Computed tomographic evaluation of gastric emphysema--a report of three cases.

We present three patients, one male and two females, who had gastric emphysema demonstrated by computed tomography (CT) by chance. All patients had adenocarcinoma of the gastric antrum resulting in gastric outlet obstruction. We have classified these as the obstructive type of gastric emphysema. An additional cause in two of our patients could be a recent biopsy at UGI endoscopy. In one patient the emphysema was localized and the diagnosis could only have been made by CT. The two other patients had the usual pattern of extensive mural gas along the greater and lesser curvature of the stomach while dissection of gas into the retroperitoneum was present in one of them. There were no systemic effects attributable to the emphysema in all three patients. This reinforces the belief that gastric emphysema is not infective in origin.

Progressive familial intrahepatic cholestasis (Byler's disease) in Arab children.

The clinical, biochemical and histological characteristics in six Arab children with progressive familial intrahepatic cholestasis (PFIC) (Byler's disease) are described. The autosomal recessive mode of inheritance is established. Jaundice and pruritus were early symptoms, with onset in the 1st 3 months in all patients. Other features included growth failure, developmental delay, ataxia, areflexia, gall-stones and epistaxis. Gamma-glutamyl-transpeptidase and cholesterol were normal, but total bile acid levels were uniformly elevated in all patients. Histology showed features of hepato-canalicular cholestasis, lack of bile duct proliferation and fibrosis or cirrhosis in all patients. Five patients who were followed up were alive at a mean age of 75.8 months.

Percutaneous nephrolithotomy in children.

Percutaneous nephrolithotomy was performed on 18 children with renal calculi. No mortality resulted from this procedure and hemorrhage was the major complication. At the end of treatment 67% of the patients were stone-free and 82% of targeted stones were removed. Percutaneous nephrolithotomy can be considered a successful treatment in the management of the pediatric patient with renal calculi.

Immunohistochemical monitoring of metastatic colorectal carcinoma in patients treated with monoclonal antibodies (MAb 17-1A).

A therapeutic trial using repeated doses of a mouse monoclonal antibody against the tumor-associated antigen (TAA) CO17-1A in metastatic colorectal carcinomas was carried out. Metastatic lesions sampled by repeated thick needle (1.2 mm) biopsies during therapy were examined immunohistochemically for the presence of various TAAs, mouse IgG, complement, and infiltrating leukocytes. The CO17-1A was consistently expressed in all cases along the basement membrane of tumor glands and could only be demonstrated on cryostat sections whereas the TAAs GICA19-9, GA73-3, and Br55-2 were also visualized in B5-fixed paraffin-embedded biopsies. The CO17-1A and GA73-3 were predominantly present at the basal region in contrast to the GICA 19-9 and Br55-2 which were predominant at the luminal and the apical region of the tumor glands. Antigenic modulation was not seen either after 24-72 h or during prolonged treatment. In all cases the infused mouse IgG was detected, from 24 h after infusion up to 6-8 weeks, mainly along the basal region of tumor glands. In 13/14 posttreatment biopsies, complement factor C3 was found at the same sites as mouse IgG. In 6 out of 9 posttreatment biopsies an increase in mononuclear cells (monocytes, natural killer (NK) cells and/or T cells) was observed. Monocytes were close to the tumor cells whereas NK cells and T cells were predominantly scattered in the stroma.

Treatment of patients with metastasizing colo-rectal carcinoma with mouse monoclonal antibodies (Moab 17-1A): a progress report.

Eight patients with metastasizing colo-rectal carcinoma have been treated with Moab 17-1A. Before infusion the antibodies were incubated in vitro with isolated autologous blood mononuclear cells (AMC) enriched for monocytes/macrophages. Treatment was given in repeated courses (2-4 times) up to a maximum amount of 1000 mg Moab 17-1A. Two patients had an objective tumor reduction. In further four patients a period of stable disease varying between 3-6 months on was observed. Therapy was well tolerated. Out of 24 treatment courses only on one occasion an anaphylactoid reaction occurred at the third infusion. All patients developed anti-mouse antibodies of IgG and IgM class with increasing levels during the course of therapy. Repeated tumor biopsies and immunohistochemical analyses showed no antigenic modulation, a weak staining for mouse IgG, no deposits of complement components but no obvious increases in the number of cells infiltrating the tumors 24 h after infusion of antibody-armed AMC.

Alcohol occlusion of segmental renal arteries as alternative to kidney resection.

Treatment of postoperative urine leakage after a lower pole resection by embolic occlusions of segmental arteries using pure ethanol in a thirty-four-year-old man is described. There were no postoperative complications, and follow-up examination at two years showed a functioning but small kidney in a patient without symptoms.

Small renal caliceal calculi as a cause of pain.

We report 7 cases of long-standing lumbar or flank pain associated with small renal calculi located peripherally in a calix and no obvious obstruction. After stone removal by percutaneous puncture the patients were relieved of the pain.

Haemorrhagic right upper lobe infarction as a complication in primary end-to-end anastomosis of oesophageal atresia.

The clinical and radiological features of right upper lobe haemorrhagic infarction as a complication to end-to-end anastomosis in oesophageal atresia are presented.

Bone mineral content in women with Colles' fracture: effect of calcium supplementation.

The effect of dietary calcium supplementation on bone mineral content was studied in 40 postmenopausal women with Colles' fracture. The participants were divided into two groups which were given either placebo or 1 g of calcium per day. The bone mineral content of the femur was determined before and after 1 year of medication. Women with Colles' fracture were found to have the same mineral content in the femur as age-matched controls without fractures. Calcium supplementation had no significant effect on the bone mineral content.

Soft tissue abnormalities at fracture of the scaphoid.

In a retrospective examination of the films from 53 cases with fracture of the scaphoid it was possible to demonstrate soft tissue alterations within the scaphoid fossa. All these cases were examined adequately, i.e. with correct projections and satisfactory penetrating exposure. A somewhat higher quality of the views was obtained on industrial film.