Three patients with epithelioid haemangioendothelioma (EHE) are described. Two patients presented with pulmonary infiltrates and one with a hepatic tumour. All had a metastatic disease ending fatally, and all were autopsied. The diagnosis was confirmed either by immunohistological or ultrastructural analysis. All three tumours were cytokeratin-negative and vimentin-positive, while only two contained cells reacting with the antibody of factor VIII-related antigen. Electron microscopy of the third tumour revealed features indicating endothelial differentiation. A short literature review is also presented demonstrating that the outlook of EHE is worse than previously thought.
A prospective study to evaluate the efficacy of a novel inflatable vest in supporting the sternotomy wound during the early period after coronary artery bypass grafting was carried out in 35 patients. The outcome variables were subjective pain score during cough, and peak expiratory flow (PEF) and vital capacity (VC) on postoperative days 2 and 3. The values without pressure in the vest were used as controls in the individual patients. Use of the vest significantly reduced the cough-associated subjective sternotomy pain score on days 2 and 3, when significant reduction of PEF and VC was also observed. The alleviation of pain by the inflatable vest may improve the efficacy of coughing and bronchial clearance in the immediate postoperative period.
The activity of femoral vessels in delayed bone scans was evaluated visually in 237 consecutive patients and quantified in 40 female patients. In visual analysis the patients were randomly divided into three groups and in quantitative analysis into four groups of equal size. Two different MDP preparations and one DPD preparation were used as bone-seeking agents. With aging, the activity in femoral vessels increased with all agents in visual analysis, significantly with MDPs (P less than 0.001) between patients less than or equal to 60 years and greater than 60 years. In female patients with all agents a significant increase in femoral activity was found (P less than 0.001 with MDPs, P less than 0.05 with DPD). In patients greater than 60 years, the femoral uptake was significantly higher with MDP when compared with the DPD uptake (P less than 0.01 with MDP1, P less than 0.05 with MDP2). Between the MDPs no significant differences were found. In quantitative analysis the femoral vessel to soft tissue ratio was significantly higher in patients greater than 70 years when compared with patients less than or equal to 50 years with MDP. No difference was found with DPD. Histological examination of excised arteries of ten patients with intense femoral uptake of MDP showed arteriosclerosis and calcification in all cases. The findings suggest that the femoral visualization in delayed bone scans is probably related to arteriosclerosis and is not a non specific finding. There may be age-related differences in the distribution of MDP and DPD.
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