ABSTRACT
Cavitation following bland pulmonary infarction is not commonly considered in the differential diagnosis of cavitary lung disease. In a 4-year period we have found 10 cases of cavitating pulmonary infarction (CPI) by reviewing serial chest radiographs from autopsies with pulmonary infarction and in all cases with positive ventilation-perfusion lung scans. We have compared these cases to 31 previously reported cases in the English literature that met our criteria for CPI. In our 10 patients, there were 12 radiographic cavities; 5 in the upper lobes, 5 in the lower lobes and 2 in the middle lobe. This distribution was consistent with a relative upper-lobe predominance in the literature review. In nine patients the cavitation appeared rapidly (mean, 5 days) and was associated with fever, purulent sputum, and leukocytosis. Sputum cultures were obtained in eight patients, revealing Pseudomonas aeruginosa and Escherichia coli in three each and Proteus species in two. In four patients, pulmonary infarction was not considered and the diagnosis was made at autopsy, a situation also common in previously reported cases. We have seen a high incidence of CPI in a retrospective review of patients with pulmonary infarction, and we believe that it is important to consider this diagnosis when evaluating cavitary lesions.
Subject(s)
Infarction/complications , Pulmonary Embolism/complications , Adult , Aged , Bacterial Infections/complications , Humans , Infarction/diagnostic imaging , Infarction/pathology , Lung Abscess/diagnostic imaging , Lung Abscess/etiology , Lung Abscess/pathology , Middle Aged , Pneumonia/diagnostic imaging , Pneumonia/etiology , Pneumonia/pathology , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/pathology , Radiography , Retrospective StudiesABSTRACT
The use of nick translation of cloned DNA segments followed by separation on low-melting-temperature agarose has been used to obtain multiple radiolabeled DNA probes from a single nick-translation procedure. This technique avoids gel matrix inhibition of enzymatic reactions. Examples of the utility of this procedure are presented and the advantages and drawbacks discussed.
Subject(s)
Nucleic Acid Hybridization , Protein Biosynthesis , Autoradiography , Chemical Phenomena , Chemistry , Cloning, Molecular , Electrophoresis, Agar Gel , Oncogenes , ThermodynamicsABSTRACT
In teaching hospitals the responsibility for cardiopulmonary resuscitation usually rests with the house-staff, yet most house-officers receive no formal training in life support. The life-support skills of 45 medical and surgical house-officers in a university teaching hospital were tested by means of simulated cardiac arrests. House-officers were graded on the basis of a performance checklist derived from the standards of the American Heart Association. No house-officer received a pass score in basic life support (BLS). Only 29% could properly compress and ventilate the mannequin. In advanced cardiac life support (ACLS) only one-third could intubate in 35 s or less; only 31%, 40%, and 33% could manage ventricular fibrillation, asystole, and complete heart block, respectively. Some house-officers were unable to operate the defibrillator or assemble resuscitation equipment. Many house-officers displayed helplessness and anxiety during the simulations; fourteen (40%) were prompted to register for additional advanced life-support courses. The performance of medical and surgical house-officers was equal. House-officers who had received prior life-support training performed better in BLS (p less than 0.001) but not in ACLS. It was concluded that (a) most medical and surgical house-officers are not reasonably proficient in BLS and ACLS, and (b) cardiac arrest simulation is a motivating exercise which permits analysis of each house-officer's life-support skills. House-officers should have more training and practice in life support, or they should not have primary responsibility for cardiopulmonary resuscitations.
