtain information about intestinal hemodynamics of healthy neonates, the authors assessed velocity and volume of blood flow with duplex Doppler sonography in the superior mesenteric artery (SMA) in 91 stable preterm and term neonates. Blood flow velocity in the SMA and estimated volume blood flow increased linearly with gestational age and increasing body weight. The mean estimated volume blood flow (+/- standard deviation) was 43 mL/kg/min +/- 13 and did not depend on differences in body weight. The authors also assessed blood flow velocity in the SMA and volume blood flow in 18 infants with conditions that may affect blood supply to the bowel. Twelve infants who were small for gestational age appeared to have an abnormally low resistance of the vascular bed of the SMA during the 1st days of life, as compared with stable appropriate-for-gestational-age infants matched for gestational age. Three of six term neonates with cardiovascular abnormalities had left ventricular outflow obstruction and an abnormal blood flow velocity waveform of the SMA, suggesting a decrease in blood supply to the bowel. The results of this study may help in evaluations of intestinal perfusion in infants with abnormal conditions.     

Preliminary validation of a prediction model for the short-term growth response to growth hormone therapy in children with idiopathic short stature

A discriminant scoring system, using multivariate analysis, has been developed for pretreatment prediction of responsiveness to a 6-month trial of growth hormone (GH) treatment in short children with subnormal growth velocity, but without GH deficiency. Inclusion criteria included a birth weight above 2.5 kg, height below the 3rd centile for chronological age, height velocity below the 25th centile for bone age, no signs of puberty, a maximal GH response to pharmacological stimulation of above 10 μg/l and treatment with GH at a dose of 12–16 IU/m²/week. Children with an increase in height velocity greater than 2.5 cm/year after therapy were considered to be responders. Pretreatment clinical data from 67 patients were employed in a discriminant analysis in order to establish the model. The scoring system developed was as follows: score = -0.4 + 0.92X₁– 0.87X₂, where X₁ is the height velocity SD score (SDS) for chronological age, and X₂ is the bone age SDS for chronological age. This model had a specificity of 96.3% and a sensitivity of 92.5% in predicting the responsiveness to GH. The model has subsequently been applied to a group of 14 patients in order to establish its validity; in this group its sensitivity was 83.3% and its specificity 100%. These preliminary data suggest that the model can be used as a guideline for selecting short, slowly growing, non-GH-deficient children who will respond to short-term GH therapy.     

HPLC柱切换法测定血浆和尿样中头孢克肟浓度

用双泵HPLC柱切换系统直接进样测定血浆和尿样中头孢克肟(cefixime,CFIX)的浓度。血浆和尿样的回收率分别为99.1%和98.6%;最低检测浓度分别为0.05和0.2μg/ml;日内和日间的RSD小于5%;血浆和尿样浓度分别在0.1～3.2和1.0～32μg/ml范围内呈线性相关。此方法集样品净化、富集成分和色谱分析一次连续进行,操作简便、快速,可以进较大的样品量,灵敏度相对明显提高。     

Postinflammatory ossicular fixation: CT analysis with surgical correlation

Postinflammatory ossicular fixation is a common problem encountered by the otologic surgeon upon exploration because of conductive hearing loss in patients with chronic otitis media. These nonotosclerotic noncongenital lesions take three pathologic forms: fibrous tissue fixation (chronic adhesive otitis media), hyalinization of collagen (tympanosclerosis), and new bone formation (fibro-osseous sclerosis). Fibrous tissue fixation appears on CT as nonbony, noncalcific soft-tissue debris encasing some or all of the ossicular chain. Tympanosclerosis appears as unifocal or multifocal punctate or weblike calcifications in the middle ear cavity or on the tympanic membrane. This debris may be in direct apposition to the ossicular chain or may replace the suspensory ligaments in symptomatic patients. New bone formation has been identified only in the attic and is the least common manifestation. Thick bony webs or generalized bony encasement may be present at CT. More than 300 patients with the clinical diagnosis of chronic otitis media have been examined. This study encompasses 23 proved cases.