Choreoacanthocytosis in a Chinese patient--a case report

A 50-year old Chinese woman with the rare neurological disorder of Choreoacanthocytosis is described. Her illness is characterised by seizures, buccolingual dyskinesia, choreiform movements, arreflexia and mild sensorimotor polyneuropathy. Acanthocytes were present in her peripheral blood in large numbers but the serum lipid profile was normal. Her features are consistent with those so far described in Caucasian and Japanese patients. The disease differs from Huntington's chorea in that there are acanthocytes, peripheral neuropathy, and metal function remains relatively intact.     

Schistosomiasis caused by Schistosoma mansoni in Baringo District, Kenya: case report

Schistosomiasis caused by Schistosoma mansoni has not been reported in Baringo District of Rift Valley Province. The intermediate host (Biomphalaria species) though has been reported to occur along the shores of the lakes in this region. Three children from Baringo District were diagnosed to have schistosomiasis caused by S. mansoni by finding ova in their stools. They gave no history of visiting an endemic area. There are many dams being built for land reclamation, creating favourable conditions for the spread of the disease, in presence of the intermediate and definitive host. Studies on the current status of the disease and malacology should be undertaken in order to control the spread of the disease at an early stage.     

Evaluation of endorectal ultrasonography in the diagnosis of prostatic cancer using a high-frequency sectorial intracavitary probe

Endorectal ultrasonography was evaluated in the diagnosis of prostatic cancer, using a high frequency (7,5 MHz) mechanical sectorial endocavitary probe developed by the authors. In a first study, sonograms from a series of 213 patients were interpreted retrospectively without any knowledge of the clinical or pathological findings. Specificity for the diagnosis of cancer (true non-malignant/total non-malignant) reached 79%, whereas sensitivity (true malignant/total malignant) was only 48%. Pathology was available for 132 patients. In a second study, 72 ultrasonically guided biopsies were performed in patients presenting either with a suspicious induration without nodule (47 cases) or a palpable nodule (25 cases). Good quality biopsy specimens, and absence of complication were remarkable. However, the 10 cancer cases (5 diagnosed in each group) did not show sonographically clearly different from the remaining adenoma, prostatitis and normal cases.     

The relationship of scoring systems and mortality in the surgical intensive care unit

To determine the relationship between severity of illness and mortality, therapeutic intervention score (TISS) and acute physiology score (APS) were determined on admission to the Surgical Intensive Care Unit (SICU). Patients were divided into survivors and nonsurvivors and differences were compared by chi-square analysis. The 1524 patients admitted to the SICU during a 12-month period had a mean TISS of 3.03 and a mean APS of 13. The average length of stay (LOS) was 3.75 days. Of the 1524 patients, 97 (6.4%) died. The number of nonsurvivors increased with higher TISS and APS scores (P less than 0.001). There were no deaths in the TISS Category 1 patients or in the APS 0-5 group. Mortality rates dramatically increased with APS greater than 20 (P less than 0.001). There were 1286 patients with APS less than 20, and 24 (2%) of these patients died, whereas 73 (31%) of 238 patients with APS greater than 20 died. Nonsurvivors had a mean TISS of 3.6, mean APS of 27, and LOS of 4.88 days, all of which totals were higher than the survivors' totals. In this study population, risk of death was one in three if the APS was greater than 20. These data indicate that TISS and APS scores are effective means of assessing mortality risk in SICU patients.     

Acute idiopathic tubulointerstitial nephritis: report of two cases and review of the literature

Two patients who presented with severe renal failure and evidence of generalized proximal tubular dysfunction were found to have severe diffuse acute tubulointerstitial nephritis on renal biopsy. No etiology could be found in either case. Both patients had dramatic improvement in renal function following steroid therapy. In the first reported case of its kind, one patient relapsed when steroids were withdrawn, but improved again with reinstitution of steroid therapy. These cases, as well as others in the literature, show that steroids are effective and may be necessary to improve renal function in some patients with acute idiopathic tubulointerstitial nephritis. Evidence of proximal tubular dysfunction is a clue to the presence of this disorder.