A rare case of choledochal cyst complicated by papillary adenocarcinoma in the cystically dilated intrahepatic bile duct is reported. The tumor was located in the neck of the cystic lesion, and imaging modalities failed to show communication between the cystic lesion and the bile ducts.

Adenocarcinoma, Papillary↗

PubMedDate not supplied

Clinical significance of arterial ketone body ratio in chronic liver disease.

BACKGROUND: Arterial ketone body ratio (acetoacetate/3-hydroxybutyrate, AKBR) has been reported to be a useful tool for the estimation of liver functional reserve, but a more recent report has cast doubt on the clinical significance of this redox theory. Furthermore, the effect of a diminution of liver functional reserve on AKBR has not been documented in chronic liver disease. METHODS: AKBR was measured in normal control subjects (n = 10), heavy alcohol drinkers (n = 19), patients with chronic hepatitis (n = 18) and patients with liver cirrhosis (n = 25). RESULTS: Though AKBR was lower in heavy alcohol drinkers (1.66 +/- 0. 82) than in the other noncirrhotic groups (1.97 +/- 0.93 in normal control subjects, 2.25 +/- 1.11 in patients with chronic hepatitis), this discrepancy did not reach a level of significance. AKBR in patients with liver cirrhosis (1.18 +/- 0.52) was significantly lower than that in normal controls (p < 0.01). AKBR in Child's class A, Child's class B, and Child's class C was 1.20 +/- 0.60, 1.07 +/- 0.56, and 1.27 +/- 0.45, respectively, and there were no significant differences among them. CONCLUSION: AKBR may be parallel to liver mitochondrial redox potential and hepatic functional reserve to some extent, but it does not appear to be an accurate parameter for their estimation.

3-Hydroxybutyric Acid↗

PubMedDate not supplied

Long-term modifications of vertical and horizontal vestibulo-ocular reflex dynamics in man. I. After acute unilateral peripheral vestibular paralysis.

Horizontal (HOR) and vertical (VERT) vestibulo-ocular reflex (VOR) responses to whole-body triangular velocity profiles with constant accelerations of 10, 15 and 20 deg/s2 were studied in two populations: normals, and patients with acute unilateral peripheral vestibular paralysis. The effect of this type of unilateral deficit on VOR gain and long time constant were determined as well as the time course of the compensation processes for HOR and VERT VOR dynamics. In the patient population, HOR VOR gain was asymmetric post deficit, being, on average, 50% and 75% of normal for rotations toward and away from the deficit, respectively. For the VERT VOR, on average, a symmetric 66% reduction occurred. The VERT VOR time constant was marginally affected by the deficit. HOR time constants were reduced for both directions of rotation. HOR and VERT VOR gain was within normal limits 1-3 months following an acute paralysis; time constants required a longer recovery period. Our results indicate that a unilateral deficit causes a markedly different alteration for HOR VOR dynamics compared to the effect on VERT VOR.

Adolescent↗

PubMedDate not supplied

Allergy to ethylenediamine and steroid.

Intravenous preparations combining aminophylline and a steroid are used frequently in the treatment of bronchial asthma attacks. However, anaphylactoid reactions to such preparations have been rarely observed. We report the case of a 31-year-old man with aminophylline and steroid allergy. Aminophylline is the ethylenediamine salt of theophylline. In our patient, aminophylline, ethylenediamine and various steroids were found to be positive in the intradermal test. The challenge test with intravenous aminophylline was positive, while that with oral theophylline was negative. Ethylenediamine is used in everyday products such as shellacs and rubber products. In the case of our patient, his asthma worsened following the remodelling of his restaurant. Occupational asthma due to exposure to ethylenediamine is also discussed.

Adult↗

PubMedDate not supplied

[Proceedings: 298. Effects of cutaneous stimulation upon the efferent discharge in the pelvic nerve of the dog (author's transl)].

Explore the source record for details and available documents.

Animals↗

PubMedDate not supplied

Intra-operative detection of lymph node involvement in carcinoma of the colon.

BACKGROUND/AIMS: We studied the accuracy rate of intra-operative lymph node assessment compared with pathological examination to determine whether surgeons could modify the extent of lymphadenectomy during the operation. METHODOLOGY: Intra-operative and pathological lymph node assessments were compared in 360 patients with carcinoma of the colon. RESULTS: A total of 6,431 lymph nodes were examined, mean number per patient was 17.9. The overall accuracy rate of intra-operative diagnosis was 56.1%, sensitivity was 93.2%, and specificity was 41.7%. The accuracy rate of the diagnosis of N1 and N2 was 43.7% and that of N3 and N4 was 78.3% (p=0.001). There was no significant difference in the diagnosis rates in the colonic region. These results indicated that diagnosis in < or = N3 was more accurate than that in > or = N2. There were 5 false-negative cases. All of the false-negative lymph nodes were located adjacent to the colonic wall. CONCLUSIONS: Intra-operative diagnosis of the positivity of < or = N2 lymph nodes was too poor to decide the extent of lymph node dissection of < D2. It is adequate to dissect according to at least the D2 criteria in all cases. If the surgeon observes N3 involvement, he should add the D3 dissection.

Adult↗