Carotid transposition: another cause of wide retropharyngeal soft tissues

OBJECTIVE: The purpose of this original report is to describe medial transposition of the common carotid arteries. This transposition may produce wide retropharyngeal soft tissues on lateral cervical radiographs. CONCLUSION: When common carotid arteries are transposed from their normal lateral positions into the retropharyngeal soft tissues, if vascular calcifications are present, this carotid abnormality is easily recognized on plain radiographs. Radiologists and clinical physicians should be aware that vascular transposition may be a benign cause of widening of the retropharyngeal soft tissues.     

Differential involvement of the brain in neonatal asphyxia: a pathogenic explanation

Multiple cystic lesions in brain parenchyma supplied by the anterior cerebral circulation is a recognized pattern of cerebral injury associated with hypoxic-ischemic encephalopathy in the term infant. This report presents a series of seven infants (gestational age, 39.3 +/- 2.8 weeks; range, 36 to 44 weeks) who developed multicystic encephalomalacia in the distribution of the anterior cerebral circulation after severe neonatal asphyxia. Cerebral imaging and pathologic studies demonstrate relative preservation of the cerebellum, brain stem, and cerebral structures supplied by the vertebrobasilar circulation. Compared to the vertebrobasilar vasculature, the anterior cerebral vessels in the term infant have dense sympathetic innervation. Asphyxia, a potent sympathetic stimulator, may induce vasoconstriction in the anterior circulation and differentially accentuate the effects of hypoxia/ischemia on cerebral tissue.     

Evaluation of problem solving and communication skills of persons with schizophrenia

This study examined gender differences in 162 female and 65 male patients with cancer referred to home care. Data were collected before hospital discharge using the Multidimensional Functional Assessment Questionnaire, the Karnofsky Performance Status, and the Quality of Life-Cancer Scale. Controlling for age and stage of disease, the results showed that men reported significantly more cancer-related impairments, more limitations in activity of daily living, and poorer social resources than women. No gender differences were found in quality of life, perceived emotional health, perceived physical health, performance status, and comorbidity. Significant predictors of self-care activities were: for women perceived physical health, Karnofsky Performance Status, and stage of disease (58% variance explained); for men Karnofsky Performance Status and medication taken (67% variance explained). Gender differences should be considered in discharge planning to provide appropriate home care services for male and female patients with cancer.     

The regulatory mechanism of phosphatidylinositol 3-kinase by insulin in 3T3 L1 fibroblasts: phosphorylation-independent activation of phosphatidylinositol 3-kinase

Progress in understanding the basis of resistance to rifampicin (RifR) has allowed molecular tests for the detection of drug-resistant tuberculosis to be developed. One hundred thirteen strains of Mycobacterium tuberculosis isolated from patients with multidrug resistant tuberculosis (MDR-TB) were investigated for genotypic analysis of RifR by polymerase chain reaction-heteroduplex formation (PCR-HDF) and characterization of mutations by automated DNA sequencing of the rpoB gene. A subset of isolates (22) representative of different mutations as confirmed by sequence analysis were also evaluated by the Line Probe Assay (LiPA). In 106 of the RifR strains, 24 mutations within an 81-bp region of the rpoB gene affecting 13 amino acids were observed. Most isolates (7/8) harboring Leu533 --> Pro codon mutation required minimum inhibitory concentrations (MICs) of < or = 8 microg/ml. There was geographic variation in the frequency of occurrence of particular rpoB mutations, with the Ser531 --> Leu/Trp codon mutation found in 59/113 of isolates. Although there are certain limitations in the use of both the rapid PCR-HDF diagnostic assay and the LiPA for the detection of rifampicin susceptibility of M. tuberculosis, these provide important and convenient tools for identifying and managing patients with MDR-TB.     

The therapeutic use of a phosphatide food concentrate in diseases of the hepatobiliary system

Our studies on phosphatide, a food concentrate, produced as a by-product during the extraction of an edible oil in the oil-extraction plants, showed its high efficacy in patients (n = 52) with abnormalities of the hepatobiliary system. The drug having more than 40 weight percent of phosphorus-containing lipids appeared to be efficacious not only in respect of the subjective status of the patients but also the functional state of the liver and paraments characterizing lipid metabolism.     

A prospective randomized study comparing a catheter-valve with a standard drainage system

OBJECTIVE: To determine if the use of a catheter-valve rather than a standard drainage system decreases the morbidity associated with the use of a long-term catheter. PATIENTS AND METHODS: One hundred patients undergoing long-term catheterization were recruited into a prospective randomized study to investigate the acceptability and determine any increase in infection associated with the use of a catheter-valve, compared with the standard drainage system. Each patient participated in the study protocol for 3 months, during which the frequency of urinary tract infection was assessed, and the patients' views obtained using a standard questionnaire and by interview. RESULTS: Ninety-four patients completed the study; most (92%) were happy or satisfied with the valve, as opposed to only 35% of those using a standard drainage bag. There was no significant difference between the groups in the incidence of urinary tract infections. CONCLUSION: The patients who used the standard drainage system felt their level of activity was impaired, whereas the group who were using the valve did not. In the long-term the valve was cheaper and caused less morbidity, but because it is constructed to allow one-way flow, this was not associated with an increase in the incidence of urinary tract infections.