Detection of intracranial tumours with special reference to immunodiagnosis

Approximately 60% of cerebral infarcts between 1 and 4 weeks old may be enhanced by contrast material. A recent infarct can be missed if contrast material is not used; however, recent infarcts can also be partially obscured by the contrast medium, so that a precontrast scan is necessary. Infarcts, arteriovenous malformations, and gliomas may appear similar on the CT scan. Recent infarcts can have a significant mass effect (seen in 22% of cases), and their anatomical location and morphology may or may not be helpful in the differential diagnosis. Ipsilateral ventricular dilatation, homogeneous low-density areas, and sharp margins are usually found in older infarcts.     

Atherosclerosis, with special reference to vitamin E

The relationship between atherosclerosis and fat soluble vitamin, especially vitamin E is reviewed on the basis of oxidised modification of low density lipoprotein (LDL). Data now support the notion that the oxidised LDL is present in the blood and arterial wall and antioxidant drugs such as probucol and vitamin E, beta-carotene, may prevent the progression of atherosclerosis. LDL alpha-tocopherol levels are generally correlated to the plasma concentrations and supplementation with alpha-tocopherol increases its content in LDL. There is a significant correlation between the LDL alpha-tocopherol level and the resistance to oxidative modification. Epidemiological data also shows the relation between low levels of plasma vitamin E and the increased incidence of coronary heart disease. Clinical application of vitamin E should be clarified in detail to inhibit the progression of atherosclerosis.     

Incidence and clinical features of splenic abscesses, with special reference to tuberculous etiology in a general hospital

BACKGROUND: The aim of this revision is to know the incidence of splenic abscess (SA) in our hospital, its etiology, with special reference to tuberculosis, and clinical characteristics. PATIENTS AND METHODS: Abdominal CT-scan performed during the period 1987-1997, with the diagnosis of splenic abscess were reviewed. Etiologic diagnosis standed on blood or sputum cultures, PAAF and/or histologic study of lymph nodes. RESULTS: Seventeen cases of SA were obtained, 12 males and 5 females. Limits of age: 13 and 77 years. The causal microorganisms were: M. tuberculosis (7), Mycobacterium aviumintracellulare (1), S. aureus (2), S. anginosus (1), S. milleri (1), E. coli (1), C. albicans (1), T. biguelle (1) and polymicrobian flora (1). One case was of unknown etiology. Underlying illnesses were: AIDS (7), malignant neoplasms (3), diabetes (2), endocarditis (2), Sj?gren syndrome (1) and complications of abdominal surgery (2). Clinical presentation in nontuberculous splenic abscess was fever and upper-left abdominal pain. Predominant symptoms in tuberculous splenic abscess were fever and weight loss. Blood cultures were positive in 80% of non tuberculous splenic abscess. Specific treatment for tuberculosis improved all patients with tuberculous splenic abscess, without needing surgery or corticosteroids. CONCLUSIONS: From the total of splenic abscess, 41.1% were tuberculous, six with AIDS and one with Sj?gren syndrome. Diabetes and malignant neoplasms were the commonest underlying illnesses in the non-tuberculous. In these, clinical presentation consisted in fever and upper-left abdominal pain. In patients with tuberculous splenic abscess, the main complaint was weight loss. A prompt treatment is generally succesful.     

Computed tomography with craniopharyngiomas: a review

A retrospective study of the computerized tomographic (CT) examinations of 20 children and 13 adults with craniopharyngiomas was undertaken, with special attention paid to the densitometric characteristics of the tumors (contrast enhancement and presence of cysts and calcifications). The aim was to quantify these characteristics and to assess their diagnostic reliability, both alone and together. In suprasellar tumors al three characteristics were present in 75% of the cases, with a diagnostic accuracy of 100%; two were present in 20.6%, with a diagnostic accuracy of 85%; and one was present in 3.4%, with a diagnostic accuracy of 50%. The unusual densitometric presentations of intrasellar tumors are discussed.     

Cerebral abscess with special reference to the angiographic changes

From 1961 to 1973 forty patients with surgically confirmed intracranial abscesses had preoperative cerebral angiography. The findings were abnormal in all cases but one. In 20 patients (50%) the primary diagnosis was a space-occupying lesion. In 19 patients (47.5%) an abscess was suggested by the presence of a capsule, the only finding definitely diagnostic of an abscess. Subtraction technique provided essential information in detecting the capsule. Angiography proved indispensable in suggesting the nature of the lesion.     

Nurse turnover with special reference to factors relating to nursing itself

The function of the peritoneum in severe abdominal sepsis involves specific properties and defence mechanisms: large surface, efficient barrier, continuous mobility, capacity of migration, multiplication, secretion and absorption. The development of peritonitis supposes an initial lesion of the peritoneal surface by septic or biochemical mechanism. Peritoneal response consists of: septation of the abdominal wall, adhesion of the omentum to damaged surfaces or visceral perforation, massive stepping up of cellular and humoral defence mechanism. In our opinion therapeutic procedures consist of: early surgical approach and management of the patient in an intensive care unit. The aim of the medical therapy is: treatment of multiple organ failure (anti-infectious therapy, hemodynamic support, treatment of respiratory and renal failure, support of the hepatic failure and balancing of metabolic changes) and prevention of the most common complications: bleeding from upper gastrointestinal tract and thromboembolic risks.     

Induced hypotension during anesthesia with special reference to orthognathic surgery

Since Gardner first used arteriotomy during anesthesia to improve visibility in the surgical field, various techniques and pharmacological agents have been tried for the same purpose. With reports documenting the spread of acquired immune deficiency syndrome through blood transfusions, prevention of homologous blood transfusions during surgery has also become a major concern. Induced hypotension has been used to reduce blood loss and thereby address both issues. In orthognathic surgery, induced hypotension during anesthesia has been used for similar reasons. It is recommended that hypotensive anesthesia be adjusted in relation to the patient's preoperative blood pressure rather than to a specific target pressure and be limited to that level necessary to reduce bleeding in the surgical field and in duration to that part of the surgical procedure deemed to benefit by it. A mean arterial blood pressure (MAP) 30% below a patient's usual MAP, with a minimum MAP of 50 mm Hg in ASA Class I patients and a MAP not less than 80 mm Hg in the elderly, is suggested to be clinically acceptable. Various pharmacological agents have been used for induced hypotension during orthognathic surgery. In addition, there are many drugs that have been used in other types of surgery that could be used in orthognathic surgery to induce hypotension. Recent reports using control groups do not show significant differences in morbidity and mortality attributable to induced hypotension during anesthesia. Appropriate patient evaluation and selection, proper positioning and monitoring, and adequate fluid therapy are stressed as important considerations in patients undergoing induced hypotension during orthognathic surgery.     

Cartoon Reaction Scale with special reference to driving behavior.

Research suggests that hostility, aggression, and other personality traits may be indicative of problem drivers. Other evidence implies that certain types of humor are related to these personality dimensions. A Cartoon Reaction Scale (with "funniness" response choices) was developed to test the hypothesis that problem and nonproblem drivers would respond differentially and to a significant degree. Out of an original pool of 150 cartoons, 34 achieved discriminatory ability. These cartoons were subsequently administered to new groups of drivers. Reliability coefficients ranged from .77-.80. Validation and cross-validation achieved significance beyond the .01 level. The test's success in separating controls from problem drivers was also demonstrated by a cutoff score. Its predictive ability has not yet been shown. (32 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

c-Met expression of thyroid tissue with special reference to papillary carcinoma

It has become clear that papillary carcinomas of the thyroid often express the receptor for c-Met/hepatocyte growth factor (HGF) receptor, but little is known about the role of the HGF and c-Met system in the pathogenesis of thyroid carcinoma. In this study, the expression of c-Met/HGF receptor was evaluated in thyroid tissue by western blot and immunohistochemistry, and compared with the concentration of HGF. Clinicopathological characteristics were also compared. Fifteen of 20 papillary carcinomas (75%) showed c-Met bands of 145 kDa. No or only a low frequency of c-Met expression was detected in healthy thyroid tissue (0/5), thyroiditis or Basedow's disease (0/2), adenomatous goiters (0/8), follicular adenomas (1/9, 11%) and undifferentiated carcinomas (0/2). These results were confirmed by immunohistochemistry, but a relatively higher frequency of c-Met expression was detected in adenomatous goiters (25%), follicular adenoma (44%) and papillary carcinoma (100%) using formalin-fixed and paraffin-embedded materials. A strong immunoreaction for c-Met was observed in the tumor cytoplasm of papillary carcinomas among the fibrous tissues situated at the periphery of the tumor. The densitometrically measured expression of c-Met had no relation to tumor stage in papillary carcinoma, but did correlate to the concentration of HGF in papillary carcinomas. In conclusion, in thyroid lesions, c-Met was highly expressed specifically in the cytoplasm of papillary carcinomas. c-Met expression was not related to the aggressiveness of the tumor but was related to the concentration of HGF, which was probably derived from the stroma. Also, the c-Met system might play a role in the pathogenesis of papillary carcinoma of the thyroid.     

Study of portal hypertension in children with special reference to sclerotherapy

Spinal cord injuries are rare in children, in face of their higher mobility comparing to adults. The high cervical and the thoracic segments of the spine are more frequently affected. In the last 10 years we had 90 cases of spinal injuries in our service being 12 with neurologic deficient (8 male and 4 female) and four of them without radiographic abnormality, even in the dynamics studies. The authors emphasise the possibility of occurrence of neurologic deficit in children after trauma, even without any radiographic abnormality.