Subclavian vein catheterization for acute and chronic haemodialysis. A safe temporary vascular access

The technique and use of a percutaneous subclavian vein catheter for haemodialysis in 20 patients are reported. The catheterization procedure carried a very low morbidity, and blood flow rates of 200–250ml/min were achieved through the catheters. Use of this angioaccess saves future possible sites for permanent vascular access. Infectious complications were not encountered. Subclavian vein catheterization is a favourable alternative to external Silastic Teflon shunt.     

Differential diagnosis of jaundice: a pocket diagnostic chart

Based on extensive clinical and clinical chemical information (107 different items) from 1002 jaundiced patients, we developed a diagnostic algorithm which was evaluated on a test sample of another 110 jaundiced patients. A primary classification into categories of obstructive jaundice (probability of obstruction greater than or equal to 0.80), non-obstructive jaundice (probability of obstruction less than or equal to 0.20), and of doubtful causes of jaundice (probability of obstruction: 0.20-0.80) was attempted. Among 234 patients in the data base who were classified as obstructive, 220 (94%) proved to be so, as did 36 (97%) of 37 in the test sample. The corresponding figures for non-obstructive jaundice were 463 (96%) of 483 patients correctly classified in the data base and 47 (92%) of 51 patients in the test sample. Altogether 69% of the patients in the data base and 75% of those in the test sample were correctly classified, in 27% and 20% the cause of jaundice was doubtful, and only 4% and 5%, respectively, were misclassified. A slight majority of the patients in whom the algorithmic diagnoses were doubtful proved obstructive. A close correlation was found between the preliminary diagnoses made by the algorithm and by the clinicians. A secondary classification of the patients by the algorithm into benign versus malignant causes of obstructive jaundice performed equally well in the data base and the test sample.     

Elliptical posts allow for detailed control of non-equibiaxial straining of cell cultures

BackgroundA modification of the Flexcell system that allows imposition of homogenous, controlled non-equibiaxial strains to cell cultures is developed and experimentally validated. The Flexcell system by default applies equibiaxial strain to cell cultures, meaning no shear strain, while soft tissue cells in vivo are subjected to a range of mechanical deformations including shear strain caused by activities of daily living. Shear strains are suspected to play an important role in tissue necrosis.MethodThe Flexcell system was redesigned using a finite element model in order to obtain large areas of the membrane in a controlled, uniform non-equibiaxial strain state.ResultsThe redesign was manufactured and the resulting strains were experimentally validated by means of image analysis methods. The results showed that the system could be used for experiments varying the shear strain.ConclusionThe result allows scientists and experimentalists to apply detailed control of the strain tensor applied to tissue samples in two dimensions.     

Surgical versus medical treatment of nasal polyps

A randomized comparison of the usual surgical removal of nasal polyps versus systemic steroid treatment was performed in 53 patients. In all, continuous topical steroid treatment was given during the one year period of observation. In both groups the initial treatment resulted in a continuous increase in mean nasal expiratory peak flow as well as in the sense of smell; these two parameters showed a temporary statistically significant difference in favour of the medically treated group. In general though, the results in the two treatment groups were alike. Therefore medical treatment is recommended for routine use. Surgical removal should be reserved for those few cases in which the presence of residual or recurrent polyps justifies the inherent risks and discomfort for the patient.     

Characterization of a liposome-based formulation of oxaliplatin using capillary electrophoresis: Encapsulation and leakage

A capillary electrophoresis-based method to characterize a PEGylated liposomal drug formulation of the anti-cancer agent oxaliplatin was developed. Pharmaceutical characterization in terms of determination of the free and total oxaliplatin concentrations in the liposomal formulation was successfully performed allowing calculation of the percentage of encapsulated drug and encapsulation efficiency. The trapping efficiency was likewise calculated. The capillary electrophoresis method allowed liposome characterization in the intended formulation media (sucrose solution with low electrolyte concentration), and the attained results were consistent with inductively coupled plasma mass spectrometry measurements. Accelerated drug leakage studies were initiated by the sonication of the PEGylated formulation, using an ultrasound probe, subsequently the drug leakage was determined by capillary electrophoresis. The results obtained with the PEGylated liposomes demonstrate that capillary electrophoresis may be a useful tool for the characterization of liposomal drug formulations.     

Benign lipoblastoma in the neck causing respiratory insufficiency

A benign lipoblnstoma in the neck, causing respiratory insufficiency and ipsilateral ptosis and miosis, in a 9-month-old girl is reported, followed by a short discussion about the nomenclature, genesis, differential diagnosis and behavior of this rare condition.     

Ultrasonographic-pathologic correlation of malignant hepatic masses

Characterization of the source of hepatic malignancy would be useful in directing a patient's workup, saving time and expense. We attempted to correlate the echographic appearance of malignant hepatic masses with the pathologic (44 patients) or clinical (1 patient) diagnosis in 45 consecutive patients scanned to evaluate this problem. In 31 patients the lesions were hyperechoic (28) or predominantly hyperechoic with central lucency. Of these lesions, 25 represented metastases from adenocarcinoma of the colon (17), pancreas (6), or unknown origin (2). Six patients with metastatic adenocarcinoma had predominantly echolucent lesions. Of the 14 malignancies of other histologic types, 6 were largely hyperechoic and could not be distinguished from adenocarcinoma metastases. No correlations could be drawn between the ultrasound patterns and the tumor source in this diverse group fo malignancies. In eight patients receiving chemotherapy, sequential examinations failed to reveal any alteration in the echographic patterns of their lesions. These results indicate that the ultrasound appearance of hepatic malignancy lacks specificity in defining the organ of origin. Such factors as homogeneity, vascularity, or desmoplastic response may be more important than cell type in producing the echographic pattern.     

Prostatic carcinoma treated with 2,6-cis-diphenylhexamethylcyclotetrasiloxane (Cisobitan).

Thirteen patients with stage III or IV carcinoma of the prostate were treated with 2,6-cis-Diphenylhexamethylcyclotetrasiloxane (Cisobitan, a new organosilicon compound. The drug proved to be a strong antiandrogen and exerted all the known effects of estrogens, including feminization and cardiovascular complications. It is therefore doubtful whether Cisobitan will be a reasonable alternative to estrogens in the treatment of patients with advanced prostatic cancer.