A prospective randomized trial of prevention measures in patients at high risk for contrast nephropathy: results of the P.R.I.N.C.E. Study. Prevention of Radiocontrast Induced Nephropathy Clinical Evaluation.

Objectives: This study was done to test the hypothesis that a forced diuresis with maintenance of intravascular volume after contrast exposure would reduce the rate of contrast-induced renal injury.

Background: We have previously shown a graded relationship with the degree of postprocedure renal failure and the probability of in-hospital death in patients undergoing percutaneous coronary intervention. Earlier studies of singular prevention strategies (atrial natriuretic factor, loop diuretics, dopamine, mannitol) have shown no clear benefit across a spectrum of patients at risk.

Validation of a decision support tool for the evaluation of cardiac arrest victims.

Background: There is currently no well-accepted model for early and accurate prediction of neurologic and vital outcomes after cardiac arrest. Recent studies indicate that individuals with acute myocardial ischemia as the etiology for the arrest may benefit from early revascularization.

Hypothesis: This study was undertaken to examine whether the cardiac arrest score is valid for predicting outcomes upon arrival at the emergency department.

Utility of routine admission chest radiographs in patients with acute gastrointestinal hemorrhage admitted to an intensive care unit.

Purpose: To determine the diagnostic yield of routine admission chest radiographs in patients with acute gastrointestinal (GI) hemorrhage and clinical predictors of radiographic abnormalities.

Patients And Methods: The study was a retrospective series of 202 adult patients with GI hemorrhage admitted to intensive care units at an academic medical center. Routine admission chest radiographs were obtained in 161 patients.

Effects of interstitial heating on the RIF-1 tumor using an Nd:YAG laser with multiple fibers.

Background And Objective: Hyperthermia was induced in tumor-bearing C3H mice using a Nd:YAG laser emitting near-infrared radiation at 1,064 nm. The efficacy of multiple implanted fiberoptics in the control of the RIF-1 tumor was investigated.

Study Design/materials And Methods: RIF-1 tumors in the right hind leg were heated interstitially at 42, 44, or 46 degrees C for 30 or 60 minutes.

Resolution of inferior vena cava syndrome after embolization of a hepatic adenoma.

A 77-year-old man presented with severe pruritus and massive lower body edema. Computerized axial tomography of the abdomen showed a large hepatic mass compressing the inferior vena cava, and a liver biopsy specimen showed hepatic adenoma. Embolization of vessels feeding the hepatic tumor resulted in complete resolution of pruritus and ascites, and clinical remission has persisted for 1 year following partial obliteration of tumor vasculature.

Modulation transfer function technique for real time radioscopic system characterization.

At the University of Virginia neutron radiography facility, a modulation transfer function technique has been developed that can easily predict and compare the resolving characteristics of the real time system and the individual system components. We desired a simple method by which new system components could be analyzed to determine their image transfer characteristics and to estimate how they would affect the composite system during data acquisition. The method employed measures a small set of constant system parameters related to data collected across a cadmium cut-edge aperture.

Femoral vein thrombosis following percutaneous placement of the Greenfield filter.

Following percutaneous insertion of the Greenfield inferior vena cava filter via the femoral route, patients were evaluated for femoral vein thrombosis by real-time ultrasound or Duplex sonography. In 23 patients (24 veins) the femoral vein was dilated with an 8-mm (24 F) angioplasty balloon catheter. Eight of 24 common femoral veins were thrombosed (33%).

Reevaluation of indications for percutaneous placement of the Greenfield filter.

In our institution twice as many Greenfield filters were inserted in the year after percutaneous placement was begun as in the previous year when all filters were surgically inserted. Review of the indications for surgical and percutaneous filter placement in our hospital reveals that more filters were inserted percutaneously for all indications except recurrent emboli. The rates of percutaneous and surgical filter insertion for prophylaxis with acute deep venous thrombosis were similar (40% and 42%, respectively) and were higher than the majority of reported filter series because of the large number of high risk patients in our hospital population.

Gamma-linolenic acid for attention-deficit hyperactivity disorder: placebo-controlled comparison to D-amphetamine.

In a Latin-square double-crossover with random assignment to sequence, 18 boys, aged 6-12 years, with attention-deficit hyperactivity disorder received 1 month each of placebo, D-amphetamine, and Efamol (evening primrose oil containing gamma-linolenic acid, with vitamin E as preservative). Parents' ratings were noncontributory. Teachers' ratings showed a trend of Efamol effect between placebo and D-amphetamine.

Percutaneous insertion of the Greenfield inferior vena cava filter: experience with ninety-six patients.

This article evaluates the ease, safety, and convenience of percutaneous Greenfield filter placement and compares percutaneous with surgical placement. Greenfield filters were inserted percutaneously into the inferior vena cava in 96 patients. Ninety filters were placed via the femoral route and 12 were placed from the right internal jugular vein.

Aortobifemoral perigraft abscess: treatment by percutaneous catheter drainage.

There is significant morbidity and mortality associated with infected prosthetic aortic grafts. The preferred method of treatment is excision of the involved graft and revascularization. Percutaneous catheter drainage of abscesses under CT scanning or ultrasound guidance has been shown to be an effective alternative to surgery.

Thoracic CT in detecting occult disease in critically ill patients.

Bedside chest radiography is important in the detection of thoracic disease in critically ill patients. Unfortunately these studies are often of poor technical quality and are frequently difficult to interpret. Eighty-seven bedside chest radiographs and concurrent thoracic CT scans obtained in 56 critically ill patients over a 20-month period were interpreted retrospectively and independently.

The bowler hat: a valid sign of colonic polyps?

This report briefly describes several cases of diverticula simulating colonic mucosal lesions. We have found that the bowler hat configuration, in particular, frequently occurs in the presence of diverticular disease. In our series, no polyp was found to exhibit the bowler hat sign, while 12 cases of diverticular disease displayed 1 or more "bowler hats.

On the mechanism for inactivation of cytochalasin binding activity associated with F-actin and spectrin-band 4.1-actin complex by sulfhydryl reagents.

The sulfhydryl group modifying reagent, p-hydroxymercuribenzoate, inhibited the cytochalasin binding activity of the actin nuclei in the spectrin-band 4.1-actin complex from the erythrocyte membrane and of muscle F-actin. Kinetic studies indicated that while the cytochalasin binding activity was immediately inhibited, the actin remained filamentous and depolymerized slowly over a period of 1 to 2 h.

Cytochalasins inhibit nuclei-induced actin polymerization by blocking filament elongation.

Polylysine was found to induce polymerization of muscle actin in a low ionic strength buffer containing 0.4 mM MgCl2. The rate of induced polymerization was dependent on the amount and on the molecular size of the polylysine added.

The behavior of cancer affecting the subglottic space.

This retrospective study comprises 45 patients with subglottic carcinoma, arising either primarily or by spread from glottic carcinoma. The relevant literature is reviewed. Points of interest concerning the natural history of these carcinomata are: 1) The incidence of primary subglottic carcinoma was seven per cent of all laryngeal carcinomata and the incidence of subglottic spread of glottic carcinoma was 11.