Biliary atresia and noncardiac polysplenic syndrome: US and surgical considerations

Ten percent of children with biliary atresia have an associated complex of anomalies, including polysplenia, azygous continuation of the inferior vena cava, preduodenal portal vein, hepatic arterial anomalies, and bilaterally bilobed lungs. These abnormalities will not be detected if the preoperative workup is limited to hepatobiliary nuclear scanning. Ultrasonography is important in the preoperative evaluation of patients suspected of having biliary atresia. It is important to identify the associated abnormalities preoperatively because they have an impact on the initial portoenterostomy and may preclude subsequent orthotopic liver transplantation.     

Evaluation of macular functional capacity by helium-neon laser interferometry

We describe the principles of the measure of visual acuity by using the laser interference retinometer. Interference fringes are projected on the retina, with variation of direction and thickness varied, to study the functional capacity of the macula. This method is particularly useful in patients with cataracts, because it is much less influenced by the clarity of the media than Snellen chart listing. We give the results of a series of 122 eyes with cataract, comparing pre-operative laser acuity and post-operative Snellen visual acuity. The pre-operative interfermometric measure is possible in 77% of the cases, but in most cases of mature cataract or dense posterior subcapsular opacities, the patients do not discern any interference fringes. In immature cataracts according to other results of the literature, post-operative Snellen visual acuity reaches preoperative laser acuity in 60% of the cases, and is better in 29% of the cases. Clinical conditions such as macular degeneration, cystoid macular oedema, amblyopia, visual field cuts through fixation or myopic choro?dopathy, may make the interferometer test unreliable.     

Nandrolone excretion is not increased by exhaustive exercise in trained athletes

PURPOSE: The anabolic steroid nandrolone is widely used as a performance enhancer. Traces of its naturally occurring metabolite 19-norandrosterone (19-NA) have been found in human urine (below 0.6 ng.mL(-1)), and it has been suggested that strenuous exercise may increase urinary 19-NA. The aim of our study was to assess the effect of exhaustive exercise on the nandrolone excretion under controlled conditions in two groups of trained male athletes, one composed of judoka and the other of long-distance runners. METHODS: A Wingate test and a treadmill limited-time test (running at 85% (.)VO(2max)) were carried out on 14 judoka and 15 athletes. Hydration was controlled during each session. Urine samples were obtained before each test and 30 min, 60 min, and 24 h after each test. Urinary 19-NA concentrations were determined using gas chromatography coupled with mass spectrometry. RESULTS: Baseline urinary 19-NA concentrations varied widely across individuals, from undetectable levels to 0.250 ng.mL (-1)(mean, 0.048 +/- 0.050 ng.mL(-1)). The both exercise tests did not significantly modified urinary 19-NA levels in the two groups of subjects. CONCLUSION: Our study provides compelling evidence that endogenous nandrolone production in male athletes, during two very different types of exercise, produces urine levels far below the IOC threshold of 2 ng.mL(-1) urine. Thus, exercise does not induce endogenous nandrolone secretion.