Magnetic Resonance Urography in Obstructive Uropathy.

BACKGROUND: Urinary obstruction is one of the few reversible causes of renal failure. Early diagnosis and treatment can salvage the kidney. Presently intravenous urography, ultrasonography, computed tomography and magnetic resonance imaging are in vogue to detect the cause and demonstrate the site of obstruction. METHODS: An evaluation of imaging technique in obstructive uropathy was undertaken in a group of 25 patients. RESULT AND CONCLUSION: Magnetic resonance urography delivered highest accuracy amongst the techniques studied.

Binding of diclofenac sodium with bovine serum albumin at different temperatures, pH and ionic strengths.

The study was designed to examine the binding of diclofenac sodium with bovine serum albumin (BSA) at different temperatures (20 degrees, 30 degrees and 40 degrees C), pH (6.4, 7.4 and 8.4) and ionic strengths (micro = 0.1, 0.2 and 0.3) by means of equilibrium dialysis method. The concentration of diclofenac sodium was maintained at wider range from 15 to 900 micromole/l and BSA concentration was maintained at 61.5 micromole/l. The data obtained were interpreted by nonlinear regression method using Graphpad prism software. The analysis showed that the interaction between diclofenac sodium with BSA results in two-site saturable binding. A decrease in association constant was observed with increasing temperature. The average standard free energy change (deltaGdegrees) value was -7.07 (site I) and -4.2 (site II) Kcal/mol. The standard enthalpy change (deltaHdegrees) and the standard entropy change (deltaSdegrees) were -7.8 Kcal/mole, -2.35 cal/mole (site I) and -7.4 Kcal/mole, -10.5 cal/mole (site II), respectively. The negative enthalpy change suggested the binding between diclofenac sodium and the binding sites of BSA were spontaneous and exothermic. The negative value of deltaHdegrees and deltaSdegrees indicated hydrogen bonding and van der Waal's force was the major mechanism for diclofenac sodium and BSA interaction. Increase in pH and ionic strength also caused decrease in association constant of diclofenac sodium and BSA binding.

Conventional B-mode Ultrasonography for Evaluation of Retinal Disorders.

Sonographic study of 164 patients (328 eyes) in the present series highlights the advantages of ocular ultra sonography (B-mode) in the evaluation of retinal disorders especially in patients with opaque ocular media. B-mode sonography of the eye is a rapid, cheap, safe and reliable investigation for the eye. The sensitivity and specificity of this modality in detecting ocular pathologies has been recorded as extremely high and is of great value to the eye surgeon for a preoperative assessment of the posterior segment when fundoscopy is not possible due to opaque ocular media from various causes.

NEED FOR PRECISE PROTOCOL IN MAGNETIC RESONANCE IMAGING OF THE POST OPERATIVE SPINE.

Gadolinium enhanced Magnetic Resonance Imaging (MRI) for the evaluation of the post operative lumbo-sacral spine is a sensitive and specific imaging technique. A need for establishing a specific protocol for Failed Back Surgery Syndrome (FBSS) for use in the service hospitals is highlighted for convenience of patient management and preservation of active manpower. The MR scan of 50 patients performed over a span of six months, who complained of persistent low backache even after surgery, were retrospectively analysed. The specificity of this series using MRI in indicating the exact cause of FBSS was clocked at only 30%. The conditions diagnosed were rectifiable. The balance of the patients who could not be offered any specific diagnosis towards the cause, were being managed conservatively / placed in low medical category for a considerable period. It was noted with concern that there was non prevalence of sequence like the fast spin echo with gadolinium enhancement as a routine.

Gastroduodenal obstruction from ovarian cancer: imaging features and clinical outcome.

OBJECTIVE: The purpose of this study was to describe the imaging features and clinical significance of gastroduodenal obstruction from ovarian cancer. MATERIALS AND METHODS: Eleven women with symptomatic gastroduodenal obstruction were identified over a 3-year period of prospective clinicoradiological review of cases managed in a specialist gynaecological oncology unit, during which period 438 women with ovarian cancer were managed. Imaging features were verified by surgery, intervention and clinicoradiological follow-up for a minimum of 12 months or until death. Management and outcome were independently reviewed by a medical oncologist not involved in primary care. RESULTS: The frequency of gastroduodenal obstruction was 2.5% (11 of 438 women). Disease stages of these women at initial diagnosis were: stage II (four women), stage III (six), stage IV (one). Histology was grade 3 in eight of the 11 women. Symptomatic gastroduodenal relapse occurred at 9-103 months after initial diagnosis (median 20 months). There were five cases of predominant involvement of the gastric body and six of the gastric outlet and duodenum. In six cases, focal mass disease resulted in obstruction, in two cases there was diffuse gastric invasion, and in three cases encysted malignant ascites in the lesser sac caused gastric compression/obstruction - the 'squashed stomach syndrome'. Diagnosis of obstruction was with CT in 10 of 11 cases. Palliative interventional procedures relieved symptoms in these three cases, surgery was performed in three cases and the remainder were treated with chemotherapy and other palliative measures. Two women are alive and well at 16 and 38 months who had loculated ascitic disease. Otherwise median survival was 5 months after symptomatic gastroduodenal involvement. CONCLUSIONS: Gastroduodenal obstruction is rare in women with ovarian cancer. Identification and drainage of encysted lesser sac ascites as its cause may be associated with long term survival, otherwise the prognosis is poor. CT accurately demonstrates the level and cause of obstruction and gives information about the wider extent of recurrent disease.

MAGNETIC RESONANCE IMAGING IN FAILED BACK SURGERY SYNDROME.

The failed back surgery syndrome (FBSS) is a severe, long-lasting, disabling and relatively frequent (5-10%) complication of lumbosacral spine surgery. Wrong level surgery, inadequate surgical techniques, vertebral instability, recurrent disc herniation, and lumbosacral fibrosis are the most frequent causes of FBSS. The results after repeated surgery on recurrent disc herniations are comparable to those after the first intervention, whereas repeated surgery for fibrosis gives only 30-35% success rates, and 15-20% of the patients report worsening of the symptoms. MRI has allowed a differentiation between these two pathologies for selection of different therapies. Gadolinium enhanced MR is at present the single most sensitive and specific imaging modality available to the neuro radiology imager for the evaluation of the post operative lumbosacral spine in the patient presenting with FBSS. Medical imaging specialists and clinicians need to better understand the origins and means of avoiding the FBSS, to more clearly focus the post operative imaging evaluation and to more successfully link the clinical diagnosis and the imaging findings with optimised patient therapy.

Diet and serum iron status in pregnant and lactating Hausa women in Kano State, Nigeria.

Serum iron concentrations were studied in two groups of Hausa women, one of pregnant subjects attending the antenatal clinics at a health centre and one of lactating subjects attending the centre's postnatal clinics. It was thought possible that the normal diet of the pregnant women had sufficient iron content to meet the women's increased demands for this metal. Of the pregnant women, 17% had serum iron concentrations of < or = 490 micrograms/litre [14% with microcytic hypochromia and a mean cell haemoglobin concentration (239 +/- 2 g/litre) indicative of iron deficiency, plus 3% with normocytic-microcytic hypochromia] and 7% had normocytic-microcytic cells and 525 +/- 25 micrograms iron/litre of serum. The low serum iron in 17% of the pregnant women may be the result of repeated pregnancies without proper child spacing, leading to maternal iron deficiency syndrome, or of infestation by the parasites that are prevalent in rural areas, or to both. None of the lactating mothers was found to be iron deficient and there were apparently no cases of haemosiderosis. Mean (+/- S.D.) blood haemoglobin concentrations (87.5 +/- 1.3 g/litre), packed cell volumes (32 +/- 3.2%), mean cell haemoglobin concentrations (274 +/- 37 g/litre) and serum iron concentrations (735 +/- 261 micrograms/litre) were all significantly lower in the pregnant women (P < 0.001) than in the lactating women (105.7 +/- 12.9 g/litre, 36.8 +/- 3.4%, 288 +/- 32 g/litre and 1154 +/- 277 micrograms/litre, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Evidence for the involvement of an energy-dependent process in gonadotropin-releasing hormone-stimulated luteinizing hormone release by rat anterior pituitary.

The involvement of an energy-dependent process in gonadotropin-releasing hormone-(GnRH) stimulated LH release in the anterior pituitary has been examined. Inhibitors of both glycolysis and oxidative phosphorylation inhibited stimulation by GnRH of LH release in a time- and dose-dependent manner. Iodoacetate and 2-deoxyglucose inhibited GnRH-stimulated LH release, and this inhibition was not overcome by the addition of pyruvate. Similarly carbonyl cyanide m-chlorophenylhydrazine, an uncoupler of oxidative phosphorylation, and sodium azide, an inhibitor of electron transport, decreased ATP levels, enhanced lactate accumulation, and inhibited GnRH-stimulated LH release. These studies demonstrate that inhibition of glycolysis and oxidative phosphorylation with metabolic inhibitors lead to inhibition of GnRH-stimulated LH release. Based on these results, it is postulated that GnRH-stimuoated LH release is dependent on an energy-dependent process.

Progesterone binding by human endometrial tissue during the proliferative and secretory phases of the menstrual cycle and by hyperplastic and carcinomatous endometrium.

Cytosol receptors for progesterone were assayed in human endometrial tissue during the proliferative and secretory phases of the menstrual cycle and in the hyperplastic and carcinomatous endometrium. The assays were performed utilizing a technique involving prior treatment of the cytosol extract with dextran-coated charcoal to remove endogenous progesterone. The results showed that the progesterone receptor activity was higher during the later proliferative and early secretory phases of the menstrual cycle. Hyperplastic and carcinomatous endometrium also contained specific cytosol receptor for progesterone, and the binding activity of the hyperplastic endometria and endometrial polyps was comparable to that found during the later proliferative phase of the menstrual cycle. No apparent correlation between the progesterone receptor level and the morphologic degree of differentiation in Grades 1 and 2 adenocarcinomas of the endometrium was observed.

Oestradiol receptors in the rat anterior pituitary gland during the oestrous cycle: quantitation of receptor activity in relation to gonadotrophin releasing hormone-mediated luteinizing hormone release.

Specific oestradiol binding to a receptor in nuclear and cytosol fractions of the rat anterior pituitary gland and pituitary responsiveness to gonadotrophin releasing horomone (GnRH) during the oestrous cycle have been studied. To accomplish this, both unoccupied and occupied oestradiol-binding sites in the nucleus and total cell were measured during the oestrous cycle. The concentration of unoccupied and occupied sites and total oestradiol binding in the cytosol fluctuated during the cycle. At pro-oestrus, the concentration of cytosol receptor was diminished by about 40% and replenishment occurred during oestrus. On the other hand, a profound increase is concentrations of cellular and nuclear receptors occurred at pro-oestrus. Administration of GnRH significantly LH release at all stages of the cycle. The maximum stimulation of LH release by GnRH was observed at 13.00 h of pro-oestrus. From these studies, it is concluded that pituitary responsiveness to exogenous GnRH during pro-oestrus parallels the changes in the content of oestrogen receptors in the cytosol and nucleus.

Binding of progesterone in the human Fallopian tube.

PIP: The uptake, subcelluar distribution, and other characteristics of progesterone binding in the human fallopian tube are presented. 65% of the radioactivity of tritiated progesterone was found in the fraction composed of nuclei, cell membranes, unbroken cells and heavy particulate matter after centrifugation. Mitochondria and microsomes had about 25% of the total radioactivity. A dissociation constant (Kd) of 5.9 x 10 to the minus 10 M was determined for the steroid binding proteins, with a probable concentration of total cytoplasmic binding sites for progesterone in each fallopian tube of 1.26 pmoles.^ieng