Diagnostic performance of chest CT average intensity projection (AIP) reconstruction for the assessment of pleuro-parenchymal abnormalities.

AIM: The comparison between chest x-ray (CXR) and computed tomography (CT) images is commonly required in clinical practice to assess the evolution of chest pathological manifestations. Intrinsic differences between the two techniques, however, limit reader confidence in such a comparison. CT average intensity projection (AIP) reconstruction allows obtaining "synthetic" CXR (s-CXR) images, which are thought to have the potential to increase the accuracy of comparison between CXR and CT imaging. We aim at assessing the diagnostic performance of s-CXR imaging in detecting common pleuro-parenchymal abnormalities. MATERIALS AND METHODS: 142 patients who underwent chest CT examination and CXR within 24 hours were enrolled. CT was the standard of reference. Both conventional CXR (c-CXR) and s-CXR images were retrospectively reviewed for the presence of consolidation, nodule/mass, linear opacities, reticular opacities, and pleural effusion by 3 readers in two separate sessions. Sensitivity, specificity, accuracy and their 95% confidence interval were calculated for each reader and setting and tested by McNemar test. Inter-observer agreement was tested by Cohen's K test and its 95%CI. RESULTS: Overall, s-CXR sensitivity ranged 45-67% for consolidation, 12-28% for nodule/mass, 17-33% for linear opacities, 2-61% for reticular opacities, and 33-58% for pleural effusion; specificity 65-83%, 83-94%, 94-98%, 93-100% and 79-86%; accuracy 66-68%, 74-79%, 89-91%, 61-65% and 68-72%, respectively. K values ranged 0.38-0.50, 0.05-0.25, -0.05-0.11, -0.01-0.15, and 0.40-0.66 for consolidation, nodule/mass, linear opacities, reticular opacities, and pleural effusion, respectively. CONCLUSION: S-CXR images, reconstructed with AIP technique, can be compared with conventional images in clinical practice and for educational purposes.

Isolation of Chlamydia trachomatis during IVF-ET.

The Authors isolated Chlamydia Trachomatis from the granulosa and from the spermatozoa of an infertile couple taking part in the IVF-ET program at the Department of Obstetrics and Gynaecology of the University of Pisa.

A possible role of Chlamydia trachomatis in unexplained infertility and sterility.

To estimate the presence of latent Chlamydia Trachomatis (C.T.) infections, we have carried out a study on a selected group of couples affected by unexplained sterility and infertility. We examined 193 women and, as control group 210 healthy fertile women. For both groups the main risk factors that could explain the infection epidemiology have been analyzed. The parameters considered are age of first intercourse, number of partners, social-economic conditions and number of voluntary abortions. Amongst all the causal agents of sexually transmitted diseases (STD), C.T. was most common, with an incidence of about 12 per cent in the study group versus the 5.7 per cent of the control group (chi 2 = 4.12).

PIP: The incidence of Chlamydia infection and factors associated with it in 193 women consulting for infertility was analyzed in comparison with 210 matched controls. All study subjects received a clinical exam, history interview, Pap test, vaginal bacteriology, colposcopy, cervical virology for Chlamydia and enzyme-linked assay for Chlamydia, herpes, rubella and toxoplasma antibodies. Results were tabulated as percent distributions for Chlamydia-positive and -negative in index cases and controls, broken down by the descriptive factors, age at 1st intercourse, number of partners, socio economic class and numbers of induced abortions. 43.5% of the index cases had primary infertility, 21.7% had secondary infertility and 34.8% were sterile. 11.9% of the study group were positive for Chlamydia infection, compared to 5.7% of controls. The only significant difference in factors related to STD infection were: earlier age at 1st intercourse among controls; higher percentage with 3 sexual partners, higher socioeconomic class and more induced abortions in the study group of infertile women; but no difference in chlamydia infection rates with abortion history. This study is unusual in finding higher socioeconomic class in the infertile women than in controls.

Captopril mediated decrease of aortic regurgitation.

The effect of captopril mediated afterload reduction on aortic regurgitation was investigated in 10 patients. Regurgitation was quantitated by means of the regurgitation fraction and the relation of regurgitant volume to end diastolic volume. These variables were derived from gated radionuclide ventriculography. After captopril treatment the blood concentration of angiotensin I rose whereas that of angiotensin II fell significantly. The conversion of angiotensin I to II was reduced to about 50% of the control value. Whereas blood pressure and heart rate did not change significantly, the regurgitation fraction and the regurgitant volume, normalised to end diastolic volume, were significantly reduced by captopril treatment. The ejection fraction remained essentially unchanged. These findings suggest that captopril reduces aortic regurgitation by reducing afterload.

[Results of treatment of achalasia with special reference to gastroesophageal reflux]. / Behandlungsergebnisse der Achalasie unter besonderer Berücksichtigung des gastrooesophagealen Refluxes.

Patients with achalasia, which had been treated in the Department of Surgery, University of Bonn, from 1953 to 1983 (n = 142), were examined by a detailed questionnaire (n = 90), endoscopy and biopsy (n = 47), esophagography (n = 53) and by gastric reflux scintigraphy (n = 12). The results of dilatation and surgical procedures are compared. Although the incidence of gastric reflux was very seldom, an esophagitis could be seen frequently. The dilatation of the esophagus is succeeded, if there is left any myogenic tone. Otherwise an esophagomyotomy by left thoracotomy should be performed without an antireflux operation.