Gallbladder motility, gallstones, and the surgeon.

Cholecystectomy is one of the commonest surgical procedures in the Western world, with more than half a million procedures performed annually in the United States alone. In recent years, studies of gallstone pathogenesis and gallbladder disease have increasingly focused on abnormal gallbladder motility in the pathogenesis of some, if not all, gallbladder conditions. The control of gallbladder motility is complex and depends on an intricate interplay of neural and hormonal factors.

Randomized trial of laparoscopic cholecystectomy and mini-cholecystectomy.

Three hundred and ten patients having elective cholecystectomy were randomized to either laparoscopic cholecystectomy or mini-cholecystectomy. There were 155 patients in each group. Conversion to open cholecystectomy was significantly more common with laparoscopic cholecystectomy (13 versus 4 per cent) and complications were significantly more frequent with laparoscopic cholecystectomy (9 versus 3 per cent).

Continuous muscle fiber activity syndrome.

A 5.5 year old Turkish boy who suffered from progressive muscle stiffness was diagnosed as having continuous muscle fiber activity syndrome. Electromyography showed continuous motor neuron activity at rest and following intravenous injection of diazepam.

Systemic oxalosis: pathognomonic renal and specific extrarenal findings on US and CT.

Hyperoxaluria is characterized by nephrocalcinosis and nephrolithiasis on radiological examination and may also result in diffuse deposition of calcium oxalate crystals in multiple extrarenal organs (oxalosis). In two cases, the renal findings of primary hyperoxaluria were diagnosed by ultrasound and computed tomography scans. In addition to renal involvement, both patients had liver involvement, and one patient had cardiac involvement.

Percutaneous treatment of pulmonary hydatid cysts.

Purpose: To evaluate the safety and efficacy of percutaneous drainage of pulmonary hydatid cysts.

Methods: Eleven pulmonary hydatid cysts in eight patients were drained percutaneously after 1-2 years of treatment with mebendazole (50 mg/kg/day). Percutaneous needle aspiration was carried out under ultrasound (US) in six patients and computed tomography (CT) in two patients.

Superior mesenteric artery aneurysm in Behçet's disease.

Behçet's disease is a multisystem disorder characterized by recurrent orogenital ulcerations and uveitis. Vascular involvement can include both arteries and veins, with a preponderance of venous lesions. Aneurysms of splanchnic arteries due to Behçet's disease have been rarely reported.

Choledochal cysts: ultrasonographic findings and correlation with other imaging modalities.

In the past, choledochal cysts had been infrequently diagnosed prior to surgical exploration for obstructive jaundice. However, with the advance of imaging modalities, preoperative diagnosis is usually apparent. We evaluated the radiological findings of choledochal cysts in 14 patients in whom ultrasonography (US) or computed tomography (CT) were mainly used for diagnosis.

Bilateral adrenal metastases of renal cell carcinoma: a case report.

We report a case of renal cell carcinoma presenting with bilateral adrenal masses diagnosed by ultrasonography four years after nephrectomy. The histopathological examination of the trucut biopsy specimens obtained percutaneously by ultrasound guidance revealed bilateral adrenal mestastases of renal cell carcinoma.

The value of radionuclide splenic scanning in the evaluation of asplenia in patients with heterotaxy.

Splenic anomalies frequently accompany conotruncal and atrioventricular septal malformations. Asplenia is a major factor in the mortality of newborns with the heterotaxy syndrome, requiring an early and accurate diagnosis. We evaluated the splenic status of five consecutive patients with heterotaxy syndrome by radionuclide splenic scanning with 99mTc-labelled and denatured red blood cells (RBCs) and by real-time abdominal ultrasonography.

Thalamic hyperdensity--is it a diagnostic marker for Sandhoff disease?

Sandhoff disease, also known as GM2-gangliosidoses variant 0, is caused by the deficient activity of both hexosaminidase A and hexosaminidase B. We report a 15-month-old boy diagnosed with Sandhoff disease by demonstrating the enzyme deficiency. The interesting finding was bilateral thalamic hyperdensity on the CT scan.

Behçet's disease in the etiology of Budd-Chiari disease.

Hepatic venous outflow obstruction (Budd-Chiari syndrome-BCS) was diagnosed in 30 patients during the period from March, 1987, to May, 1991, in Hacettepe University Hospital, Turkey. Patients with Behçet's disease constituted the major group (12/30) in the etiologic distribution. Although the vascular manifestations of Behçet's disease, including venous and arterial occlusions, varices, and aneurysms, are well known, the hepatic vein involvement has been reported in only 22 cases in the literature so far.

Case report: interruption of the inferior vena cava with anomalous intrahepatic continuation.

Infrahepatic interruption of the inferior vena cava (IVC) with azygos and hemiazygos substitution is a rare IVC anomaly which has been documented in the literature (Anderson et al, 1961; Chuang et al, 1974; Floyd & Nelson, 1976; Mayo et al, 1983). Recently Bercoff et al and Ghossain et al reported two cases with portal continuation of the interrupted IVC (Bercoff et al, 1985; Ghossain et al, 1988). In our case, we describe a left sided IVC with infrahepatic interruption which continues by both the azygos system and the hepatic veins via anomalous intrahepatic vessels.

Unusual appearance of the liver on ultrasonography and computed tomography in a patient with cystic fibrosis.

A seven-year-old boy with cystic fibrosis (CS) who presented with abdominal pain is reported. Ultrasonographic and computed tomographic studies of the upper abdomen revealed unusual liver findings. An ultrasound scan showed a liver that was exceedingly heterogeneous and a mixed echo pattern with dominant hyperechogenicity.

8-year clinical experience in cerebral palsy.

The changes in frequency and distribution of the clinical types of cerebral palsy (CP) were evaluated in 1873 CP cases admitted to the Department of Pediatric Neurology between 1982 and 1989. The observed panorama of CP was unlike the situation in developed countries. The majority of the cases were term-born and perinatal risk factors were noted to play the predominant role in the etiology of these cases.

Peritoneal mesothelioma: sonographic findings in nine cases.

Ultrasonographic findings in nine cases of peritoneal mesothelioma are presented. The most common findings were sheet-like or nodular peritoneal thickening, soft tissue masses, fixation of the intestinal loops, mesenteric thickening, and minimal ascites which was disproportional to the degree of tumor dissemination. The authors found that abdominal sonography, using 3.

Tuberculous pleural effusions: ultrasonic diagnosis.

Twenty patients with tuberculous pleural effusions were studied with ultrasonography. In 18 patients, ultrasonography demonstrated regular pleural thickening which was less than 1 cm except in 1 case. In 4 cases there were a few pleural nodules, whereas in 2 cases the pleural surface showed small nodularity.

Percutaneous transcatheter ethanol sclerotherapy of postoperative pelvic lymphoceles.

Although percutaneous procedures have been used for the treatment of lymphoceles, transcatheter sclerosing therapy has not been widely applied. We present the results of transcatheter sclerotherapy of lymphoceles with 96% absolute ethanol in 7 patients who had developed lymphocele after pelvic lymphadenectomy for uterine cancer. Seven of the eight lymphoceles (88%) completely disappeared after treatment.

Wolman's disease: ultrasonographic and computed tomographic findings.

Acid lipase deficiency which is an inborn error of lipid metabolism leads to an abnormal accumulation of cholesteryl esters and triglycerides in many tissues. It is manifested in two clinical forms: Wolman's disease (WD) which is fatal in infancy and cholesteryl ester storage disease (CESD) which is a milder form and usually presented in adulthood. An infant with a clinical diagnosis of WD was examined with CT and ultrasound.

Detection of deep vein thrombosis: combined flow and blood pool radionuclide venography vs contrast venography.

This study was performed to validate the combined study of flow radionuclide venography (FRV) with subsequent 99mTc-red blood cell(RBC) blood pool radionuclide venography(BRV) for the detection of deep vein thrombosis (DVT). Findings in 32 patients with suspected DVT of lower extremities (n = 52) were compared with those of corresponding contrast venograms (CV) serving as a reference method. FRV was performed by using three separate doses of a large 99mTc04-bolus (10-12 cc) injection.