Adrenal neuroblastoma in the aged

A case of adrenal neuroblastoma in the aged is presented because of its rarity in this age group, particularly after 60 years of age. The diagnostic problem is presented for this type of tumor can easily be confused with any of the more common abdominal tumors in the elderly group of patients. The clinical features and diagnostic procedures are discussed. (Summary)

The accuracy of diagnostic tools in hepatic diseases utilizing scintiscan angiography and laparoscopy

1. One hundred twenty-one cases of problematic liver diseases comprised the material of this study, consisting of 48 hepatomas, 32 amoebic abscesses, 28 schistosomialsis and 13 tuberculomas2. The clinical features, objective findings, liver function abnormalities, and even some radiographic presentations, closely resemble each other, thus raising problems in definitive diagnosis3. The Scintiscan is effective in showing hepatic architectural distortions, while not actually specifying the nature of the lesion, helps in the eventual diagnosis4. Angiography is an effective diagnostic technique in showing characteristic vascular patterns. We have established as the first report in this country the vascular pattern within the liver in tuberculosis and schistosomiasis5. Laparoscopy is the confirmatory procedure, which is simple, safe, and highly accurate. (Summary)

Electrocardiographic monitoring during sigmoidoscopy

The study was conducted to document any changes in the electrocardiographic tracing in patients undergoing sigmoidoscopy and to evaluate the clinical significance of these changes. It also studied the relation of these changes to the age of the patient, the position assumed during examination, the level of instrumentation, and the inflation of the colon with airTwenty-four patients (13 females and 11 males) with gastrointestinal symptoms divided into two groups of 12 were monitored electrocardiographically during proctosigmoidoscopy at the University of Santo Tomas Hospital Clinical Division. History and physical examinations were performed. The Welch-Allyn proctosigmoidoscope set was used in all these examinationsFindings showed that all 24 patients had no heart disorder by history, physical examination, and the pre-procedure electrocardiography. In the first group who were placed on their left lateral decubitus position, five showed sinus tachycardia which ranged from 120/min - 130/min. In the second group who were placed on their knee-chest posture, only two showed sinus tachycardia, which ranged from 110/min - 130/min. Sinus tachycardia did not appear to be related to the age of the patient, the level of the insertion of the scope and air inflation in both groups. No other electrocardiographic changes were notedProctosigmoid, therefore, is a safe procedure to use in any age group especially in the absence of any cardiac disease

Amoebic liver abscess at Santo Tomas University Hospital Clinical Division 1966-1970

Fifty-two cases of amoebic liver abscess were seen at the Santo Tomas University Clinical Division during the period, 1966-1970The majority were in their third and fifth decades of life, mostly males. Clinically, the high incidence of fever and tender hepatomegaly was noteworthy. Differing from other reports was the frequency of jaundice, 67.3 per centOf the various liver function tests, the elevations of serum globulin and alkaline phosphatase were the more constant. Serum transaminase levels were often below 100 units, although a few showed elevations simulating those seen in viral hepatitis. The nature of the bilirubin picture was obstructiveThe findings on double contrast studies are reported. The appearance of the hepatic surface as photographed during peritoneoscopy in liver abscess is included. The elevation of the right diaphragm and the pleural reactions seen in the chest X-ray films rallied with previous reportsThe results of the various therapeutic methods agree with the recent trend towards medical conservatism; not only that none died nor developed any complications when treated conservatively, but that the duration of hospital confinement was shorter. One impressive observation as that the abscess cavity can resolve in record time without the need of any aspiration, as shown by serial hepatic scanningDeath is certain in those who are not treated. The mortality is high in those who are complicated by perforations of the abscess, either into the pericardial, pleural or peritoneal cavities. (Summary)