Biomedical subjects
Publications and source records attributed to Q Summers.
Progressive massive fibrosis is a well-recognized complication of long-term industrial dust exposure. Typically, it occurs in a setting of background parenchymal nodulation. We wish to report a case occurring in the absence of lung nodules.
Aerosols of nedocromil sodium labelled with 99Tcm were delivered on 20 separate occasions to healthy male volunteers. Planar and single photon emission computerized tomography (SPECT) gamma scintigraphy were immediately performed to assess the pulmonary regional distribution of delivered aerosol. On a separate occasion volunteers were imaged using X-ray computed tomography (CT). Alignment of SPECT and CT images was performed using marked anatomical features and the anterior and lateral skin outlines. CT images provided data for attenuation correction and were used to define the anatomical lung volume. Central to peripheral (CP) ratios of deposited activity were calculated from volumes of interest in coronal and transverse sections of the right lung. These were compared with CP ratios obtained from planar images obtained immediately following aerosol inhalation. Volumetric CP ratio correlated significantly with immediate planar CP ratio (p < 0.001). Analysis of deposition in the whole right lung was performed by separating the SPECT lung data into a series of thin concentric shells centred on the entry of the right main bronchus. Measures were defined for describing the variation of deposition density and cumulative total deposition with distance from the lung centre. These showed significant correlation with planar CP ratio (p < 0.001). SPECT analysis using CT is consistent with planar measures of aerosol deposition but offers a more complete quantification of aerosol penetration and absolute deposited activity within the whole lung. It is a valuable new tool for aerosol analysis.
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A woman with autonomic neuropathy after rubella infection is described. She had features of both sympathetic and parasympathetic impairment, the major problems being postural hypotension, abdominal and parotid pain, and fatigue. Autonomic dysfunction persisted 38 months after the rubella infection with minimal response to treatment. The literature relating to autonomic neuropathy is reviewed, and the similarities of this patient's condition to the Guillain-Barré syndrome are discussed.
A case of cephalic tetanus that occurred in a fully immunized patient is described. An 18-year-old man presented with bilateral facial spasms, without trismus or more generalized involvement, followed by facial weakness. The difficulties in clinical diagnosis and the contribution of electrophysiological studies to the management of such patients are highlighted. The variable level of protection that is conferred by immunization is discussed.