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PubMed · 3386924

Testing for abdominal fluid.

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C E Smith. 1988. Testing for abdominal fluid.. https://pubmed.ncbi.nlm.nih.gov/3386924/

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Estimation of postmortem interval. Temperature-correction of extracellular abdominal impedance during the first 21 days of death.

Extracellular impedance of the intact abdomen of rats increased from 79.0+/-7.4Omega, 1h postmortem (i.e. 0.04 day), to 130.5+/-14.4Omega at postmortem interval (PMI)=1 day. Impedance then decreased with time, reaching 64.2+/-9.9Omega at PMI=21 days. The time taken for mean abdominal impedance to decrease below the value at PMI=0.04 day averaged 16 days. It is therefore impossible, using extracellular abdominal impedance alone, to distinguish (in terms of interpolating PMI) between numerically equal impedances on the rising and falling phases of curves depicting impedance as a function of PMI. Correction of measured impedances to their theoretically-predicted values at an arbitrarily chosen temperature of 40 degrees C appreciably diminished the magnitude of the increase in impedance following death. Thus, temperature-corrected abdominal impedance increased from 56.2+/-4.8Omega at PMI=0.04 day to 59.5+/-6.2Omega at PMI=1 day. Impedance then decreased, reaching 29.2+/-4.1Omega at PMI=21 days. The time taken for mean, temperature-corrected abdominal impedance to decrease below the value at PMI=0.04 day averaged 3 days (as opposed to 16 days (see above) in the absence of temperature-correction). These findings are believed to improve the usefulness of extracellular abdominal impedance as a potential tool for estimation of postmortem interval.

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Abdominal obesity is associated with accelerated progression of carotid atherosclerosis in men.

Abdominal obesity increases the risk of clinical atherosclerotic diseases, but whether it accelerates the progression of preclinical atherosclerosis is unknown. We studied whether waist-to-hip ratio (WHR) and waist circumference are associated with 4-year increase in indicators of common carotid atherosclerosis, assessed by B-mode ultrasonography, in 774 Finnish men aged 42-60 years without atherosclerotic diseases. Men with WHR of <0.91, 0.91-0.96 and >0.96 (thirds) had increase in maximal intima-media thickness (IMT) of 0.230, 0.255 and 0.281 mm/4 years (P=0.007 for linear trend; P=0.025 for difference) and plaque height of 0.241, 0.254 and 0.291 mm/4 years (P=0.005, P=0.013) adjusting for age, body mass index and technical covariates. Men with waist circumference of <85, 85-93 and >93 cm (thirds) had increase in maximal IMT of 0.227, 0.251 and 0.290 mm/4 years (P=0.011, P=0.035) and plaque height of 0.229, 0.263 and 0.296 mm/4 years (P=0.003, P=0.013). These associations were stronger in men with high (> or =3.8 mmol/l) than lower serum LDL cholesterol (P<0.05 for interaction). This is the first documentation that abdominal obesity is associated with accelerated progression of atherosclerosis, and supports the view that it is an important cardiovascular risk factor. This study emphasizes the role of avoiding abdominal obesity to prevent atherosclerotic diseases.

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Sonographic findings in achalasia.

PURPOSE: The aim of this study was to describe the sonographic features of achalasia. METHODS: Thirty-five patients with achalasia (17 men and 18 women; mean age, 43 years) were examined with transabdominal sonography, and the findings were compared with those in 41 volunteers without esophageal disease (21 men and 20 women; mean age, 41 years), 10 patients with gastroesophageal junction carcinoma (7 men and 3 women; mean age, 55 years), and 4 patients with peptic stricture (3 men and 1 woman; mean age, 39 years). The distal end of the esophagus was evaluated, and the thickness of the esophageal wall was measured. RESULTS: In 28 fasting patients (80%) with achalasia, sonography showed dilatation, retention of fluid, and smooth narrowing of the distal esophagus (like a bird's beak). These findings were not identified in the other patients or volunteers. In addition, in 6 of 7 achalasia patients who had no sign of esophageal dilatation in the fasting state, water retention was demonstrated after ingestion of water, bringing the total number of patients with achalasia with positive sonographic findings to 34 (97%). In patients with achalasia, the mean thickness (+/- standard deviation) of the esophageal wall at the gastroesophageal junction was 4.8 +/- 0.9 mm (range, 3.6-7.2 mm). The thickening was regular, symmetric, and localized to the gastroesophageal junction. In the volunteers, the mean thickness of the esophageal wall was 2.3 +/- 0.5 mm (range, 1.4-3.5 mm). The difference between the 2 groups was statistically significant (p < 0.001). In the patients with carcinoma, the mean wall thickness was 17.0 /+ 1.1 mm, and the thickening was irregular. In the patients with peptic stricture, the mean wall thickness was 5.1 +/- 1.1 mm (range, 3.8-8.3 mm), and the thickening was irregular and occupied a longer segment of the distal esophagus. CONCLUSIONS: In patients with achalasia, transabdominal sonography clearly shows the regular thickening of the esophageal wall, water retention, dilatation of the distal esophagus, and the bird's beak appearance. Sonography may help in differentiating achalasia from carcinoma and peptic stricture of the gastroesophageal junction, which is difficult to do with other modalities.

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