Role of ultrasonography in blunt abdominal trauma: a prospective study

OBJECTIVE

To evaluate the role of ultrasonography in screening for blunt abdominal trauma in a general hospital.

DESIGN

Prospective study.

SETTING

University hospital, Kuwait.

SUBJECTS

53 patients (44 male and nine female) with suspected blunt abdominal trauma or decreased consciousness were studied in the period between March 92 and April 93.

INTERVENTIONS

Real time ultrasonography of the abdomen during resuscitation.

MAIN OUTCOME MEASURES

The sensitivity and specificity of ultrasonography as an investigative tool and predictor of clinical outcome.

RESULTS

Ultrasonography was 85% sensitive, 100% specific, and 96% accurate. The positive predictive value was 100% and the negative predictive value was 95%. The sensitivity was less in the hands of the surgeon than the radiologist (67% compared with 90%).

CONCLUSION

Ultrasonography is an accurate, safe method for screening patients with blunt abdominal trauma even in general hospitals.

Abdominal tuberculosis: comparison of sonography and computed tomography

Sonographic and computed tomography findings were retrospectively compared in 13 patients with proven abdominal tuberculosis who had both diagnostic modalities in their workup. The patients were treated over 9 years in two general hospitals in Kuwait. Ultrasound could detect the same findings as CT in 9 of 13 patients. Both had the same accuracy in detecting the type of ascites (in 6 patients) and solid organ tuberculosis (four lesions). Ultrasound gave useful information but could not completely replace CT as it detected less bowel thickening (3 of 5 lesions) and abdominal tuberculous lymphadenopathy (1 of 4 lesions) than CT scanning.

Regulation of pml messenger-RNA expression in human breast-carcinoma cells

We examined the mRNA expression profile of PML, a novel nuclear protein recently characterized from acute promyelocytic leukemia (APL) blast cells, in a number of breast carcinoma cell lines. PML mRNA was found to be differentially expressed among the cell lines examined. A correlation of borderline significance between PML mRNA expression and the proliferative capacity of the cell Lines was noted. Serum stimulation significantly elevated the PML mRNA levels in the T47D and MDA-MB-231 cells. These results would suggest that PML may function as a positive regulator of cellular proliferation in breast carcinoma cells.

Expression of the retinoic Acid nuclear receptors (rars) and retinoid x-receptor (rxr) genes in estrogen-receptor positive and negative breast-cancer

Retinoid inhibition of breast carcinoma growth correlates with the estrogen receptor (ER) positivity and elevated retinoic acid nuclear receptor (RARalpha) mRNA levels. We therefore examined retinoid nuclear receptor mRNA levels in patient breast carcinoma biopsy specimens to determine if such a correlation exists between ER positivity and RARalpha mRNA levels. We have now shown that RARalpha mRNA levels are significantly higher in ER positive samples. RARgamma mRNA is expressed at relatively high levels in a majority of the tumor samples independent of the ER-status while RARbeta mRNA was expressed at low levels in only one tumor sample. We also found high RXRalpha mRNA levels in all of the tumor samples examined while RXRgamma mRNA could not be detected. Our study demonstrates that RARalpha mRNA levels are either low or absent in ER-negative patient samples and that RARalpha levels may serve as a potential marker to determine patient responsiveness to RA therapy.

Hybrid molecules containing the A-domain of insulin-like growth factor-I and the B-chain of insulin have increased mitogenic activity relative to insulin

Two synthetic insulin-like compounds consisting of the B-chain of insulin linked via disulfide bonds to A chains corresponding to the A-domain or the A- and D-domains of insulin-like growth factor I (IGF-I) have been evaluated for mitogenic activity and for binding to IGF receptors and IGF carrier proteins. Both compounds are 3- to 5-fold more potent mitogens than insulin, and have a comparably increased affinity for the type I IGF receptor that mediates these mitogenic effects in chick embryo fibroblasts. Neither compound interacts with IGF carrier proteins. These results indicate that the A-domain of IGF-I is importantly involved in its growth-promoting properties.

Echocardiographic diagnosis of supravalvular aortic stenosis

The echocardiographic features of supravalvular aortic stenosis seen in a patient with valvular aortic and multiple pulmonary branch stenosis are described. Since patterns of valvular, discrete subvalvular, and supravalvular aortic stenosis can be recognized by echocardiography, it is now possible to screen close relatives of patients having supravalvular aortic stenosis and pulmonary branch stenosis by this non-invasive technic.

[Herpes gestationis. Immunopathologic studies in mother and child]

Herpes gestationis is a nosologically undefined uncommon bullous disease in pregnancy. In a patient with herpes gestationis C3, C5 und C9 deposits could be demonstrated by immunohistological methods at the epidermal basement membrane (BM). Deposits of immunoglobulins, properdin and C3PA were absent. Autoantibodies against BM were found in the serum of the mother by using rabbit oesophagus but not with normal human skin as antigen. In the sera of mother and child a factor could be demonstrated which in vitro leads to complement fixation in human epidermal BM. Immunopathological findings may speak in favor of a nosological entity of herpes gestationis with respect to dermatitis herpetiformis and bullous pemphigoid.

Long-stay patients with long-stay drugs. A case review; a cause for concern

The psychotropic medication of 200 long-stay psychiatric patients was reviewed by the consutant in charge of the ward, the ward doctor, and the ward sister. Those patients in whom medication was altered or stopped were reassessed by the same team after 6 months. About half the patients on medication had been receiving unnecessary or excessive medication.