The Value of Lung Injury Score in Assessing the Outcome of Patients with Rib Fracture

Background and Purpose:   

Management of rib fractures constitutes a major part of the trauma workload of any unit. Rib fractures result in disrupted chest wall mechanics and ventilatory insufficiency. The ability of a lung injury scoring system to predict the degree of respiratory dysfunction after rib fractures was evaluated.     

Immunohistochemical differentiation of atypical hyperplasia vs. carcinoma in situ of the breast.

The distinction between atypical hyperplasia and carcinoma in situ in breast lesions can be difficult. The identification of myoepithelial cell layers may be helpful in establishing a diagnosis of proliferative breast disease vs. intraepithelial neoplasia. We reviewed pathologic material on 20 cases of atypical hyperplasia and 29 cases of carcinoma in situ. Immunohistochemical stains were employed against muscle-specific actin, S-100 protein, and cytokeratin to identify myoepithelial cells and to recognize different staining patterns. In atypical hyperplasia, muscle-specific actin staining identified myoepithelial cells in fine branching fibrovascular layers or as scattered cells between other proliferating cells. This pattern was absent in carcinoma in situ. S-100 protein showed more positive staining in atypical hyperplasia than in carcinoma in situ with patterns distinct from muscle-specific actin. Immunostaining for cytokeratin demonstrated distinctly different patterns between the two lesions. This study suggests that muscle-specific actin, S-100 protein, and cytokeratin in combination may assist in distinguishing proliferative breast disease with atypia from carcinoma in situ.     

Craniofacial serial dimensions related to age, sex, and cleft-type from six months of age to two years.

The first two postnatal years are a time of rapid craniofacial growth. We selected 30 cleft lip/palate children, each seen at 6, 12, 18, 24 months, at which time lateral X-ray headfilms were taken. There were five boys, five girls, in each of three cleft-types: cleft palate only (CP), unilateral cleft lip/palate (UCLP), and bilateral cleft lip/palate (BCLP). Three dimensions were selected: 1) anterior cranial base (S-N); 2) upper face height (N-Pt.A); 3) maxillary depth (Pt.A-Ptm). All were in the midsagittal plane. This is a repeated measures study on the factor patient age, so that for each combination of sex and cleft-type the same subject was measured at the four levels of patient age. The multiple comparison technique utilized was the Newman-Keuls Procedure. There is no significant joint effect in the 6-24 months period. The factors seem to operate singly. There is no main effect due to the factor sex. Dimensions N-Pt.A. and Pt.A-Ptm show a significant main effect due to the factor cleft-type. There is a highly significant main effect due to the patient age factor.