[Color Doppler in the echographic evaluation of breast nodules]. / Il contributo del Color Doppler nella valutazione ecografica dei noduli mammari.

The authors report on their experience with color Doppler sonography in the diagnosis of solid breast masses. Twenty-two patients were examined; breast masses were studied with B-mode US first, and then with color Doppler US to evaluate eventual tumor vascularization. Color Doppler US demonstrated only one vascular pole in histologically confirmed benign masses. On the contrary, in 92.8% of histologically confirmed malignant masses, color Doppler easily depicted 2 or more groups of nutritional arteries. Color Doppler makes the diagnosis of malignant masses easier, thus allowing, in the author's opinion, a reduction in the number of biopsies of solid breast masses clinically/mammographically detected. The use of color Doppler US is therefore suggested: the technique is noninvasive, fast, and easy and its widespread use would translate into advantages for both the patient and the clinician.

[Doppler color in the echographic study of hyperplastic parathyroid glands]. / II contributo del color Doppler nello studio ecografico delle ghiandole paratiroidi iperplasiche.

The sonographic examination of hyperplastic parathyroid glands is a well-known and appreciated technique. However, its diagnostic contribution is still somehow inadequate, due to the difficult differential diagnosis of the various solid hyperechoic nodular structures in the neck and to the presence of frequently ectopic glands. The combined use of B-mode and color-Doppler US allows the vascular features of suspicious parathyroid nodules to be satisfactorily demonstrated. Higher sensitivity and specificity than conventional US are the main advantages of this technique. Still, further research is needed for B-mode color-Doppler US to actually replace fine needle biopsy in confirming the diagnosis.

Serum enzymes in acute myocardial infarction after intracoronary thrombolysis.

Serum kinetics of total creatine kinase (CK), CK-MB isoenzyme, aspartate aminotransferase (AST), lactate dehydrogenase (LD) and alpha-hydroxybutyrate dehydrogenase (HBD) activities were studied in twenty patients with acute myocardial infarction randomly assigned to receive either intracoronary urokinase (group A) or conventional (control) therapy (group B). The temporal characteristics of enzyme changes described were the time lag from onset of chest pain until maximum catalytic concentration value, the rate at which enzymes are released into blood, the peak value of the serum enzyme curves and (d) the fractional disappearance rate (Kd) for each enzyme considered. Thrombolytic treatment induced earlier peak times in group A: for CK, 10.8 vs 27.0 h, for CK-MB, 10.4 vs 23.1, for AST, 13.9 vs 31.3, for LD, 24.4 vs 49.1, and for HBD, 20.5 vs 48.5 (for all enzymes, p less than 0.001). The maximal rate of release for the enzymes was at least twofold greater in group A. Enzyme peak activities and Kd were not significantly different between the groups. The most significant discrimination between the two groups was obtained with AST peak time (Hartz overlap index (Oi) = 0.11) and CK-MB peak time (Oi = 0.12).