Abdominal tuberculosis. A report of 3 cases

Three patients admitted to the surgical wards of Johannesburg Hospital in whom abdominal tuberculosis was suspected are presented. In every case difficulties were encountered in diagnosis and treatment. Each case presentation is followed by a short commentary on relevant aspects of abdominal tuberculosis.     

The stereoisomers of 17α-[123I]iodovinyloestradiol and its 11α-methoxy derivative evaluated for their oestrogen receptor binding in human MCF-7 cells and rat uterus,and their distribution in immature rats

We studied the potential of both stereoisomers of 17-[¹²³I]iodovinyloestradiol (E- andZ-[¹²³I]IVE) and of 11-methoxy-17-[¹²³I]iodovinyloestradiol (E-andZ-[¹²³I]MIVE) as suitable radioligands for the imaging of oestrogen receptor(ER)-positive human breast tumours. The 17-[¹²³I]iodovinyloestradiols were prepared stereospecifically by oxidative radio-iododestannylation of the corresponding 17-tri-n-butylstannylvi-nyloestradiol precursors. Competitive binding studies were performed in order to determine the relative binding affinity (RBA) of the unlabelled 17-iodovinyloes-tradiols for the ER in both human MCF-7 breast tumour cells and rat uterine tissue, compared with that of diethylstilboestrol (DES). Target tissue uptake, retention and uptake selectivity of their¹²³I-labelled analogues were studied in immature female rats. All four 17-iodovi-nyloestradiols showed high affinity for the ER in human MCF-7 cells, as well as rat uterus. Their RBA for the ER showed the following order of decreasing potency: RBA of DES >Z-IVE >Z-MIVE >E-MIVE E-IVE. Neither of these 17-iodovinyloestradiols showed any significant binding to the sex hormone binding globulin in human plasma. The biodistribution studies showed ER-mediated uptake in the uterus, ovaries and pituitary, that ofE- andZ-[¹²³I]MIVE being higher than that ofE- andZ-[¹²³I]IVE. High target-to-non-target tissue uptake ratios, especially at longer periods after injection (up to 24 h), were exhibited by both isomers of [¹²³I]MIVE. The uterus-to-blood uptake ratio was higher for^E-[¹²³I]MIVE. However, the uterus-to-fat uptake ratio appeared to be higher for theZ-isomer of [¹²³I]MIVE, especially at 24 h after injection. Metabolic properties and temperature effects, which play a more important role in vivo, probably cause the discrepancies seen between in vitro and in vivo binding results. On the basis of their in vitro binding properties and in vivo distribution characteristics we conclude thatE- andZ-[¹²³I]MIVE could be suitable radioligands for the diagnostic imaging of ER in human breast cancer. Therefore, further studies with these radioligands in mature normal and tumour-bearing rats are warranted.     

The Endoscopic Fascial Sling for Treatment of Female Urinary Stress Incontinence

Purpose

We describe a new technique, the endoscopic fascial sling, for the treatment of female urinary stress incontinence.

Materials and Methods

A total of 22 women 25 to 84 years old with urinary stress incontinence underwent this procedure.

Results

There were no urethral erosions or wound infections using the fascial strip. Of the women 16 (73 percent) are cured of incontinence and 4 (18 percent) are improved (use pads less frequently than preoperatively), and the procedure failed in 2 (9 percent).

Conclusions

The endoscopic fascial sling offers a new alternative for the treatment of female urinary stress incontinence, combining the reliability of sling procedures and the decreased morbidity of needle suspension techniques.     

Laser prostatectomy or TUIP for BPH?

Management of benign prostatic hypertrophy has been and continues to be a major focus of urologic care. Every year, some 300,000 transurethral resections are performed annually in the United States. In this Point and Counterpoint, Drs. Madsen, Bruskewitz, and Kabalin review the relative merits of transurethral incision and laser prostatectomy, two newer treatments for BPH.     

Penfluridol: An open phase III study in acute newly admitted hospitalized schizophrenic patients

An open study was carried out in 17 acutely ill, newly admitted, floridly psychotic schizophrenic patients to a city hospital in New York. Penfluridol was given on a daily basis up to doses of 120 mg and patients were rated objectively by means of different psychometric evaluations; vital signs were monitored daily as were side effects.The drug was found to be a rapid acting, well-tolerated, and highly effective antipsychotic agent within the population of patients explored and within the dose range used. It was particularly effective in acutely agitated floridly paranoid schizophrenics; a statistically significant impact was achieved by 7 days and usually within 72 h after initiating treatment. The drug appears unique in that (1) its effects are realized without the untoward and usually trouble-some effects of nonspecific sedation attendant upon the use of many other neuroleptic medications, and (2) even within the relatively high doses used it produces no hypotensive effects. It is concluded that this appears to be a unique antipsychotic agent and a potentially important addition to the treatment armamentarium of both acute and chronic schizophrenic individuals.Dr. Klein was a research fellow who has since returned to the University of Munich, West Germany. Dr. Selzer was also a research fellow who is now in private practice     

Kniegelenksmeniskusverletzungen im Kindesalter mit Berücksichtigung der Nachuntersuchungen

Zusammenfassung Es wurden 30 Fälle der Kniegelenksmeniskusverletzung im Kindesalter vorgestellt, die operativ behandelt waren. 20 der Behandelten wurden nach 1–12 Jahren nach dem operativen Eingriff nachuntersucht. Es wurden n die Ätiologie, der Verletzungsmechanismus und der klinische Befund besprochen. Die klinische und radiologische Nachuntersuchung ermöglichte die morphologische und funktionelle Auswertung des Kniegelenks nach der Meniskusverletzung.

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Injury of the semilunar cartilages of the knee-joint in childhood

Summary In the paper, 30 patients at the age of 5 till 14 with injuries of the semilunar cartilages of the knee-joint, are presented. All the children were subjected to surgery, and 20 of them underwent same examinations performed in a delay of 1 to 12 years after they had been operated. Both etiology and the injury mechanism subjects are hadled together with the clinical pictures, specific to the age of the young patients. Basing on the clinical and X-ray examinations, the state of the morphological and functional condition of the knee of a child after semilunar cartilage had been removed, was considered and estimated.