The use of surface coils for magnetic resonance-guided interventional procedures.

The advantages of surface coils for magnetic resonance imaging (MRI) of superficial structures include improvement in signal and decreased noise. There is now a growing use ofMRI to guide interventional procedures [1–4]. Because of the geometry of needles and other interventional devices, which extend outside the patient, optimal head receiver coils often cannot be used for imaging and the lower signal-to-noise body coil must be used because of its large size.     

An experiment to evaluate carbon monoxide absorption by hockey players in ice skating rinks

Carbon monoxide (CO) released from the exhaust of ice resurfacing machinery is frequently found in indoor ice skating rinks. We conducted a study with 14 male adult non-smokers unexposed occupationally, who played hockey games in 4 different atmospheric CO concentrations. To document absorption, we measured their alveolar CO (alvCO). Exposure was the average CO level in the rink during the game. Environmental concentrations were between 0.0 (undetected) and 76.2 parts per million (ppm). The exposure-absorption relationship was linear (regression parameters: r2 = 0.93, slope = 0.411, intercept = -1.45). This means that for each 10 ppm of CO in the indoor air, the players absorbed enough CO to raise their alvCO by 4.1 ppm (approximately 0.76% carboxyhemoglobin). Taking into account the duration of the games, the regression coefficients were almost similar to those of an earlier study we made with 122 adult male hockey players playing in recreational leagues of the Quebec city area. These results show the exposure-absorption relationship for an acute 60-minute exposure, in a design which eliminated certain of the uncontrolled variables of our first study. It also emphasizes the importance of prevention for CO pollution in indoor skating rinks.     

Response to 5-fluorouracil in metastatic extramammary Paget disease of the scrotum presenting as pancytopenia and back pain

Extramammary Paget disease is a rare intraepithelial neoplasm of the vulvar, penoscrotal, or perianal skin. No effective therapies for metastatic disease have been reported, and prognosis for metastatic disease is poor.Here, we report the case of an Asian man who was initially diagnosed with extramammary Paget disease of the scrotum. Three years later, the patient presented to hospital with pancytopenia and back pain. After an extensive work-up, biopsies of liver and bone marrow revealed adenocarcinoma with signet cells and immunohistochemical staining positive for keratin 7, carcinoembryonic antigen, and prolactininduced protein, but negative for keratin 20, S100, and prostate markers, consistent with his previous biopsyproven Paget disease of the scrotum. The patient was treated with 5-fluorouracil–based therapy in addition to palliative radiotherapy to selected spine levels. A promising palliative response was demonstrated following 5-fluorouracil chemotherapy.A review of the literature on the pathogenesis, diagnosis, treatment options, and outcomes for metastatic extramammary Paget disease is presented.     

Comorbidity,limitations in activities and pain in patients with osteoarthritis of the hip or knee

Background  

This study aims to contribute to the knowledge of the influence of comorbidity in OA. The objectives of the study were (i) to describe the prevalence of comorbidity and (ii) to describe the relationship between comorbidity (morbidity count, severity and the presence of specific diseases) and limitations in activities and pain in elderly patients with knee or hip OA using a comprehensive inventory of comorbidity.     

Abnormal pulsatile secretion of luteinizing hormone in men with epilepsy: relationship to laterality and nature of paroxysmal discharges

We compared the pulsatile secretion of luteinizing hormone (LH) between 13 men with clinically and electrographically documented temporal lobe seizures and 8 age-matched controls. Serum for LH measurement was drawn every 15 minutes during 8 hours of EEG telemetry in both groups. The 2 groups did not differ significantly in average mean baseline LH secretion, total LH secretion, or average pulse amplitude. The group with seizures, however, showed a significantly greater (p less than 0.05) variability of baseline LH secretion and pulse frequency. Among the men with unilateral paroxysmal EEG findings, pulse frequency was significantly greater (p = 0.05) with right epileptiform discharges or left slowing (6.4 +/- 0.4) than with left epileptiform discharges or right slowing (3.0 +/- 1.3). The relationship of pulse frequency to the nature and laterality of paroxysmal discharges makes it unlikely that endocrine abnormalities can be attributed to medication alone and strengthens the notion that temporal lobe epileptiform discharges may disrupt hypothalamic regulation of pituitary secretion.     

Polyradiculoneuritis and pregnancy. Apropos of 1 case

The authors report a case of severe Guillain-Barre syndrome that appeared during the eighteenth week of a second gestation which evolved to full term without complication. The particularity of this observation was that the follow-up of the foetus was made possible for the first time by echography which showed normal active foetal movements even during maximum maternal paralysis. From of review of thirty three cases recorded in the literature, it seems clear that the interrelationship between the neurological disorder and pregnancy is nil or minimal beside an increased risk of prematurity childbirth can proceed normally and cesarean section is not indicated. Plasmapheresis proposed as an early treatment is discussed in the case of pregnant women. Today pregnancy is no longer a particular contraindication of such management.     

Cloning of SHV-2, OHIO-1, and OXA-6 beta-lactamases and cloning and sequencing of SHV-1 beta-lactamase

Molecular cloning of DNA fragments permitted the isolation of structural genes coding for SHV-1, SHV-2, OHIO-1, and OXA-6 beta-lactamases. DNA probes were constructed for SHV-1, and under conditions of high stringency, hybridization was observed only between SHV-1 and SHV-2. Oligonucleotide typing with a 15-mer SHV-1 probe was capable of discriminating between SHV-1 and SHV-2 but not OHIO-1. The nucleotide sequence of the SHV-1 beta-lactamase gene from plasmid R974 has been determined. The structural gene encodes a polypeptide product which differs by 9 residues from the p453 (SHV-1) PIT-2 enzyme determined by peptide sequencing. The significance of each mutation was assessed by alignment of amino acid sequences and comparisons with the Staphylococcus aureus PC1 penicillinase crystal structure. Structural similarities between SHV-1 and class A beta-lactamases are extensive, with amino acid identities of 88.9% between SHV-1 and LEN-1, 91.8% between SHV-1 and OHIO-1, and 63.7% between SHV-1 and TEM-1.     

The Treatment of Septicemia in Pacemaker Patients

The authors analyzed the data of seven patients who had undergone open heart surgery because of pacemaker endocarditis in the past 4 years. Repeated surgical interventions on the pacemaker system were found to be the most common predisposing factors. Staphylococcus aureus and Staphylococcus epidermidis were the most common causative organisms. Two-dimensional echocardiography was important in the diagnosis of cases with atypical clinical picture and negative blood cultures. We concluded that: (1) any pacemaker patient with fever should be considered to have a pacemaker endocarditis; (2) all of these patients should be examined by two-dimenensional echocardiography; and (3) the total removal of the infected hardware seems to be the only way to achieve complete recovery.