Hepatolithiasis complicated by cholangiocarcinoma

A case of hepatolithiasis complicated by intrahepatic cholangiocarcinoma is reported. Awareness of this association is important for the radiologist, who may detect clinically occult malignancy in patients with intrahepatic biliary calculi.     

Computed tomography in endobronchial neoplasms

Computed tomography (CT) was performed in 86 patients with bronchoscopically proven endobronchial neoplasms. There were 76 primary and 10 metastatic lesions. CT correctly identified the abnormal airway in 95% of cases (82/86) by demonstrating either nodule, mass, or stricture. A discrete endobronchial nodule was seen in 55% (47/86). There was good morphological correlation of CT with bronchoscopic findings (89% for discrete nodule, 80% overall). Appropriate atelectasis was noted in 80% (69/86) of cases. CT is sensitive in detecting and localizing endobronchial neoplasms and correlates well with bronchoscopic findings.     

Ultrasonographic diagnosis of post-percutaneous renal biopsy hematoma

Perirenal hematoma is an uncommon, but significant complication of renal biopsy. Ultrasound provides a quick, non-invasive means of diagnosis.     

Color-flow Doppler sonography in Graves disease: "thyroid inferno"

Graves disease is a common diffuse abnormality of the thyroid gland usually characterized by thyrotoxicosis. We performed color-flow Doppler sonography in 16 patients with Graves disease and compared the results with those in 15 normal volunteers and 14 patients with other thyroid diseases (eight with multinodular goiter, four with focal masses, and two with papillary thyroid carcinoma). All 16 Graves disease patients exhibited a pulsatile pattern we call "thyroid inferno." This pattern consists of multiple small areas of intrathyroidal flow seen diffusely throughout the gland in both systole and diastole. In systole, both high-velocity flow (color coded white) and lower velocity flow (color coded red and blue) were noted. In diastole, fewer areas of flow and lower velocity flow were noted. Patients with Graves disease also exhibited color flow around the periphery of the gland. The inferno pattern did not occur in normal subjects or in patients with other thyroid diseases. On occasion, focal areas of intrathyroidal flow were detected in patients with multinodular goiter and focal thyroid masses. High-resolution gray-scale images did not show the small vascular channels from which the flow signal originated. Color-flow Doppler sonography shows promise as a cost-effective, noninvasive technique for diagnosing Graves disease.     

In vitro study of crevicular fluid sampling methods: Sampling variability and effect of volume and orientation on fluid removed

An in vitro system was designed to evaluate properties of gingival crevicular fluid (GCF) sampling. Four polysiloxane test wells were fabricated with volumes of 2.7. 4.3. 6.2 and 11.0 μl. Wells were sampled for a test solution of 50% fetal call serum in phosphate buffered saline, while in upright and inverted orientations, using capillary micropipettes and filter paper strips. With the pipette method. 6 sample volumes removed from each well were calculated directly. With the paper method, 1μ(Ci/ml of ³H-lbymidine was added to the test solution, and countsper-minute (CPM) were determined at 24 hours for 10 test samples in each condition and for 10 standard samples. For both sampling methods, well volume and well orientation had significant effects on amount of fluid removed. Larger volumes/increased CPM were obtained from both deeper and inverted wells. For upright wells only, a quadratic relationship, associated with a ceiling effect, was found between total well volume and volume removed/CPM. Coefficients of variation of measurements involving the paper method were higher than those for the pipette method when wells were inverted but not when they were upright. Pocket depth and tooth arch (analogs of variables tested in vitro) may affect GCF sampling variability in vivo.     

Development of the Diabetes Indicators and Data Sources Internet Tool (DIDIT)

Developing a Web-based tool that involves the input, buy-in, and collaboration of multiple stakeholders and contractors is a complex process. Several elements facilitated the development of the Web-based Diabetes Indicators and Data Sources Internet Tool (DIDIT). The DIDIT is designed to enhance the ability of staff within the state-based Diabetes Prevention and Control Programs (DPCPs) and the Centers for Disease Control and Prevention (CDC) to perform diabetes surveillance. It contains information on 38 diabetes indicators (measures of health or factors associated with health) and 12 national- and state-level data sources. Developing the DIDIT required one contractor to conduct research on content for diabetes indicators and data sources and another contractor to develop the Web-based application to house and manage the information. During 3 years, a work group composed of representatives from the DPCPs and the Division of Diabetes Translation (DDT) at the CDC guided the development process by 1) gathering information on and communicating the needs of users and their vision for the DIDIT, 2) reviewing and approving content, and 3) providing input into the design and system functions. Strong leadership and vision of the project lead, clear communication and collaboration among all team members, and a commitment from the management of the DDT were essential elements in developing and implementing the DIDIT. Expertise in diabetes surveillance and software development, enthusiasm, and dedication were also instrumental in developing the DIDIT.     

Intraclass correlations of periodontal measurements in beagle dogs*

The intraclass correlations of Gingival Index, probing depth, and attachment level scores were estimated in a sample of beagle dogs. These estimates were made over a ten-week period at the time of ligature placement, eight weeks later at ligature removal, and two weeks postremoval. Estimates of the intraclass correlation were computed for the actual scores and for differences in scores between the first and second, and second and third observation points. All intraclass correlations were of sufficient magnitude to preclude statistical analyses which do not consider the subject as the sampling unit. For all conditions. intraclass correlations decreased upon experimental intervention and were generally larger than those reported in human studies. Intraclass correlations of Gingival Index scores were larger than those of probing depth and attachment level measurements. The results were discussed in terms of sources of variation within and between subjects.     

Evaluation using sequential trials methods

Dental school faculty members, as well as many practitioners, are interested in evaluating products and procedures used in clinical practice. Research design and statistical analysis, however, can pose problems to some, while others would like to avoid detailed consideration of protocol until after a preliminary investigation. Sequential trials methods provide an analytical structure that is both easy to use and statistically valid.