Pelvic congestion syndrome: demonstration and diagnosis by helical CT.

Pelvic pain is a common gynaecological complaint, sometimes without any obvious etiology. We report a case of pelvic congestion syndrome, an often overlooked cause of pelvic pain, diagnosed by helical computed tomography. This seems to be an effective and noninvasive imaging modality.

Is combined phacoemulsification and trabeculectomy as effective as trabeculectomy alone?

We reviewed the charts of 60 consecutive patients with open-angle glaucoma who underwent a trabeculectomy (T) or a single-site combined glaucoma and cataract procedure (phaco-trabeculectomy = PT) to compare the pressure lowering effect of both techniques. The pressure lowering effect after 12 months was significant in both groups: 11.44 +/- 5.

Diode laser cyclophotocoagulation in refractory glaucoma.

A retrospective analysis was made of the first 19 eyes of 19 patients with intractable glaucoma treated with contact diode cyclophotocoagulation. We assessed intraocular pressure (IOP) and number of glaucoma medications. The mean follow-up was 4 months (range 1 to 11 months).

Abnormal BMIPP uptake in chronically dysfunctional myocardial segments: correlation with contractile response to low-dose dobutamine.

Unlabelled: Discordance between 123I-15-(p-iodophenyl)-3-(R,S)-methyl pentadecanoic acid (BMIPP) and sestamibi uptake has been described as a good predictor of functional recovery in patients with a recent myocardial infarction. The current investigation aimed at evaluating BMIPP as a viability tracer in patients with chronic ischemic left ventricular dysfunction.

Methods: Thirty-one studies were obtained in 25 patients with severe left ventricular dysfunction postinfarction (median infarction age 3.

An unexpected triplet heterotopic pregnancy after replacement of two embryos.

We report a case of a triplet heterotopic pregnancy consisting of an intrauterine monozygous twin pregnancy and a tubal pregnancy after replacement of only two embryos in an in-vitro fertilization cycle with donor spermatozoa. This case demonstrates that sonographic demonstration of two intrauterine pregnancies after transfer of two embryos does not exclude the presence of an ectopic pregnancy. As both heterotopic pregnancy and spontaneous monozygotic twinning are more frequent after the use of assisted reproductive techniques, this combination, although extremely rare, must be kept in mind, especially in older patients with pre-existing tubal damage.

Fetal ascites associated with an imperforate hymen: sonographic observation.

We report a case of fetal ascites in which no abnormalities other than an imperforate hymen were noted. The ascites resolved after abdominal tap and incision of the hymen. A possible mechanism for an association between imperforate hymen and fetal ascites is proposed.

Corticotropin-dependent Cushing's syndrome in older people: presentation of five cases and therapeutical use of ketoconazole.

Background: Cushing's syndrome is a rare disorder. The corticotropin (ACTH)-dependent form of this syndrome generally results either from excessive ACTH secretion by a pituitary adenoma or ectopic secretion by a malignant tumor. Theoretically, the latter type can be assumed to occur more frequently in old age as the incidence of malignancy increases.

Temporal lobe abscess as a complication of cholesteatoma: sequential radiological findings.

Temporal lobe abscess is a rare but known complication of petrosal bone cholesteatoma. We present a case with clinical history, diagnostic imaging and sequential radiological findings of the abscess from the early temporal cerebritis phase till the late full encapsulated abscess. We also succeeded in visualizing the fistula through the tegmen tympani on MR-images.

Nuclear cardiology, Part II: Scintigraphic evaluation of cardiac function.

Different methods are currently available to assess cardiac function, especially left ventricular ejection fraction, using either planar or tomographic imaging, first-pass or equilibrium techniques, and blood-pool or myocardial perfusion agents. This is the second article of a four-part series on nuclear cardiology. In this article the authors review the most widely used radiopharmaceuticals and methodologies.

Treatment of acute ischemic stroke with piracetam. Members of the Piracetam in Acute Stroke Study (PASS) Group.

Background And Purpose: Piracetam, a nootropic agent with neuroprotective properties, has been reported in pilot studies to increase compromised regional cerebral blood flow in patients with acute stroke and, given soon after onset, to improve clinical outcome. We performed a multicenter, randomized, double-blind trial to test whether piracetam conferred benefit when given within 12 hours of the onset of acute ischemic stroke to a large group of patients.

Methods: Patients received placebo or 12 g piracetam as an initial intravenous bolus, 12 g daily for 4 weeks and 4.

Mycotic pseudo-aneurysm of the extracranial carotid artery.

A rare case of mycotic pseudo-aneurysm of the common carotid artery as a complication in an immunosuppressed paediatric patient is presented. Treatment of pseudo-aneurysms of the common carotid artery is generally considered to be an emergency, necessitating quick and accurate diagnosis. In patients with septicemia, angiography has to be avoided.

Interpretation of automated perimetry.

This paper discusses basic principles of visual field interpretation. Only the two most popular perimeters, the Octopus and the Humphrey Field Analyzer, were considered. Choices of tests and strategies, software to assist interpretation (with emphasis on glaucoma progression), and future trends in visual field testing are covered.

Primary systemic amyloidosis complicated by massive thrombosis.

We present a case of primary systemic amyloidosis complicated by multiple thrombotic events and initially presenting with a massive thrombosis of the inferior vena cava. Widespread infiltration of the vascular tree by amyloid was found at the time of autopsy. In addition, we report successful treatment of the massive inferior vena cava thrombosis with systemic thrombolysis.

D-penicillamine-induced myositis in rheumatoid arthritis.

D-penicillamine, an agent still used in the treatment of rheumatoid arthritis (RA) may produce inflammatory myopathy or myositis. Some reported cases are documented with muscle biopsy. We report a 34-year old female, receiving the drug for more than 4 years, who consulted us with recently developed proximal muscle pain and weakness.

Securing nasogastric tubes in non-cooperative patients.

To prevent extubation, nasogastric tubes (NGT) were attached to a fine bore polyurethane tube, which loops loosely around the nasal septum. In a prospective study, 124 cases were evaluated for the efficiency and possible complications. On average, a Nasal Septal Loop (NSL) remained 21,2 +/- 1,8 days and a NGT 13,8 +/- 1,1 days.

The effect of naloxone and metoclopramide on the secretion of luteinizing hormone in a hyperprolactinemic hypogonadotropic postmenopausal woman.

Objective: To determine the role of opioidergic and dopaminergic activity in the suppression of GnRH0LH in a hyperprolactinemic state.

Design: Case report.

Setting: University hospital.

Biliary phytobezoar: a medical curiosity.

This report describes a case of cholestatic jaundice caused by concretions of vegetable material obstructing the extrahepatic bile ducts. We have named this a biliary phytobezoar, by analogy with its gastric counterpart. The anomaly underlying this curiosity was a surgical cholecystogastrostomy performed 15 yr earlier.

Elevated glucose levels increase retinal glycolysis and sorbitol pathway metabolism. Implications for diabetic retinopathy.

Purpose: To assess effects of elevated glucose levels on retinal glycolysis and sorbitol pathway metabolism.

Methods: Freshly isolated retinas from normal male Sprague-Dawley rats were incubated for 2 hours at 37 degrees C, pH 7.45, in Krebs bicarbonate-Hepes buffer containing 5, 10, 20, or 30 mM glucose.