In 19 patients with closed-loop intestinal obstruction, including 16 patients with strangulating obstruction, the findings at examination with computed tomography (CT) were retrospectively correlated with the surgical and pathologic findings and evaluated by two radiologists. Signs of closed-loop obstruction, present in 15 patients, were associated with the configuration of the incarcerated loop of small bowel, abnormalities detected at the site of obstruction, or both. These abnormalities were the following: a U-shaped, distended, fluid-filled bowel loop; the whirl sign; the beak sign; a triangular loop; two adjacent collapsed loops of bowel at the site of obstruction; or all of these. CT signs of strangulation, seen in 10 of the 16 patients with ischemic or infarcted bowel, were associated with the appearance of the bowel wall (thickening, high attenuation, and the target sign), abnormalities in the attached mesentery, or both. In mechanical obstruction of the small bowel, detection of ischemic changes in the bowel wall or mesentery with CT indicates strangulation. Absence of CT findings of ischemia or infarction does not rule out strangulation.

Significant subfertility exists in patients following unilateral testicular torsion, implying bilateral testicular disease. Immunological activation has been detected after experimental torsion and the present study sought to demonstrate immunologically mediated effects on contralateral spermatogenesis following experimental torsion, as well as quantifying ipsilateral damage. Early and late effects of torsion on bilateral spermatogenesis were studied at 1 and 6 months in 10 groups each containing 20 rats. Gross and histological examination, direct immunofluorescence tests, vas deferens counts and copulation studies were performed. Severe ipsilateral damage was noted, even after brief torsion periods. No contralateral testicular effects, immunological or otherwise, were observed. Ipsilateral damage after torsion may have been underestimated. There is no damage to contralateral testicular exocrine function following unilateral experimental torsion.

SUMMARY A serial study of peripheral blood T lymphocytes in 27 patients with clinically definite multiple sclerosis and 11 healthy controls was carried out over a 12 month period. This showed that contrary to many previous reports, relapses were not consistently associated with reduced numbers of peripheral blood suppressor T lymphocytes or any other T cells. Persistently low T cells numbers, including both the helper and suppressor T cell subsets, were, however, associated with disease activity as measured by the development of increased disability during the course of the study. This was true both for the patients with relapsing/remitting disease and those with progressive disease. The importance of carrying out a serial study was emphasised by the consistent and significant differences that were detected between individuals in both the control and the patient groups. A serial study is the most reliable means by which clinical events can clearly be correlated with laboratory estimations. The association in this study between the development of increased disability and persistently low levels of peripheral blood T lymphocytes suggests that both may be related to the underlying disease process in multiple sclerosis.