Gastric trichobezoar: sonographic findings

Ultrasonographic diagnosis of trichobezoar may be relatively specific. A broad band of high-amplitude echoes can be seen superficially, with complete sonic shadowing behind. The authors describe a patient in whom the diagnosis was made prior to conventional barium studies and in whom the question of trichobezoar had not been raised clinically.     

毛白杨化学成分的研究

从毛白杨(Populus tomentosa Carr.)的叶中分得一个新的黄酮类化合物,鉴定为洋芹素-7-O-(6″-O-p-羟基肉桂酰)-B-D-吡喃葡萄糖甙(Ⅰ),同时还分得四个已知成分分别鉴定为水杨甙(salicin,Ⅱ)、2″-苯甲酰水杨甙(tremulodin,Ⅲ)、特里杨甙(tremulacin,Ⅳ)和胡萝卜甙(dauvasterol,Ⅴ)。     

Small renal cell carcinomas: resolving a diagnostic dilemma

Thirty-nine patients with pathologically proved renal cell carcinomas 3 cm or les in diameter were examined. Results of intravenous urography (n = 30) were true positive in 20 patients and false negative in ten (sensitivity, 67%). Renal ultrasound (US) (n = 29) had true-positive results in 23 patients and false-negative results in six (sensitivity, 79%); computed tomography (CT) (n = 36) had true-positive results in 34 and false-negative results in two (sensitivity, 94%). For selective renal angiography (n = 35%), the results were true positive in 26 and false negative in nine (sensitivity, 74%), with typical hypervascular renal cell carcinomas demonstrated in 17. Finally, the findings of percutaneous fine-needle aspiration biopsy were true positive in one of five patients when US guidance was used (sensitivity, 20%) and in five of eight when CT guidance was used (sensitivity, 62%). Small renal cell carcinomas are more frequently encountered in clinical practice than heretofore realized, and they are best imaged by CT.     

Technetium-99m mercaptoacetyltriglycine clearance values in children with minimal renal disease: can a normal range be determined?

Use of technetium-99m labelled mercaptoacetyltriglycine (^99mTc-MAG3) simplifies and improves the quantification of renal clearance in children by virtue of its permanent availability, good imaging properties and low radiation exposure. Due to the lack of reference values for ^99mTc-MAG3 clearance in children, the Paediatric Task Group of the EANM initiated a multicentre study to evaluate ^99mTc-MAG3 clearance values in children with minimal renal disease. One hundred and twenty-five children aged between 12 months and 17 years, classified as renally healthy using defined diagnostic criteria, were included in the study. ^99mTc-MAG3 clearance was calculated using an algorithm on the basis of a single blood sample taken at any time between 30 and 40 min after tracer injection. In addition, the absolute ^99m-Tc-MAG3 clearance values were normalized to body surface area. For further evaluation the children were classified into several groups according to age. There was a continuous increase in non-corrected ^99mTc-MAG3 clearance values from the age of 1 year up to the age of 17 years (mean value <2 years: 98±57 ml/min; mean value >8 years: 208±66 ml/min). Normal clearance values for adults were achieved by the age of 8 years. Analysis of the relationship between non-corrected clearance and age yielded a correlation coefficient of r=0.7. When these absolute clearance values were normalized to body surface area, we found nearly constant clearance values for all age groups, with a mean clearance value of 315±114 ml/min×1.73 m². The correlation coefficient for the relationship between normalized clearance and age was r=0.28. In conclusion, the clearance of ^99mTc-MAG3 increases continuously throughout childhood into adolescence due to the maturation and growth of the kidney. After normalization of the absolute clearance to body surface area, no correlation between clearance and age could be proven. Received 16 June 1997 and in revised form 1 September 1997     

Oral chronic graft‐versus‐host disease: current pathogenesis,therapy, and research

Optimal management of complex autoimmune diseases requires a multidisciplinary medical team including dentists to care for lesions of the oral cavity. In this review, we discuss the presentation, prevalence, diagnosis, and treatment of oral manifestations in chronic graft‐versus‐host disease (cGVHD), which is a major late complication in patients treated by allogeneic hematopoietic stem cell transplantation. We assess current general knowledge of systemic and oral cGVHD and present general treatment recommendations based on literature review and our clinical experience. Additionally, we review areas where the understanding of oral cGVHD could be improved by further research and address tools with which to accomplish the long‐term goal of providing better health and quality of life to patients with cGVHD.     

哺乳期避孕药ST-1435衍生物的合成

19-失碳-16-亚甲基-17α-乙酰氧基黄体酮(3)最早由我国合成,后来西德E.Merk AG药厂使其开发成高效低毒的非口服避孕药,称ST-1435,其皮下埋植缓释系统国外已临床使用,有效避孕期约一年,临床研究还发现它对脂代谢、糖代谢、内分泌与肝功能等均无不良影响,并因其口服无效,近年来国外认为它更适合于哺乳期妇女使用。     

Mercaptoacetyltriglycine (MAG 3) 99mTc--a new radiopharmaceutic for uropoietic diagnoses

The present authors show mercaptoacetyltrigylcine (MAG 3), labelled with 99mTc technetium, as a novel prospective diagnostic agent of the uropoietic system, replacing the injections of sodium iodohippurate labelled with 131I. The paper reports the procedure of labelling of this novel radiopharmaceutical with technetium 99mTc, evaluation of its quality by chromatographic methods, and biological distribution of MAG 3 in laboratory animals in comparison with the biodistribution of injections of sodium iodohippurate labelled with 131I.     

A new approach in radionuclide imaging to ureteric peristalsis using 99Tcm-MAG 3 and condensed images.

A new method for the evaluation of ureteric peristalsis is described. Standard, dynamic renal scintigraphy was carried out using 99Tcm-MAG 3 in 59 patients. Time-activity curves and condensed images over the ureter area were created simultaneously. A six-grade scale (O-V) was chosen for the classification of ureteral function. The results obtained were compared with parameters of renographic curves and other clinical findings. In a group of 13 patients, two different renal radiopharmaceuticals were used: 131I-OIH and 99Tcm-DTPA. The results show that the new method is suitable for the assessment of ureteral disorders, and has some advantages compared with previously described methods. 99Tcm-MAG 3, with a better target-to-background ratio compared to 131I-OIH and 99Tcm-DTPA, is the most suitable radiopharmaceutical for this purpose.     

PGD8 Comparison of Prevalence Rates of Low Back Disorders Obtained from Two Large National Claims Databases

Large national claims databases are sources of vital information concerning health care resource utilization. However, the comparability of data obtained from such databases has not yet been ascertained.
OBJECTIVE: To compare prevalence rates of low back disorders obtained from two large national inpatient claims databases and to study variations in length of stay and corresponding costs.
METHODS: Data were obtained from two independent databases with inpatient claims information including ICD-9 codes for specific diagnoses, demographics, length of stay (LOS), and payments or charges made. One of the databases is a 20% national inpatient sample of all community hospitals in the U.S. (HCUP). The other national database consists of data gathered for privately insured population (MarketScan). Claims for specific diagnoses of low back disorders (ICD-9 codes: 720.0–724.9) for 1994 were obtained. Using age, gender, and diagnosis-adjusted rates (direct method), the overall low back disorder rates were compared. Also age, gender, and diagnosis-specific low back disorder rates were compared between two databases.
RESULTS: The overall adjusted prevalence rates of low back disorders were 1.49 and 1.88 per 100 admissions for HCUP and MarketScan, respectively. Significant difference was observed in the age, gender-adjusted rates for diagnosis of displacement of lumbar intervertebral disc without myelopathy, with MarketScan showing a higher rate as compared to HCUP (1.06 vs. 0.78/100 admissions). The adjusted average LOS and age, gender, and diagnosis-specific LOS were higher for HCUP than MarketScan. The specific and adjusted payments (based on MarketScan) were, however, higher than the charges reported in HCUP.
CONCLUSIONS: The prevalence rate of low back disorders is higher in the MarketScan database than in HCUP. The differences in the length of stay and associated costs might be attributable to other variables such as geographical variations.