[Nonocclusive ischemia of the right colon]. / Nichtokklusive Ischämie (NOI) des rechtsseitigen Kolons.

BACKGROUND: Nonocclusive disease (NOD) is known to be a common cause of ischemic colitis, which is frequently underestimated. MATERIAL AND METHODS: A computer-assisted search of radiological reports at our institute over a period of 18 months, describing ischemic colitis of the ascending colon with an unimpaired perfusion of the superior mesenteric artery, was performed. RESULTS: A retrospective analysis of the clinical and radiological data of 14 patients was performed. In ten cases colonic ischemia was confirmed clinically or intraoperatively. Most of our patients needed intravenous catecholamines due to severe hypotension. However, no significant radiographic predictors could be identified. CONCLUSION: Awareness of NOD seems to be crucial. Especially in cases of acute abdominal pain associated with severe hypotension, renal insufficiency, or pancreatitis, one should include NOD as a differential diagnosis at an early stage.

Hippocampal volume and cognitive performance in long-standing Type 1 diabetic patients without macrovascular complications.

AIMS: Hippocampal atrophy and memory deficits have been reported in Type 2 diabetes. Whether similar alterations occur in Type 1 diabetes is currently unknown. METHODS: In a case-control design, 13 Type 1 diabetic patients with at least 10 years' duration of disease, but free from clinical signs of macrovascular disease, were compared with age- and gender-matched control subjects. Hippocampal volume and measures of global cerebral cerebrospinal fluid (CSF) were determined from magnetic resonance imaging (MRI) scans. Cognitive functions were assessed using four neuropsychological tests. Mood and depression were measured by questionnaires. RESULTS: Hippocampal volume and memory did not differ between Type 1 diabetic patients and control subjects. However, a significantly increased amount of cerebral CSF suggestive of mild cerebral atrophy was observed in the patients. In addition, deficits in psychomotor speed and selective attention were apparent. Eleven of 13 patients had retinopathy and/or nephropathy. Findings were unrelated to cerebrovascular disease, white matter disease or silent strokes. CONCLUSIONS: Results from our small study in Type 1 diabetic patients do not support findings from previous studies of Type 2 diabetic patients demonstrating reductions in hippocampal volume and impaired memory. On the contrary, we observed evidence for mild cerebral atrophy and impaired psychomotor speed and selective attention. This is in line with some previous studies in Type 1 diabetes. If replicated in larger studies, our findings would support the idea that the effects on brain function and structure differ between Type 1 and Type 2 diabetes.

Primary non-Hodgkin's lymphoma of bone: three cases and a short review of the literature.

Primary non-Hodgkin's lymphoma of bone (PLB) is a rare entity. We present three new cases and a review of the literature. If PLB is suspected radiologically, the diagnosis must be confirmed by open biopsy. Histopathologically, PLB usually represents diffuse large B-cell lymphoma or lymphoma of the follicular center type. The extent of local disease manifestation, additional skeletal involvement, and the presence or absence of lymphadenopathy is assessed by radiological examination. Localized stages of the disease require involved-field radiotherapy (45-50 Gy) to the entire bone that is affected. Regional lymphatics must also be irradiated. Radiotherapy may be required immediately to prevent pathological fractures. In the few cases of more widespread skeletal or extraskeletal involvement, radiotherapy of the major site of manifestation may be followed by a "watch-and-wait" strategy until progression of the disease becomes apparent. In cases of intermediate or high-grade lymphoma of bone, combined radiochemotherapy is the treatment of choice for all stages. Six to eight cycles of chemotherapy (usually the CHOP regimen) are recommended for remission induction. This is followed by involved-field radiotherapy with 45-50 Gy. High-dose chemotherapy with autologous stem cell support is an option if there is no satisfactory response to conventional chemotherapy, or if early relapse occurs.