Osgood-Schlatter lesion: fracture or tendinitis? Scintigraphic, CT, and MR imaging features.

To determine whether the Osgood-Schlatter lesion (OS) is produced by avulsion fracture or injury to the patellar tendon, all images obtained in 28 cases of OS in 20 patients (16 scintigrams, 34 computed tomographic [CT] scans, and 27 magnetic resonance [MR] images) were retrospectively analyzed. In 21 cases, imaging was performed before and after treatment; in 20 cases, relief from pain was complete at the time of repeat examination. In all patients (100%), abnormal size of the tendon, decreased attenuation, and increase in signal intensity were compatible with the CT and MR imaging appearance of tendinitis. Distended deep infrapatellar bursa was a frequent finding, particularly on MR studies. These abnormalities had partially disappeared at follow-up examination. An ossicle was seen in only nine of 28 cases (32%); in three of seven cases with follow-up, the ossicle remained nonunited to the tibial tuberosity on follow-up studies despite relief from symptoms. This implies that healing of fracture is not essential for relief from symptoms. These results strengthen the argument that in most cases of OS, insult to the tendon and associated soft tissues, rather than avulsion fracture, causes OS.     

Renin-producing renal cell carcinomas—clinical and experimental investigations on a special form of renal hypertension

Summary The pathogenetic relationship between tumour and hypertension was investigated in 129 patients with renal cell carcinoma, of whom 41 (31.8%) were hypertensive. Of these 41 patients with renal tumours and hypertension, 6 (14.6%) were found to have primary reninism. In these patients the plasma renin activity in blood from the renal veins showed a tumour kidney to contralateral kidney ratio of between 4 and 7, and 2 patients also had secondary hyperaldosteronism. In the same 6 cases the renin content in the renal tumour tissue was significantly higher than that in tissue from the adjacent tumour-free renal cortex of the ipsilateral kidney. Immunohistochemical demonstration of renin in the tumour was only possible in these 6 cases. In 5 of these patients blood pressure returned to normal following nephrectomy; in the 6th case there was a drop in blood pressure after nephrectomy. In 3 renin-positive tumours examined, autonomous renin production was demonstrated in cell culture. Renin-producing renal cell carcinomas are an uncommon cause of renal hypertension. The differential diagnosis of hypertension should therefore also include renal tumour.     

Epidemiology and clinical manifestation of HIV infection in Northern Zaire

1275 patients were evaluated for HIV-1+2 seroprevalence and its association with clinical symptoms of HIV infection. Of 667 apparently healthy subjects, 8.2% had anti-HIV-1 antibodies. In 465 patients with clinical signs of AIDS, 39.4% were seropositive. 143 patients with miscellaneous symptoms had positive predictive values for HIV infection between 67% (vaginal ulcerations) and 20% (profound pyogenic abscesses). The WHO definition for AIDS had a specificity of 78.3%, a sensitivity of 72.2% and a predictive value of 61.6%.     

Interface echos between the retina and choroid

In 61 patients echographically examined in A and AB mode at Münster University Eye Hospital a membrane-like echo was found between the retina and the choroid. The acoustic characteristics were studied. The usefulness for the differential diagnosis of retinal detachment was demonstrated with several situations of the retina. The thickness of the retina and choroid can be measured in routine examinations.     

VACUOLE SIGN AND SMALL NODE SIGN IN EARLY PERIPHERAL LUNG CANCER PATHOLOGIC BASIS AND DIAGNOSTIC VALUE

Radiologic and pathologic mani;estations of 30 peripheral pulmonary masses around l.5-3 cm in dia- meter were compared to the pathologic basis of va- cuole sign and small node sign on tomogram. Stati stics of 100 conventional X-ray tomograms of peri- pheral pulmonary masses about l-3 cm in diameter suggested that the vacuole sign and small node sign, more common in early peripheral lung cancer than in tuberculoma, are valuable for differentiating early peripheral lung cancer from tuberculoma.     

Indoor air pollution of coal fumes as a risk factor of stroke, Shanghai.

A cohort of 957 male persons in Shanghai has been followed up for 12 years after they entered a screening program for coronary heart disease and stroke. During the period of study, 24 of the subjects who had no previous history of heart disease and stroke died from stroke. Risk factors for stroke were analyzed by the Cox proportional hazards model. Coal fumes were found to be an independent risk factor for stroke in addition to diastolic blood pressure, age, and cigarette smoking.     

Morphological study of the anterior segment of cynomolgus monkey eyes following treatment with prostaglandin F2 alpha

Topically applied prostaglandin F2 alpha has been shown to lower intraocular pressure in cynomolgus monkeys. In this study the morphological changes, following topical treatment with 4-50 micrograms of prostaglandin F2 alpha for 4-8 days, were investigated. Semiquantitation of (1) accumulation of white blood cells as one sign of inflammation, (2) edema and (3) enlarged spaces between ciliary muscle cells were performed. Eighty sections per eye encompassing the whole circumference were investigated. No accumulation of white blood cells was seen in any of the eyes. Slight edema in the most anterior part of the ciliary processes occurred in most eyes, but only in part of the circumference. These changes could be either directly induced by the prostaglandin treatment or secondary to the decrease in intraocular pressure. The most pronounced change was the dilatation of the intramuscular spaces. These enlarged spaces could explain the physiologically shown increase in uveoscleral outflow.     

In vivo measurement of the shear modulus of the human vocal fold: interim results from eight patients

The shear modulus of the vocal fold is an essential parameter required to enhance our understanding of how the vocal fold operates, to develop mathematical models of phonatation, and to provide benchmarks to quantify the effectiveness of surgical procedures. The authors announced the successful deployment of an instrument to measure vocal fold elasticity in vivo last year, and now present the data taken from eight patients in vivo. The shear modulus was measured at the mid-membranous point, in a transverse direction with respect to the axis drawn between the anterior commissure and vocal process. The range of mean shear modulus results is 701–2,225 Pa, with a mean value of 1,371 Pa.