Epiploic appendagitis and omental infarction: pitfalls and look-alikes

Epiploic appendagitis and omental infarction are benign self-limiting conditions that are more frequent than generally assumed. Both disorders frequently mimic symptoms of an abdominal surgical emergency, often leading to clinical misdiagnosis of appendicitis or diverticulitis. Because a misdiagnosis can result in an unnecessary laparotomy, a correct diagnosis is of great importance. Ultrasound and computed tomography can be used to make a reliable diagnosis. This pictorial essay illustrates the various ultrasonographic and computed tomographic appearances of epiploic appendagitis and omental infarction and focuses on their radiologic differential diagnoses and pitfalls. Received: 22 February 2001/Accepted: 18 April 2001     

Rechtsprechung aktuell

Ohne Zusammenfassung     

Should every patient undergo cardiac catheterization after myocardial infarction?

During the past few decades, management of patients with myocardial infarction has dramatically evolved. High-risk patients are now identified by a variety of noninvasive tests, and aggressive use of reperfusion strategies has improved clinical outcomes. Despite the benefits of reperfusion, only a few patients are eligible to receive thrombolytic therapy. Mortality rates among patients excluded from thrombolytic trials (15% to 20%) have been far greater than those eligible for treatment (3% to 10%). Because most deaths occur within the first few days of infarction, interventions designed to reduce mortality should be performed acutely. Immediate catheterization allows identification of high-risk anatomy that may benefit from surgery and allows coronary angioplasty to be performed as a reperfusion strategy (when appropriate). Furthermore, catheterization allows documentation of ejection fraction, vessel patency, number of diseased vessels, and residual stenosis, all of which have been predictive of prognosis. Conversely, frequently repeated noninvasive diagnostic tests are associated with increased cost, are generally performed in low-risk patients, and 60% to 80% of patients with myocardial infarction ultimately require catheterization anyway. It is possible that early catheterization and percutaneous transluminal coronary angioplasty when indicated may effectively risk stratify patients (eliminating the need for noninvasive testing), may reduce morbidity and mortality, and shorten the length of hospital stay.     

脂质体携载SOD的实验研究

本文采用去垢剂透析法成功制备出携载ＳＯＤ的脂质体（Ｌ－ＳＯＤ），其直径为１０２ｎｍ，对ＳＯＤ的包裹率为２１％，９０％以上酶活性存在于脂质体内部。将Ｌ－ＳＯＤ注射到大鼠静脉血中，其半衰期超过４ｈ，明显长于天然ＳＯＤ（８ｍｉｎ）。表明Ｌ－ＳＯＤ优于天然ＳＯＤ，具有临床应用前景。     

Role of nuclear cardiology for determining management of patients with stable coronary artery disease

Both radionuclide angiography and myocardial perfusion imaging provide important insights that determine the management of patients with stable coronary artery disease. Both nuclear cardiology procedures have clearly demonstrated use in the noninvasvie identification of severe (left main or three-vessel) coronary artery disease and the noninvasive assessment of prognosis and thereby determine which patients should be sent to coronary angiography. Both radionuclide angiography and myocardial perfusion imaging provide prognostic information that is independent of resting left ventricular function and coronary anatomy and thereby influence the decision regarding which patients should be sent to coronary revascularization. This review considers the evidence supporting the uses of these nuclear cardiology procedures and provides suggestions regarding their cost-effective application.