Exploring the low-Z shore of the island of inversion at n=19.

The technique of invariant mass spectroscopy has been used to measure, for the first time, the ground state energy of neutron-unbound (28)F, determined to be a resonance in the (27)F+n continuum at 220(50) keV. States in (28)F were populated by the reactions of a 62 MeV/u (29)Ne beam impinging on a 288 mg/cm(2) beryllium target. The measured (28)F ground state energy is in good agreement with USDA/USDB shell model predictions, indicating that pf shell intruder configurations play only a small role in the ground state structure of (28)F and establishing a low-Z boundary of the island of inversion for N=19 isotones.

First rib fractures: incidence of vascular injury and indications for angiography.

Forty-five consecutive patients with 49 fractures of the first rib caused by blunt trauma underwent arteriography. The fractures were classified as posterior, lateral, or anterior and as nondisplaced, minimally displaced, or significantly displaced. Seven patients (14%) had serious vascular injuries: five had posterior injuries, and one had a lateral fracture, and one had an anterior fracture. All seven had significantly displaced fractures. We postulate that vascular injury can result from a violent lever mechanism in which the posterior portion of the rib is displaced downward and the anterior portion is forced upward, pinching the contents of the thoracic outlet against the clavicle. Four patients with subclavian artery injury had clinical evidence of arterial insufficiency. Branchial plexus injury occurred only in association with vascular injury. These data suggest that only displaced first rib fractures, and in particular posterior displaced fractures, result in vascular injury. Arteriography is indicated if there is an absent pulse, a brachial plexus injury, or a displaced first rib fracture. Using these criteria all vascular injuries would be detected. The majority (78%) of the patients with first rib fractures could be managed without arteriography.

Determination of the N=16 shell closure at the oxygen drip line.

The neutron unbound ground state of (25)O (Z=8, N=17) was observed for the first time in a proton knockout reaction from a (26)F beam. A single resonance was found in the invariant mass spectrum corresponding to a neutron decay energy of 770_+20(-10) keV with a total width of 172(30) keV. The N=16 shell gap was established to be 4.86(13) MeV by the energy difference between the nu1s(1/2) and nu0d(3/2) orbitals. The neutron separation energies for (25)O agree with the calculations of the universal sd shell model interaction. This interaction incorrectly predicts an (26)O ground state that is bound to two-neutron decay by 1 MeV, leading to a discrepancy between the theoretical calculations and experiment as to the particle stability of (26)O. The observed decay width was found to be on the order of a factor of 2 larger than the calculated single-particle width using a Woods-Saxon potential.

Nuclear magnetic moment of the 57Cu ground state.

The nuclear magnetic moment of the ground state of (57)Cu(Iota(pi) = 3/2(-), T(1/2) = 196.3 ms) has been measured to be /mu((57)Cu)/ = (2.00 +/- 0.05)mu(N) using the beta-NMR technique. Together with the known magnetic moment of the mirror partner (57)Ni, the spin expectation value was extracted as = -0.078 +/- 0.13. This is the heaviest isospin mirror T = 1/2 pair above the (40)Ca region for which both ground state magnetic moments have been determined. The discrepancy between the present results and shell-model calculations in the full f p shell giving mu((57)Cu) approximately 2.4mu(N) and approximately 0.5 implies significant shell breaking at (56)Ni with the neutron number N = 28.

Perforation in malignant disease of the stomach.

Perforation of the stomach occurring as a complication of malignant disease is a rare event. Patients often present with a prior history suggestive of benign gastrointestinal disease followed by an abrupt episode of abdominal pain. Silent perforations are unusual, but do occur. The radiographic criteria of the ulcer crater suggest benign disease in the majority of cases an it is only when there is a definitive operation the differentiation from benign disease is difficult and multiple biopsies of the ulcer are necessary. Perforation is a catastrophic complication and survival beyond one year is uncommon.

Outpatient angioplasty.

In a 51/2-year period, 111 outpatients were admitted to the short-stay unit of the authors' institution for angioplasty or angiography with angioplasty. A total of 149 angioplasty procedures were performed on 106 of the 111 patients. The other five patients underwent only angiography and were admitted for further care. Complications included a puncture-site pseudoaneurysm following iliac artery angioplasty and transient hypertension that necessitated hospitalization in a renal artery angioplasty patient. One other patient was to undergo angiography and renal angioplasty if possible. The patient was admitted for surgical revascularization following angiography and an unsuccessful attempt at crossing a severe renal artery stenosis. This stenosis could not be crossed at the time, and this patient was admitted for surgical revascularization. The angioplasty sites included lesions within the abdominal aorta and the renal, iliac, superficial femoral, popliteal, peroneal, celiac, and superior mesenteric arteries. Common femoral artery, antegrade femoral, and high brachial artery approaches were used. The results suggest that outpatient angioplasty is feasible.

Outpatient arteriography and cardiac catheterization: effective alternatives to inpatient procedures.

Traditionally, arteriography and cardiac catheterization have been inpatient procedures. Growing public and medical interest in cost containment prompted consideration of performing them as outpatient procedures. Ninety-five outpatient cerebral, peripheral, or visceral arteriograms and 89 outpatient cardiac catheterizations done in a 36-month period were reviewed. Findings indicate that outpatient cardiovascular examinations can be performed safely, with no additional risk to the patient, and provide an efficient, convenient alternative to hospitalization.

Obstruction of the inferior vena cava by seminoma.

Oncology patients require extensive radiological evaluation for staging. Ultrasound frequently is used in evaluating abdominal and retroperitoneal masses in seminoma patients. Inferior vena cava obstruction by seminoma has not been reported previously. We herein discuss the ultrasonic diagnosis of a seminoma that produced obstruction of the inferior vena cava and the ultrasonic findings that differentiate a mass within the inferior vena cava from one producing extrinsic compression.

Hospice planning in North Staffordshire.

A study of the work of the Douglas Macmillan Home at Blurton, Stroke-on-Trent, during the years 1974-76 suggests that hospice care for those dying from terminal malignancy is required on a minimum scale of 50 or 60 beds per million of the population and that 10 per cent more women than men will be admitted. Enquiries have shown that these estimates are reliable and that the service is valued locally.

Chronic ectopic pregnancy: ultrasonic diagnosis.

The classical ultrasonic description of a chronic ectopic pregnancy is a slightly enlarged uterus with uniform internal echoes and no evidence of an intrauterine pregnancy, combined with an extrauterine semicystic mass, gestational sac, or fetal structures. It is our experience that the ultrasonographer more commonly finds a midline pelvic mass containing irregular echo patterns and cystic areas. The mass may also be associated with abdominal or pelvic fluid and obliteration of normal anatomical structures. We wish to emphasize these variations from the classical description with illustrations that demonstrate the differences in the ultrasonic presentation of chronic ectopic pregnancy.

Amebiasis: unusual radiographic manifestations.

Unusual radiographic manifestations of amebiasis have not previously been emphasized in the literature. These unusual manifestations often mimic other, more common disease entities. A recent case of urinary bladder-cervical amebiasis prompted a review of other unusual manifestations of amebiasis. Over a 25-year period, unusual cases involving the musculoskeletal, genitourinary, cardiopulmonary, and gastrointestinal systems have been encountered. Primary amebiasis of any organ may occur without clinical evidence of gastrointestinal or hepatic involvement. These unusual cases illustrate the clinical spectrum of amebiasis and will clarify aspects of this interesting disease entity.

Splenic subcapsular hematoma--ultrasonic diagnosis.

In five patients with varying histories of blunt abdominal trauma, examinations were carried out with ultrasonography and other imaging modalities. In all five patients, large, fluid-filled masses were noted in the left upper quadrant. Two patients had nonpalpable hematomas, but examinations were done because of history and vague clinical symptoms. Three patients had palpable masses. In all five patients there was surgical confirmation of the ultrasonic findings, and all recovered without complications. Ultrasonic tomography offers a convenient noninvasive method for assessing suspected splenic hematoma and can also exclude the possibility in a careful examination.

Spin polarization of 37K produced in a single-proton pickup reaction at intermediate energies.

Spin polarization of 37K nuclei produced via single proton pickup from a 9Be target by a beam of 150 MeV/nucleon 36Ar has been observed. Positive spin polarization with magnitude (8.5+/-0.6)% was deduced near the peak of the 37K momentum distribution. The variation of the spin polarization as a function of outgoing 37K momentum is explained by a classical conservation model, as previously applied to describe the induced spin polarization observed for fragments produced in intermediate-energy heavy-ion reactions, with the condition that the picked-up proton has an average momentum equal to the Fermi momentum and is aligned along the incident beam direction.