Inhaled prostacyclin (PGI2) versus inhaled nitric oxide in adult respiratory distress syndrome.

Inhalation of nitric oxide (NO) and prostacyclin (PGI2) may induce selective pulmonary vasodilation and-by improving ventilation-perfusion ratio in ventilated areas of the lung-increase Pao2 in patients with acute lung injury. To assess the therapeutic efficacy of both compounds, dose-response curves were established in patients with adult respiratory distress syndrome (ARDS). Patients received both PGI2 (doses of 1, 10, and 25 ng/kg/min) and NO (concentrations of 1, 4, and 8 ppm).

[A new score for comparing outcome of surgical management of Achilles tendon ruptures].

From January 1987 to March 1994 three hospitals in the city of Magdeburg treated a total of 103 subcutaneous Achilles tendon ruptures operatively. We created a special score to compare the outcome of the different operation techniques used. Important aspects of the follow-up examination were isokinetic measuring of power and staying power by means of a KIN-TREX dynamic measuring device and the clinical check-up in comparison with the histological results and the patients' history.

Aerosol production and aerosol droplet size distribution during mechanical ventilation (IPPV) with a new ultrasonic nebulizer.

Administration of drugs via the airway is increasingly practiced in ICU- and surgical patients. For this purpose, aerosols may be produced by either jet nebulization or ultrasonic droplet generation. In mechanically ventilated patients, aerosol delivery is often insufficient.

[Dermatomyositis-like skin changes with long-term hydroxyurea (Litalir) therapy].

We report on dermatomyositis-like adverse cutaneous reactions following long-term maintenance therapy with hydroxyurea in two patients suffering from chronic myelogenous leukaemia (CML). In addition to non-specific side effects, such as xerosis, pruritus and hyperpigmentation, both patients presented with more specific skin changes, i.e.

A 5' splice-region mutation and a dinucleotide deletion in the lysosomal acid lipase gene in two patients with cholesteryl ester storage disease.

Cholesteryl ester storage disease (CESD) results from inherited deficiencies of the lysosomal hydrolase, acid lipase (LAL; E.C. 3.

Fibrous neoplasms of the adult larynx.

Fibrous neoplasms of the adult larynx are uncommon and can be benign, locally aggressive, or malignant. From January 1, 1987 to December 31, 1991, 189 adult patients underwent partial or total laryngectomy for laryngeal neoplasms at the University of Texas Southwestern Medical Center-affiliated hospitals. During this period, three (1.

Purification, characterization and molecular cloning of human hepatic lysosomal acid lipase.

Lysosomal acid lipase (LAL) is a hydrolase essential for the intracellular degradation of cholesteryl esters and triacylglycerols. This report describes a multi-step procedure for the purification of LAL from human liver. After solubilization with non-ionic detergent, acid hydrolase activity was purified 17000-fold to apparent homogeneity by sequential chromatography on Concanavalin A Sepharose, carboxymethyl-cellulose, phenyl Superose, Mono S cation exchange and Superose 12 gel-filtration columns.

Principles of radical oesophageal surgery.

The standard procedure for cervical oesophageal carcinoma consists of partial pharyngectomy, laryngectomy with tracheostomy, resection of one thyroid lobe and complete oesophagectomy. For intrathoracic and abdominal carcinoma of the oesophagus, subtotal resection leaving a small cervical portion is sufficient. If the carcinoma has not exceeded the organ boundaries or is located below the tracheal bifurcation, the choice of resection either by transthoracic, transmediastinal or endoscopic methods is not critical with respect to the radical nature of the resection.

[The role of Helicobacter pylori in the development of chronic gastritis and gastroduodenal ulcers].

To determine the correlation between Helicobacter pylori colonization of the gastric mucosa and the incidence of chronic gastritis as well as gastric and duodenal ulcer, 52 patients (26 women and 26 men) aged 19-77 years (mean 46 years) with gastrointestinal symptoms were studied. Biopsy specimens for histological and bacteriological examinations were taken during upper gastrointestinal tract endoscopies. Helicobacter pylori was found in 21 (40%) patients: 14 women and 7 men (p less than 0.

Computed tomographic evaluation of regional lymph node involvement in cancer of the oral cavity and oropharynx.

To evaluate the efficacy of computed tomography (CT) in the identification of metastatic cervical node involvement from cancer of the oral cavity and oropharynx, 61 consecutive, previously untreated patients with T2 or greater squamous cell carcinoma of these sites were studies prospectively by CT, followed within 1 month by surgery to the primary and neck as initial treatment. The CT scan of each patient was evaluated according to the location, size, and appearance of visible nodes, and each feature was correlated with the histopathologic findings of all 83 neck specimens. A significant relationship was found between CT findings (node size, node appearance, and multiplicity of nodes) and the pathologic status of the neck using Chi-square contingency table analysis (overall chi 2 = 30.

[Bacterial flora of the surgically treated stomach].

In 33 patients operated on for peptic ulcer the pH and the bacterial flora of the gastric contents were studied. In 30 cases the pH of the gastric juice was increased, and parallelly the bacterial flora was more numerous. In 33 patients 139 various bacterial strains were cultured from gastric juice (70 strains of Enterobacteriaceae, 46 strains of cocci and Gram+ bacilli, 23 strains of fungi) in concentrations of 10(3)-10(7)/ml.

Silent supraglottic carcinoma.

In a review of 51 consecutive patients with previously untreated squamous cell carcinoma of the supraglottic larynx, five (9.8%) patients were found to have no mucosal abnormality on initial evaluation by both computed tomography (CT) and direct laryngoscopy. All five patients who manifested submucosal disease had at least one endoscopic procedure done with a biopsy negative for cancer before definitive diagnosis, resulting in an average delay from initial endoscopy to diagnosis of 19.

Adult parapharyngeal extracardiac rhabdomyoma.

The case of a parapharyngeal adult extracardiac rhabdomyoma (ER) in a 69-year-old man is presented focusing on computed tomographic diagnosis, surgical approach, and pathologic diagnosis. Although a rare neoplasm, adult ER has a propensity for occurring in the head and neck. Systematic computed tomography evaluation with contrast serves to define the extent of the lesion and assist in the differential diagnosis of parapharyngeal masses.

Cricoarytenoid subluxation, computed tomography, and electromyography findings.

A case of cricoarytenoid subluxation secondary to endotracheal intubation and documented by computed tomography (CT) and electromyography (EMG) is reported. Successful endoscopic reduction of the displaced arytenoid is confirmed by CT. The normal anatomy and physiology of the cricoarytenoid joint is presented and the literature regarding this rarely reported injury is reviewed.

Asymptomatic laryngocele: incidence and association with laryngeal cancer.

Since laryngoceles are usually asymptomatic, their incidence is probably higher than the literature suggests. With the advent of computed tomography, the incidence and significance of the asymptomatic laryngocele in a general head and neck practice can be addressed. To this end, 304 consecutive patients with a variety of otolaryngic diagnoses were studied prospectively by computed tomography of the neck from January 1983 to February 1985.

Drug monitoring of etoposide (VP16-213). Correlation of pharmacokinetic parameters to clinical and biochemical data from patients receiving etoposide.

Pharmacokinetic parameters established in 15 patients receiving parenterally administered etoposide (80-120 mg . m-2) are reported. The etoposide assay by means of mass spectrometry after sample separation by thin-layer chromatography or high-pressure liquid chromatography used in this study has been described elsewhere.

Verrucous carcinoma of the cervix: a report of two cases and literature review.

Verrucous carcinoma of the cervix, like verrucous carcinoma of the vulva, is commonly misinterpreted as condyloma accuminata, resulting in a protracted delay of appropriate treatment. Since the correct diagnosis depends upon histological criterion which frequently belies the malignant nature of this lesion, conveyance to the pathologist of the history, physical findings, and clinical behavior of the lesion may facilitate early recognition. Aggressive surgical procedures including exenteration should be considered as primary treatment for large lesions and recurrent lesions when local excision fails.

Computed tomography in the assessment of mandibular invasion by intraoral carcinoma.

A critical factor in the pretreatment evaluation of patients with carcinoma of the oral cavity or oropharynx is the presence or absence of bone invasion. A prospective study was performed to compare the sensitivity and specificity of plain radiographs and computed tomography in detecting mandibular invasion by cancer arising in these sites. Forty-three consecutive patients with previously untreated oral cavity or oropharyngeal carcinoma were evaluated preoperatively by intraoral radiographs (dental occlusal views and panoramic radiographs) and CT, and the results were compared with postoperative pathologic findings.

Giant congenital cystic malformation of the gallbladder.

This report describes the diagnosis and management of a "giant cystic malformation of the gallbladder," in a child with multiple congenital anomalies.

[Atypical corneal changes in Ehlers-Danlos syndrome].

An unusual case of corneal thinning is reported. Corneal thinning and many mesodermal tissue abnormalities corresponding to Ehlers-Danlos syndrome were observed.

Magnetic resonance imaging vs computed tomography. Comparison in imaging oral cavity and pharyngeal carcinomas.

Twenty-one patients with oral cavity and pharyngeal carcinomas were enrolled in a prospective protocol to study the diagnostic efficacy of magnetic resonance imaging vs computed tomography. Magnetic resonance imaging was found to be superior to computed tomography in the area of tumor contrast (conspicuity) and equal or inferior in edge definition, delineation of regional disease, and lymph node metastasis. These findings are consistent with the current applications and limitations of magnetic resonance imaging.

Evaluation of NMR versus CT for parotid masses: a preliminary report.

Twelve patients with various parotid masses were prospectively studied by both nuclear magnetic resonance (NMR) imaging and intravenously enhanced computed tomography (CT). These imaging techniques were then correlated with the disease process and clinical relevance of both forms of imaging assessed. Our results suggest high resolution, spin-echo NMR offers several advantages over CT, and is likely to become the preferred method of evaluating a parotid mass.