Bladder imaging using multidetector row computed tomography,volume rendering,and magnetic resonance imaging

Both multidetector row computed tomography (MDCT) and magnetic resonance imaging (MRI) are used to evaluate the bladder noninvasively. MDCT offers fast imaging with near-isotropic data sets optimized for three-dimensional imaging, including the latest software for volume rendering. MRI provides distinctive soft tissue contrast resolution and can perform dynamic imaging without radiation exposure. This article discusses the techniques and protocols of each modality with case illustrations of their application in a range of bladder pathologies to show their respective distinct advantages and limitations.     

Diagnosis of disease in renal allografts: correlation between ultrasound and histology

Ultrasound was compared with histology in 66 cases to assess the accuracy of sonography in demonstrating abnormality in renal allografts. Patients with suspected acute, chronic or acute and chronic rejection, acute tubular necrosis and glomerulonephritis in the transplant kidney were included in the study. It was noted in this trial that ultrasound is less accurate at demonstrating abnormality in the grafted kidney than has been suggested previously in the literature. It was concluded that, where doubt exists, even when ultrasound examination is normal, biopsy should be considered.     

Obstructive jaundice secondary to benign hepatic cyst

A case of hepatic cyst causing obstructive jaundice is presented. Following percutaneous aspiration of the cyst, the jaundice was relieved. Modern interventional radiologic techniques can provide prompt diagnosis and treatment, thus avoiding major surgery and prolonged hospitalization.     

Biofeedback-assisted relaxation training with brain injured patients in acute stages of recovery

There are few published accounts or empirical studies of biofeedback assisted relaxation training with brain injured patients still in acute stages of recovery. Given the efficacy of biofeedback assisted relaxation training with other medical populations, brain injured patients in acute stages of recovery with anxiety based symptoms may also stand to gain some benefits form this form of treatment. It has yet to be determined, however, if severe cognitive impairment or disorientation contraindicate biofeedback treatment. The cases profiled here tentatively suggest that consideration of biofeed back assisted relaxation training, even for severely cognitively impaired brain injured patients in acute stages of recovery, may be appropriate. Empirical investigations will be needed to determine selection criteria and contraindications for biofeedback treatment in the acute brain injury population.     

A myeloproliferative disease in two infants associated with eosinophilia and chromosome t(1;5) translocation

Two children are described who presented at the age of 5 and 7 months with anaemia, a high white cell count with eosinophilia and thrombocytopenia. Both children had an identical balanced translocation t(1;5)(q23;q33) and no evidence of a constitutional abnormality. The response to treatment of one child was poor, the other remains well on therapy. This translocation has not been previously reported and is likely to represent a subclass of myeloproliferative disorder analogous to the monosomy 7 syndrome, although less common. The previous literature of acquired chromosome abnormalities involving chromosomes 1 and 5 is reviewed.     

Relationship between patient race and survival following admission to intensive care among patients of primary care physicians.

This study investigated the existence of racial differences in the survival of patients admitted to intensive care by family physicians and general internists for circulatory illnesses. The study population consisted of 249 consecutive patients admitted by these specialists to an ICU in a tertiary care hospital in Pitt County, North Carolina, during the June 1985 to June 1986 period. Logistic regression was used to specify the unique effect of race on ICU patient survival in-hospital, controlling for potential confounding factors such as disease severity, type of health insurance, and case mix. Black patients were almost three times more likely than white patients to die in-hospital following admission to the ICU (RR = 2.9, 95 percent I = 1.5, 5.6). Most of this difference in survival was explained by racial differences in disease severity.