Invasive cervical carcinoma: comparison of MR imaging and surgical findings

The accuracy of magnetic resonance (MR) imaging in staging invasive carcinoma of the cervix was determined retrospectively in 57 consecutive patients in whom the extent of disease was surgically confirmed. MR images were analyzed for (a) location and size of the primary tumor; (b) tumor extension to the uterine corpus, vagina, parametria, pelvic sidewall, bladder, or rectum; and (c) pelvic lymphadenopathy. The accuracy of MR imaging in determination of tumor location was 91% and for determination of tumor size within 0.5 cm, 70%. Its accuracy was 93% for vaginal extension and 88% for parametrial extension. Pelvic sidewall, bladder, and rectal involvement were accurately excluded in all patients, but the positive predictive values were 75%, 67%, and 100%, respectively. Overall, the accuracy of MR imaging in staging was 81%. MR imaging is valuable because it can accurately demonstrate tumor location, tumor size, degree of stromal penetration, and lower uterine segment involvement. It is also valuable for ruling out parametrial, pelvic sidewall, bladder, and rectal involvement.     

Transvaginal pelvic abscess drainage with US guidance

Transvaginal catheter drainage of pelvic and intraabdominal abscesses with the use of real-time ultrasound guidance is described. The technique was successfully used in two patients to drain abscesses in the cul-de-sac. Transvaginal drainage is a safe, simple alternative to transabdominal, transgluteal, and transrectal drainage of these abscesses.     

Salpingitis isthmica nodosa: radiologic and clinical correlates

Salpingitis isthmica nodosa (SIN) is thought to be an inflammatory condition of the fallopian tubes and is strongly associated with infertility and an increased risk of ectopic pregnancy. The diagnosis is best made radiographically at hysterosalpingography (HSG), where the characteristic finding consists of multiple nodular diverticular spaces in close approximation to the true tubal lumen. We reviewed 1,194 HSGs performed over a five year period and identified 45 patients who had SIN (4%). There was a high rate of primary infertility (37.5%) and ectopic pregnancy (9.4%). Of 70 involved tubes, 62 (89%) had evidence of associated inflammation on historic, radiologic, surgical, or histologic grounds. We conclude that SIN is a disorder most likely acquired during the fertile years, and that the lesion is either a direct consequence of infection or that--once present--it predisposes the patient to subsequent infections.     

Gender and age differences in the recurrence of sickness absence due to common mental disorders: a longitudinal study

Background  

Common mental disorders (CMDs) are an important cause of sickness absence and long-term work disability. Although CMDs are known to have high recurrence rates, little is known about the recurrence of sickness absence due to CMDs. The aim of this study was to investigate the recurrence of sickness absence due to CMDs, including distress, adjustment disorders, depressive disorders and anxiety disorders, according to age, in male and female employees in the Netherlands.     

Glutamate acting at NMDA receptors stimulates embryonic cortical neuronal migration

During cortical development, embryonic neurons migrate from germinal zones near the ventricle into the cortical plate, where they organize into layers. Mechanisms that direct neuronal migration may include molecules that act as chemoattractants. In rats, GABA, which localizes near the target destination for migrating cortical neurons, stimulates embryonic neuronal migration in vitro. In mice, glutamate is highly localized near the target destinations for migrating cortical neurons. Glutamate-induced migration of murine embryonic cortical cells was evaluated in cell dissociates and cortical slice cultures. In dissociates, the chemotropic effects of glutamate were 10-fold greater than the effects of GABA, demonstrating that for murine cortical cells, glutamate is a more potent chemoattractant than GABA. Thus, cortical chemoattractants appear to differ between species. Micromolar glutamate stimulated neuronal chemotaxis that was mimicked by microM NMDA but not by other ionotropic glutamate receptor agonists (AMPA, kainate, quisqualate). Responding cells were primarily derived from immature cortical regions [ventricular zone (vz)/subventricular zone (svz)]. Bromodeoxyuridine (BrdU) pulse labeling of cortical slices cultured in NMDA antagonists (microM MK801 or APV) revealed that antagonist exposure blocked the migration of BrdU-positive cells from the vz/svz into the cortical plate. PCR confirmed the presence of NMDA receptor expression in vz/svz cells, whereas electrophysiology and Ca2+ imaging demonstrated that vz/svz cells exhibited physiological responses to NMDA. These studies indicate that, in mice, glutamate may serve as a chemoattractant for neurons in the developing cortex, signaling cells to migrate into the cortical plate via NMDA receptor activation.