Ultrasonic anatomy of the biliary system

Real-time ultrasound has vastly improved the diagnosis of the diseases involving the tubular structures of the liver and biliary tract. Puncture of the bile duct and gallbladder can now be carried out under ultrasound visual guidance. An understanding of ultrasound anatomy is essential for taking full advantage of ultrasound in diagnosis.

Collateral veins in portal hypertension: demonstration by sonography

The diagnostic value of real-time sonography for portal hypertension was assessed in 38 patients with collateral veins using a linear array scanner in comparison with percutaneous transhepatic portography. The frequency of detection of collaterals by sonography relative to that by percutaneous transhepatic portography was 85% for the coronary, 100% for the paraumbilical, and 10% for the short gastric veins. Sonography demonstrated the paraumbilical vein in three patients in whom portography failed to opacify it. Real-time sonography is perhaps the first-choice procedure for the demonstration of collateral veins and diagnosis of portal hypertension.

Deformable mirror using the PMN electrostrictor

A simple deformable bimorphous mirror using the PMN electrostrictor has been made for refocusing a light beam. Parabolic deformation of the mirror has been measured by an interferometric technique on a cycle with rising and falling electric fields. In comparison with the hard PZT piezostrictor, the electrostrictor is found to be promising for practical mirror control applications because of a large strain with neither hysteresis nor aging effects.

Ultrasonically guided percutaneous drainage of solitary liver abscess: successful treatment in four cases

We used a specially designed real-time ultrasound probe (puncture transducer) to puncture solitary liver abscesses for diagnosis and drainage therapeutic purposes. The techniques in four patients so treated is described along with the ultrasonograms and roentgenograms of the opacified abscesses.

Spectrin extractability from erythrocyte in Duchenne muscular dystrophies and the effect of proteases on erythrocyte ghosts

We studied the erythrocyte membrane proteins from patients with Duchenne muscular dystrophy (DMD) using SDS-polyacrylamide gel electrophoresis. Our observations were the following: (1) The electrophoretic densitogram of freshly prepared DMD-ghosts was similar to that of controls. After the extraction of spectrin from ghosts with 1 mmol/l EDTA, pH 8.0, the unextractable spectrin remained more firmly bound in the DMD ghost residues than in controls. Extractability of spectrin from DMD ghosts was decreased about 20%. In addition, several minor bands were detected between spectrin and Band 3 in the DMD ghost residues (treated ghosts). (2) Ca2+-activated, neutral protease reacted more effectively with spectrin of DMD ghosts and ATP-depleted ghosts than with that of controls. (3) Erythrocyte actin (Band 5) of DMD ghosts was more fragile than that of controls and of ATP-depleted actin in the EDTA extracts. Gradually, partial degradation of actin was observed for three weeks at 4 degrees C. (4) The intracellular ATP level and the activities of membrane-bound (Mg2+--Ca2+) ATPases in DMD erythrocytes were unchanged. We suggest that spectrin from DMD ghosts as well as actin may be subject to increased degradation.

An unusual form of vitamin D-dependent rickets in a child: alopecia and marked end-organ hyposensitivity to biologically active vitamin D

A 12-yr-old female patient with an unusual form of vitamin D dependency and alopecia is described. She was a product of consanguineous mating and developed signs and symptoms suggesting vitamin D dependency early in life. Neither 150 microgram/day (6 microgram/kg.day) 1 alpha-hydroxyvitamin D3 nor 5 microgram/day (0.2 microgram/kg.day) 1,25-dihydroxyvitamin D3 proved to have an effect on her abnormal serum chemistry. Seven million international units per day (about 2 x 10(5) IU/kg.day) of native vitamin D restored her serum chemistry to normal and brought about marked improvement on skeletal radiographs, when her serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and 24,25-di-hydroxyvitamin D were 4250, 4.8, and 35 ng/ml, respectively. Even with the high serum levels of vitamin D metabolites, her intestinal 47Ca absorption rate remained in the lower normal range and urinary calcium excretion was decidedly low. Association of hypoparathyroidism was ruled out. These results suggest that the patient has extreme and-organ (intestine) hyposensitivity, probably of congenital origin, to the biologically active metabolites of vitamin D.

Ultrasonically guided percutaneous contrast medium injection and aspiration biopsy using a renal-time puncture transducer

A real-time transducer for ultrasonically guided puncture was used for percutaneous contrast medium injection and aspiration biopsy in 160 patients with various diseases of the abdomen. Opacification of the bile ducts, pancreatic duct and the portal vein was accomplished in 157 patients. Percutaneous aspiration biopsy provided cytological proof of malignancy in 56 of 64 patients with suspected carcinoma. Ducts or vessels less than 10 mm wide on ultrasound images were successfully opacified, and biopsy confirmed at 2 X 2.5-cm carcinoma.

Real-time sonography of the pancreatic duct: application to percutaneous pancreatic ductography

Using a linear-array electronic real-time scanner, ultrasonic pancreatograms were obtained in 21 of 25 normal adults and in 28 of 29 patients with pancreatic disease. The normal pancreatic duct was seen as a thin anechoic tube with echogenic walls and an inner diameter under 0.8 mm. In patients with pancreatic disease, changes in the duct such as dilatation, obstruction, and pancreatic stones could be seen. When ultrasonic pancreatograms were compared with endoscopic pancreatograms in the same patients, there was a good correlation in the patterns of duct dilatation. Using a real-time transducer to guide a thin needle for puncture, both percutaneous pancreatic ductography and percutaneous aspiration biopsy of the pancreas were successfully performed as a single procedure in eight patients with carcinoma of the head of the pancreas. There were no major complications, and the examination provided a definitive diagnosis in all patients.

Fatal herpesvirus tamarinus infection in cotton-topped marmosets (Saguinus oedipus)

Fatal herpesvirus tamarinus infection was observed in cotton-topped marmosets (Saguinus oedipus) imported from South America via the United States on August 26, 1976. In addition to the lesions hitherto reported in herpesvirus tamarinus infection, severe degenerative and necrotic changes of ganglion cells were recognized with intranuclear inclusion bodies in the plexus of the digestive tract and the sympathetic nerves and their ganglions in the abdominal cavity. Inflammatory or regressive changes were also noted in the central nervous system. A large number of basophilic or eosinophilic intranuclear inclusion bodies frequently recognized in multinucleated giant cells were observed in various organs and tissues, and they showed different shapes at the electron microscopic level. Morphological findings indicated that herpesvirus tamarinus infection seemed to be similar to herpes simplex virus infection in man. The findings of the susceptibility of a variety of cell cultures to the virus isolate serologically identified as herpesvirus tamarinus and physicochemical characteristics of the virus isolate were in general agreement with the findings of herpesvirus tamarinus already reported by previous workers.

Biological activity of 1-alpha-hydroxy vitamin D3 in vitamin D dependency

The biological activity of 1(OH) vitamin D3 was evaluated in 2 cases of vitamin D dependency. For the improvement of serum chemistry and increment of urinary excretion of calcium 1(OH) vitamin D3 was 500--1000 times more active than vitamin D2. The administration of 0.05 microg/kg/day and 0.1 microg/kg/day of 1(OH) vitamin D3 were equally effective to keep the serum chemistry within normal limits. However, urinary excretion of calcium increased to an abnormal height on 0.1 microg/kg/day of 1(OH) vitamin D3. On the other hand, administration of 0.05 microg/kg/day of 1(OH) vitamin D3 kept both serum level and urinary excretion of calcium normal. It is suggested that 0.05 microg/kg/day is close to the optimum requirement of 1(OH) vitamin D3 in vitamin D dependency and this should correspond to the essential requirement of 1(OH) vitamin D3 in man.

Plaque formation by a host range mutant of vaccinia virus in non-permissive cells co-infected with Yaba virus

A host-dependent conditional lethal mutant of vaccinia virus strain DIs was rescued to form plaques in a non-permissive cell line JINET co-infected with Yaba virus, a poxvirus serologically distant from the rescued virus. The efficiency of plaque formation under optimal conditions in this system was comparable to that in Vero cells which were permissive for the mutant. The plaque number of the mutant in JINET cells was influenced greatly by the multiplicity of Yaba virus, the interval between inoculations with DIs and Yaba virus and the maintenance medium for pre-infection of cells with Yaba virus. The plaque formation by DIs in JINET cells was suppressed or inhibited when the duration of pre-infection with high multiplicities of Yaba virus was prolonged. Thus, Yaba virus possessed both rescuing and inhibitory activities on DIs and the plaque number of DIs in doubly infected cells was thought to be determined by the balance between the two activities. Ultraviolet light-inactivated Yaba virus retained rescuing activity on DIs in JINET cells.

In vitro effect of D-isoascorbic acid and betaine hydrate alone and in combination on normal and malignant cells

D-Isoascorbic acid, an isomer of vitamin C, and betaine hydrate (quaternary amine) were found to inhibit mitoses of sarcoma 37, Ehrlich carcinoma, and L1210 leukemia cells in vitro. However, the combined effect of these compounds produced a greater inhibitory activity than when either was administered individually.