Quantification of joint space width with different grades of manual traction in patients with adhesive capsulitis-A fluoroscopic study

Adhesive capsulitis causes adaptive shortening of the non-contractile structures around the shoulder joint which may affect the distraction distance or joint space width (JSW) between the glenoid and humeral head. Joint traction is a commonly used manual therapy technique to reduce pain and gain range of motion in patients with adhesive capsulitis. However, changes in JSW with manual traction are not objectively assessed. This study aimed to find differences in shoulder JSW with different grades of traction and made comparisons between the affected and the unaffected side using 2D fluoroscopy. Forty-one subjects (24 males, 17 females; age 53.9±7.9 years) diagnosed with adhesive capsulitis with low to moderate joint irritability were included. Their mean duration of symptoms was 5.25±1.7 months. True anteroposterior view images of the shoulder were taken with the patient in a supine position with their arms held at 75° of abduction. Images of the affected and unaffected side were taken while no traction, grade 2 and grade 3 manual traction were applied. The JSW was determined as the linear distance between the articular surfaces. Repeated measures ANOVA with post hoc testing was used for analysing differences across the sides (affected and unaffected side) and conditions (No, grade 2 and grade 3 traction). There was no significant interaction between conditions and sides (P=0.99). Averaged across sides, the JSW with grade 2 or 3 traction was 0.18 and 0.23 mm more than the no traction condition (P=0.013 and P=0.001, respectively). There were no differences in the JSW with grade 2 or 3 traction. Averaged across the conditions, the JSW on the unaffected side was 0.21 mm more than the affected side (P=0.03). The study demonstrates that adhesive capsulitis causes a reduction in JSW at 75° abducted position and grade 2 or 3 manual traction can significantly increase this JSW.

Clinical Trial Registry India: CTRI/2018/12/016657.

Fluoroscopic measurements of the glenohumeral joint position and space in true anteroposterior and axillary views – a reliability study

Two-dimensional (2D) fluoroscopy has been used in shoulder pathologies to estimate the humeral head position (HHP) in the true anteroposterior (AP) view. However, there is a lack of evidence regarding the reliability estimating it in the axillary view and in measuring the shoulder joint space width (JSW). True AP view images (n=36) of subjects with adhesive capsulitis were taken in supine in multiple arm abduction positions. The axillary view images (n=48) were taken in supine and prone in 75° of abduction. The HHP was assessed in the glenoid reference frame. The position and radius of the humeral head along with the superior, inferior, anterior, posterior, and middle JSWs were measured in each image. All the images were coded and randomly presented twice to a physiotherapist at a gap of 48-72 h for intra-rater reliability and to 2 therapists and an orthopaedic surgeon for inter-rater reliability. Reliability was expressed using intraclass correlation coefficients (ICC) and standard error of measurement (SEM). In both the views, inter-rater, and intra-rater reliability was excellent for the radius of the humeral head (inter-rater – 0.95-0.97 and intra-rater -0.98)], moderate (ICC: 0.70 and 0.76), and excellent (ICC: 0.89 and 0.93) for HHP. The reliability for JSWs was moderate to good (ICC: 0.66-0.82) for inter-rater and good to excellent (ICC: 0.75-0.95) for intra-rater analysis. The SEM for HHP and JSWs were <0.4 mm for intra-rater analysis, and <0.7 mm for inter-rater reliability in both views. The study demonstrated that the glenohumeral arthrokinematic parameters can be measured with good to excellent levels of reliability when using 2 D fluoroscopy.

The study is part of a clinical trial (Clinical Trial Registry India: CTRI/2018/12/016657).

Masses and Beta-decay Studies of Neutron-rich Nuclei using the X-array and Gammasphere

Properties of neutron-rich nuclei in the A˜160 region are important for achieving a better understanding of the nuclear structure in this region where little is known owing to diffculties in the production of these nuclei at the present nuclear physics facilities. These properties are essential ingredients in the interpretation of the rareearth peak at A˜160 in the r process abundance distribution, since theoretical models are sensitive to nuclear structure input. Predicated on these ideas, we have initiated a new experimental program at Argonne National Laboratory. During the first experiment, beams from the Californium Rare Isotope Breeder Upgrade radioactive beam facility were used in conjunction with the SATURN decay station and the X-array. We focused initially on several odd-odd nuclei, where β decays of both the ground state and an excited isomer were investigated. Because of the spin difference, a variety of structures in the daughter nuclei were selectively populated and characterized based on their decay properties. Mass measurements using the Canadian Penning Trap aimed at establishing the excitation energy of the β-decaying isomers were also carried out. Evidence was found for a change in the single-particle structure, which in turn results in the formation of a sizable N=98 sub-shell gap at large deformation. Results from the first experimental campaign using the newly-commissioned β-decay station at Gammasphere are also presented.

Superallowed α Decay to Doubly Magic ^{100}Sn

We report the first observation of the ^{108}Xe→^{104}Te→^{100}Sn α-decay chain. The α emitters, ^{108}Xe [E_{α}=4.4(2)  MeV, T_{1/2}=58_{-23}^{+106}  μs] and ^{104}Te [E_{α}=4.9(2)  MeV, T_{1/2}<18  ns], decaying into doubly magic ^{100}Sn were produced using a fusion-evaporation reaction ^{54}Fe(^{58}Ni,4n)^{108}Xe, and identified with a recoil mass separator and an implantation-decay correlation technique. This is the first time α radioactivity has been observed to a heavy self-conjugate nucleus. A previous benchmark for study of this fundamental decay mode has been the decay of ^{212}Po into doubly magic ^{208}Pb. Enhanced proton-neutron interactions in the N=Z parent nuclei may result in superallowed α decays with reduced α-decay widths significantly greater than that for ^{212}Po. From the decay chain, we deduce that the α-reduced width for ^{108}Xe or ^{104}Te is more than a factor of 5 larger than that for ^{212}Po.

Novel ΔJ=1 Sequence in ^{78}Ge: Possible Evidence for Triaxiality

A sequence of low-energy levels in _{32}^{78}Ge_{46} has been identified with spins and parity of 2^{+}, 3^{+}, 4^{+}, 5^{+}, and 6^{+}. Decays within this band proceed strictly through ΔJ=1 transitions, unlike similar sequences in neighboring Ge and Se nuclei. Above the 2^{+} level, members of this sequence do not decay into the ground-state band. Moreover, the energy staggering of this sequence has the phase that would be expected for a γ-rigid structure. The energies and branching ratios of many of the levels are described well by shell-model calculations. However, the calculated reduced transition probabilities for the ΔJ=2 in-band transitions imply that they should have been observed, in contradiction with the experiment. Within the calculations of Davydov, Filippov, and Rostovsky for rigid-triaxial rotors with γ=30°, there are sequences of higher-spin levels connected by strong ΔJ=1 transitions which decay in the same manner as those observed experimentally, yet are calculated at too high an excitation energy.

Masses and β-Decay Spectroscopy of Neutron-Rich Odd-Odd ^{160,162}Eu Nuclei: Evidence for a Subshell Gap with Large Deformation at N=98

The structure of deformed neutron-rich nuclei in the rare-earth region is of significant interest for both the astrophysics and nuclear structure fields. At present, a complete explanation for the observed peak in the elemental abundances at A∼160 eludes astrophysicists, and models depend on accurate quantities, such as masses, lifetimes, and branching ratios of deformed neutron-rich nuclei in this region. Unusual nuclear structure effects are also observed, such as the unexpectedly low energies of the first 2^{+} levels in some even-even nuclei at N=98. In order to address these issues, mass and β-decay spectroscopy measurements of the ^{160}Eu_{97} and ^{162}Eu_{99} nuclei were performed at the Californium Rare Isotope Breeder Upgrade radioactive beam facility at Argonne National Laboratory. Evidence for a gap in the single-particle neutron energies at N=98 and for large deformation (β_{2}∼0.3) is discussed in relation to the unusual phenomena observed at this neutron number.

Probing the Single-Particle Character of Rotational States in ^{19}F Using a Short-Lived Isomeric Beam

A beam containing a substantial component of both the J^{π}=5^{+}, T_{1/2}=162  ns isomeric state of ^{18}F and its 1^{+}, 109.77-min ground state is utilized to study members of the ground-state rotational band in ^{19}F through the neutron transfer reaction (d,p) in inverse kinematics. The resulting spectroscopic strengths confirm the single-particle nature of the 13/2^{+} band-terminating state. The agreement between shell-model calculations using an interaction constructed within the sd shell, and our experimental results reinforces the idea of a single-particle-collective duality in the descriptions of the structure of atomic nuclei.

Fast-timing measurements in neutron-rich odd-mass zirconium isotopes using LaBr3:Ce detectors coupled with Gammasphere

A fast-timing experiment was performed at the Argonne National Laboratory to measure the lifetimes of the lowest lying states of nuclei belonging to the deformed regions around mass number A≃110 and A≃150. These regions were populated via spontaneous fission of 252Cf and the gamma radiation following the decay of excited states in the fission fragments was measured using 51 Gammasphere detectors coupled with 25 LaBr3:Ce detectors. A brief description of the acquisition system and some preliminary results from the fast-timing analysis of the fission fragment 100Zr are presented. The lifetime value of τ = 840(65) ps was found for the 2+ state in 100Zr consistent within one standard deviation of the adopted value with 791 +26 -35ps. This is associated with a quadrupole deformation parameter of 0.36(2) which is within one standard deviation of the literature value of 0.3556+82 -57.

Study of the ^{26}Al^{m}(d,p)^{27}Al Reaction and the Influence of the ^{26}Al 0^{+} Isomer on the Destruction of ^{26}Al in the Galaxy

The existence of ^{26}Al (t_{1/2}=7.17×10^{5}  yr) in the interstellar medium provides a direct confirmation of ongoing nucleosynthesis in the Galaxy. The presence of a low-lying 0^{+} isomer (^{26}Al^{m}), however, severely complicates the astrophysical calculations. We present for the first time a study of the ^{26}Al^{m}(d,p)^{27}Al reaction using an isomeric ^{26}Al beam. The selectivity of this reaction allowed the study of ℓ=0 transfers to T=1/2, and T=3/2 states in ^{27}Al. Mirror symmetry arguments were then used to constrain the ^{26}Al^{m}(p,γ)^{27}Si reaction rate and provide an experimentally determined upper limit of the rate for the destruction of isomeric ^{26}Al via radiative proton capture reactions, which is expected to dominate the destruction path of ^{26}Al^{m} in asymptotic giant branch stars, classical novae, and core collapse supernovae.

Trimester specific reference intervals for thyroid function tests in normal Indian pregnant women

CONTEXT

Accurate assessment of thyroid function during pregnancy is critical, for initiation of thyroid hormone therapy, as well as for adjustment of thyroid hormone dose in hypothyroid cases.

AIMS

We evaluated pregnant women who had no past history of thyroid disorders and studied their thyroid function in each trimester.

SETTINGS AND DESIGN

86 normal pregnant women in the first trimester of pregnancy were selected for setting reference intervals. All were healthy, euthyroid and negative for thyroid peroxidase antibody (TPOAb). These women were serially followed throughout pregnancy. 124 normal nonpregnant subjects were selected for comparison.

MATERIAL AND METHODS

Thyrotropin (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and anti-TPO were measured using Roche Elecsys 1010 analyzer. Urinary iodine content was determined by simple microplate method. The 2.5th and 97.5th percentiles were calculated as the reference intervals for thyroid hormone levels during each trimester.

STATISTICAL ANALYSIS

SPSS (version 14.0, SPSS Inc., Chicago, IL, USA) was used for data processing and analysis.

RESULTS

The reference intervals for the first, second and third trimesters for the following parameters: TSH 0.09-6.65, 0.51-6.66, 0.91-4.86 µIU/mL, FT4 9.81-18.53, 8.52-19.43, 7.39-18.28 pM/L and FT3 3.1-6.35, 2.39-5.12, 2.57-5.68 pM/L respectively. Thyroid hormone concentrations significantly differed during pregnancy at different stages of gestation. The pregnant women in the study had median urinary iodine concentration of 150-200 µg/l during each trimester.

CONCLUSIONS

The trimester-specific reference intervals for thyroid tests during pregnancy have been established for pregnant Indian women serially followed during pregnancy using 2.5th and 97.5th percentiles.

Transverse wobbling in ^{135}pr

A pair of transverse wobbling bands is observed in the nucleus ^{135}Pr. The wobbling is characterized by ΔI=1, E2 transitions between the bands, and a decrease in the wobbling energy confirms its transverse nature. Additionally, a transition from transverse wobbling to a three-quasiparticle band comprised of strong magnetic dipole transitions is observed. These observations conform well to results from calculations with the tilted axis cranking model and the quasiparticle rotor model.

Prevalence of risk factors for coronary artery disease in an urban Indian population

OBJECTIVE

The objective of this study was to assess the prevalence of risk factors for coronary artery disease (CAD) in government employees across India.

METHODS

The study population consisted of government employees in different parts of India ({n=10,642 men and n=1966 women; age 20-60 years}) and comprised various ethnic groups living in different environmental conditions. Recruitment was carried out in 20 cities across 14 states, and in one union territory. All selected individuals were subjected to a detailed questionnaire, medical examinations and anthropometric measurements. Blood samples were collected for blood glucose and serum lipid profile estimation, and resting ECG was recorded. Results were analysed using appropriate statistical tools.

RESULTS

The study revealed that 4.6% of the study population had a family history of premature CAD. The overall prevalence of diabetes was 16% (5.6% diagnosed during the study and the remaining 10.4% already on medication). Hypertension was present in 21% of subjects. The prevalence of dyslipidemia was significantly high, with 45.6% of study subjects having a high total cholesterol/high density lipoprotein ratio. Overall, 78.6% subjects had two or more risk factors for CAD.

CONCLUSIONS

The present study demonstrates a high prevalence of CAD risk factors in the Indian urban population. Therefore, there is an immediate need to initiate measures to raise awareness of these risk factors so that individuals at high risk for future CAD can be managed.

Evaluation of hypoglycemic and antioxidant effect ofOcimum sanctum

Ocimum sanctum leaves have been traditionally used in treatment of diabetes mellitus. Dietary supplementation of fresh tulsi leaves in a dose of 2 gm/kg BW for 30 days led to significant lowering of blood glucose levels in test group. Intake ofOcimum sanctum also led to significant increase in levels of superoxide dismutase, reduced glutathione and total thiols, but marked reduction in peroxiodised lipid levels as compared to untreated control group. The leaves were found to possess both superoxide and hydroxyl free radical scavenging action. The present observations establish the efficacy ofOcimum sanctum leaves in lowering blood glucose levels and antioxidant property appears to be predominantly responsible for hypoglycemic effect.

Loss of histaminergic modulation of thermoregulation and energy homeostasis in obese mice

Histamine acts centrally to increase energy expenditure and reduce body weight by mechanisms not fully understood. It has been suggested that in the obese state hypothalamic histamine signaling is altered. Previous studies have also shown that histamine acting in the preoptic area controls thermoregulation. We aimed to study the influence of preoptic histamine on body temperature and energy homeostasis in control and obese mice. Activating histamine receptors in the preoptic area by increasing the concentration of endogenous histamine or by local injection of specific agonists induced an elevation of core body temperature and decreased respiratory exchange ratio (RER). In addition, the food intake was significantly decreased. The hyperthermic effect was associated with a rapid increase in mRNA expression of uncoupling proteins in thermogenic tissues, the most pronounced being that of uncoupling protein (UCP) 1 in brown adipose tissue and of UCP2 in white adipose tissue. In diet-induced obese mice histamine had much diminished hyperthermic effects as well as reduced effect on RER. Similarly, the ability of preoptic histamine signaling to increase the expression of uncoupling proteins was abolished. We also found that the expression of mRNA encoding the H1 receptor subtype in the preoptic area was significantly lower in obese animals. These results indicate that histamine signaling in the preoptic area modulates energy homeostasis by regulating body temperature, metabolic parameters and food intake and that the obese state is associated with a decrease in neurotransmitter's influence.

Effect of Ocimum sanctum on homocysteine levels and lipid profile in healthy rabbits

CONTEXT

Ocimum sanctum has been reported to have a variety of medicinal properties.

OBJECTIVE

The present study was planned to evaluate the effect of O. sanctum on plasma homocysteine levels and lipid profile in healthy rabbits.

MATERIAL AND METHODS

Forty rabbits were divided into two groups (20 each). Group I rabbits received normal diet and group II rabbits received fresh leaves of O. sanctum (2 g/day) for 8 weeks along with normal diet. Fasting plasma samples were estimated for homocysteine and lipid profile. The results were analysed statistically.

RESULTS

The levels of homocysteine, total cholesterol, triglycerides, low density lipoprotein cholesterol, very low density lipoprotein cholesterol were found to be decreased and high density lipoprotein cholesterol levels increased significantly on supplementation with O. sanctum (p < 0.001).

DISCUSSION AND CONCLUSION

Thus, O. sanctum can prove to be a significant cardioprotective substance and an important adjuvant in the treatment of hyperhomocysteinemia and dyslipidemia.

Effect of tulsi (Ocimum Sanctum Linn.) on sperm count and reproductive hormones in male albino rabbits

Fresh leaves of Ocimum Sanctum (OS) were used to study its effect on male reproductive function (sperm count and reproductive hormones) in male albino rabbits. Animals in the test group received supplementation of 2 g of fresh leaves of OS per rabbit for 30 days, while the control group was maintained on normal diet for the same duration. Sperm count and hormonal estimation [testosterone, follicle stimulating hormone (FSH), and luteinizing hormone (LH)] were done in serum samples of both groups and compared. A significant decrease was noted in the sperm count in test group rabbits. Serum testosterone levels showed marked increase while FSH and LH levels were significantly reduced in OS-treated rabbits. The results suggest the potential use of OS as an effective male contraceptive agent.

Antioxidant effect of Triticum aestivium (wheat grass) in high-fat diet-induced oxidative stress in rabbits

Wheat grass is used as a general health tonic and is reported to be effective against several medical disorders, although detailed literature is not available. Besides drug therapy, a number of medicinal plants are effective in treating hyperlipidemia. This study examined the effects of wheat grass on high-fat diet-induced hyperlipidemia in rabbits. Thirty rabbits were divided into 3 groups of 10 rabbits each, group I receiving a control diet, group II a high-fat diet and group III a high-fat diet together with wheat grass over a period of 10 weeks. Fasting serum samples from the animals were analyzed for total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), malondialdehyde (MDA), reduced glutathione (GSH) and vitamin C, and the results were compared. The high-fat diet resulted in hyperlipidemia and an increase in oxidative stress, indicated by a significant rise in MDA levels, whereas antioxidant levels of GSH and vitamin C were significantly reduced. Wheat grass supplementation with a high-fat diet resulted in improved lipid levels (decreased total cholesterol and increased HDL-C) together with significantly reduced MDA levels and increased GSH and vitamin C levels. These results indicate the beneficial role of wheat grass in ameliorating hyperlipidemia and the associated oxidative stress.

Effect of body posture on dynamic lung functions in young non-obese Indian subjects

Flow volume loop and its various indices can be used to diagnose UAO. Change in posture from sitting to horizontal position per se causes a decrease in effort dependent inspiratory and expiratory flow rates but no significant change in upper airway obstruction indices. Thus, measurement of FVL in supine posture may be used to detect UAO as it may be missed if spirometry is performed in sitting posture.

beta-Adrenergic regulation of IL-6 release from adipose tissue: in vivo and in vitro studies

Circulating IL-6 levels are elevated in obesity. Although IL-6 is expressed in adipose tissue, neither its regulation nor cell of origin is well characterized. Here we investigated the beta-adrenergic regulation of IL-6 release in a combination of studies on humans and animals in vivo and cultured adipocytes in vitro. Human in vivo study: Human volunteers were infused with isoproterenol, norepinephrine, or saline [4 M:4F; mean (SD) age 35.5 (5.8) yr; body mass index 24.6 (4.2) kg/m(-2)]. Plasma IL-6 levels increased during a 3-h infusion of isoproterenol (P = 0.01) and fell 2 h post infusion (P = 0.05). IL-6 levels did not change significantly with either norepinephrine or saline. Murine in vivo study: C57BL6/J male mice were injected ip with dobutamine (beta(1) agonist), clenbuterol (beta(2)), CL316243 (beta(3)), or saline placebo. Plasma IL-6 levels at 3 h were increased by clenbuterol (P = 0.02) and CL316243 (P = 0.02) but not dobutamine (P = 0.51), compared with placebo.

IN VITRO STUDIES

In human peripheral blood cells, lipopolysaccharide treatment enhanced secretion of IL-6 (vs. controls; P < 0.001), whereas isoproterenol inhibited IL-6 secretion (P = 0.012) and norepinephrine had no significant effect. In contrast, isolated human adipocytes and differentiated 3T3F442A adipocytes all rapidly secreted IL-6 in response to adrenergic agonists (P < 0.01, compared with untreated cells). We conclude that beta 2/beta 3 adrenoceptor stimulation on adipocytes, rather than macrophages, may be responsible for the increases in plasma IL-6 concentrations observed during sympathetic activation and in obesity.

Efficacy of itraconazole in the treatment of tinea versicolor

Twenty adult patients (15 males and 5 females) with extensive, clinically diagnosed tinea versicolor (TV.) resistant to topical agents, of long duration were selected. Laboratory investigations like KOH smear, routine haemogram, LFT, and RFT were done. They were given itraconazole (100 mg) orally twice daily for 5-7 days and followed up at the end of 1 week and again three weeks later. After one week itching, erythema and scaling subsided in 80% of cases. There was no recurrence during one year follow up.

Patient-assessed outcomes after excision of acoustic neuroma: postoperative symptoms and quality of life

OBJECT

The aim of this study was to assess whether outcomes from excision of acoustic neuroma vary among patients and have a material impact on their quality of life (QOL).

METHODS

A questionnaire concerning postoperative symptoms and the Short Form 36 (SF-36) QOL instrument were mailed to 97 consecutive patients who had undergone acoustic neuroma surgery via the translabyrinthine approach. The survey response rate was 78% and the symptomatology was consistent with other reports, supporting the representativeness of the sample. The respondents' QOL was rated significantly below published norms and their work capacity was reportedly reduced. Specifically, the following SF-36 dimensions were reduced: physical functioning and role-physical, together with vitality, general health, and social functioning. Greater numbers of postoperative symptoms and larger tumors were associated with a worse rating of physical functioning. More severe balance problems were associated with lower ratings of social functioning. The disparity between the patient's self-estimate and self-measurement and the clinician's assessment of the patient's facial functioning raises doubts about the validity of subjective reports and assessment.

CONCLUSIONS

The present study supports the use of generic QOL measures to assess outcome and to draw comparisons between different populations.

Reducing clozapine-related morbidity and mortality: 5 years of experience with the Clozaril National Registry

The Clozaril National Registry (CNR) was created to help protect patients from developing potentially fatal agranulocytosis secondary to treatment with the antipsychotic medicine clozapine. The CNR, designed and maintained by the manufacturer of the branded Clozaril (clozapine), has the principal goals of (1) prophylaxis-preventing inappropriate retreatment, and (2) quality assurance-overseeing adherence to a "no blood, no drug" policy. This article reviews the estimated impact of the CNR on clozapine-related morbidity and mortality over the first 5 years of commercial experience in the United States.

METHOD

Complete data on leukopenia and agranulocytosis, gathered from the CNR database for the period of 1990-1994, were reviewed and compared with data from the pre-CNR period.

RESULTS

Use of clozapine in 99,502 patients according to package labeling requirements (distribution of the medicine linked to mandated white blood cell count testing) was associated with a total of 382 cases of agranulocytosis (0.38%) versus an expected cumulative total of 995 cases (based on the pre-CNR rate of 1% to 2%). Based on the expected agranulocytosis rate, up to 149 deaths might have been anticipated. Instead, there were only 12 deaths attributed to complications of agranulocytosis.

CONCLUSION

The CNR provides for universal rechallenge protection as well as controlled dispensing of clozapine. It also serves as an early warning system to promote the safe and effective use of clozapine. The CNR includes quality assurance mechanisms designed to enhance compliance. Despite the added logistic requirements this system places upon physician, pharmacist, and manufacturer, the CNR has helped to reduce substantially potential fatal outcomes. The CNR reinforces both patient and treatment system compliance. Based on this favorable experience concerning agranulocytosis and associated fatalities, the Neuropsychopharmacology Advisory Committee to the U.S. Food and Drug Administration has unanimously recommended a reduction in frequency of the white blood cell count testing requirement after 6 months to every 14 days, instead of weekly. Finally, the CNR database containing white blood cell count and demographic data on every patient in the United States who has received the medicine has served as a unique epidemiologic database.

Evaluating cognitive learning for radiography education

This discussion has been written to assist radiologic technology educators build better teacher-made tests. The systematic framework for test development has included defining cognitive learning objectives, constructing a test blueprint, writing clear test directions, and writing objective test items. This process enables the faculty to effectively monitor student progress, assess their own teaching effectiveness, and diagnose learning difficulties. It is hoped that this systematic approach to the assessment of cognitive learning will contribute to the education and development of a competent entry level radiologic technologist.

Choice and specificity of complement in complement fixation assay

This study examines the relative activity of various complement sources in a variety of antigen-antibody (Ag-Ab) complement fixation assay systems. Studied were Ag-Ab systems of cytomegalovirus, adenovirus, Pneumococcus, Coccidiodes, and guinea pig kidney. Ab titers in each system were determined by microcomplement fixation assay using two batches of titrated rabbit, monkey, cat, dog, human cord, human adult, and guinea pig sera as complement sources. Assay sensitivity and Ab titers proved to be strongly related to the complement sources. There was considerable variation in the ability of Ag-Ab complexes to bind the complement of each of the species tested. Guinea pig, rabbit, and monkey sera gave comparable titers in four of the five Ag-Ab systems tested. Cat serum complement was able to detect anti-adenovirus and anti-Pneumococcus reactivity only. Human adult, human cord, and dog sera exhibited anti-complementary activity. The study emphasizes the importance of complement source in determining both the specificity and sensitivity of complement fixation assays in a given Ag-Ab system.

Experience in the urologic management in 120 early spinal cord injury patients

More than 120 patients with recent spinal cord injuries have been admitted to our hospital during the last 3 years. Intermittent catheterization has been the preliminary step in the urologic management of these patients. The transcutaneous suprapubic cystocath with intermittent aspiration of urine also has been used in 7 cases. A bladder outlet operation after 3 months was indicated 3 times more often in patients with complete than in those with incomplete neurologic lesions. Results and indications are discussed.

Growing human sarcomas in culture

Efforts to establish human soft tissue and bone sarcomas in long-term cultures are described. Of 49 attempts 22 (45%) were successful, yielding cells that proliferated in vitro for 6 months or longer. Infrequent medium changes, maintenance of pH in physiologic range and avoidance of early trypsinization all appear to be important for survival of explanted cells and their initial growth under culture conditions. Cytologic criteria can be used to confirm that cells in established lines derive from malignant mesenchymal cells present in the tumors of origin.

Complement-fixing antigen of human sarcomas

Further investigation of the humoral immune responses of patients with sarcoma to their tumors revealed a sarcoma-associated antigen that was readily detected by complement fixation. Circulating levels of antibody to this antigen, tentatively labeled S3, rose markedly after surgical removal of the tumor. Antibody to S3, as to S1 and S2, was highly prevalent in patients with various malignant tumors other than sarcoma.