Directional needle for antegrade guide wire placement with vertical arterial puncture

A directional needle with a closed pencil-point tip and a distal side hole was developed to permit antegrade guide wire placement by way of a 90 degrees puncture angle. It has been used in over 25 patients without technical difficulties or complications. It has been very effective for catheterization of the superficial femoral artery for angioplasty, diagnostic studies, and chemotherapy infusion, providing easy antegrade access in patients in whom the traditional antegrade approach may be difficult.     

Retrievable Gianturco-coil introducer

A new delivery system for placement of Gianturco coils has been devised that permits retrieval of the coil if malposition occurs. The delivery system itself consists of a very fine coaxial cannula that will cut the monofilament once the coil is properly placed. It has been successfully used on three patients in whom a total of 48 coils were employed to occlude great vein of Galen aneurysms. The system is applicable for routine coil embolization but has particular application in treating high-flow vascular lesions (arteriovenous fistulas or malformations).     

HENOCH-SCHONLEIN PURPURA ASSOCIATED WITH RANITIDINE

Ranitidine is one of the widely prescribed H₂ receptor antagonists in the treatment of peptic ulcer. It is well tolerated and has few side-effects. Vasculitic rash occurring in association with ranitidine has been described.¹ We report a case of a 39-year-old man who developed a purpuric rash, polyarthritis, abdominal pain, melaena and impaired renal function characteristic of Henoch-Schonlein purpura, following treatment with ranitidine.     

Contamination and resterilization of the Bain circuit.

Fifty Bain circuits were tested for contamination following single patient use. A contamination rate of 8 per cent was found. Two methods of resterilization were examined. Sterilization by activated glutaraldehyde proved unsatisfactory, while ethylene oxide sterilization was found to be an effective method which produced no detectable adverse physical or chemical alterations of the circuits.     

Long term language deficiencies in children with otitis media during their first year of the life

A cohort of lower socio-economic children who experienced multiple and prolonged episodes of otitis media (OM) during their first year of life were compared to an equivalent group of children who were largely free of OM during their first year. Both groups were followed until 9 years of age. The data indicate that children with positive histories of OM performed poorer on a variety of Iinguisitc tasks across the nine year age span than the children with the positive histories of OM. The results suggest that the effect of the otitis media and its accompanying hearing loss on communication skills may extend throughout childhood.     

Tumors of the parapharyngeal space and upper neck: MR imaging characteristics

Magnetic resonance (MR) imaging characteristics of 40 tumors involving the parapharyngeal space and the upper part of the neck were reviewed. These lesions could be classified as being either hypervascular (glomus tumors or metastatic kidney, thyroid, or venous hemangiomas) or hypovascular (salivary gland tumors, neurogenic tumors, lymphomas, sarcomas). Detailed analysis of the contour of the neoplasm combined with clinical findings allowed further refinement of the differential diagnosis in each category. Most lesions had an intermediate signal intensity on T1-weighted images and a fairly high signal intensity on T2-weighted images. Hypervascular tumors had a number of "channel voids" caused by high-flow vessels on T1- and T2-weighted images, and on T2-weighted images there were areas of high signal intensity, presumably due to sites of slow flow within the image plane. The hypovascular lesions were quite homogeneous, and it was therefore more difficult to differentiate among the neoplasms in this group.