Evaluation of plain abdominal radiographs in the diagnosis of abdominal pain

In an effort to develop referral criteria for the ordering of abdominal radiographs for patients presenting with abdominal symptoms, we prospectively studied the relation between clinical data and radiographic abnormalities. Of 1780 examinations, 179 (10.0%) showed some radiographic abnormality. If abdominal radiographs would have been limited to those patients who had moderate or severe abdominal tenderness, or to patients with a high clinical suspicion of bowel obstruction, renal or ureteral calculi, trauma, ischemia, or gallbladder disease, regardless of the degree of tenderness, 956 (53.7%) examinations would not have been done. All radiographic abnormalities reflecting a serious pathologic process would have been identified. Only 33 (3.5%) abnormalities of limited significance, almost all localized or generalized ileus, would have been undetected. The adoption of these referral criteria would result in minimal loss of clinically useful information, large financial savings, and a reduction in radiation exposure.     

Quality of life: CVA patients take stock

Exposure to low-energy ultrasound shock waves (1000 impulses at a frequency of 2/sec and an energy density of 0.08 mj/mm2; peak positive/negative pressure 16/-7 MPa; pulse duration about 10 musec) led to the following alterations in the cells and tissues of stage 35 embryos of Oryzias latipes ranked according to their extent: (1) In various tissues, especially in the trunk musculature, orthodox mitochondria were transformed into condensed (= low energy) mitochondria. (2) Nuclear envelopes and sarcoplasmatic reticulum of muscle fibres as well as endoplasmatic reticulum of epidermal ionocytes were often vesicularly dilated. (3) Muscle fibres in the trunk musculature began to separate from each other. Epidermal intercellular spaces were enlarged and increased in number. (4) Destruction of vessels and haematomas were observed in the circulatory system of the yolk sac. (5) Necroses up to total disintegration were found in various organs of the body cavity (intestine, liver, spleen). The less serious alterations (1 and 2) occurred in organs completely surrounded by other tissues. Major damages (4 and 5), however, affected only organs with free outer and inner surfaces, probably explained by cavitation and jet stream phenomena within the adjacent fluids.     

Hyperthermia and AIDS: a critical review

Torsade de pointes in the congenital long QT syndrome (LQTS) is often pause dependent. Thus, the main goal of pacemaker treatment in the LQTS may be the prevention of pauses that facilitate the onset of torsade de pointes. A pause prevention pacing algorithm (rate smoothing) was used for arrhythmia prevention in a 14 year old girl with congenital LQTS. By temporarily increasing the pacing rate after spontaneous premature beats, rate smoothing down of 18% prevented postextrasystolic pauses, pause related T-U changes, and recurrence of pause induced torsade de pointes. Rate smoothing is a potentially useful tool that ought to be evaluated for the prevention of torsade de pointes in the LQTS.     

Frequencies of thalassemia in American blacks

The frequency of thalassemia was determined in a group of 541 healthy adult black males. Individuals with decreased mean corpuscular hemoglobin (MCH) values were evaluated further with hemoglobin analysis, iron studies, and globin chain synthesis. Of the males screened, 13.4% had MCH levels below 27.0 pg, while 1.4% had heterozygous beta thalassemia, 2.3% had iron deficiency, and 5.7% had globin synthesis findings compatible with the diagnosis of alpha thalassemia trait (alpha thalassemia-1). This study suggests that thalassemia is one of the most frequent hematologically depictable abnormalities in American blacks.     

Radiographic evaluation of pancreatico-jejunal shunts

This paper describes opacification and identification of two surgically constructed pancreatico-jujunal shunts. A fibreoptic panendoscope was used with retrograde injection via the ampulla of Vater (ERCP). This procedure makes possible more accurate anatomical evaluation and so more precise clinical appraisal of both pre- and post-surgical states.     

Fibrosarcoma of the orbit (author's transl)

During a period of 8 months a capsulated orbital tumour--not adherent the orbital walls or the bulbus--developed in a 21-year-old female patient. The tumour was exstirpated in toto. The histological findings show a fibrosarcoma with poorly differentiated cells, giant cells and numerous mitoses. The comparatively small incidence of the tumour as well as the prognosis quoad vitam are discussed.     

Allergic contact dermatitis and stomatitis caused by a cinnamic aldehyde-flavored toothpaste

A patient had acute stomatitis and dermatitis due to a popular toothpaste containing cinnamon oil flavor. Cinnamon cassia oil is known as a topical sensitizer and was demonstrated to be the offending allergen. Cinnamic aldehyde and related chemicals are used widely, so that patients having cinnamon allergy may be exposed to many sources. There is difficulty in diagnosing allergic contact stomatitis.