Optimal scoring of serial change on chest radiography in sarcoidosis.

BACKGROUND: The optimal means of quantifying change on chest radiography in sarcoidosis is uncertain. In current guidelines, the role of serial measurement of carbon-monoxide diffusing capacity (DLco) remains undefined and the prevalence of discordance between serial chest radiographic change and pulmonary function tends is unknown. OBJECTIVE: To identify and explore key uncertainties in the monitoring of sarcoidosis by serial pulmonary function tests and chest radiography. DESIGN: 354 patients with sarcoidosis and concurrent tests (chest radiography and PFTs within three months at baseline, two years and/or four years) were studied. Chest radiographs were assessed by two radiologists for changes in stage and disease extent. Radiographic change and pulmonary function trends were quantified and compared. RESULTS: Change in radiographic extent of lung disease was always more frequent than change in stage (p < 0.0001) and there was poor agreement between change in stage and change in radiographic extent (Kw = 0.21 at two years; Kw = 0.23 at four years). Change in disease extent on chest radiography was linked to PFT trends on analysis of variance (p < 0.0005 for FEV1, FVC, DLco), whereas change in radiographic stage was not. Changes in gas transfer were often isolated or discordant with other serial data. Discordance between pulmonary function data and chest radiographic data was observed in 50% of cases. CONCLUSIONS: Change in radiographic extent is more applicable to routine monitoring in sarcoidosis than change in radiographic stage. In future guidelines, the role of serial gas transfer estimation and reconciliation of divergent chest radiographic and functional trends might usefully be addressed.

Single bubble sonochemistry: decomposition of alkyl bromide and the isomerization reaction of maleic acid.

Single bubble cavitation offers an unique opportunity to evaluate the effect of bubble activity in promoting chemical reactions. In this paper we study the isomerization reaction of maleic acid into fumaric acid using an aqueous solution of maleic acid saturated with CH2Br2. The Br* radicals are generated at the bubble surface and a whitish thread forms. For comparison, the same reaction was conducted in a sonochemical bath. A possible scheme of the reactions activated at bubble surface after the decomposition of organic brominated substances is proposed.

Moving single bubble sonoluminescence in phosphoric acid and sulphuric acid solutions.

The phenomenon of sonoluminescence still presents some unsolved aspects. Recently [Y.T. Didenko, K. Suslick, Molecular Emission during Single Bubble Sonoluminescence, Nature 407 (2000) 877-879.], it was found that a single cavitating air bubble in polar aprotic liquids (including formamide and adiponitrile) can produce very strong sonoluminescence while undergoing macroscopic translation movements in the resonator, a condition known as moving single bubble sonoluminescing (MSBSL). Here we describe some experiments conducted in aqueous solutions of phosphoric and sulphuric acid. In these liquid media, it is possible to reproduce MSBSL and luminescence is emitted even if a trapped bubble is subjected to a strong shape instability, named in the literature "jittering phase". When a moving and luminescing bubble was present and the acoustic pressure gradually increased, we observed the generation of a discrete lattice of trapped bubbles. The bubbles in the lattice emit very intense light flashes and can change their position while maintaining the overall spatial distribution in time. Some preliminary results, obtained from Mie-scattering and measurements of relative light intensity, are reported.

Palliative surgery of metastatic bone disease: a review of 83 cases.

Of a total of 83 patients with metastatic bone disease, surgery was performed in 17 cases at the prefracture stage, in 54 cases after complete fracture and in 10 cases to decompress the spinal cord. Positive short-term results were obtained in 75% of cases. 7 patients presented mild complications. In 2 cases, the patients had to be reoperated. 55% of the patients were still alive after 6 months, 31% after 12 months and 10% after 2 years.

Primary hemangiopericytoma of bone - a case-report and literature-review.

Clinical, radiological and histological aspects of a case of primary bone haemangiopericytoma, treated by wide surgical resection and pre- and postoperative radiotherapy, are described. The patient was disease-free 20 months from the operation. From a literature review of 52 cases of this very rare tumour it emerges that the tumour is aggressive but of variable malignancy. Prognosis seems to depend on histology, size at diagnosis and treatment. The best available treatment is probably wide exeresis plus radiotherapy.

Evidence for liquid phase reactions during single bubble acoustic cavitation.

We extended the recent experiment by Lepoint et al. [Sonochemistry and Sonoluminescence, NATO ASI Series, Series C 524, Kluwer Academic Publishers, Dordrecht/Boston/London, 1999, p. 285], involving a so-called single bubble sonochemistry process, to a three-phase system. We have found experimental evidence that a single cavitating bubble can activate the oxidation of I- ions after the injection of a CCl4 liquid drop in the bubble trapping apparatus. The solvent drop (CCl4 is almost water insoluble) is pushed towards the bubble position and forms a thin film on the bubble surface. When the acoustic pressure drive is increased above 100 kPa, the three-phase system gives rise to a dark filament, indicating the complexation reaction between starch (added to the water phase) and I2. I2 species is the product of surface reactions involving bubble-induced decomposition of CCl4. Further increase of the acoustic drive causes the thin CCl4 film to separate from the bubble and stops I2 production. The study of the chemical activity of this three-phase system could give new advances on dynamics of the bubble collapse.

A computer system for timing and acoustical analysis of crackles: a study in cryptogenic fibrosing alveolitis.

A system for recording and processing lung crackles is described. These are detected by a microphone on the chest wall and recorded simultaneously with flow rate, tidal volume and oesophageal pressure on a four-channel tape recorder. The sound signal is subsequently digitized by an analog-to-digital converter and processed by a minicomputer, using the Time Series Language and the fast Fourier transform algorithm. A preliminary study on seven patients with cryptogenic fibrosing alveolitis (CFA) confirms that crackles typically occur at the end of inspiration; timing seems to be well related to inspired volume and esophageal pressure. Inspiratory crackles of CFA have a well-defined waveform: it consists of a starting component and a damped oscillation, which probably depends on the resonant frequency of the lung. The crackle energy content is mainly concentrated in the frequency range between 100 and 2 000 Hz, the spectrum shape being determined by the energy distribution between the two components of the waveform. This recording and processing system gives more complete information about crackles than auscultation does, allowing their quantification and reproducibility. It may be used to compare crackles in different diseases, and may be simplified and standardized for routine clinical use as an additional noninvasive diagnostic technique.