Antenatal diagnosis of conjoined twins.
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Biomedical subjects
Publications and source records attributed to C C Lu.
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Indirect signs such as clover-leaf deformity, pseudodiverticulum formation, eccentric location of pyloric channel, and flattening of the fornix are of considerable value in the radiologic detection of an ulcer crater. We have found another indirect sign, base line tenting (BLT) to be very useful in the detection and diagnosis of duodenal ulcer disease. This is characterized by interruption of the base line of the bulb, with 2 associated perpendicular lines extending from the base and converging to a point in the duodenal bulb. After we observed this sign in various patients with peptic ulcer disease, a prospective investigation was performed involving 62 patients with duodenal ulcer disease over a period of 2 years. We found the BLT sign in 52 (83.8%). To date, no false-positive incidence has been identified. We concluded that BLT is a most valuable sign in the radiologic identification of duodenal ulcer disease.
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In this study, 163 normal fetuses of between 25 and 41 weeks' gestational age were examined sonographically using B-mode and Doppler equipment to measure umbilical vein diameter, umbilical venous flow amount (UVFA) and velocity (UVFV), and abdominal area (AA). A total number of 230 examinations were performed. The relationships between gestational age and umbilical vein diameter, UVFA, UVFV, and the UVFA/AA ratio were analyzed. Throughout pregnancy, the umbilical venous blood flow velocity remained relatively constant, whereas the umbilical venous blood flow amount increased steadily with gestational age and was proportional to abdominal area.
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Giant colonic diverticulum is an uncommon complication of diverticulosis, with only 52 previously reported cases. Complications secondary to the giant air cysts occurred in only six instances, and all but one occurred in the sigmoid colon. Two additional cases are described, presenting atypical location, age, and complication by pneumoperitoneum.
The rectum can be perforated by an enema tip during a barium enema examination due to direct trauma during insertion or the undesirable mechanical properties of the balloon catheters. The author describes a newly designed, safer tip.
We combined separation procedures based on three independent physical properties, sedimentation coefficient, density, and partitioning in an aqueous polymer two-phase system, to generate a three-dimensional subcellular fractionation of rat exorbital lacrimal gland. The distributions of protein and five enzymatic markers define a total of 13 physically and biochemically distinct membrane populations. These include epithelial cell apical membranes, purified 330-fold with respect to the initial homogenate; basal-lateral membranes, purified 80-fold; mitochondria, purified 19-fold; and a major endoplasmic reticulum population, purified 22-fold. Also apparent is a major Golgi population, which is extensively overlapped by other membrane populations; two populations that can be visualized as forming transitions between the endoplasmic reticulum and Golgi membranes; and several populations with unknown subcellular origins. Most of the markers have complex distributions among the isolated membrane populations; this complexity is consistent with current concepts of the synthesis and recycling of membrane constituents and the regulation of cytosolic electrolyte activities.
The survival of spermatogonial stem cells in CBA and C3H mice after single and split-dose (24-hr interval) irradiation with fission neutrons and gamma rays was compared. The first doses of the fractionated regimes were either 150 rad (neutrons) or 600 rad (gamma). For both strains the neutron survival curves were exponential. The D0 value of stem cells in CBA decreased from 83 to 25 rad upon fractionation; that of C3H stem cells decreased only from 54 to 36 rad. The survival curves for gamma irradiation, which all showed shoulders, indicated that C3H stem cells had larger repair capacities than CBA stem cells. However, the most striking difference between the two strains in response to gamma radiation was in the slopes of the second-dose curves. Whereas C3H stem cells showed a small increase of the D0 upon fractionation (from 196 to 218 rad), CBA stem cells showed a marked decrease (from 243 to 148 rad). The decreases in D0 upon fractionation, observed in both strains with neutron irradiation and also with gamma irradiation in CBA, are most likely the result of recruitment or progression of radioresistant survivors to a more sensitive state of proliferation or cell cycle phase. It may be that the surviving stem cells in C3H mice are recruited less rapidly and synchronously into active cycle than in CBA mice. Thus, it appears that the strain differences may be quantitative, rather than qualitative.
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Technetium-99m di-isopropylphenylcarbamoylmethylimidodiacetic acid cholescintigraphy, together with measurements of radioactivity in duodenal juice, was used to evaluate 23 infants with prolonged obstructive jaundice. Four patients proved to have biliary atresia. The remainder had neonatal hepatitis. There was distinct differentiation of biliary atresia from neonatal hepatitis when the time-activity curves were analyzed. In neonatal hepatitis the radioactivity in duodenal juice is obviously higher, peaking above 1500 cpm/100 microliter per mCi dose. In biliary atresia the pattern is flattened, with maximal activity below 500 cpm/100 microliter per mCi dose.
The natural history of adult Hirschsprung's disease was reviewed in 22 patients (four from our hospital and 18 from the literature). The diagnosis in nearly half the patients was made before age 30, and the oldest patients were 69 years of age. Male to female ratio was 4:1. Almost all patients had severe constipation since birth. Barium enema showed rectal narrowing in 77%, and colonic dilation in 100%. Anorectal manometry was performed in only four patients; three showed no relaxation with rectal distention. In all patients, rectal biopsy showed no ganglion cells. Appropriate operation for Hirschsprung's disease improved symptoms in over 80% of patients. Hirschsprung's disease should be considered in all adult patients who have had severe constipation since birth, especially if they are male.