The complete array of electrocardiogram abnormalities secondary to myocardial contusion in a single case.

Myocardial contusion is a complication of blunt thoracic injuries. Transthoracic echocardiography and electrocardiography (ECG) monitoring are important in suspected cases. We report a 54-year-old man, who sustained a number of injuries including blunt chest injury as a consequence of a road traffic accident.

Chronic idiopathic pain syndromes.

In this review, we outline a rational approach to the complex problem of chronic idiopathic pain syndromes. We focus principally on musculoskeletal pain disorders and emphasize the differences between adults and children. The different nomenclatures in use are clarified and the epidemiology is examined.

Bone marrow transplant in Ph+ ALL patients.

Although the outcome for Philadelphia positive (Ph+) acute lymphoblastic leukemia (ALL) with conventional chemotherapy is poor, the outcome after a sibling-matched allogeneic bone marrow transplantation (BMT) seems to be significantly better. The surprising success of allogeneic BMT may be because of disease response to high-dose chemotherapy combined with a graft-versus-leukemia effect. However, less than 30% of patients have a matched related donor available, and some of them will be too old/not fit for conventional BMT.

A simple, rapid method for measuring the percentage of water in alcohols used for dehydrating tissues.

A method is described for determining the concentration of water in alcohols that have been used for dehydrating specimens. The alcohol to be tested is added dropwise to 5.0 ml of xylene, counting the number of drops that causes turbidity, then the number of additional drops required to make the liquid transparent again.

For debate: concomitant critical coronary arterial disease and abdominal aortic aneurysm--timing of corrective procedures.

Background: The high prevalence of coronary artery disease (CAD) in patients with abdominal aortic aneurysm (AAA) is responsible for most , 30-day mortality and morbidity in elective repair of AAA. The continuing debate regarding staged or combined surgery for AAA and CAD (coronary artery bypass grafting -CABG) in the small number of patients with critical degrees of both co-morbidities has not had a significant impact on the greater mortality and morbidity when the AAA repair is undertaken using the standard open operation.

Patients: We report four cases with these combined pathologies which we have managed over the last 30 months during which time we have developed techniques of endolumenal repair of AAA.

Moderately low vitamin B12 does not compromise transmethylation in adults on a free diet: implications for assessment of vitamin B12 status.

Lower reference limits for vitamin B12 are often defined solely in relation to haematological criteria. This may be misleading and there is evidence indicating that biochemical anomalies should also be considered. In 50 patients we measured creatine, as the major product of B12-mediated remethylation, to see if this helps the definition of the B12 reference interval and to investigate the possible effect of low B12 on essential transmethylation.

Comparison of microembolism detected by transcranial Doppler and neuropsychological sequelae of carotid surgery and percutaneous transluminal angioplasty.

Background And Purpose: Percutaneous transluminal angioplasty (PTA) is currently being assessed for the treatment of carotid stenosis. In comparison with carotid endarterectomy (CEA), there is evidence of an increased risk of cerebral microembolism during the procedure. We have sought evidence of any neuropsychological sequelae of carotid PTA and compared it with CEA to demonstrate the relative safety of the 2 treatment options.

The role of virus-specific CD8(+) cells in liver damage and viral control during persistent hepatitis B virus infection.

Hepatitis B virus (HBV) is a noncytopathic virus, and the recognition of infected hepatocytes by HBV-specific CD8 cells has been assumed to be the central mechanism causing both liver damage and virus control. To understand the role of cytotoxic T cells in the pathogenesis of HBV infection, we used functional assays that require T cell expansion in vitro and human histocompatibility leukocyte antigen (HLA)-peptide tetramers that allow direct ex vivo quantification of circulating and liver-infiltrating HBV-specific CD8 cells. Two groups of patients with persistent HBV infection were studied: one without liver inflammation and HBV replication, the other with liver inflammation and a high level of HBV replication.

Percutaneous fixation of scaphoid fractures. An anatomical study.

Percutaneous scaphoid fracture fixation has many advantages over the open method of fixation. We describe the anatomical basis for a safe percutaneous approach. Cannulated screws were inserted into 32 cadaveric scaphoids through 1 cm palmar incisions under fluoroscopic control.

Imaging approaches to the correlation of structure and function in the kidney.

Aims: This review sets out to cover the areas of radiology and imaging concerned with the structure and function of the kidney which may not be familiar to those outside the field.

Methods: A brief historical introduction to renal imaging is followed in more detail by descriptions of the use of computed tomography in 3D reconstruction, angiography, and functional studies. Comparison with magnetic resonance imaging is made and the use of radiological techniques in intervention.

A study to determine whether trisomy 8, deleted 9q and trisomy 22 are markers of cryptic rearrangements of PML/RARalpha, AML1/ETO and CBFB/MYH11 respectively in acute myeloid leukaemia. MRC Adult Leukaemia Working Party. Medical Research Council.

Acute myeloid leukaemia (AML) patients with either a t(15;17), t(8;21) or inv(16) at diagnosis have 'good-risk' disease with a favourable response to therapy and improved survival. Detection of cryptic fusion genes created by these translocations has been reported where there is no cytogenetic evidence of the corresponding abnormality. It is likely that these cases share the same favourable prognosis.

Three-dimensional US of the fetus. Work in progress.

Purpose: To develop a system for three-dimensional (3D) ultrasonography (US) that readily interfaces with conventional equipment and to apply this system to fetal imaging.

Materials And Methods: An acquisition system based on transputer technology records from the video output of standard clinical scanners was interfaced with a position-sensing device, one component of which was attached to the US probe. The method differs from other 3D US methods as any conventional probe may be used, freehand scanning is possible, and no line-of-sight limitations operate.

An in vitro characterization of cefditoren, a new oral cephalosporin.

Cefditoren (ME 1206) is a new cephalosporin available for oral administration as the pivaloyloxymethyl ester (ME 1207). The effect of medium formulation. pH, cation concentration and inoculum on the in vitro activity of cefditoren was investigated prior to determining its comparative antibacterial potency against a wide range of clinical bacterial isolates, its bactericidal activity against susceptible strains and the duration of its post-antibiotic effect (PAE).