Early computed tomographic scanning after resection of brain tumors in children

Enhanced and non-enhanced computed tomography (CT) brain scans were performed within 72 h of surgery on 21 children in whom brain tumors had been resected totally or subtotally, and scans were repeated at varying intervals thereafter. Biopsies of the resection margins were performed in 12 patients at the end of the surgical procedure. The immediate CT scan showed enhancement in the resection margin in 13 of the 21 patients and in 9 of the 13, the enhancement disappeared on follow-up scans. There was discordance between the results of immediate CT scan examination and the biopsies of the resection margins in 7 of the 12 cases. The advantages and disadvantages of an immediate postoperative scan versus a more delayed CT scan are discussed.     

Peritoneal dialysis patient survival: a comparison between a Swedish and a Korean centre.

BACKGROUND: Dialysis patient mortality remains high, and this high mortality may be due to many factors. In peritoneal dialysis (PD) patients, old age, co-morbid diseases, malnutrition, low residual renal function (RRF) and a high peritoneal transport rate have been shown to influence survival, but the relative importance of these factors may differ between different patient populations. Besides, centre practice patterns may differ between centres and may influence patient survival. In addition, the literature suggests that dialysis patient survival may be better in Asian than in Caucasian patients. METHODS: The influence of centre and patient characteristics on patient survival was investigated in 132 Korean and 106 Swedish incident PD patients, who underwent initial biochemical measurements and assessment of adequacy of dialysis, nutritional status, RRF and peritoneal transport characteristics. RESULTS: At the start of PD, Korean patients had a higher prevalence of diabetes, peritoneal Kt/V(urea), peritoneal creatinine clearance and peritoneal fluid removal, and lower body mass index, RRF and dialysate to plasma creatinine concentration ratio (D/P Cr) compared with Swedish patients. Significantly more patients from Korea were placed on temporary haemodialysis before PD (100 out of 132) when compared with Swedish patients (21 out of 106). During the follow-up, there was a significantly higher rate of transfer to other units in Korea and a significantly higher rate of kidney transplantation in Sweden. On Kaplan-Meier analysis, overall patient survival did not differ and relative risk for death was also not different between the two centres even after adjustment for age, diabetes, cardiovascular disease, RRF and D/P Cr. On Cox proportional hazards multivariate analysis, age, diabetes, RRF and D/P Cr were found to be independent predictors of mortality in the combined cohort of patients. While age, diabetes and D/P Cr were independent predictors of mortality in Korean patients, age and RRF independently predicted mortality in Swedish patients. CONCLUSION: Although there were significant differences in centre and patient characteristics, we were unable to confirm a survival advantage for Korean over Swedish PD patients. The results of this study suggest that the reported difference in survival between Asian and Caucasian dialysis patients may have been due, in part, to differences in centre and patient characteristics rather than to race as such. The genetic influence on patient characteristics remains, however, to be elucidated.     

Glucose concentration in the vitreous of nondiabetic and diabetic human eyes

Glycation (nonenzymatic glucosylation) of collagen may play a role in the primary pathology of the vitreous in diabetes. The extent of glycation is determined by the glucose concentration in the tissue. In this study glucose concentration was assayed in blood and vitreous samples obtained from three patient groups undergoing vitrectomy: nondiabetic patients (ND), diabetic patients with insulin-dependent diabetes mellitus (IDDM) and diabetic patients with non-insulin-dependent diabetes mellitus (NIDDM). In the ND group the glucose concentration in the vitreous (3.5 +- 1.8 mM/1) was always lower than in the blood (9.1 +- 3.5 mM/1). In the diabetic groups the vitreous glucose concentration was, with a few exceptions, generally lower than the blood glucose concentration. The vitreous glucose concentration in these groups was generally higher (IDDM 9.4+-3.3 mM/1, NIDDM 7.2+-3.9 mM/1) than in the ND group, and in 15 specimens exceeded 11 mM/1, a level increasing the probability of collagen glycation in the vitreous of diabetic patients.This study was given financial support by the Herman Järnhardt Foundation, the Inez and Joel Carlsson Foundation and by Diabetesföreningen in Malmö     

Natural killer cell activity and CSF monoamine metabolites in suicide attempters

The aim of this study was to investigate markers of serotonin and immune function in suicidal patients. Cytotoxic activity of natural killer cells (NK) and CD16 lymphocytes were studied in 28 suicide attempters and 26 healthy controls, and related in patients to 5-hydroxyindoleacetic acid (5-HIAA) in cerebrospinal fluid (CSF). Patients with CSF 5-HIAA below the median had significantly lower NK cell activity than other patients. CD16 cell frequency was significantly lower in patients than in controls, and patients also tended to have lower NK cell cytotoxicity than healthy controls. There were no statistically significant correlations between 4-hydroxy-3methoxyphenyl glycol (HMPG), homovanillic acid (HVA), CSF cortisol and NK cell activity. The results support the hypothesis of compromised immune function in suicidal patients with evidence of disordered serotonin function.     

Radiographic prediction of failure after fixation of cervical hip fracture

During 1984-1985, 410 patients with cervical hip fracture were randomized between 2 methods of internal fixation-a single nail (Rydell) or 2 LIH hook pins (LIH). The patients were followed-up prospectively for at least 2 years. Radiographs were taken after 1 week, 1, 3, 6, 12, and 24 months. The radiographs of the 295 paients alive 2 years postoperatively were examined by one of the authors. The sliding and the diversion of the pins and the nail in the anteroposterior projection and the diversion in the lateral projection were measured. In the failure group (non-union, late segmental collapse), the greatest sliding was noted within 1 month postoperatively and the diversion increased up to 3 months. Significant differences between the failure and the non-failure groups could be seen even after 1 week. We also found that the degree of sliding of the LIH pins and the Rydell nail 1 month postoperatively is comparable to the scintigraphic pattern 2 weeks postoperatively in predicting failure after nternal fixation of cervical hip fractures.     

Biological exposure limits estimated from relations between occupational styrene exposure during a workweek and excretion of mandelic and phenylglyoxylic acids in urine

Summary Styrene exposure of 18 workers in fiber-glass reinforced plastic industries was measured for 30-min periods throughout each workday for a week. The styrene uptake was estimated using pulmonary ventilation measurements. All urine voidings were collected separately and the styrene metabolites, mandelic acid (MA) and phenylglyoxylic acid (PGA) were determined. The relationship between both exposure and uptake versus excretion of these metabolites was studied. Styrene metabolite concentrations and excretion rates (with 95% tolerance limits) were calculated to correspond to a constant 8-h exposure at the Swedish exposure limit level (25 ppm) or an uptake of an exposure limit related styrene dose (6.3 mmol). The tightest tolerance limits were obtained for excretion rate of MA + PGA per 24 h. The calculated biological exposure limit was 3.4 (± 0.7) mmol MA + PGA/24 h for a dose of 6.3 mmol styrene.     

Evaluation of the image quality of ink-jet printed paper copies of digital chest radiographs as compared with film: A receiver operating characteristic study

Paper copies of digital radiographs printed with the continuous ink-jet technique have proved to be of a high enough quality for demonstration purposes. We present a study on the image quality of ink-jet printed paper copies of digital chest radiographs, based on receiver operating characteristic (ROC) analysis. Eighty-three digital radiographs of a chest phatom with simulated tumors in the mediastinum and right lund, derived from a computed radiography (CR) system were presented in two series of hard copies as ink-jet printed paper copies and as laser recorded film. The images, with a matrix of 1,760×2,140 pixels, were printed with a spatial resolution of 10 pixels/mm in the CR film recorder as well as in the ink-jet printer. On film, every image was recorded in two versions, one optimized for the mediastinum and one for the lungs. On paper, only one image was printed; this constituted an effort to optimize both the mediastinum and the lungs. The ink-jet printed images, printed on a matt coated paper, were viewed as on-sight images with reflected light. The exdaminations were reviewed by six radiologists, and ROC curves were constructed. No significant difference was found between the performance of film and that of ink-jet paper prints. Because the cost for a paper copy is only a tenth of that of film, remarkable cost reductions can be achieved by using the ink jet technique instead. Our results show that further quality studies of ink-jet printed images are worthwhile.     

Biochemical, Enzymatic, and Serological Differentiation of Peptococcus indolicus (Christiansen) Sørensen from Peptococcus asaccharolyticus (Distaso) Douglas

Peptococcus indolicus (formerly Micrococcus indolicus) is an asaccharolytic anaerobic coccus that is frequently isolated from udder secretions from cases of heifer and dry-cow mastitis (summer mastitis). To facilitate better identification and its differentiation from Peptococcus asaccharolyticus, a variety of biochemical, enzymatic, and serological properties were studied. Seventy-nine strains of P. indolicus of bovine origin and 10 strains of P. asaccharolyticus of human origin were examined using the API 20A and API-ZYM test kit systems. In addition, production of extracellular enzymes by using sensitive substrate-containing agar plate tests, production of peptocoagulase (a plasma-clotting factor), hemolytic properties, metabolic end products by gas chromatography, and serological characteristics with a set of P. indolicus typing antisera were investigated. P. indolicus and P. asaccharolyticus were not satisfactorily differentiated solely by the API 20A system. P. indolicus differed from P. asaccharolyticus in producing H(2)S, reducing nitrate to nitrite, producing peptocoagulase, possessing alkaline phosphatase, and producing large amounts of propionate from lactate. Moreover, none of the strains of P. asaccharolyticus was typable with the P. indolicus typing antisera. The majority (88%) of P. indolicus strains also gave weak hydrolysis of ribonucleic acid, and 6 out of 79 produced deoxyribonuclease. All strains in this study were sensitive to metronidazole (5 mug) by disk diffusion tests.