Training and postgraduate examinations in radiology in Australasia.
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Biomedical subjects
Publications and source records attributed to J Syme.
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To evaluate the place of intravenous digital subtraction angiography (IV-DSA) in the investigation of patients with carotid territory ischemia, we have compared the IV-DSA and conventional angiographic (CA) findings in 40 patients in a prospective study. Arterial disease was assessed by grading stenosis from zero (normal artery) to six (complete occlusion) and recording any luminal ulceration. In 59 of 66 bifurcations imaged by both techniques, the IV-DSA evaluation of any internal carotid artery origin disease was within one grade of the CA assessment, with three false negatives and four false positives. Luminal ulceration was less reliably predicted, and two clinically important middle cerebral artery lesions were missed by IV-DSA. In 11 patients who had carotid endarterectomy, there was a good correlation between surgical, CA, and IV-DSA findings, although some ulcerations were not detected by either angiographic technique. These results suggest that IV-DSA is a sensitive technique for detection of carotid bifurcation stenosis when the study is of good quality, but that intracranial lesions may be missed.
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During the period November 1976 to September 1980, 2703 babies born in one Edinburgh hospital were screened in the neonatal period by estimation of their serum creatine kinase levels for Duchenne muscular dystrophy. Among the 2336 male babies tested, none proved to be affected and only 16 required second specimens to be obtained. Overall the false positive rate in the study was 0.78%. This study confirms that neonatal screening for Duchenne muscular dystrophy is feasible in a British hospital setting and is here most conveniently carried out on the 5th day of life along with routine testing for phenylketonuria.
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A family is described in which the mother, her two live offspring, and a therapeutically aborted fetus each had a ring 14 chromosomes. The two children were mentally retarded and the mother's intelligence was at the lower end of the normal range. In addition, the mother had two spontaneous abortions, one of which was shown to be chromosomally normal.
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Serial mineral balances have been obtained in 3 children undergoing therapy with EHDP (ethane-1-hydroxy-1, 1-diphosphonate) for diseases involving ectopic calcification. Although clinical outcome was not uniformly satisfactory, all cases showed an overall reduction in calcium balance. This was due to increased faecal excretion of calcium and was most marked after a long duration of therapy. Although these results conflict with reported experience in adults, they are in agreement with published observations of the effects of EHDP on calcium absorption in experimental animals.
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