Halo around the gallbladder--a prognostic sign?

The implications of the finding of a sonolucent zone around the gallbladder, characterized on ultrasonography by loss of definition of the outer (serosal) aspect of the gallbladder wall with a moderately well defined inner (mucosal) surface in patients with signs and symptoms of acute cholecystitis, are described. Of the nine consecutive patients with this finding, five were found to have gangrenous cholecystitis and/or perforation of the gallbladder at surgery. Four of these patients were operated upon within 24 hours of the ultrasound study, one 19 days later. The pathologic basis for this finding is thought to represent massive thickening of the gallbladder wall, with a possible contribution from adherent edematous omentum in the region of the fundus of the gallbladder. Thus this finding of a sonolucent halo about the gallbladder was important in our series, being frequently an indicator of acute cholecystitis complicated by gangrene with or without perforation of the gallbladder.

Reye's syndrome in three siblings. Association with type A influenza infection

Reye's syndrome occurred simultaneously in three siblings. All had characteristic changes in liver histology ascertained by light and electron microscopy. The two patients with the most severe disease also had serum that caused marked stimulation of mitochondrial state 4 respiration in vitro. Histocompatibility locus antigen typing showed that no unique haplotypes were shared by all three children. There was no evidence of exposure to aflatoxins, pesticides, or other substances that have been previously postulated to be associated with Reye's syndrome. Influenza A/Brazil/11/78-like virus was isolated from one patient, and all three patients had a fourfold or greater rise in hemagglutination-inhibiting antibody to H1N1 influenza virus.

Persistent sciatic artery: a case report

A persistent sciatic artery was an incidental finding in a 29-year-old man who was being investigated for severe varicose veins and venous ulceration. The authors review the embryology and literature pertaining to persistent sciatic artery. Because it has a propensity for aneurysm formation and thrombosis they recommend that elective surgery be considered for this condition. In young asymptomatic patients the condition of the anomalous artery should be monitored by ultrasonography until operative intervention is indicated. The operative procedure should consist of occlusion with a balloon catheter or ligation of the persistent artery following by femoropopliteal bypass.

Carcinoid tumour of the oesophagus: report of a case

A case of carcinoid tumour of the oesophagus in a 54-year-old man is described and the literature is briefly reviewed. This is the third reported case in the world literature and the rarity of the disease is emphasised.

Loeffler's endocarditis presenting as mitral and tricuspid stenosis

Loeffler's endocarditis characteristically produces cardiac dysfunction by the combined effects of endocardial fibrosis with restriction to diastolic inflow and intracavitary thrombosis with partial cavity obiliteration. Although valve dysfunction may complicate this condition, it is rarely of primary hemodynamic significance. This report describes an unusual case in which mitral and tricuspid stenosis were the primary cardiac lesions. Because of the critical nature of the valve stenosis, surgical intervention was attempted despite evidence of left ventricular involvement. This case suggests than when significant valve dysfunction complicates Loeffler's endocarditis, surgical revision may be undertaken with at least temporary amelioration of the valve disorder and without apparent adverse effect on the underlying disease process.

Eye-movement fixations in reading as related to anxiety in college females

9 highly anxious Ss were compared with 9 Ss of low anxiety (from a pool of 90). Both groups of females made comparable comprehension scores but those with high anxiety made more eye movements. The research needs replication and extension.

A factorial investigation of scores on the Porteus Maze

A group form of the Porteus Maze was given to 180 freshman students. Each part was treated as a separate test and intercorrelated with all other parts. The intercorrelations were relatively low and a factor analysis revealed four interpretable factors underlying the test. It is suggested that investigation determine which subscore is most valid for the prediction of delinquency.