Internal carotid artery narrowing in children with retropharyngeal lymphadenitis and abscess

BACKGROUND AND PURPOSE: Our purpose was to describe the association between narrowing of the internal carotid artery (ICA) and retropharyngeal abscess in children. METHODS: Neck CT scans from 13 consecutive children with suppurative retropharyngeal lymphadenitis and abscess were evaluated retrospectively for asymmetric ICA diameters at the level of the abscess. Clinical status at the time of illness was established via a chart review. Twenty control CT scans obtained from pediatric patients with normal imaging findings were evaluated prospectively to determine symmetry and size of the ICA. RESULTS: Mean diameter of the normal ICA, contralateral to the retropharyngeal abscess, was 5 mm (range, 3-8 mm), while mean diameter ipsilateral to the abscess was 3 mm (range, 1-5 mm). The diameters of the normal and abnormal ICAs were statistically significantly different. All children were neurologically normal. The right and left ICAs in children with normal CT findings in the neck were symmetrical in diameter. CONCLUSION: Despite dramatic narrowing of the ICA ipsilateral to retropharyngeal lymphadenitis and abscess, no children in this series had neurologic deficits, suggesting that such narrowing is a common, benign, and, most likely, incidental imaging finding.     

Establishment of human parotid pleomorphic adenoma cells in culture: morphological and biochemical characterization

This study reports the establishment of alpha-amylase-producing human parotid pleomorphic adenoma cell lines (2HP and 2HP1) which have been maintained in culture for over 1 yr. The procedures required preparation of cellular clumps from tumor tissue and plating them on plasma clot or precoated dishes. During the initial phase of growth they required modified MCDB-153 medium without serum. When cells showed signs of degeneration they were changed to MCDB-153 medium containing first 2% and then 10% heat inactivated fetal bovine serum. Although cells grew well in MCDB-153 containing 10% serum, the epithelial cell morphology was not distinct. Therefore, the growth and morphology of cells grown in MCDB-10% serum were compared with those in RPMI growth medium containing 10% fetal bovine serum and F12 containing 10% agammaglobulin newborn bovine serum. Although the growth of cells was a little slower in F12 medium than those in MCDB and RPMI, the epithelial cell morphology was maintained better than in other growth media. The cells of 2HP and 2HP1 produce low levels of alpha-amylase and relatively high levels of alpha-amylase mRNAs of 1176 and 702 bp and contain neurofilament-160, a neuronal-specific marker. The cells of 2HP1 are tumorigenic when tested in athymic mice, but the cells of 2HP are not. The establishment of amylase-producing human parotid adenoma cell lines of different characteristics in culture provides a new opportunity to study the mechanisms of differentiation and transformation, and regulation of alpha-amylase in these cells.     

Therapeutic strategies in acute myocardial infarction. Results of STIM 93 registry

A registry was set up by the national college of cardiologists practicing in general hospitals in February 1993. The data concerned mode of admission, demographic details, initial clinical and haemodynamic evaluation and hospital outcome. Special attention was given to the electrocardiographic changes before and, in patients receiving thrombolytic therapy, after treatment. An analysis of predictive factors for mortality was performed both in the group of patients "revascularised" and in the group treated conventionally. One thousand and twenty three cases from 327 centres were analysed. There were 1292 men and 531 women, with an average age of 67.9 years. The average time interval from onset of symptoms to hospital admission was 5 h 30 min, 56.8% of patients arriving within 6 hours. 36.4% of the population underwent thrombolysis or angioplasty, 75% of patients under 75 years of age admitted before the 5th hours underwent a procedure of myocardial revascularisation. The hospital mortality was 14%, 8.7% in those revascularised and 17% in patients treated conventionally. Factors predictive of mortality were age, female gender, Killip Classes III or IV, systolic blood pressure of less than 100 mmHg, heart rate of more than 100/min and contraindications of thrombolysis. The maximum ST depression, the sum of ST depression, the sum of ST elevation and depression, were also significant predictive factors of a fatal hospital outcome in the whole population group and in patients treated conventionally. In the reperfused group, only the initial sum of ST elevation and depression was predictive of mortality: 120 minutes after the beginning of thrombolysis, the sum of ST elevations and of elevations and depressions was predictive of twice the mortality when the values exceeded 0.6 mv and 1.4 mv respectively.     

Relationships between the academic community and the pharmaceutical industry: the legislative background and its effect on spending on medical research and development

Patent legislation governing drugs has evolved through a series of amendments to the Patent Act. From 1923 until 1993, Canada operated a system of "compulsory licensing," allowing generic copies of patented medicines to be manufactured within Canada and, by 1969, to be imported. In 1987, the act was amended (Bill C-22) to provide patented medicines with a fixed period of market protection before a compulsory license could be issued and to create a price review board to monitor and control prices charged. In return for patent protection, brand-name drug companies promised to invest a growing percentage of sales revenue in research and development in Canada. A 1993 amendment to the Patent Act (Bill C-91) brought a fundamental change to the legislation by abolishing the system of compulsory licensing and applying general patent regulations to medicines, thereby bringing Canadian law into line with that of its trading partners. It is now illegal to sell a copy of a drug until the patent expires (20 years after the patent is filed). This means that marketed drugs are protected for 8 to 13 years, since drug development takes a large proportion of the life of the patent. Since this amendment was passed, the brand-name drug companies have made major contributions to research and development in Canada, increasing from 6.5% of sales revenue in 1987 to 11.6% in 1994. Major irritants in the legislation remain. Generic drug companies have complained about "linkage regulations" that allow brand-name drug companies to legally challenge generic drug production on the basis of alleged infringements of linked patents, delaying the marketing of the generic drug. The act also prohibits Canadian manufacturers from exporting a generic drug to a country where it is not protected if it still protected in Canada. Brand-name manufacturers want some means of patent term restoration if regulatory authorities prolong the time taken before marketing a drug. This legislation is being reviewed by parliament beginning in 1997.     

A simple method for calculating left ventricular functions from angiographic data using a programmable hand calculator

The end diastolic volume and systolic ejection fraction have gained increasing acceptance as important indicators of ventricular performance. Time consuming calculations and lack of computer facilities have hindered the emergence of these calculations as a routine part of cardiac catheterization studies. The introduction of the programmable hand calculator has provided means for rapid analysis of ventricular volume data in an efficient and inexpensive manner. In this paper the step-by-step procedure for programming the hand calculator is given, as well as instructions for entering raw data and obtaining final calculations. Programs are given for both single plane and biplane cine angiographic studies.     

Anatomical study of the cervical sympathetic trunk and ganglia in the albino rat (Mus norvegicus albinus)

Nine adult albino rats of both sexes were studied. 16 sympathetic trunks and ganglia were dissected in detail in eight rats. The right and left superior cervical ganglion and the sympathetic trunk below the ganglion were removed from an additional rat. The cell bodies of these ganglia and the axons of the trunks were counted with the aid of light and electron microscopy. Considering the number and location of ganglia and patterns of branching, the rat's cervical sympathetic nervous system compares closely with man's. There appears to be a relationship between body size and myelination of preganglionic neurons in the cervical sympathetic trunks, with smaller animals having the least number of myelinated fibers.     

Characterization of natriuretic activity from posterior pituitary lobes

Previous studies have indicated the existence of natriuretic factors of hormonal nature with the posterior pituitary gland as a possible site of origin. It was in this light that a series of experiments was designed to examine the posterior pituitary for such factors. Acetic acid extracts of porcine and bovine posterior pituitary lobe tissue were subjected to gel filtration on Sephadex G-25. Several fractions in the molecular size range of 1000 were obtained which possessed potent natriuretic activity as assayed in rats. The activity of these fractions maximally increased sodium excretion to 6-8 muequiv./min, a 10- to 40-fold increase above control, when administered intraperitoneally to hydropenic, conscious rats. However, oxytocin and vasopressin, present in the posterior pituitary are natriuretic. These hormones were measured by radioimmunoassay, and invariably only those fractions which contained vasopressin and (or) oxytocin possessed natriuretic activity. Moreover, the extent of the natriuresis could be accounted for by the vasopressin and (or) oxytocin content of the test fractions. The natriuretic property of this material was abolished by treatment with thioglycollate. Further purification of natriuretic fractions by ion exchange resins, thin-layer chromatography and isoelectric focusing failed to resolve natriuretic activity from vasopressin and oxytocin. Similar results were observed following analysis of fractions isolated by gel filtration of acetic acid extracts of ventral hypothalamus tissue. The natriuretic fractions isolated from hypothalamic tissue were indistinguishable from oxytocin and vasopressin. These experiments suggest that the natriuretic activity in neurohypophyseal extracts can be attributed to oxytocin and vasopressin.     

Detection and estimation of azomethane in expired air of 1,2-dimethylhydrazine-treated rats

Azomethane (AM) gas was identified as a major metabolite of 1,2-dimethylhydrazine (1,2-DMH) in the expired air of F344 rats. The compound was characterized by high-pressure liquid chromatography, gas chromatography, and mass spectrometry, in comparison to a synthetic standard. At a dose of 21 mg 1,2-DMH/kg sc, approximately 14 and 11% of the dose were exhaled as AM and CO2, respectively, in 24 hours. At 200 mg 1,2-DMH/kg, 23 and 4% of the dose appeared as AM and CO2, respectively, in the respired air within the same period. Most AM was seen in the first 6 hours, but the CO2 evolution was more progressive, especially after the higher dose of 1,2-DMH.     

Common complications of vaginal hysterectomy: thoughts regarding their prevention and management

Quantitative estimates were computed for exponential coefficients and rate constants contributing to afferent unit impulse responses obtained from bundles innervating specific regions of the semicircular canal. The grouping of these estimates into specific response classes provided quantitative correlations with specific anatomical regions of innervation of the crista. Linear system gain and phase spectra were computed also, by applying Fourier transformations to unit impulse responses, for purposes of comparison with previous studies employing frequency domain analyses. Responses fitted by third-order linear system equations were specific to afferents innervating the crest and transition regions of the crista; whereas those fitted by overdamped, second-order equations were specific to afferents innervating the slopes and transition crista regions. It was concluded that strictly mechanical models of the transduction process are inadequate to account for the diverse and spatially distributed classes of observed responses and, moreover, structural features such as different hair cell types or efferent innervation effects could be excluded as inoperative in this preparation. The alternative hypothesis was suggested that certain of the observed subcomponents could be direct reflections of the initial mechanical stimulus, but that other subcomponents were reflections of more complex filtering mechanisms operating at the cellular or synaptic levels.     

Changes in the hatch rate of Haemonchus contortus eggs between geographic regions

Vulvar phenotypes and the rate of development of eggs over a range of temperatures were used to compare Haemonchus contortus populations in New York State and Ohio. These parameters indicated that the westernmost boundary of the subspecies Haemonchus contortus cayugensis is the Chautauqua valley in New York. The Haemonchus ecotype in Ohio had a vulvar phenotype formula similar to that described for the subspecies Haemonchus contortus contortus. The relationship between slope and intercept of the regression of rate of egg hatch on temperature was different for morphs within ecotypes as well as between the New York and Ohio ecotypes. Linguiform-A appeared to be the cold-adapted morph in both ecotypes. Smooth was the warm-adapted morph in New York with linguiform-B filling that niche in Ohio.