The bile ducts after a fatty meal: further sonographic observations

The sonographic appearance of the response of the common hepatic duct to physiologic stimulation by a fatty meal was assessed in 131 patients referred because of right upper quadrant symptoms or abnormal liver chemical studies. In the determination of the presence or absence of biliary obstruction, the sensitivity of the examination was 84%, the accuracy of a positive test was 84%, and the accuracy of a negative test was 93%. This test proved helpful in several circumstances: equivocal duct caliber (6-10 mm); abnormal caliber (6-14 mm) with normal laboratory values; normal caliber duct with abnormal laboratory values; persistent question of cholelithiasis or asymptomatic pancreatic duct dilatation. Measurements of bile duct caliber alone may be insufficient to ascertain the presence of bile duct obstruction and fatty meal stimulation significantly improves diagnostic accuracy.     

Eigenimage filtration of intravenous digital subtraction angiograms of the heart. Work in progress

The authors developed a postprocessing technique, eigenimage filtering, to extract phase-dependent information from digital subtraction angiograms of the heart. This technique suppresses the interference from the right ventricle and left atrium and produces an image of the left ventricle and aorta that is substantially free of these overlap artifacts. The resultant eigenimages of the heart appear more like conventional ventriculograms than do digital subtraction angiograms and matched filtered images.     

IMAGES IN CARDIOLOGY: LEFT VENTRICULAR FREE WALL RUPTURE

Left ventricular free wall rupture is thought to account for approximately 15% of deaths following acute myocardial infarction (MI). We present a case of left ventricular free wall rupture in a 64-year-old man following a lateral MI. The diagnosis was made with 2D and colour flow Doppler echocardiography. Unfortunately the patient died before emergency surgery, could be performed.     

Sweet''s syndrome responding to cyclosporin

We report a case of Sweet's syndrome which responded to treatment with cyclosporin 4 mg/kg/day. Cyclosporin is effective in the treatment of many dermatoses, and although the immunosuppressive effects of cyclosporin are mainly attributed to inhibition of T-lymphocyte proliferation, it has also been shown to affect the functions of both neutrophils and monocytes. Possible mechanisms of action of cyclosporin in Sweet's syndrome are discussed.     

Headaches and stress in schoolchildren: an epidemiological study

Headache parameters, personality variables and stress factors were assessed in a sample of about 2,300 school pupils between 10 and 17 years of age in Amsterdam. More than 15% of the subjects reported headaches occurring weekly. Fear of failure and school problems, but not achievement motivation, had significant positive correlations with headache complaints after correction for differences in sex and age. Menarche and social class had little bearing in relation to the headache variables. From all reported causes of headache, stress was mentioned most frequently in both elementary and secondary schools.     

Morbidity in responders and non-responders in a register-based population survey

BACKGROUND: Non-response analysis is often restricted to the influence of age, sex and socio-economic status on response status. In this study the health status of responders and non-responders was also compared. RESULTS: Responders were comparable to non-responders with regard to the number of diagnosed disorders as well as to the prevalences of disorders within body systems. Non-responders only showed psychological disorders more often. CONCLUSION: It is useful to assess the relation between non-response and morbidity patterns in other studies as well, in order to detect selective non-response and bias.      

A prospective, randomized, double-blind study for the evaluation of assisted hatching in patients with advanced maternal age

The objective of this study was to determine if assisted hatching improved the rates of implantation, clinical pregnancy and ongoing pregnancy for in-vitro fertilization (IVF) patients aged > or =36 years. On the day of oocyte aspiration, consenting patients were randomized according to whether all embryos underwent the hatching procedure (hatched; n = 41) or all embryos remained unhatched (controls; n = 48). Patients in both groups were treated with methylprednisolone and doxycycline starting on the day of oocyte retrieval and continuing for 4 days. The hatching procedure was performed approximately 55 h after insemination on all potential embryos for transfer and employed the release of acidified acid Tyrode's medium against the zona pellucida to create an opening approximately 20 microm in diameter. No significant differences were noted in the mean age, number of oocytes aspirated and number of embryos transferred between the hatched and control groups. In addition, no significant differences were observed in the rates of implantation (11.1 versus 11.3%), clinical pregnancy (39.0 versus 41.7%) and ongoing pregnancy (29.3 versus 35.4%) between the hatched and control groups respectively. These results suggest that assisted hatching may have no significant impact on IVF success rates in the patient population studied.