Ultrasonic features of pyogenic liver abscesses

Ultrasonic features of 21 surgically confirmed pyogenic liver abscesses in 18 patients were analyzed. Typical lesions were round or ovoid with a discrete, irregular, echo-poor margin. The number and intensity of internal echoes and sound transmission were variable. Such lesions can be aspirated percutaneously for definitive preoperative diagnosis. Pyogenic liver abscesses appear to have more ragged walls and are less frequently elliptical or multilocular than abscesses elsewhere in the abdomen.     

Locomotor activity detects subunit-selective effects of agonists and decahydroisoquinoline antagonists at AMPA/kainic acid ionotropic glutamate receptors in adult rats

Rationale In vitro studies have identified a series of decahydroisoquinoline compounds with differential selectivity for the subunits that comprise AMPA/kainic acid receptors. Compounds have been identified that have preferential activity at AMPA receptors (LY302679), whereas others (LY377770) have affinity for GluR5-kainic acid preferring subunit, which is activated by ATPA and kainic acid.Objectives These studies set out to determine if locomotor activity could differentiate these profiles in vivo.Methods Locomotor activity was assessed in photocell drums in male Lister Hooded rats.Results AMPA, kainic acid and the GluR5 selective agonist ATPA, all suppressed spontaneous locomotor activity (SLA) in rats at doses of 1.0, 5.0 and 20 mg/kg resp. All three agonists achieve micromolar concentrations measured in whole brain after dosing with 10 mg/kg SC. The decahydroisoquinoline antagonist compounds, LY302679 (GluR2), LY293558 (GluR2, 5) and LY377770 (GluR5) all decreased SLA in rats (ED_min 2.5, 5.0 and 20 mg/kg respectively). The rank order of potency at GluR2 subunits (LY302679>LY293558>LY377770) was reflected in the same rank order of activity for suppression of SLA. LY293558 reversed the suppression of SLA induced by all three agonists (0.62–2.5 mg/kg). LY377770 reversed the effects of ATPA only (ED_min 1.0 mg/kg), LY302679 (ED_min 2.5 mg/kg) attenuated the effect of kainic acid but was ineffective against AMPA and ATPA.Conclusions Both agonist and antagonist suppression of SLA is associated with greater affinity for the GluR2 subunit, while compounds with affinity for the GluR5 subunit were less potent in suppressing SLA.     

Possible Linkage between Xg and the Locus for a Gene causing Mental Retardation with or without Hydrocephalus

The Xg groups of a kindred in which an X-borne gene evidently caused mental retardation with or without hydrocephalus suggest that the locus for this gene may be linked to Xg.     

Cost-effective management of isolated facial fractures

The purpose of this study was to evaluate the subset of costs incurred for surgical treatment of isolated midface and mandible fractures of patients admitted directly from the emergency department compared with those admitted as outpatients after evaluation and discharge from the emergency department. After institutional review board approval, the records of patients admitted to Wake Forest University Baptist Medical Center were studied retrospectively for patients who underwent surgical repair of an isolated facial fracture between July 1, 1999 and June 30, 2000. Patients were placed into one of two groups: admission from the emergency department versus admission as an out-patient. Total hospital charges were compared, and complications were evaluated. Mechanism of injury, age, and gender were recorded within each group. Forty-two patients met the study criteria. Twenty-eight patients were admitted directly from the emergency department (Group A), and 14 were admitted as outpatients after elective scheduling for operative repair (Group B). Operative charges based on utilization of time and materials showed no statistical significance between Group A (P = 0.275) and Group B (P = 0.393). Patients admitted directly from the emergency department had a mean hospital charge of 3,556.66 dollars higher (P< or = 0.001) and stayed 2 days longer in the hospital as compared with the outpatient group. No differences were noted in complications between the study groups. The results of this study reveal a significant decrease in cost for patients with isolated facial fractures admitted as outpatients on scheduling surgery as compared with immediate admission from the emergency department.