Serological studies in acute maxillary sinusitis.

A comparison was performed between bacteriological and serological findings in 97 patients suffering from acute maxillary sinusitis. A significant titre change (larger than or equal to 2 titre steps) of complement-fixing antibodies to H. influenzae was demonstrated in 15 patients. H. influenzae was demonstrated in aspirated sinus secretions from 7 of these 15 patients. Further, titre changes to Neisseria catarrhalis were demonstrated in 25 patients. No significant titre changes in anti-streptolysin and anti-staphylolysin titres were demonstrated. The results are discussed briefly.     

Postoperative extradural analgesia with morphine and ropivacaine. A double-blind comparison between placebo and ropivacaine 10 mg/h or 16 mg/h

BACKGROUND: Some controversy exists in the literature on the benefit of epidurals compared to patient-controlled intravenous analgesia (PCA). Also, the dose of ropivacaine for epidural analgesia when combined with morphine remains uncertain. The aim of this study was to compare the epidural vs. PCA technique and high-dose vs. low-dose ropivacaine combined with morphine during knee replacement surgery. METHODS: In this prospective, randomized, double-blind study, postoperative pain relief with a combination of epidural ropivacaine (Group L: 10 mg h-1, Group H: 16 mg h-1) and morphine (0.16 mg h-1) was evaluated in 30 patients. A placebo group (Group PL) of 15 patients having PCA morphine served as the control. Visual analog pain (VAS), morphine consumption, sensory and motor block and side-effects were recorded during 48 h. RESULTS: VAS scores at rest were significantly lower in Groups L and H compared to Group PL. On movement, Group H had lower VAS scores than Group PL during 3-27 h (P<0.05) and Group L during 4-9 h (P<0.05), while Group L had lower a VAS than Group PL during 9-18 h (P<0.05). Morphine consumption after 48 h was greater in Group PL (64.6+/-36.3 mg) vs. Group L (23.3+/-33.9 mg) (P<0.001) and Group H (4.3+/-9.6 mg) (P<0.0001). Mild motor block was seen in Group H in 20% and 14% patients at 24 h and 48 h, respectively, but time to mobilization was similar between the groups. Pruritus was more common in the ropivacaine groups (P<0.05). CONCLUSION: Lumbar epidural analgesia using a combination of ropivacaine (16 mg h-1) and morphine (0.16 mg h-1) provides superior analgesia compared to the PCA technique or ropivacaine (10 mg h-1) and morphine (0.16 mg h-1). Although this resulted in a mild motor block during the first 12 h, patient mobilization was similar in all groups.     

Cyclooxygenase inhibition in early onset of tumor growth and related angiogenesis evaluated in EP1 and EP3 knockout tumor-bearing mice

It is well established that prostanoids are essential for local inflammation including cell proliferation and apoptosis. Accordingly, prostaglandin E2 (PGE(2)) is a critical factor in wound healing, tumor invasiveness and progression. Therefore, the aim of the present work was to evaluate effects by PGE(2) on tumor vascular density at early onset of tumor growth where hypoxia is limited. Wild-type mice (C57Bl, C3H/HeN) bearing either MCG-101 tumors or a malignant melanoma (K1735-M2) with either high or insignificant PGE(2) production and subsequently different in sensitivity to cyclooxygenase (COX) inhibition were used. Tumor angiogenesis was estimated by intravital microscopy and immune histochemical analysis in wild type and EP(1) or EP(3) subtype receptor knockout mice (C57Bl). Both MCG-101 and K1735-M2 tumor cells stimulated early outgrowth of tumor vessels in proportion to intrinsic growth rate of tumor cells. Indomethacin had no effects on tumor growth or tumor related vascular area in K1735-M2 bearing mice. By contrast, indomethacin decreased tumor cell proliferation and increased apoptosis in MCG-101 tumors with subsequent adaptation in tumor vascular density. Effects of indomethacin on early growth of MCG-101 tumors were not related to tumor content of bFGF protein, while our earlier studies on long-term tumor growth have shown decreased mRNA levels of bFGF during indomethacin treatment. Early onset of tumor growth was significantly promoted in EP(3)- but not in EP(1)-knockouts, although long-term tumor growth is attenuated in EP(1)-knockouts as reported elsewhere. Our results demonstrate that tumor production of PGE(2) promotes primarily net growth of tumor cells with subsequent adaptations in development of the tumor vasculature. Therefore, it is likely that angiogenesis is not a limiting step at the early onset of tumor growth.     

The Plasma Cells of the Bone Marrow in Myelomatosis Treated with Alkeran® (Melphalan)

The cytological appearance of the bone marrow was studied during Alkeran treatment of 46 patients with myelomatosis. The plasma cell count had decreased in 39 per cent, it remained unchanged in 48 per cent and was increased in 13 per cent. The plasma cell count seems to be of little value in the appraisal of the effect of treatment, especially compared with that of the concentration of the M component. The only qualitative change seen was a disappearance of the nucleoli from the plasma cells in 4 cases.     

Tinnitus in noise-induced hearing loss

Tinnitus was analysed in 94 patients with noise-induced hearing loss. Tinnitus of a pure tone character was most common followed by narrow-band noises, and a combination of these. A broad-band noise type of tinnitus was the least common finding. Tinnitus was most common at high frequencies. The suggested mean tinnitus level (in dBHL) corresponded well with the mean audiometric threshold for these patients. Most patients characterized their tinnitus as moderate to severe. Subjective tinnitus grading showed poor correlation to the audiometric threshold or to sensation level e.g. patients with a suggested tinnitus threshold corresponding to the hearing threshold could consider their tinnitus severe. The most common subjective discomforts were concentration difficulties, insomnia and decreased speech discrimination. In most cases residual inhibition was limited to 60 seconds.     

A radioimmunoassay of oestrone in plasma. Plasma levels of oestrone and oestradiol in oophorectomized Rhesus monkeys during treatment with subcutaneous implants containing oestrone.

A highly specific antiserum to oestrone was used to develop a sensitive radioimmunoassay. Plasma was generally analysed without prior separation of the oestrogens. A small amount of plasma (0.1-0.2 ml) was extracted once with diethyl ether. The above and previously described radioimmunoassays were used to estimate plasma levels of oestrogens in oophorectomized monkeys treated with subcutaneous oestrone implants. Three monkeys received a rod containing 40 mg of oestrone. The rods were kept in place for about one year. The release rates from the rods were calculated. The oestrone plasma levels were initially high (370-500 pg/ml). In about 3 months they had fallen to a level of 50-100 pg/ml which was maintained till the removal of the rods. A rise in the oestradiol plasma levels was also observed. It is concluded that rods are suitable for administration of oestrone.     

Visual testing with 'preferential looking' in mentally retarded children

In 21 out of 26 children and young adults with mental retardation visual acuity could be successfully examined with operant preferential looking. There was a good correlation in this group of patients between ocular abnormalities demonstrated in an ophthalmological examination and the visual acuity results.     

Reduction of absorbed dose in storage phosphor urography by significant lowering of tube voltage and adjustment of image display parameters

Purpose: To investigate whether image quality in storage phosphor urography can be maintained when the X-ray tube voltage is significantly lowered to give a lower patient dose.

Material and Methods: Initial phantom studies were used to establish exposure settings at 53 kV that gave signal-to-noise ratios for contrast media structures equivalent to those obtained at the reference kilovoltage of 69 kV. Dose area product and image quality, assessed by image quality criteria and visual grading, were then recorded for 44 patients drawn at random to be examined by either the standard or modified technique.

Results: Absorbed dose could be reduced by more than 30% without any significant change in image quality in manually controlled exposures and by 13% in exposures controlled by AEC.

Conclusion: It might be possible to lower the tube voltage in digital examinations involving contrast media as a means of lowering patient dose. The image display parameters need to be adjusted to maintain image quality.