The ultrasonographic appearance of cystic hepatoblastoma

Cystic hepatoblastomas share ultrasonographic characteristics with simple hepatic cysts; however, a distinction can be made by the demonstration of internal septations. The differentiation is important because cystic hepatoblastoma may have malignant potential. The ultrasonographic and scintigraphic findings in five children with cystic hepatoblastoma are reviewed.     

The efficacy of topical 0.2% hyaluronic acid gel on recurrent oral ulcers: comparison between recurrent aphthous ulcers and the oral ulcers of Behçet's disease

Background Hyaluronic acid (HA) is a primary component of the extracellular matrix, and the efficacy of HA on oral ulcers is rarely reported. Objective To observe the efficacy and safety of the topical application of 0.2% HA gel on recurrent oral ulcers and to compare its effects in patients with recurrent aphthous ulcers (RAU) and the oral ulcers of Behçet's disease (BD) Materials and methods Thirty‐three outpatients with recurrent oral ulcers were included in the study (17 patients: BD, 16 patients: RAU). The patients used topical 0.2% HA gel twice daily for 2 weeks. The subjective parameters of patients [number of ulcers, healing period, visual analogue scale (VAS) for pain] were investigated and objective assessments (number of ulcers, maximal area of ulcer and inflammatory signs) were inspected by a physician. Results A subjective reduction in the number of ulcers was observed in 72.7% of the patients. A decrease in the ulcer healing period was observed in 72.7% of the patients; 75.8% experienced improvement in VAS for pain. Objective inspection of the ulcers showed a reduction of numbers in 57.6% of the patients, and 78.8% of the ulcers showed a decrease in area. Among the inflammatory signs, swelling and local heat were significantly improved after treatment. No significant differences were found between the BD group and RAU group in subjective and objective parameters, except for inflammatory signs. No side‐effects were observed. Conclusions The topical application of 0.2% HA gel seems to be an effective and safe therapy in patients with recurrent oral ulcers; the study supports the use of HA in BD with oral ulcers.     

Photosensitizers in clinical PDT

Photosensitizers in photodynamic therapy allow for the transfer and translation of light energy into a type II chemical reaction. In clinical practice, photosensitizers arise from three families—porphyrins, chlorophylls, and dyes. All clinically successful photosensitizers have the ability to a greater or lesser degree, to target specific tissues or their vasculature to achieve ablation. Each photosensitizer needs to reliably activate at a high enough light wavelength useful for therapy. Their ability to fluoresce and visualize the lesion is a bonus. Photosensitizers developed from each family have unique properties that have so far been minimally clinically exploited. This review looks at the potential benefits and consequences of each major photosensitizer that has been tried in a clinical setting.     

THE EFFECT OF RANITIDINE ON SYMPTOM RELIEF AND QUALITY OF LIFE OF PATIENTS WITH GASTRO-OESOPHAGEAL REFLUX DISEASE

SUMMARY A 4-week study involving 354 patients with the symptoms of gastro-oesophageal reflux disease was conducted to assess the effect of ranitidine (as effervescent tablets) on their relief and quality of life. All patients received 150 mg bd for 2 weeks, with those responding to treatment continuing on the same dosage for a further 2-week period and 'non-responders' having the dosage increased to 150 mg qds for a further 2 weeks. Quality of life and symptom assessments were carried out at 0, 2 and 4 weeks. Two weeks' treatment with ranitidine 150 mg bd was effective at controlling the GORD symptoms in 78% of patients. A 4-week treatment with either 150 mg bd or qds controlled the symptoms in 85% of patients. All patients had significant improvements in all dimensions of their quality of life over the study period.     

Neck evaluation with barium-enhanced radiographs and CT scans after supraglottic subtotal laryngectomy

Supraglottic subtotal laryngectomy (SSL) is a radical, yet voice-conserving, surgical procedure commonly performed for carcinoma of the supraglottic larynx. The pharyngograms and computed tomographic (CT) scans of 35 patients obtained after SSL were evaluated retrospectively. These examinations reliably demonstrated the changes in anatomy caused by removal of the epiglottis, aryepiglottic folds, and false vocal cords. Fourteen patients had documented recurrence of cancer; five mucosal, nine extramucosal. Three of five macroscopic mucosal recurrences in the larynx/pharynx were detected on the barium pharyngograms; the two mucosal lesions not seen were in the base of the tongue and tonsillar fossa. CT enabled detection of five of five recurrences and was superior to pharyngography in demonstrating the soft-tissue extent of disease. CT findings mimicking recurrence were seen in two patients: one with diffuse histiocytic lymphoma; the second, with benign hyperkeratosis. Barium and CT examinations are useful adjuncts to the clinical examination in detecting recurrent squamous cell carcinoma in patients following SSL.     

Analysis of late results in postpregnancy mammoplasty

The purpose of this paper is to study the alterations produced by pregnancy in women who submitted to breast reduction. We studied a group of 50 women younger than 32 years of age who submitted to this operation and had an incidence of pregnancy of 22%. The alterations of ponderable weight and increased breast volume had no relation to pregnancy. Breast ptosis was twice as frequent in the group of women who became pregnant than in the group of women who did not become pregnant. Breast-feeding was normal. We found a large percentage of women were gratified by the results of the operation (92%), and those not fully satisfied did not report any disturbances in their sexual life.     

The aetiology of ocular toxoplasmosis in Melbourne

The biological mothers of 23 patients presenting with acute chorioretinal toxoplasmosis had sera screened for the presence of antibodies to Toxoplasma gondii. Twenty-two of the mothers (96%) had positive serology and one (4%) had negative serology. This is consistent with the hypothesis that most cases of ocular toxoplasmosis are congenital in origin, but indicates that some cases are due to acquired toxoplasmosis.     

心血管活性生物碱——原小檗碱衍生物的合成

小檗碱(berberine,BR)是以治疗肠道菌痢而著称的黄连素。近年来报道BR有正性肌力和抗心律失常作用,并伴有改善冠脉血流量、降低动脉压和扩张周围血管等作用,临床试用于治疗心衰和心律失常,取得了一定疗效。但BR为一季铵盐,极性大,胃肠道吸收差且不规则,剂量较大时对心肌产生抑制作用。又据报道四氢小檗碱型生物碱如四氢巴马汀(tetrahydropalmatine)和考雷明(coreximine)     

Duplex Doppler US of the kidney: differentiation of obstructive from nonobstructive dilatation

Distinction of the obstructed from the nonobstructed dilated renal collecting system is a difficult problem often requiring interventional procedures and pressure measurements. The authors prospectively performed duplex Doppler ultrasound (US) evaluations in 21 kidneys (obstructed, n = 14; nonobstructed, n = 7) immediately before percutaneous nephrostomy. In addition, ten of the obstructed kidneys were evaluated with follow-up Doppler US after percutaneous nephrostomy. Renal obstruction caused a change in the Doppler waveform detected by means of the resistive index (RI). Thirteen of the 14 obstructed kidneys had a RI value greater than .70, while none of the nonobstructed kidneys had a RI value exceeding .70. Relief of the obstruction resulted in a reduced RI; in nine of ten kidneys, the RI was less than or equal to .70 (similar to that of the nonobstructed kidneys). When a dilated collecting system is being imaged, additional evaluation with duplex Doppler US may help distinguish obstructed from nonobstructed dilatation, which may be of particular benefit in patients with conditions that usually predispose them to collecting system dilatation.