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The analysis of a data file comprising 776 lung cancer patients from the Tumor Registry at a 705-bed community hospital in New Jersey reveals that women are diagnosed with squamous cell and large cell lung cancer at an earlier age than men.

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The cause of early postburn leukopenia (EPBL) is unknown. The evidence suggests that treating burn wounds with 1% silver sulfadiazine cream (SSD) is contributory, but that other factors exist, possibly including burn stress. Differences of opinion exist as to whether SSD applications to the wounds of non-septic burn patients should be discontinued if EPBL develops. A survey of opinion in 101 North American burn treatment facilities and a review of the literature show a strengthening of the perception that EPBL, whether caused by SSD or not, holds little risk for the burn patient. The majority of burn patients are now being assigned to treatment strategies in which the onset of EPBL requires discontinuance of SSD only at WBC counts lower than 2,000/cu mm or not at all. This is significantly lower (p less than .02) than the mean of the values recorded in the literature. There is now substantial experience with continuing the SSD therapy in this setting regardless of the WBC count. No complications are reported therefrom.

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A microcomputer system is described that has been incorporated into a custom-designed cart for mobility throughout a clinical setting with consequent increased utilization and cost-effectiveness. A library of clinical profiles has been developed that processes and consolidates quantitative clinical data into a bar-graph format for more convenient interpretation and documentation. It is suggested that even a small hospital can acquire a mobile computer system and hire a senior or graduate student in the physical or computer sciences, on a part-time basis, from a neighboring university or technical college, to develop clinical computer software suitable for that particular institution.

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Fingerprints of one hundred nineteen Caucasian females were obtained. Of these females, thirty-four had histologically proven breast cancer, fifty-three were at high risk for development of breast cancer, and thirty-two comprised a control group. The digital pattern frequencies and the pattern intensity index were significantly different between the three groups. The presence of six or more whorls appears significant as noted by 32.4% of breast cancer patients possessing this number of whorls as compared to 3.1% controls. Also of note is that 95% of subjects with six or more whorls either had cancer or were at high risk.

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Instant nutritional assessment of the critically ill patient using serum albumin level and total lymphocyte count is reported. When an intensive care unit population is compared to the general hospital population a 6-fold increase in albumin level depressions, a 2-fold increase in lymphocyte count depression, and an 11-fold increase in depression of both parameters was noted in the intensive care unit population. Surgical intensive care unit (SICU) patients with depressed albumin levels and total lymphocyte counts had twice the complication rate and 4.5 times the death rate of those SICU patients with normal albumin levels and lymphocyte counts. It is concluded that serum albumin levels and total lymphocyte count determinations are valuable tools for instant nutritional assessment of the critically ill patient.

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Estimation of intrapulmonary blood shunt fraction requires accurate evaluation of pulmonary capillary, arterial, and mixed venous oxygen contents. The presence of carboxyhemoglobin, as well as methemoglobin and sulfhemoglobin, may lead to large errors in the calculated intrapulmonary blood shunt fraction. The errors are most pronounced at low values of carboxyhemoglobin and low values of true intrapulmonary shunt fraction.

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Indocyanine green dye dilution curves with abnormal contours have been recorded in four patients with acute and critical illnesses using standardized recording methods. The abnormal curves are characterized by a high and prolonged concentration of dye occurring after the peak concentration. This altered contour can be detected by use of routine mathematical processing since the derived hemodynamic parameters are affected by the altered contour. A physiologic basis for the altered curve contour is proposed.

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An automated system has been developed for measuring hemodynamic, oxygen transport and tissue utilization functions. Rapid measurement and data analysis of physiologic profiles by paramedical personnel allow prompt evaluation of altered cardiovascular function. Evaluation of physiologic function allows therapeutic interventions to be instituted on a timely basis, appropriately directed toward improvement of the measured cardiovascular abnormalities. Physiologic profile studies were performed on 1016 occasions in 580 patients during a three-year period and form the basis of this report. Although utilized on hospitalized patients, there are implications for use in evaluating and treating all critically ill patients.

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A relatively simple and inexpensive data management system is described with which comprehensive physiologic and cardiovascular profiles are produced. The system is comprised of a desk-top programmable calculator interfaced with an acoustic digitizer input, and an X-Y plotter, with alphanumeric printing output capability. Numerical clinical data such as intracardiac pressures and blood gas values are entered into the calculator via the keyboard, and graphical data such as dye-dilution curves or ventricular contours are digitized with a pen stylus on the acoustic tablet. The data are processed in the calculator and the results charted in familiar and readily interpreted bar-graph format on preprinted charts on the X-Y plotter. The entire system is inexpensive and compact enough to be applicable to small- and medium-size community hospitals.

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Measurements of hemodynamic, oxygen transport, and tissue utilization functions were incorporated into a physiologic profile assessment system in order to evaluate patients who are candidates for mechanical support of the failing heart. Circulatory function was assessed in patients with acute myocardial infarction associated with diminished peripheral perfusion and compared to an age-matched, normal patient group. Serial studies performed prior to and during intra-aortic balloon counterpulsation provide a means to assess circulatory status accurately and document the efficacy of therapeutic interventions.

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The automated physiologic profile provides the critical care physician with hemodynamic, oxygen consumption and tissue utilization data at reasonable cost. A paramedical assistant performs all data acquisition, recordings and blood sampling procedures. Data reduction is performed through use of off-the-shelf desk-top calculator equipment and accessories and a standardized graphic display is provided for the physician in charge. The physiologic profile has been utilized in high-risk patients requiring medical and surgical interventions. It is routinely employed in postoperative monitoring of cardiac patients and patients undergoing major surgical procedures with associated cardiovascular decompensation. Diagnosis of cardiac and pulmonary deterioration and promptness of advanced support interventions represent additional areas of effective clinical application.

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Fourier analysis of electron micrographs has been accomplished underptimum conditions with a gas laser as the light source for an optical diffractometer.