Mesenteric panniculitis versus pancreatitis: A computed tomography diagnostic dilemma

A case of mesenteric panniculitis is described in a patient with CT features mimicking pancreatitis. Emphasis is on the important CT features for accurate diagnosis.     

Factors influencing the functional outcome of restorative proctocolectomy in ulcerative colitis

BACKGROUND: Restorative proctocolectomy is considered to be the procedure of choice in the operative treatment of ulcerative colitis. The aim of this study was to evaluate the functional outcome following operation and to identify possible predictive factors. METHODS: Some 168 patients (median age 32 years, 102 men) with ulcerative colitis underwent restorative proctocolectomy. The functional outcome was evaluated by a symptom index created from a questionnaire at a median of 29 (13-123) months of follow-up. The records of these patients were reviewed, and preoperative, peroperative and postoperative variables were registered and related to outcome. RESULTS: The response rate to the questionnaire was 155 (92 per cent) of 168. The symptom index was related to patients' overall assessment of outcome. In spite of a perceived good result many patients experienced a number of symptoms. Age over 50 years (P < 0.01), presence of extraintestinal manifestations (P < 0.05) and late complications, such as anastomotic stricture (P < 0.05), pouchitis (P < 0.01) and anal pain (P < 0.05), were related to a less favourable outcome. CONCLUSION: While preoperative data may help in selecting patients suitable for restorative proctocolectomy, prevention of late complications seems most important in improving the functional outcome.     

Fibroblast growth factor receptor expression reflects cellular differentiation in human oral squamous carcinoma cell lines

This study examined the expression of fibroblast growth factor receptor 2 (FGFR 2) splice variants, IIIb and IIIc, in normal and malignant human oral keratinocytes and in normal oral fibroblasts by RT-PCR using both exon-specific primers and primers common to both FGFR 2 isoforms. Fibroblasts expressed exclusively FGFR 2/IIIc whilst the normal and malignant keratinocytes co-expressed FGFR 2/IIIb and FGFR 2/IIIc. Well- differentiated keratinocytes expressed proportionally more FGFR 2/IIIb than IIIc whereas the poorly-differentiated cells expressed more FGFR 2/IIIc than IIIb. The normal and malignant keratinocytes, but not fibroblasts, expressed an additional amplification product, which consisted of both IIIb and IIIc of FGFR 2 joined by an extra base pair and with the intronic sequence removed. The results indicate that the expression of FGFR 2 isoforms reflects the degree of cellular differentiation in normal and malignant human oral keratinocytes and that receptor complexes of FGFR 2/IIIb and IIIc may regulate ligand- receptor interactions.      

STANDARDIZATION OF CERVICAL/VAGINAL CYTOPATHOLOGY REPORTING: THE BETHESDA SYSTEM (TBS) FOR REPORTING CERVICAL/VAGINAL CYTOLOGIC DIAGNOSES

The complex detection system leading to the discovery and treatment of precancerous lesions and early cancers of the uterine cervix is touched upon. By far the most difficult and underestimated component of this system is the screening and interpretation of cervical smears. Emphasis on the latest system of reporting, The Bethesda system is highlighted upon. Weaker points of the previous systems and the need for a newer system for reporting are stressed upon. The classification of the precursors of invasive squamous cancers is not easy, and various groups have advocated several schemes, none is yet perfect or universally accepted. The variation in nomenclature become less significant when the cytopathologist is a full member of a team made up of a clinician, histopathologist, colposcopist, and oncologist. As long as all members speak to each other frequently and use the same language and terminology, they will be able to determine the best treatment for the patient.KEY WORDS: Cervical smears, Epithelial cell abnormalities, The Bethesda system, Vaginal smears     

The course and outcome of pregnancy after ovarian electrocautery in women with polycystic ovarian syndrome: the influence of body-weight

Summary. In 89 women with polycystic ovary syndrome (PCOS) who conceived after ovarian electrocautery, the pregnancy continued beyond 31 weeks in 62. In this group the frequency of pre-eclampsia and diabetes was 12·9 and 8·1% respectively. The increased frequencies were confined to overweight women. The frequency of major and minor malformations was 1% and 3·8% respectively. The rate of early miscarriage of the first pregnancy after ovarian electrocautery was 15%, and when later pregnancies were included the rate reduced to 10·3%. These data do not indicate any impact upon the course or outcome of pregnancy from the state of PCOS per se or the ovarian electrocautery that induced ovulation in this series.     

Neutralizing Activity in Human Milk Fractions against Respiratory Syncytial Virus

ABSTRACT. Neutralizing activity against respiratory syncytial virus (RSY) was measured in milk samples from 17 healthy women whose infants had an acute infection with respiratory syncytial virus (RSV) and from 27 women with healthy infants. All milk samples were obtained 2-8 months post partum. Neutralizing activity was detected in 36 samples. No major difference in neutralizing titers was observed between the two groups, and the titers were low. RSV-specific IgA was found in two samples, and RSV-specific IgG in one sample. RSV-specific IgM was not detected. In gel filtration studies, the neutralizing activity was eluted with an apparent molecular weight above 400 000. The neutralizing activity remained after removal of IgA by affinity chromatography. These findings suggest that both immunoglobulin and non-im-munoglobulin components in human milk can neutralize RSV.     

Histochemical changes in livers from portacaval-shunted rats

Portacaval shunt (PCS) operations were performed on male inbred SD rats. The activity of liver gamma-glutamyltranspeptidase (GGT) increased a few days after the operation and remained high after several months. However, the activity was only present in periportal areas of liver lobules and was mainly restricted to the endothelial lining cells of periportal blood vessels. Phenobarbital sodium (CAS: 57-03-7) administration did not change the distribution of GGT. The activity of liver glucose-6-phosphatase disappeared in the centrilobular areas a few days after the operation but was present in the periportal areas. The distribution of this activity returned to normal after several months. The capacity of liver cells to store glycogen was significantly decreased following the PCS operation. Morphologic changes in hepatocytes observed after the PCS operation did not show similarities to those seen in preneoplastic livers. The nuclei of the small compact hepatocytes found in the animals with PCS were irregular in shape and stained intensively with hematoxylin and eosin. The large pale-staining cells in the periphery of liver lobes were GGT negative and their nuclei had a normal morphology. Neither morphologic nor histochemical changes consistent with preneoplastic and/or neoplastic stage were observed after 10 months in the liver when the PCS operation was performed on rats having received an ip dose (10 mg/kg) of diethylnitrosamine (CAS: 55-18-5) 2 weeks prior to the operation.     

Cemented total hip prosthesis: radiographic and scintigraphic evaluation

Conventional radiographs, technetium-99m bone scans, and gallium-67 scans were reviewed in 44 patients who had undergone cemented total hip joint replacement and were imaged because of suspicion of prosthesis loosening or infection. A complete radiolucent line of 2 mm or wider along the bone-cement interface or metal-cement lucency on conventional radiographs was used as the criterion for prosthetic loosening with or without infection and proved to be 54% sensitive and 96% specific. Scintigraphic criteria for prosthetic loosening were increased focal uptake of the radiopharmaceutical for the femoral component and increased focal or diffuse uptake for the acetabular component. For bone scintigraphy, sensitivity was 73% and specificity was 96%. Combining the results of conventional radiographs and bone scans increased sensitivity to 84% and decreased specificity to 92% for the diagnosis of loosening, infection, or both. The study also showed that Ga-67 scintigraphy has a low sensitivity for the detection of infection.