B-N-acetyl hexosaminidase (B-NAH) serum levels after endotoxin administration into the portal vein in the rat.

Endotoxin was injected directly into the portal vein in rats with and without common bile duct (CBD) ligation. B-N-acetyl hexosaminidase (B-NAH) activity levels in the serum were found to be significantly elevated 24 h later in both groups. Serum bile acid levels were found to be significantly higher in the endotoxin-injected groups of rats compared to controls. Thus, endotoxin, as well as bile acids, may cause damage to Kupffer cell membranes, resulting in accumulation of B-NAH in rat serum.     

Heterotopic bone formation in abdominal operation scars

Heterotopic ossification in abdominal wounds is a rare post-operative occurrence. Two cases are presented and possible causative factors are discussed.     

Emergency subtotal colectomy. A new trend for treatment of obstructing carcinoma of the left colon.

During a 5-year period, 22 patients with obstructing carcinoma of the left colon were operated on in our department. All patients underwent emergency subtotal colectomy with primary ileocolonic or ileorectal anastomosis. The quality of life for patients undergoing subtotal colectomy is excellent. All patients enjoy an almost normal diet and those with an ileorectal anastomosis stabilize on two to three bowel movements per day. During a followup period of 65 months, four patients died from spread of their primary disease while two other patients died of unrelated causes. Sixteen patients are alive and free of disease. We consider subtotal colectomy the procedure of choice for patients with obstructing carcinoma of the left colon.     

99Tcm-MIBI scintimammography for the detection of breast malignancies: the contribution of the count ratio to specificity.

We evaluated the efficacy of 99Tcm-sestamibi (MIBI) scintimammography for the detection of breast cancer in 332 patients. Two hundred and seven scans were confirmed by histological or cytological results; the other patients were examined because they belonged to high-risk groups or had dense fibroglandular breasts. Of 207 patients with histological confirmation, 112 positive studies were obtained: 86 true-positive and 26 false-positive. Scintimammography was negative in 95 patients: 88 true-negative and seven false-negative. Six of seven false-negative results were obtained in patients with impalpable tumours. The sensitivity, specificity, positive and negative predictive values were 92.5%, 77.2%, 76.8% and 92.6% respectively. The overall accuracy was 84.1%. To identify false-positive results, the count ratio of the target lesion to the contralateral normal area on 38 true-positive scans and in 26 false-positive examinations was calculated from the region of interest drawn on the 99Tcm-MIBI scan (L/N ratio). A significantly higher ratio was found for the true-positive scans (1.583 +/- 0.501 vs 1.246 +/- 0.213; P = 0.0002). In conclusion, 99Tcm-MIBI scintimammography is a sensitive and accurate method for the detection of breast malignancies.     

Inflammatory fibroid polyp and Helicobacter pylori. Aetiology or coincidence?

OBJECTIVE: To evaluate our incidence of inflammatory fibroid polyps, compare our experience with that of others, and to analyze the possible pathophysiological and aetiological factors. DESIGN: Retrospective review. SETTING: Teaching hospital. MATERIAL: All histopathological slides of the gastrointestinal tract. MAIN OUTCOME MEASURES: Incidence and treatment in our Medical Center and elsewhere. RESULTS: We could find only one case of inflammatory fibroid polyp, an estimated incidence of 1/4000. Between 1987-1996 only 331 were reported elsewhere, most of which (293, 88.5%), were located in the stomach. CONCLUSION: Primary mucosal damage can expose the stroma to several irritants (chemical, mechanical and biological), that may subsequently cause inflammatory fibroid polyps in certain people.     

Plasma neuropeptides and perception of pruritus in psoriasis

The aim of this study was to evaluate the influence of selected neuropeptides on itching in psoriatic individuals. Fifty-nine patients (43 pruritic and 16 non-pruritic) with psoriasis were included in the study. The severity of psoriasis, measured using the Psoriasis Area and Severity Index scale, ranged between 2 and 43.7 points. The intensity of pruritus was evaluated using a Visual Analogue Scale. The plasma levels of substance P, vasoactive intestinal peptide, calcitonin gene-related peptide and neuropeptide Y were measured radioimmunologically. The plasma level of neuropeptide Y was significantly decreased in patients with pruritus compared with those without pruritus (21.6 +/- 39.6 pg/ml and 144.3 +/- 385.7 pg/ml, respectively; p=0.03). Levels of other neuropeptides did not differ significantly between pruritic and non-pruritic patients; however, a tendency to lower plasma levels of substance P and vasoactive intestinal peptide in patients with itching was noted. Moreover, a significant negative correlation was observed between pruritus severity and levels of substance P (r = -0.36; p=0.02), as well as between pruritus severity and plasma levels of vasoactive intestinal peptide (r = -0.34; p=0.03). The imbalance of neuropeptide activity in the sera of pruritic subjects may suggest a role for neuropeptides in perception of itching in psoriatic individuals.     

Thrombosis of superior vena cava during total parenteral nutrition,managed successfully with low dose streptokinase

Superior vena cava syndrome due to catheter related thrombosis, developed in a patient receiving total parenteral nutrition. Local infusion of low dose streptokinase immediately proximal to the thrombus, was strikingly successful and may be the treatment of choice for this condition.     

Serum B-N-acetyl hexosaminidase levels in rats with experimental acute pancreatitis,small-bowel ischemia,and small-bowel obstruction

B-N-acetyl hexosaminidase (B-NAH), a lysosomal hydrolase, was measured in the blood of rats with induced acute pancreatitis, massive small-bowel ischemia, and small-bowel closed-loop obstruction. B-NAH was not significantly elevated within 24 h after induction of the above conditions. This suggests that B-NAH is not an acute phase reactant in a severe acute abdominal catastrophe, such as those mentioned above. Some rats showed an extremely high level of B-NAH, and this may imply a fatal prognosis in such animals.     

Diagnosis of acute pancreatitis using the amylase-creatinine clearance ratio and radionuclide hepatobiliary and pancreas imaging

Amylase-creatinine clearance ratio and radionuclide hepatobiliary and pancreas imaging were used together as noninvasive screening procedures in 24 patients suspected of having acute pancreatitis. An increased amylase-creatinine clearance ratio, normal filling of the gallbladder demonstrated by the radionuclide study, and decreased uptake of the radionuclide in the pancreas scan were helpful in reaching the diagnosis of acute pancreatitis.

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Résumé Le rapport de la clearance amylase-créatinine et la scintigraphie hépato-biliaire et pancréatique ont été employés par les auteurs chez 24 sujets supposés présenter une pancréatite aiguë en raison de l'inocuité de ces explorations. L'augmentation du rapport de la clearance amylase-créatinine, l'injection normale de la vésicule et la diminution de l'absorption de l'isotope marqué par le pancréas ont été utiles pour aboutir au diagnostic de pancréatite aiguë.