Fibrin-film stenting in a porcine coronary injury model: efficacy and safety compared with uncoated stents

Pyogenic liver abscess is an uncommon complication of intra-abdominal or biliary tract infection and is usually a polymicrobial infection associated with high mortality and high rates of relapse. However, over the past 15 years, we have observed a new clinical syndrome in Taiwan: liver abscesses caused by a single microorganism, Klebsiella pneumoniae. We reviewed 182 cases of pyogenic liver abscess during the period September 1990 to June 1996; 160 of these cases were caused by K. pneumoniae alone, and 22 were polymicrobial. When patients with K. pneumoniae liver abscess were compared with those who had polymicrobial liver abscess, we found higher incidences of diabetes or glucose intolerance (75% vs. 4.5%) and metastatic infections (11.9% vs. 0) and lower rates of intra-abdominal abnormalities (0.6% vs. 95.5%), mortality (11.3% vs. 41%), and relapse (4.4% vs. 41%) in the former group. Liver abscess caused by K. pneumoniae is a new clinical syndrome that has emerged as an important infectious complication in diabetic patients in Taiwan.     

In B-cell chronic lymphocytic leukaemia chromosome 17 abnormalities and not trisomy 12 are the single most important cytogenetic abnormalities for the prognosis: a cytogenetic and immunophenotypic study of 480 unselected newly diagnosed patients

Of 560 consecutive, newly diagnosed untreated patients with B CLL submitted for chromosome study, G-banded karyotypes could be obtained in 480 cases (86%). Of these, 345 (72%) had normal karyotypes and 135 (28%) had clonal chromosome abnormalities: trisomy 12 (+12) was found in 40 cases, 20 as +12 alone (+12single), 20 as +12 with additional abnormalities (+12complex). Other frequent findings included abnormalities of 14q, chromosome 17, 13q and 6q. The immunophenotype was typical for CLL in 358 patients (CD5+, Slg(weak), mainly FMC7-) and atypical for CLL in 122 patients (25%) (CD5-, or Slg(strong) or FMC7+). Chromosome abnormalities were found significantly more often in patients with atypical (48%) than in patients with typical CLL phenotype (22%) (P < 0.00005). Also +12complex, 14q+, del6q, and abnormalities of chromosome 17 were significantly more frequent in patients with atypical CLL phenotype, whereas +12single was found equally often in patients with typical and atypical CLL phenotype. The cytomorphology of most of the +12 patients was that of classical CLL irrespective of phenotype. In univariate survival analysis the following cytogenetic findings were significantly correlated to a poor prognosis: chromosome 17 abnormalities, 14q+, an abnormal karyotype, +12complex, more than one cytogenetic event, and the relative number of abnormal mitoses. In multivariate survival analysis chromosome 17 abnormalities were the only cytogenetic findings with independent prognostic value irrespective of immunophenotype. We conclude that in patients with typical CLL immunophenotype, chromosome abnormalities are somewhat less frequent at the time of diagnosis than hitherto believed. +12single is compatible with classical CLL, and has no prognostic influence whereas chromosome 17 abnormalities signify a poor prognosis. In patients with an atypical CLL immunophenotype, chromosome abnormalities including +12complex, 14q+, del 6q and chromosome 17 are found in about 50% of the patients, and in particular chromosome 17 abnormalities suggest a poor prognosis.     

Hetero-duplication type of cancerous mitosis

In order to delineate the efficacy of plasmin-treated intravenous gamma-globulin (IVGG) in the treatment of Kawasaki syndrome, we compared the frequency of coronary artery abnormalities in children treated or not with IVGG for Kawasaki syndrome. Among 291 cases of Kawasaki syndrome diagnosed during the period of 1987 to 1991 without coronary abnormalities within 10 days of the onset of illness, 128 were treated with IVGG and aspirin and were compared with 163 treated with aspirin alone. IVGG was given in a dosage of 400 mg/kg/day for 4 consecutive days. The detection of coronary abnormalities was monitored by two dimensional echocardiography. Two weeks after enrollment coronary artery abnormalities were present in 37 (22.7%) of 163 children in the aspirin group and in 9 (9%) of 128 in the gamma-globulin group (P < 0.05). Seven weeks after enrollment, abnormalities were present in 20 (12.3%) of 163 children in the aspirin group and in 6 (4.6%) of 128 in the IVGG group (P < 0.05). We conclude that plasmin-treated IVGG is effective in reducing the prevalence of coronary artery abnormalities in Kawasaki syndrome and suggest a predominant role of the Fc gamma fragment of IgG in the therapeutic effect.     

Comparison of p53 gene abnormalities in bilateral and unilateral breast cancer

BACKGROUND: The results of recent studies have suggested that p53 gene abnormalities are associated with carcinogenesis in several neoplasms. It is believed that bilateral breast carcinomas develop as a result of a different carcinogenetic mechanism and genetic environment from those of unilateral lesions. METHODS: p53 Gene abnormalities in bilateral primary breast cancer were detected by polymerase chain reaction-single strand comformation polymorphism (PCR-SSCP) analysis. A total of 76 paraffin embedded tissue specimens from 38 patients with bilateral primary breast cancer were examined, and 62 patients with unilateral breast cancer were analyzed as control subjects. The bilateral tumors were defined as primary, based on clinical parameters and the presence of an intraductal component. There were 13 patients with synchronous bilateral breast cancer and 25 with metachronous bilateral breast cancer. RESULTS: p53 Gene abnormalities were detected in 50% of the bilateral and 25.8% of the unilateral cases, and the difference was significant (P < 0.01, chi-square test). Abnormalities were detected in 56% of the metachronous cases, representing a much higher incidence than that of the unilateral cases (P < 0.001, chi-square test). The incidence of p53 gene abnormalities in the first and second tumors of the metachronous cases was 44% and 68%, respectively. The percentage of patients with a p53 gene abnormality and positive family history was higher for those with bilateral than with unilateral breast cancer (P < 0.01, chi-square test). CONCLUSION: These findings indicate that the genetic changes and mechanism of carcinogenesis in bilateral and unilateral breast cancer are different.     

Local vascular complications after heart catheterization

BACKGROUND: A prospective study was carried out to clarify the efficacy of an endoscopic screening program for detecting superficial colorectal neoplasias by color changes such as faint redness or discoloration, which have been described as a key finding of these lesions in the literature. METHODS: We enrolled 716 consecutive cases in this study, but more than half of them did not reveal any abnormalities colonoscopically. RESULTS: Of the 716 cases, 48 (7%) were examined by magnifying colonoscopy with a dye spraying technique, following the detection of superficial color changes. Sixteen neoplastic lesions (in 16 cases) were detected among the 48 cases and the detection rate was calculated as 2.2% (16/716) in the total number of cases and 33% (16/48) in those showing color abnormalities. Histologically, all of the 16 were adenomas. These neoplastic lesions were most frequent (52%; 11/21) in those showing faint redness in an oval shape, whereas 14 (94%) of the 15 lesions were non-specific in those showing faint redness with unclear margin. CONCLUSIONS: These results may confirm the diagnostic utility of color abnormality, particularly faint redness in an oval shape, for endoscopic screening of superficial colorectal neoplasias.     

Assessment of baseline levels of PCDD/F in soils in the neighbourhood of a new hazardous waste incinerator in Catalonia, Spain

In order to determine the baseline contamination by polychlorinated dibenzo-p-dioxins (PCDD) and polychlorinated dibenzofurans (PCDF) in an area from Catalonia (Spain), which will be under the influence of a new hazardous waste incinerator, PCDD/F concentrations were measured in 40 soil samples collected in the vicinity of the facility now under construction. Thirty samples represented rural soils and 10 samples urban soils. PCDD/F concentrations ranged between 0.08-8.4 ng I-TEQ/kg for rural soils and 0.63-24.2 ng I-TEQ/kg for urban soils. The mean value for the 40 samples was 1.64 ng I-TEQ/kg (dry matter). The current PCDD/F levels and profiles are comparable to those found in soils from other countries. The PCDD/F concentrations found in this study show that at present the contamination by PCDD/F in soils of the examined area is rather low.     

Treatment of patients with spontaneous pneumothorax during videothoracoscopy

Thoracoscopy for spontaneous pneumothorax has been performed over the years by many pulmonologists. The aim of the procedure was merely diagnostic: the detection of blebs and bullae. Therapeutic modalities were restricted to chemical pleurodesis. The development of videothoracoscopy has made more complex interventions, such as bullectomy possible. A protocol for videothoracoscopic treatment of spontaneous pneumothorax, with all treatment modalities in one session, has been developed. All patients with spontaneous pneumothorax underwent videothoracoscopy under general anaesthesia with double lumen tube intubation. If no abnormalities were found on the visceral pleura, talc pleurodesis was performed. Small lesions, blebs or bullae < 2 cm, were coagulated prior to pleurodesis. In case of blebs or bullae > 2 cm, thoracoscopic resection with an EndoGIA stapling device was performed, followed by scarification, i.e. electrocoagulation, of the parietal pleura. In 43 patients, 44 procedures were performed. In 15 cases (34%) no blebs or bullae were found. In 6 cases (14%) only blebs < 2 cm were found. In 23 cases (52%) blebs and bullae > 2 cm were found. In 21 out of 44 cases (48%), talc pleurodesis was performed, and in 23 cases (52%) bullectomy was performed. No major complication occurred. The average hospital stay was 5.7 days after talc pleurodesis and 6.0 days after bullectomy. There were 2 recurrences (5%) after a follow-up of at least 18 months. In conclusion, the use of videothoracoscopy in spontaneous pneumothorax makes it possible to continue a diagnostic procedure as a therapeutic session.(ABSTRACT TRUNCATED AT 250 WORDS)     

Changes in patterns of growth and nutritional anthropometry in two rural modernizing Papua New Guinea communities

In Papua New Guinea growth is slow and adult body size is small. This is often considered an adaptation to the low energy and nutrient densities of the diets in which tubers and root crops predominate. Social and economic change have been a feature of Papua New Guinea, particularly in recent times. In 1969 the human biology of two contrasting communities, one coastal with a long interaction with external influences and cash cropping, the other a highland community with a history of more recent contacts, was investigated. In 1984 repeat measurements of nutritional anthropometry were made on the villagers and those born in the previous 14 years. The coastal boys and girls were taller and heavier in 1984 compared with 1969 but remained below the 5th percentile of reference North American data. Increases were also found in the highland children, particularly girls, but significantly lower means were found in children under 2 years. Although stunting was less common in the coastal children in 1984, 156 cases (37%) versus 175 cases (43%) (chi 2 = 7.69, rho < 0.05), wasting increased in prevalence from 11 cases (3%) to 20 cases (5%) (n.s.), either because of recent food shortages or because height change was greater than weight change. Stunting rose by 3% to 53% (165 cases) in highland children (chi 2 = 7.24, p < 0.05). In adults, heights were 2-3 cm greater in 1984 than 1969, and weights 2-3 kg greater, with peak differences in the 30-39-year-olds. The percentage of coastal women with body mass indices of less than 18.5 kg/m2 fell from 32% to 15% (chi 2 = 27.4, p < 0.01). Mid-upper arm circumferences and triceps skinfolds were significantly higher in all groups. National and regional data suggest that the communities were better off in 1984 than 1969, but social and economic changes were associated with variable benefits in growth and nutritional status.     

Cytogenetic findings in adult de novo acute myeloid leukaemia. A population-based study of 303/337 patients

During a 10-year period (1992-2001) in the region of Southern Denmark, 337 patients aged 15 years or older (range 16-93 years, median 67 years) were diagnosed with acute myeloid leukaemia (AML). Cytogenetic analysis was carried out in 90%, of whom 53% had clonal chromosome aberrations. Some 24% and 31% had only numerical or structural abnormalities respectively. The remaining patients showed both types of abnormalities. Ploidy levels in decreasing order were: pseudodiploidy, 41%; hyperdiploidy, 32%; and hypodiploidy, 27%. Pseudodiploidy characterizes type M3 (70%) and hypodiploidy M6 (56%). Recurrent cytogenetic abnormalities--t(8;21), t(15;17) and inv(16)--were found in 3.3%, 3.3% and 2.0% of all patients respectively. Prognostically intermediate and adverse aberrations were found in 39% and 44%, respectively, of those with an abnormal karyotype. Rare recurrent aberrations were found in two patients in this material. A previously described non-recurrent abnormality was found to be recurrent in one patient [der(20)t(11;20)(q13.2;p13)]. New, previously undescribed abnormalities were found in 41 patients. Statistically significant correlations were found between t(15;17) and young age (P < 0.001), inv(16) and young age (P < 0.006), -17 and M6 (P = 0.007), and M6 and complex karyotype with five or more unrelated aberrations (P = 0.004). We conclude that this truly population-based cytogenetic study of adult AML showed distributions of chromosome abnormalities that differ from those described so far.     

Cytogenetic follow-up of patients with nonlymphocytic leukemia. II. Acute nonlymphocytic leukemia

Bone marrow (BM) karyotypes of 86 patients with acute nonlymphocytic leukemia (ANLL) were studied at the time of diagnosis: 39 of them (45%) were normally diploid and 47 (55%) showed acquired abnormalities. The median survival was no longer in the diploid group than in the aneuploid one. Nonrandom aberrations were often found: trisomy 8 (15 times), monosomy 7 (7 times), and t(8;21) (7 times). Two patients with acute promyelocytic leukemia presented with the t(15;17) in BM cells. Serial cytogenetic studies performed in 17 cases showed that karyotypic evolution closely followed the clinical evolution. Complete remission, obtained in 10 cases, was characterized by BM metaphases with a normal karyotype. Relapse after a period of complete remission was documented four times; the BM metaphases then showed the original abnormal karyotype with additional changes that, in three cases, were limited to a new structural aberration.     

Correlation of cytogenetic, molecular cytogenetic, and clinical findings in 59 patients with ANLL or MDS and abnormalities of the short arm of chromosome 12

Abnormalities of the short arm of chromosome 12 (12p) are found in about 5% of acute nonlymphocytic leukaemias (ANLL) and myelodysplastic syndromes (MDS). They are described to be characteristic of secondary leukaemias, especially after prior mutagenic exposure, and to be associated with a poor prognosis. In our series of 59 patients with 12p abnormalities and ANLL or MDS, exposure to genotoxic agents was proven only in five patients, but in 13/44 patients ANLL evolved from an MDS. Patients with a small deletion del(12)(p11.2p13) having a mild clinical course were distinguished from those with a large del(12)(p11.2), additional chromosomal anomalies, and a poor clinical course. Among the 31 patients with translocations or dicentric chromosomes involving 12p, a group of eight with t/dic(12;13) was the most frequent and was associated with a poor prognosis. The clinical outcome was adverse in the majority of patients with complex karyotype abnormalities, but in some patients a milder clinical course seems likely. A new, hitherto undescribed, abnormality in an MDS case with a duplication dup(12)(p11.2p13) was the amplification of the signal of the yeast artificial chromosome (YAC) clone 964c10 (D12S736). In 38 cases with deletions or unbalanced translocations/dicentrics one YAC signal was lost. Five patients with balanced translocations demonstrated breakpoints within the YAC, containing the ETV6 (TEL) gene. The breakpoints were telomeric to the YAC 964c10 in seven cases and centromeric in one patient.     

Aplastic anemia or aplastic preleukemic syndrome?

The incidence of aplastic anemia appears to be relatively high in some parts of the world, including Pakistan. Since some of the etiological factors are shared by aplastic anemia and the preleukemic syndrome, there is a strong possibility that a proportion of cases of aplastic anemia may in fact be preleukemia. The study of chromosomes offers a relatively easy method of detecting cases of preleukemia, because some chromosomal abnormalities are frequently observed in this condition. Chromosomal studies were carried out in peripheral blood cell cultures of 31 patients with otherwise typical aplastic anemia. Chromosomal abnormalities were detected in 7 (22.5%) cases. The most common chromosomal abnormality detected was trisomy 8, seen in four cases. Other abnormalities detected were 22q-, t(14;22) and t(15;21), in one case each. These abnormalities have been found to be associated with AML, MDS, ALL, and NHL as well. We hypothesize that a proportion of cases of otherwise typical aplastic anemia may in fact be due to a leukemic process in evolution.     

Angiography in non-traumatic brain haematoma. An analysis of 100 cases

PURPOSE: The primary purpose of this project was to study the anatomical characteristics of intracerebral haematoma (ICH) in order to determine features that may negate the need for angiography in some patients. MATERIAL AND METHODS: The study was prospective and designed to investigate the underlying cause of non-traumatic ICH in 100 cases assessed by conventional angiography. Patients were excluded if there was a history of trauma or known pre-existing brain abnormality. All patients were examined with CT and angiography within 4 days of the ictus. RESULTS: Ruptured aneurysms or arteriovenous malformations (AVMs) were diagnosed on the initial angiogram in 49% of cases: 27 AVMs and 22 aneurysms. One case of superior sagittal sinus thrombosis was also detected. Vascular abnormalities were found most frequently in the under-40 age group and in cases in which subarachnoid haemorrhage, intraventricular haemorrhage or extracerebral haematoma accompanied the ICH. The temporal lobe was the most frequent anatomical location (37%). When a temporal lobe haematoma extended into the Sylvian fissure from the inferior pole of the temporal lobe or when it was associated with subarachnoid haemorrhage, structural abnormalities were found in over 90% of cases. CONCLUSIONS: There are groups of patients with ICH in whom the CT features are highly suggestive of AVM or aneurysm rupture. If the initial angiography is negative in these cases, careful follow up by repeat angiography and/or MR imaging is essential. However, potentially treatable abnormalities cannot be excluded with certainty by the distribution of the haematoma on CT alone, even if there is a history of pre-existing hypertension.     

CADASIL: 2 case reports of hereditary multi-infarct dementia

OBJECTIVE: To further investigate the role that cytogenetic may play in the diagnosis and prognosis of leukemia, a study was conducted in 319 acute leukemias. METHODS: 100 patients with acute lymphoblastic leukemia (ALL) and 219 patients with acute non-lymphoblastic leukemia (ANLL) were from Rui Jin Hospital, Xin Hua Hospital, Ren Ji Hospital and Shanghai Children's Hospital. Their cytogenetic data were analyzed together with those of morphology, immunology and clinical prognosis. RESULTS: In ALL group, 48 cases were karyotypically normal whereas 52 cases revealed chromosomal changes, among which 32 had quantitative abnormalities and 20 had qualitative abnormalities. The translocation t(9; 22) was identified in 11 out of 20 cases of structural aberrations (55%). Specific structural aberrations t(9; 22) and t(8; 14) were detected to be related to B-lineage associated differentiation antigens and t(8; 14) also with ALL-L3 according to FAB classification. With regard to clinical prognosis, the survival rate of structural aberration subset decreased significantly compared with the normal karyotype subset (P < 0.05). However, no statistically significant difference was found between hyperdiploidy subset (not including near-triploidy) and normal karyotype subset (P > 0.75). In ANLL group, 80% of de novo patients and relapsed patients had chromosomal abnormalities. Importantly, structural aberrations accounted for 73% of these abnormalities and frequently corresponded to specific types of FAB classification. Relevant prognostic studies demonstrated that t(15; 17) subset had the best overall survival probability, followed by t(8; 21) and normal karyotype subset, while the numerical aberration subset showed a relatively poor prognosis. CONCLUSION: Our data confirmed that cytogenetic study is important for the molecular study of the leukemogenesis. On the other hand, it also provides an independent parameter for prognosis in acute leukemia.     

Opportunistic infections of the central nervous system in the course of acquired immune deficiency syndrome (AIDS). Morphological analysis of 172 cases

A neuropathological analysis of 172 cases of AIDS in adults was carried out, to determine the occurrence and nature of the opportunistic infections of the central nervous system (CNS). The material comprised 155 cases of men, and 17 women. Mean age of patients was 38 years. Collection under study originated from the period between 1987 and 1997. Opportunistic infections were present in 57.5 percent of cases being in 38.4 percent the only pathological process, whereas in 19.1 percent they coexisted with HIV-dependent pathology or with neoplastic growth. Cytomegalovirus infection (22.7%), toxoplasmosis (16.3%), cryptococcosis (8.1%) and progressive multifocal leukoencephalopathy (9.3%) were the most common opportunistic infections of CNS. The remaining viral (herpetic encephalitis, tick-borne encephalitis and herpes zoster multifocal encephalitis), bacterial (lues, metastatic encephalitis connected with heart valvular changes) and fungal (candidiasis) infections were present only in single cases. It is worth mentioning 3 cases of brain aspergillosis and 5 cases of leptomeningeal tuberculosis. Great morphological variability in the most common opportunistic infections found in our material (cytomegaly, toxoplasmosis, cryptococcosis and PML) was the most striking phenomenon. Neuropathological abnormalities in cases of toxoplasmosis and cryptococcosis revealed remarkable dependence on clinical medication used. Cases of PML were characterized by strong variances of the type and intensity of demyelination, ranging from disseminated foci of various size to diffuse complete myelin loss in the white matter involving uni- or bilaterally cerebral or cerebellar hemispheres. The coexistence of opportunistic infections with HIV-dependent cerebral pathology or other types of opportunistic processes was a very characteristic feature. Concomitance of HIV-dependent pathology with viral opportunistic processes was common. The frequency of this concomitance and more severe HIV-dependent pathology in cases with other viral cerebral infections may suggest pathogenetic interaction of viral infections. Cerebral tuberculosis was less frequent as compared with other neuropathological collections, especially those from the United States. However, it seems worth mentioning that 3 of 5 cases occurred in the last year of observation.     

Bacteriological, pharmacokinetic and clinical evaluation of azithromycin in the pediatric field]

Azithromycin (AZM), a new macrolide antibiotic, in fine granules and in capsules was studied for pharmacokinetic and clinical evaluation in the pediatric patients. Antibacterial activity of AZM against 43 clinical isolates: AZM exhibited slightly lower activity against Gram-positive bacteria and 2-8-fold higher activity against Gram-negative bacteria than erythromycin or clarithromycin. Plasma or urine samples were collected from eight patients receiving the drug in fine granular form, and two patients receiving it in capsules for the determination of drug levels. The elimination half-lives of AZM after administration at dose of 10 mg/kg/day for 3 days were 50.0 and 51.2 hours for fine granules, and 41.5 hours for capsules. AUC0-infinity was 11.7 and 24.3 micrograms.hr/ml for fine granules, and 8.3 micrograms.hr/ml for capsules. The cumulative excretion rates up to 120 hours after the start of treatment were 8.24 and 13.84% for fine granules, and 3.83% for capsules. AZM was administered to 123 patients once daily at 3.7-20.0 mg/kg body weight over 3 to 5 days with reference to the standard dose of 10 mg/kg. The drug was used to treat patients with pharyngitis, tonsillitis, scarlet fever, pneumonia, mycoplasmal pneumonia, chlamydial pneumonia, otitis media, pertussis, intestinal infection, and SSTI. The effectiveness of AZM was evaluated in 109 cases. The drug was rated "excellent" in 65.1% of the patients and "good" in 29.4%, resulting in an efficacy rate of 94.5%. Furthermore, AZM eradicated 43 of 46 (93.5%) bacteria that had been identified before the treatment. Three patients complained of side effects of urticaria (1 case) and diarrhea (2 cases). Abnormal laboratory changes were reported as follows: decreased leukocyte (3 cases), increased eosinophil (5), increased platelet (2), increased eosinophil and platelet, elevated GPT (1), and elevated GOT and GPT (1). The abnormalities, however, were mild enough to raise no clinically significant problems. In conclusion, AZM in once daily regimen was effective and safe in treatment of pediatric infections.     

Diagnostic value of hysterosalpingography and laparoscopy in infertile women

Tubal pathology with tubal blockage due to the pelvic inflammatory diseases is one of the most frequent causes of infertility in a woman [1]. The two most important diagnostic procedures which are used for evaluation of tubal patency are hysterosalpingography and laparoscopic hydrotubation [4]. SUBJECT: The aim of the study was the comparison of hysterosalpingographic and laparoscopic findings and determination of accuracy of these two procedures in the diagnosis of tubal patency. MATERIAL AND METHODS: We studied and compared the results of hysterosalpingography and laparoscopy in 102 infertile women who were operated on at the Narodni Front Hospital of Gynaecology and Obstetrics in Belgrade during 1993 and 1994. Of 102 operated women 47 women were with primary infertility and 55 with secondary infertility. The patients were from 20 to 41 years of age, the average 28 +/- 2.4 years. RESULTS: Of one hundred and two operated women tubal blockage was found in 94 (92.1%) patients. Unilateral hydrosalpinx was found by hysterosalpingography in 16 (15.7%) subjects and bilateral hydrosalpinx in 30 (29.4%) women. Unilateral hydrosalpinx was found by laparoscopy in 17 (16.1%) patients and bilateral hydrosalpinx in 32 (31.4%) subjects. The concordant findings by hysterosalpingography and laparoscopy in the diagnostics of unilateral hydrosalpinx were found in 76.5% of cases, and in bilateral hydrosalpinx in 70.4%. This difference was not statistically significant. Unilateral tubal blockage was identified by laparoscopy in 26 (25.5%) patients and bilateral in 27 (26.5%) subjects. The concordant findings by hysterosalpingography and laparoscopy in unilateral tubal blockage were found in 61.5% of cases, and in bilateral tubal blockage in 70.4% of women. The total concordant findings by hysterosalpingography and laparoscopy in tubal blockage were found in 65.7 of cases, and concordant findings after hysterosalpingography and surgery were noted in 61.7% cases. The findings by laparoscopy and surgery were in harmony in 86.3% patients. Ovarian abnormalities were found by laparoscopy and surgery in 22 (21.6%) women. Pelvic adhesions were found by laparoscopy in 42 women of 49 patients in whom pelvic adhesions were found during the operation. Uterine congenital anomalies were found by laparoscopy in 3 (2.9%), women and by hysterosalpingography in 6 (5.9%) patients. DISCUSSION: Of 102 operated women tubal blockage was found in 94 (92.2%) women. Unilateral tubal blockage was found in 38 (40.4%) patients, and bilateral tubal blockage in 56 (59.6%) subjects. Hysterosalpingographic and laparoscopic hydrotubation findings in the diagnosis of tubal patency were concordant in 65% of cases, hysterosalpingographic and operative findings in 61.7% of patients, and laparoscopic and operative findings in 86.3% of subjects. Although concordant findings of 65.7% were noted in this study, which were similar to findings of other authors, the percentage of 62.5% [4], and 76% was observed [5]. During the operation pelvic adhesions were found in 49 patients, and laparoscopic in 42 women only. Ovarian abnormalities were found by laparoscopy in 22 (21.6%) patients, while uterine fibroid was found in 10 (9.8%) subjects. Uterine congenital anomalies were found by hysterosalpingography in 6 (5.9%) cases and by laparoscopy only in 3 (2.9%) patients. The advantage of visual hysterosalpingography seems to be in identification of some congenital uterine anomalies. However, the advantage of laparoscopy is identified by the possibility of visualisation of some other pelvic abnormalities which may be the cause of infertility. CONCLUSION: There are some hysterosalpingographic and laparoscopic advantages and disadvantages in the diagnosis of infertility in women. Only by using both procedures accurate results can be achieved in the tubes, the uterus and the ovary, that can be a cause of infertility in women.     

Importance of intraoperative transesophageal echocardiography during coronary artery surgery without cardiopulmonary bypass

The goal of this study was to assess left ventricular segmental wall motion (SWM) abnormalities during coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB), and its impact on the immediate postoperative outcome. Transesophageal echocardiography was used intraoperatively in 27 patients (mean age 57 years) who had CABG without CPB. Images obtained with a 5-MHz biplane transesophageal echocardiographic probe in the transgastric and transesophageal planes were recorded before, during, and after 48 coronary artery clampings for saphenous vein or internal mammary artery anastomosis. Transthoracic echocardiography was performed 1 day before surgery and on the seventh postoperative day. During the 48 coronary artery clampings, 31 (64%) new SWM abnormalities were found. At the time of chest closure, complete recovery occurred in 16 (50%) segments, partial recovery in 10 (33%), and no recovery in 5 (17%). On the seventh postoperative day the new SWM abnormalities persisted in all 5 segments without recovery at the end of the surgery and in 2 of 10 (20%)segments with partial recovery (group 1). Group 1 had higher variation on the echocardiographic point score index between the beginning and end of surgery, higher enzymatic levels, more ST-T changes on the electrocardiogram, and more clinical problems than group 2 (patients without new SWM abnormalities on the seventh postoperative day) (P < .05). We concluded that new SWM abnormalities of the left ventricle occur during CABG without CPB as assessed by intraoperative transesophageal echocardiography. Persistence of these abnormalities at the end of surgery may be a predictor of SWM dysfunction and clinical problems in the immediate postoperative period.     

Eye tracking dysfunction in schizophrenia: Characterization of component eye movement abnormalities, diagnostic specificity, and the role of attention.

To characterize oculomotor components and diagnostic specificity of eye tracking abnormalities in schizophrenia, we examined a large consecutively admitted series of psychotic patients and matched controls. The most common abnormality in schizophrenic patients was low gain (slow) pursuit eye movements (47% of cases). Pursuit and saccadic eye movement abnormalities were no more severe in schizophrenic Ss than in those with affective psychoses, except that high rates of catch-up saccades were unique to schizophrenic Ss (17% of cases). These findings indicate that impaired pursuit eye movements are a major cause of eye tracking impairments in schizophrenia, that tracking dysfunctions commonly occur in affective psychoses, and that markedly high rates of catch-up saccades during eye tracking may be specific to schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lung function and exercise capacity in thalassaemia major

Lung function abnormalities in thalassaemia major are various and complex; however, patients still die from cardiac lesions. This study aimed to investigate pulmonary and cardiac involvement at an early stage in thalassaemic patients and study their respective implications at rest and during exercise. Ten patients (five adults and five children) with thalassaemia major were investigated by echocardiography, lung function and exercise testing a few days after transfusion. All have had regular transfusions and chelation with deferoxamine and none had chronic pulmonary disease symptoms. Minor lung function abnormalities were found: two patients had moderate obstructive syndrome and two had a decreased carbon monoxide transfer factor. Hypoxaemia was never found at rest and no desaturation was observed at the end of exercise. Echocardiographic abnormalities were also moderate. Peak oxygen consumption (V'O2) was decreased in three adults and was lower in adults than children (means 27.7+/-4.6 and 41.1+/-4.8 mL.kg(-1).min(-2) respectively). The V'O2/cardiac frequency slope was lower in adults than children (0.25+/-0.06 versus 0.42+/-0.10 mL.kg(-1).min(-2)), whereas end-exercise breathing reserve was >40% maximal voluntary ventilation for all patients. In conclusion, none of the patients had ventilatory limitations but older patients had cardiac limitations assessed by the relationship between oxygen consumption and cardiac frequency. Exercise testing may detect cardiac impairment in thalassaemia major earlier than investigations at rest.