Intra-abdominal desmoplastic small cell tumor presenting as an acute abdomen after trauma

The intraperitoneal mass most commonly encountered after blunt abdominal truama is a hematoma. However, one must also consider unusual bulky tumors that can have imaging characteristics similar to those of hematoma. The most typical of these neoplasms is lymphoma, but a desmoplastic small cell tumor also may be observed. The presentation and imaging findings of a desmoplastic small tumor are described.     

Untersuchung zur Morbidität der indigenen Volksgruppen der Chiquitanos im südlichen Amazonasgebiet

The Chiquitano-tribe lives in the southern Amazonas region in Bolivia, remote from larger towns. A study (n=1514) on morbidity over an one year period (April 1995 till March 1996) and its relation to general and social medicine is given. Most frequently, childreh under 15 years and women in parity age (15–45 years) sought consultation (34,1 %, 42,7 %). Gastrointestinal, respiratoral and gynecological-obstetric diseases were predominant (22,4 %, 16,2 % and 15,7 %). In the dry season, common colds and respiratoral infections represented the major health problem. In the rainy season, infectious diarrhea diseases caused by polluted water as a consequence of extended floods were most frequent. Typical tropical diseases (malaria, Dengue fever, Chagas’ disease, leprosy a.o.) and socially caused diseases (AIDS, dependencies on drugs and alcohol, consequencies of crime) were rarely seen. With respect to severity, 55,8 % of the patients showed mild disorders. More serious diseases were observed in 39, 8 %. 4,6 % of the patients were diagnosed severly ill and needed hospitalization. Epidemiological data on general and social medicine of minorities in developing countries and their actual degree of medical care are important in a shrinking world. The data are useful to estimate medical needs and plan improvements to the health care system especially in rural areas.     

A monitoring,feedback, and triggering system for reproducible breath-hold MR imaging

A technique is described that provides improved reproducibility of breath-holding for MR image acquisition by monitoring the superior-inferior (S/I) position of the diaphragm. The method incorporates detection of the level of inspiration using an MR signal, rapid display to the patient of diaphragm position to enable breath-hold adjustment, and triggering of image data acquisition once appropriate position is attained. The response time of the system is short, approximately 10 ms. Studies in six volunteers using this method demonstrate a considerable decrease in the S/I range of diaphragm position over 10 consecutive periods of suspended respiration. The mean range is 1.3 mm with the system, while it is 8.3 mm without using it is expected that this method will be of assistance in many abdominal and cardiothoracic studies that use breath-hold techniques.     

Therapeutic factors in partial hospitalization

In recent years, partial hospitalization programs have become an accepted major component of community-based care for psychiatric patients. Studies have shown that partial hospitalization is at least as effective as inpatient hospitalization in treating a spectrum of psychiatric disorders and is substantially more cost effective than standard inpatient care (Guillette et al. 1978; Herz et al. 1971; Washburn et al. 1976; Wilder et al. 1966). Despite these positive findings, the therapeutic factors that contribute to the effectiveness of partial hospitalization continue to be a subject of speculation (e.g., Goldberg 1982; Vannicelli et al. 1978; Washburn 1983). In a recent review of the literature on the efficacy of partial hospitalization, Mason et al. (1982) emphasize that the "active ingredient" in this treatment modality remains unclear. In an outcome study by Dunn et al. (1982, p. 297), hope was expressed that "future studies might best explore which nonspecific factors are most powerful therapeutically." The current study is part of a larger effort to develop from an empirical base a comprehensive model of partial hospitalization. The comprehensive model provides a framework for understanding partial hospitalization by examining: 1) the functions of a partial hospital admission, 2) the types of patient changes that occur in these programs, 3) the processes of change, and 4) the therapeutic factors that appear to facilitate change. Findings regarding the first three elements of the model are described in a companion paper. This report focuses on the findings regarding the fourth element of the model, the therapeutic factors that appear to facilitate change in a short-term partial hospitalization program. It also examines how specific program components contribute to these therapeutic factors.     

Prognostic value of somatosensory- and motor-evoked potentials in patients with a non-traumatic coma

Summary A total of 28 patients with non-traumatic coma were studied both with somatosensory- and motor-evoked potentials. While somatosensory-evoked potentials (SEP) have proved to be useful in predicting the outcome in patients with severe brain damage, the aim of this study was to find out whether the additional evaluation of motor-evoked potentials (MEP) could contribute to a better prediction of the outcome than SEP alone. Our results clearly indicate that in terms of prognostic value, SEP are superior to MEP. Nine patients with bilaterally preserved MEP died, while all of the patients with bilaterally preserved SEP and a central conduction time 6.5 ms survived, with a Glasgow outcome score of 1 to 3. Therefore, we cannot recommend the inclusion of MEP in the prognostic evaluation of patients with non-traumatic coma.     

Commentary on Retzinger

Suzanne Retzinger's article, "A Theory of Mental Illness," provides further untangling of the complex links between social relationships and psychopathology. Those links have been demonstrated in such diverse areas as the impact of family relationships on relapse (e.g., Brown et al. 1972), the predictive importance of social relations to outcome (e.g., Strauss and Carpenter 1977), and the genetic connections between social relationship traits and vulnerability to psychopathology (Kendler et al. 1982). The research presented here focuses on social relationships with special emphasis on stigma in those relationships and its impact on disorder. It also has the valuable role of forging connections between the more abstract labeling theory and the actual behaviors of people as viewed in their interaction.     

Radiologic search for embolized leaflets of prosthetic heart valves: A report of two cases

In a radiologic search for embolized leaflets of Edwards-Duromedics bileaflet valves in 2 patients, the embolized fragments were localized in the iliac vessels using computed tomography. Sonography was successful in one case and standard X-ray films of the abdomen were negative in both cases.In vitro investigations with Björk-Shiley and Edwards-Duromedics leaflets suggested that standard X-ray films of the abdomen and pelvis should be considered as the first investigational technique. If negative, computed tomography of the lower abdomen should be done.     

Glycosylation of cardenolide aglycones in the leaves of Nerium oleander

Application of [ (14)C]-progesterone to the leaves of NERIUM OLEANDER L. (Apocynaceae) resulted in the formation of [ (14)C]-digitoxigenin and [ (14)C]-oleandrigenin glycosides; the labelled aglycones were obtained after hydrolysis from the cardenolide extract. Both radioactive cardenolide aglycones were further transformed by the leaves of NERIUM OLEANDER L. to the corresponding 3- O-beta-glucosides digitoxigenin glucoside and oleandrigenin glucoside. It could be shown that both cardenolide glucosides are genuine constituents of the cardenolide fraction of NERIUM OLEANDER L. leaves. The structures of these newly identified compounds were verified by (1)H-NMR and FAB (+) mass spectroscopy and by enzymatic cleavage of the glycosidic bond with a beta-glucosidase from HELIX POMATIA.     

Genetic alterations of Carney complex are not present in sporadic cardiac myxomas.

Cardiac myxomas are the most frequent cardiac tumors and cause for significant morbidity and mortality. Recent evidence indicates that cardiac myxomas are, in fact, neoplasms rather than organized thrombi. Cardiac myxomas may present as solitary lesions or in association with the Carney complex. Carney complex has been linked to chromosome 2p16 and the PRKAR1A gene at 17q22-24. In this study, we analyzed sporadic cardiac myxomas to evaluate whether the genetic alterations seen in Carney complex are present in non Carney complex associated cardiac myxomas as well. We analyzed microdissected material from 13 patients with cardiac myxomas for the markers PRKAR1 9CA, D2S2153, D2S2251 and D2S123. None of the cases demonstrated loss of heterozygosity or definite band changes suggestive of microsatellite instability for any of the markers used. We conclude that sporadic cardiac myxomas are genetically not related to Carney complex and most likely do not represent an incomplete form of Carney complex.     

Zwei Kammern für die Mikroskopie und Mikrophotometrie vitaler Zellen

Zusammenfassung Es werden zwei Kammern zur mikroskopischen Beobachtung und mikrophotometrischen Untersuchung von lebenden Zellen beschrieben. Mit ihrer Hilfe ist es möglich. Zellen ohne Schädigung mechanisch so zu stabilisiren, dasß sie bis zu Stunden an derselben Stelle liegen bleiben.In der Einstromkammer liegen die Zellen in einlagiger Schicht zwischen einem Deckglas und einer licht- und gasdurchlässigen Folie, die durch Adhäsion festgehalten wird. Der an die Folie angrenzende Raum kann mit gewünschten Gasgemischen durchströmt werden.In der Zweistromkammer liegen die Zellen zwischen zwei lichtdurchlässigen Folien, von denen die eine Gase, die andere auch Flüssigkeiten und gelöste Substanzen durchtreten läßt. Der an die flüssigkeitsdurchlässige Folie angrenzende Raum kann mit gewünschten Lösungen, der andere gleichzeitig mit Gasgemischen beströmt werden. Die Funktionsweise der Zweistromkammer wird am Beispiel der Formänderung von Erythrocyten bei Beströmen mit Lösungen verschiedenen osmotischen Druckes demonstriert. Beide Kammern eignen sich zur Vital-Mikroskopie und Photometrie von einzelnen Zellen, insbesondere Blutzellen und Gewebeschnitten.