The PEP respiratory monitor: a validation study.

The search for a reliable and accurate respiratory rate monitor for use in non-intubated patients has proved to be a long and fruitless one. A new device fulfilling the criteria for such a monitor has recently been described. The pyroelectric polymer (PEP) device is safe, non-invasive, and cheap. In this study the PEP device, transthoracic impedance, and standard observer counting were all compared with the existing gold standard of capnography in 12 healthy adult volunteers. Using a standard statistical technique it was shown that the PEP device performed as well as a capnograph and was more accurate than the other currently available methods of monitoring respiratory rate.

Ploidy independence of Ag-NOR number in neuroblastoma.

BACKGROUND: Ag-NOR number and ploidy have potential use in predicting prognosis in malignancy. The issue of independence has not been conclusively studied. In contrast to other malignancies in neuroblastoma poor outcome is linked to diploidy, allowing independent analysis of the reaction of Ag-NOR status to outcome. EXPERIMENTAL DESIGN: A consecutive unselected series of 20 pediatric neuroblastoma patients was used to study the relation between ploidy and mean Ag-NOR number per nucleus. Ploidy was established by flow cytometric analysis of nuclear suspensions prepared from Formalin fixed and paraffin embedded tissue. The mean number of Ag-NORs per nucleus was determined using 3-microns paraffin sections, silver staining methods and quantification procedures detailed in the literature. RESULTS: The seven diploid lesions were found to have a mean Ag-NOR number per nucleus of 4.38 (range 0.86-7.5). The 13 aneuploid lesions were found to have a mean Ag-NOR number per nucleus of 2.31 (range 1.17-4.44). Probability of difference (Wilcoxon's two-tailed rank sum test) was greater than 99%. Nonsurvivors (6 of 10 diploid) had mean Ag-NOR number per nucleus of 4.34 (range 2.24-7.5). Survivors (9 of 10 aneuploid) had mean Ag-NOR number per nucleus of 1.73 (range 0.86-2.56). Probability of difference (Wilcoxon's two-tailed rank sum test) was greater than 99%. In aneuploid lesions (n = 13) a negative correlation exists between DNA index and mean number of Ag-NORs per nucleus (correlation coefficient 0.84, slope -0.74, probability of noncorrelation less than 0.010). CONCLUSIONS: The present observations offer the first independent support to the theory that Ag-NOR number is an independent variable to DNA ploidy based on the unique feature of neuroblastoma that diploid lesions have an established poorer prognosis than aneuploid lesion. The observations, although the number of cases is too limited for independent analysis, confirm previously published, strong negative relations between mean Ag-NOR number per cell and survival in childhood neuroblastoma. This relation is similar to findings in other solid tumor lesions.

Rhabdomyosarcoma, presenting as a facial swelling in a child. A case report and review of the literature.

A case of the very rare rhabdomyosarcoma as the more common second primary in a young child who had been treated for bilateral, genetic retinoblastoma is described and the importance early diagnosis emphasised. A review of the literature is presented with special reference to the prognosis of head and neck rhabdomyosarcoma and the various treatment alternatives, related to both new primary and secondary tumours in children with retinoblastoma.

Facial nerve paralysis complicating bilateral fractures of the mandible: a case report and review of the literature.

A case report of a unilateral lower motor neurone facial nerve paralysis complicating bilateral fractures of the mandible is described. The injury was the result of a fall. The differential diagnosis is discussed together with the treatment undertaken. The importance of a thorough examination of the cranial nerves following trauma is emphasised. A review of the literature is presented with special reference to the relative merits and indications for the use of cortico-steroids and surgical exploration.