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Ultrasonography versus roentgenography in suspected instances of cholecystolithiasis.

In a consecutive series of 102 patients with no jaundice and with symptoms of cholecystolithiasis, the predictions from both ultrasonography and cholecystography were compared with the final diagnosis. The accuracy of both examinations was high. However, in 38 per cent, single dose oral cholecystography failed to visualize the gallbladder whereas ultrasonography was conclusive in all patients. Judged by a simple scoring system, ultrasonography obtained a significantly better score than cholecystography (p less than 0.01) and an insignificantly better score than combined oral and intravenous cholecystography (0.05 less than p less than 0.1). Ultrasonography is recommended as the primary investigation in suspected instances of cholecystolithiasis.

Adult↗

Left ventricular hypertrophy in adolescents with elevated blood pressure: assessment by chest roentgenography, electrocardiography, and echocardiography.

The purpose of this study was to assess the prevalence of left ventricular hypertrophy in adolescents with persistently elevated blood pressures. Chest roentgenograms, electrocardiograms, and echocardiograms were performed on 50 adolescents with elevated blood pressure and 50 matched normotensive control subjects. No subject in either group demonstrated cardiomegaly on x-ray. Interpretation of the electrocardiograms indicated that similar numbers of both hypertensive (7/50) and control subjects (8/50) had ECG evidence of left ventricular hypertrophy. The echocardiograms showed that the mean left ventricular wall thickness (LVWT) in the hypertensive adolescents was 7.8 mm +/- 0.1 (SE), compared with 6.5 +/- 0.1 in the control subjects (P less than .001). When the measurements were indexed to body surface area, the difference remained highly significant. Indexed left ventricular mass (LVM)/body surface area (BSA) was also significantly greater (P less than .001) in the hypertensive (84.2 gm/sq m +/- 2.1) than in the control subjects (72.0 +/- 2.1). Using data from the normotensive control subjects, we defined the 95th percentile for both LVWT/BSA and LVM/BSA. Among hypertensive adolescents, 9/50 had LVWT/BSA and 8/50 had LVM/BSA above this level. For control subjects, only 1/50 had elevated LVWT/BSA values and 2/50 elevated LVM/BSA values. This study demonstrates that hypertensive adolescents have an increased prevalence of left ventricular hypertrophy and that echocardiography is the most useful noninvasive method to detect these changes.

Adolescent↗