Ultrasound screening for Opisthorchis viverrini-associated cholangiocarcinomas: experience in an endemic area.

In Thailand, liver cancer is the most common malignancy in males and the third most common among females. In the Northeast region, cholangiocarcinoma (CHCA) is the prevalent type, with Opisthorchis viverrini (OV), an endemic liver fluke, being considered the cause. We evaluated the role of ultrasound (U/S) for cholangiocarcinoma screening as part of a larger cohort to characterize the linkage between liver fluke infestation and CHCA in Khon Kaen (Northeast Thailand). Most people (77%) had normal U/S findings while only 0.5% had suspected CHCA; thus, U/S should be used primarily for those with the highest risk, presenting symptoms and/or being OV positive.

Value of clinical findings, electrodiagnosis and magnetic resonance imaging in the diagnosis of root lesions in traumatic brachial plexus injuries.

OBJECTIVE: To evaluate the diagnostic value of clinical findings, electromyography and magnetic resonance imaging of root lesions in traumatic brachial plexus injuries MATERIAL AND METHOD: The authors clinically evaluated 175 cervical roots (C5-8, T1) in patients with traumatic brachial plexus injuries then with electromyography and magnetic resonance imaging (MRI). Each finding, taken alone and in combination with each other, was compared with the findings of exploratory surgery. RESULTS: The mean correlations of the clinical findings, electromyography and MRI in relation to the surgical findings were 60, 87 and 70 percent, respectively. The mean correlation was highest (90%) when the positive findings from the clinical, electromyographic or MRI investigations were combined. The correlation of the C5-6 root injuries was improved to 100% though the mean correlation was only 90%. CONCLUSION: The combination of clinical findings and electromyography correlated well with the surgical findings of root lesions caused by traumatic brachial plexus injury. MRI markedly improved identification only of C5-6 root injuries.

Changes in erythrocyte contents of potassium, sodium and magnesium and Na, K-pump activity after the administration of potassium and magnesium salts.

Low potassium and magnesium status and decreased Na, K-pump activity is an endemic condition among rural Northeast Thais. The authors examined the effect of supplementing potassium and magnesium on erythrocyte potassium, sodium and magnesium content and on Na, K-pump activity. Rural Northeast Thai renal stone patients (62) were recruited, divided into four groups and supplemented for one month with potassium chloride (Group1, n = 16), potassium-sodium citrate (Group2, n = 15), chelated magnesium (Group 3, n =16) and potassium-magnesium citrate (Group 4, n =15) in order to achieve 40 mmol potassium, 10 mmol magnesium and 60 mmol citrate daily. After supplementation with potassium (Groups 1, 2 and 4), plasma potassium and Na, K-pump activity rose significantly in Groups 1, 2 and 4, but erythrocyte potassium rose only in Groups 2 and 4. When supplementing elemental magnesium (Groups 3 and 4), the chelated magnesium caused a significant increase in plasma potassium, erythrocyte potassium, sodium and magnesium without a significant increase in Na, K-pump activity. By contrast, potassium-magnesium citrate caused a significant increase in erythrocyte potassium and magnesium and Na, K-pump activity, but depressed erythrocyte sodium. These results suggest the forms of potassium and /or magnesium salts being supplemented should be considered because they affect erythrocyte potassium, sodium and magnesium content and Na, K-pump activity differently.