Evaluation of the inflammatory response in sera from acute ischemic stroke patients by measurement of IL-2 and IL-10

Objectives  

We compared the concentrations of the proinflammatory cytokine interleukin-2 (IL-2) with the anti-inflammatory cytokine interleukin-10 (IL-10) in serial serum samples from improved and expired acute ischemic stroke (AIS) patients to determine their prognostic usefulness.     

Management of a high-risk intestinal anastomosis

An experimental model was utilized to evaluate and compare the function of an exteriorized intestinal anastomosis and an intraperitoneal anastomosis in sixteen animals. No anastomotic leakage occurred and no difference was noted in the microscopic appearance, function, and strength of the anastomoses at seven days. Return of the exteriorized anastomosis to the peritoneal cavity did not result in significant late complications. This technic was then utilized in managing thirty animals with obstructed colons. Sixty-seven per cent of these animals had healing of exteriorized anastomosis; those anastomoses which leaked (33 per cent) were converted to colostomies. No intraperitoneal contamination resulted from leakage of an exteriorized anastomosis.     

Gossypiboma: its laparoscopic diagnosis and removal

Retained surgical sponges are an under-reported occurrence. Clinical presentation may be acute or subacute, and may follow months or even years after surgery. We report on a case in which laparoscopy was used to both diagnose and treat a retained surgical sponge.     

Prostate cancer localization with endorectal MR imaging and MR spectroscopic imaging: effect of clinical data on reader accuracy

PURPOSE: To determine the effect of digital rectal examination findings, sextant biopsy results, and prostate-specific antigen (PSA) levels on reader accuracy in the localization of prostate cancer with endorectal magnetic resonance (MR) imaging and MR spectroscopic imaging. MATERIALS AND METHODS: This was a retrospective study of 37 patients (mean age, 57 years) with biopsy-proved prostate cancer. Transverse T1-weighted, transverse high-spatial-resolution, and coronal T2-weighted MR images and MR spectroscopic images were obtained. Two independent readers, unaware of clinical data, recorded the size and location of suspicious peripheral zone tumor nodules on a standardized diagram of the prostate. Readers also recorded their degree of diagnostic confidence for each nodule on a five-point scale. Both readers repeated this interpretation with knowledge of rectal examination findings, sextant biopsy results, and PSA level. Step-section histopathologic findings were the reference standard. Logistic regression analysis with generalized estimating equations was used to correlate tumor detection with clinical data, and alternative free-response receiver operating characteristic (AFROC) curve analysis was used to examine the overall effect of clinical data on all positive results. RESULTS: Fifty-one peripheral zone tumor nodules were identified at histopathologic evaluation. Logistic regression analysis showed awareness of clinical data significantly improved tumor detection rate (P <.02) from 15 to 19 nodules for reader 1 and from 13 to 19 nodules for reader 2 (27%-37% overall) by using both size and location criteria. AFROC analysis showed no significant change in overall reader performance because there was an associated increase in the number of false-positive findings with awareness of clinical data, from 11 to 21 for reader 1 and from 16 to 25 for reader 2. CONCLUSION: Awareness of clinical data significantly improves reader detection of prostate cancer nodules with endorectal MR imaging and MR spectroscopic imaging, but there is no overall change in reader accuracy, because of an associated increase in false-positive findings. A stricter definition of a true-positive result is associated with reduced sensitivity for prostate cancer nodule detection.     

Intraocular ciprofloxacin levels after oral administration in silicone oil-filled eyes

PURPOSE: To evaluate penetration of oral ciprofloxacin in the retro-silicone oil space fluid (RSOF) in silicone oil (SO)-filled eyes. METHODS: One dose of 750 mg ciprofloxacin was given to two groups of five patients with vitrectomized eyes with SO endotamponade, 4 hours (group I) and 8 hours (group II) before SO removal. In 10 vitrectomized eyes with SO endotamponade (group III) and another 10 patients scheduled for vitrectomy for the first time (group IV), two 750-mg doses every 12 hours, with the last dose 12 hours before surgery, were given. Blood samples were taken at the time of collection of RSOF samples in groups I, II, and III and of the vitreous in group IV. All samples were assayed for ciprofloxacin by high-performance liquid chromatography. RESULTS: The mean drug concentration in the RSOF was 0.34 +/- 0.09, 0.37 +/- 0.04, 0.84 +/- 0.29, and 0.44 +/- 0.11 micro g/mL in groups I, II, III, and IV respectively. The mean serum concentration was 1.29 +/- 0.63, 1.08 +/- 0.14, 1.93 +/- 0.84, and 1.34 +/- 0.55 micro g/mL in groups I, II, III, and IV respectively with no statistically significant difference between groups III and IV (P = 0.081). CONCLUSIONS: Antibiotic levels in the RSOF in SO-filled eyes after oral administration of ciprofloxacin in two 750-mg doses exceeded the minimal inhibitory concentration for 90% of isolates (MIC(90)) for most bacterial species and was higher than levels reached in the vitreous in nonvitrectomized eyes (P = 0.001).     

Left ventricular diverticulum A scintigraphic diagnosis

This report describes the scintigraphic features of a congenital left ventricular diverticulum in a child. The types of congenital diverticula of the heart and the possible diagnostic role of nuclear imaging is discussed.