Portal radiographs: digital enhancement of contrast

The quality of low-contrast portal radiographs for radiation therapy can be improved with electronic contrast enhancement. After the image is copied digitally with a laser scanner microdensitometer into 4,096 gray-scale levels (12 bits) and 1,686 X 2,048 pixels, a special software package permits linear, logarithmic, exponential, or sigmoid transformations of the optical density. The precise representation of the portal image can then be interactively adjusted to emphasize the desired anatomy. Clinical examples demonstrate the value of the digital enhancement approach.     

A simplified procedure for preparing innervated gastric pouches

Conventional innervated gastric pouches can be technically difficult to construct, and fistula formation between the pouch and the main stomach cavity is a common problem. This paper describes the method of construction of a small pouch on the lesser curvature (LC pouch) which we have found to be relatively free of these difficulties. Compared with the Pavlov-type pouch, this pouch gives a stronger acid secretory response to a meat meal. Furthermore, the acid secretory response was prompt to insulin hypoglycemia and sham feeding.Dr. Faichney is a Research Fellow in Surgery, State University of New York at Buffalo, New York. Special Research Fellow in Gastroenterology, The Genesee Hospital, Rochester, New York.Dr. Kim was a Fogarty International Research Fellow, 1977–1979.This work was supported in part by The Genesee Hospital Gastrointestinal Research Fund, NIH Fogarty International Research Grant 1 F05-TW02535 and NIH Heart and Lung Institute Grant HL 03181.     

Biplane arteriography in ischemia of the lower extremity

A technique for simultaneous bilateral biplane arteriography of the abdomen, pelvis, and lower extremities is described. The biplane views provided clinically significant information in approximately 40% of cases.     

Effects of ethanol on the gastric mucosa of the Heidenhain pouch of dogs

The effect of ethanol on the mucosa of the Heidenhain pouch in dogs was studied by instilling ethanol in concentrations of 10, 20 and 40% using changes in ionic fluxes of an acid solution and mucosal alterations to measure the effects of ethanol. The instillation of 20 or 40% ethanol resulted in increased insorption of H⁺ and increased exorption of Na⁺ into the pouch lumen. Following the administration of 20 and 40% ethanol, the mucous layer and mucin content of the lining epithelial cells decreased markedly. Hourly bathing with the acid test solution aggravated the injury and induced bleeding, but hourly instillation of a buffer solution minimized the damage. Ionic fluxes returned to pre-ethanol levels 2 hr after 20% ethanol and 3–4 hr after 40% ethanol. Partial restoration of mucosal damage occurred in 4–6 hr and was complete in 24 hr.Supported by NIMH Grant No. 15614-01 and the Licensed Beverage Industry, Inc, New York, NY.     

Social capital, socio-economic status and psychological distress among Australian adults

High levels of social capital may be associated with positive mental health in adults. However, quantifying the various dimensions of social capital has presented a challenge due in part to the diverse definitions and measures used. Data from a representative, population-wide survey of Australian adults aged 16 years and older were used to investigate the links between dimensions of social capital and mental health morbidity. Social capital comprised three constructs and was measured at the individual level: feelings of trust and safety, community participation and neighbourhood connections and reciprocity. Mental health was measured by the 10-item Kessler (K10) instrument and assessed symptoms of psychological distress (i.e., depression and anxiety) over the previous month. Community participation showed a weak, and neighbourhood connections and reciprocity a moderate association with distress. Having higher levels of trust and feeling safe were consistently associated with low levels of psychological distress, after adjusting for socio-demographic characteristics and health conditions. The results clearly demonstrate that having trust in people, feeling safe in the community and having social reciprocity are associated with lower risk of mental health distress. The implications for conceptualising and measuring the individual and collective (contextual) dimensions of social capital are discussed. The findings also suggest the importance of examining the interrelationships between socio-economic status, social capital and mental health for community-dwelling adults.     

A case of neonatal alloimmune neutropenia associated with anti-human neutrophil antigen-1a (HNA-1a) antibody

Neonatal alloimmune neutropenia (NAN) is an uncommon disease of the newborn provoked by the maternal production of neutrophil-specific alloantibodies, whereby neutrophil IgG antibodies cross the placenta and induce the destruction of fetal neutrophils. Affected newborns are usually identified by the occurrence of bacterial infections. The most frequent antigens involved in NAN are the human neutrophil antigen-1a (HNA-1a), HNA-1b, and HNA-2a. We report a neonate who was delivered at 36 weeks and had a severe neutropenia but who responded well to recombinant human granulocyte colony-stimulating factor (rhG-CSF). Anti-HNA-1a antibody was identified by mixed passive hemagglutination assay in both the sera of the baby and the mother. The baby had HNA-1a and HNA-1b but the mother had only HNA-1b on granulocytes. This is the first Korean report of NAN in which the specificity of the causative antibody was identified.     

Medial temporal lobe volume of nondemented elderly individuals with poor cognitive functions

Poor cognitive performance of elderly individuals with low educational attainment is often difficult to interpret in dementia evaluation. Lack of education, as well as dementia, is often associated with poor cognitive test performance. To elucidate the underlying structural change of low cognitive performance in elderly individuals with low educational attainment, this study examined the relationship between low cognitive performance (LCP) and brain volumes, especially regions vulnerable to Alzheimer's disease, in nondemented elderly Koreans. Individuals with LCP (n=14) were matched on age and education with individuals with normal cognitive performance (n=14). The two groups were compared on the MR-based volumetric measures in the hippocampus, the entorhinal cortex, the amygdala, the temporal lobe, the frontal lobe, the cerebrum, and the intracranial cavity. Intracranial volume (p<.05) and absolute hippocampus (p<.05) and frontal lobe volumes (p<.05) were significantly reduced in individuals with LCP. Normalized volumes of the hippocampus and the frontal lobe did not differ in the two cognitive performance groups. ICV was associated with the K-DRS scores. General cognitive functioning of the LCP individuals, measured with the Korean version of the DRS, did not deteriorate in the 1- or 2-year follow-up cognitive tests. LCP in a nondemented elderly population with limited education appears to be associated with stable lower intelligence rather than increased risk for dementia of the Alzheimer's type.