Antegrade internal ureteral stenting: a technical refinement

A pliable, easy to place, double pigtail, internal ureteral stent made of elastomeric polyurethane is described. The tapered distal pigtail end minimizes bladder irritation and the combination of a pusher and absorbable suture enables optimal placement of the proximal pigtail end in the renal pelvis. Ten stents used in eight patients remained functional without bladder irritation for a mean period of 8 months (range, 2-14 months).     

Effect of daily oral omeprazole on 24 hour intragastric acidity

Twenty four hour intragastric acidity was measured in nine patients with duodenal ulcer before and after one week of treatment with oral omeprazole 30 mg daily, a drug that inhibits gastric secretion by inhibition of parietal cell H+K+ adenosinetriphosphatase (ATPase). Omeprazole virtually eliminated intragastric acidity in all patients: the median 24 hour intragastric pH rose from 1.4 to 5.3 and the mean hourly hydrogen ion activity fell from 38.50 to 1.95 mmol(mEq)/1 (p less than 0.001). This inhibition of 24 hour intragastric acidity is more profound than that previously reported with either cimetidine 1 g daily or ranitidine 300 mg daily.     

Low-silver amalgam restorations: a two-year clinical evaluation

A clinical survey of amalgam restorations made with four proprietary alloys with low-silver and high-copper contents was followed during a two-year period, according to USPHS criteria. With the exception of one alloy, the marginal integrity was found to be very satisfactory. All the restorations lost their superficial luster in a short period of time.     

Dopamine might not be involved in the pathogenesis of polycystic ovary syndrome

The possible alteration in dopamine (DA) metabolism as an etiological factor was investigated in 31 normoprolactinemic patients with typical polycystic ovary syndrome (PCOS) in comparison with 14 normal women (early follicular phase). Subjects were submitted to intravenous infusion of 4 micrograms/kg DA per minute over a period of 3 hours and blood samples were collected every 30 minutes over a period of 5 hours. Two days later subjects were submitted to intravenous infusion of 10 mg metoclopramide (MCP) as a bolus and blood samples were collected every 15 minutes over a period of 2 hours. Dopamine infusion caused a similar maximum decrease (MD) in LH levels in both the PCOS and control groups (50.9% and 47.5%, respectively). No changes in plasma LH levels were observed in either group after MCP infusion. Dopamine caused a 50.2% and 60.4% MD in prolactin (PRL) in the PCOS and control groups, respectively, the difference being statistically non-significant. Metoclopramide increased PRL levels by 1261.0% and 1832.0% in the PCOS and control groups, respectively (not significant). In a double-blind study, the PCOS patients were treated with 5 mg/day bromocriptine (n = 16) or placebo (n = 15) over a period of 3 months and evaluated in clinical and laboratory terms during and after treatment. Seven patients in each group had monthly menstrual periods, but only 1 in each group had an ovulatory cycle (progesterone greater than 5 ng/ml). During treatment, median plasma PRL levels were significantly decreased only in bromocriptine-treated patients (10.8 vs 7.3 ng/ml). The present results lead us to question whether dopamine is indeed involved in the pathogenesis of normoprolactinemic PCOS and whether bromocriptine treatment is of benefit in this type of patients.     

Pachygyriclike changes: topographic appearance at MR imaging and CT and correlation with neurologic status

Studies of 23 pediatric patients with pachygyriclike changes (PLCs) examined with computed tomography (CT) and magnetic resonance (MR) imaging were reviewed to determine topographic patterns and correlate them with various clinical syndromes and degrees of neurologic impairment. Three types of topographic distributions were identified: unilateral, diffuse, and bilateral nondiffuse (of which eight of 10 showed frontotemporal predominance). PLCs were an isolated finding in seven patients, were associated with various congenital syndromes in nine patients, and were associated with congenital infection in seven patients, six of whom showed marked white matter abnormalities. Although most patients had severe developmental delay, three with nondiffuse PLCs had less severe impairment, permitting less required care.