Accuracy of roentgenograms of the chest in metastases to the lungs

The findings on roentgenographic and tomographic examination of the chest were compared in 63 instances of suspected pulmonary metastases. These were further compared with the findings at thoracotomy in 41 instances. Of the 60 patients, 30 had soft tissue or bone sarcomas and 30 had carcinomas arising from colon, ovary or breast, and it also included five with malignant melanoma. Three patients with sarcomas had more than one thoracotomy. The diagnosis of pulmonary metastases by roentgenography of the chest was correct in 60 of 63 instances. Tomograms showed more lesions in 14 of 33 instances of sarcomas and 14 of 30 instances of carcinomas. Thoracotomy revealed even more lesions than were detected by tomography in 21 out of 26 instances with sarcomas and eight of 15 instances of carcinomas. Of the 37 patients with a solitary metastasis detected on roentgenograms of the chest, 22 were found to have additional lesions on the tomograms, 11 of 16 sarcomas and 11 of 21 carcinomas. At thoracotomy, however, nine of ten patients with a single metastasis from sarcomas were found to have even more lesions, while, in patients with carcinomas, tomograms were found to be accurate. Routinely, prior to major ablative operations for sarcomas and before excision of pulmonary metastases, it is suggested that tomography be carried out.     

Enteroviral persistence in eye infections in monkeys (postuveitis syndrome)

Follow-up (5.5 years) of monkeys with a history of acute enterovirus uveitis (AEU) after intraocular infection with ophthalmotropic ECHO 11 and ECHO 19 strains showed progressive changes in the infected eye; destruction of the iris, formation of films in the anterior chamber of the eye, deformation of the pupil, and signs of cataract and glaucoma. A short (1-30 days) stage of active reproduction of infective virus (up to 10(10) TCD50/g tissue in the first days postinfection) was followed by the second very long stage of limited specific multiplication of virus in ocular tissues. The virus was not detected during the second stage, but its components (virusspecific antigen and crystalloid accumulations of virions) were found in ophthalmic and conjunctival tissues; moreover, high levels of neutralizing antibodies were detected in the blood. The results indicate AEU transformed into a stubborn persistent infection of the eye in monkeys. The findings of this follow-up and published reports about many-year follow-up of children with AEU permit us to classify a post-uveitis disease as a special nosological form of a persistent enterovirus infection and denote it as enterovirus post-uveitis syndrome. The main signs of this syndrome are a history of AEU, progressive destructive changes in the anterior segment of the eye, presence of virus components in ocular tissues in remote periods after infection, and high antibody level in the blood.     

Pharmacokinetics of rifampicin in experimental animals]

Rifampicin is rapidly absorbed when administered orally. Its high levels were detected during 1 to 3 hours after administration. The antibiotic was preserved in the blood serum in therapeutic concentrations for at least 24 hours depending on the dose used. When used repeatedly, it did not cumulate. Rifampicin easily penetrated into the organs and tissues of the animals, the highest concentrations being observed in the liver and kidneys. The antibiotic was mainly excreted with the bile. The drug pharmacokinetics depended on the animal species.     

Thrombocyte lactate dehydrogenase isoenzymes in patients with ischemic stroke

It was established that in the acute period of the ischemic stroke in the maiority of cases a change of isoenzyme structure of LDG thrombocytes was due to a decrease of LDG3 activity. In a number of patients the dominant change in the spectrum was determined by LDG and LDG4 fractions. The changes were of a stable character up to 10 weeks. LDG4 increase was characteristic of the isoenzymes spectrum in the patients with a severe development of the disease and in the patients in the remote period of the stroke. The obtained data can serve as a criterion for evaluating the adaptive changes in acute brain ischemia.     

Validity and use of written simulation tests of clinical performance

The outcome of a simulated clinical problem (drug-induced agranulocytosis) was compared with the outcome of similar cases in real medical service. The total performance of 100 sixth-year medical students at the end of their clerkship in internal medicine resulted in a mortality of 10 per cent in the simulation exercise. This mortality rate is the same as that which occured in the medical service during a four-year period. The total performance of the students was at about the same level at the end of the first clinical term and at the beginning of the clerkship in internal medicine (sixth term) but significantly better at the end of the latter.