Routine computed tomography of the brain in headache patients with normal physical and neurologic exams and no unusual clinical symptoms has a low likelihood ratio for discovering significant intracranial disease.

The metabolism of albumin and IgA was studied in normal and lactationg mice. Lactation resulted in significant changes in the metabolism of these proteins. The serum albumin concentration was lowered from 47 mg/ml in normals to 24 mg/ml in lactating mice. However, only a slight decrease in the serum concentration of IgA was observed during lactation. The proportion of polymeric and monomeric IgA in serum and milk was evaluated by gel exclusion chromatography. The onset of lactatin led to a rise in the proportion of polymeric IgA (P-IgA) in serum from 37% to 51%. The proportion of P-IgA in milk was 65% and remained constant throughout lactation. P-IgA and albumin were shown to be efficiently transferred from the serum of lactating mice into their milk. Serum decay studies were performed to evaluate the turnover of the serum pools during lactation. The rates of disappearance from the serum of isotopically labeled albumin and P-IgA were observed to increase dramatically during lactation, suggesting that both of these two mild proteins might be derived at least in part from the serum. The sites of synthesis of mild IgA (local vs. extra-mammary gland) were evaluated by determining the extent of dilution of isotopically labeled serum IgA during transport through the mammary gland into the milk. Early in lactation, the majority of the IgA in mouse milk appeared to be derived from distant sites and transferred via the blood to the mammary gland. However, by day 8 of lactation, the isotopically labeled P-IgA in milk was significantly diluted by the IgA synthesized in the mammary gland. Albumin and IgG were not diluted by local synthesis indicating that these proteins were exclusively serum-derived.

The presence of echogenic gas bubbles in the wall of the bowel, often seen as a circle within the circumference of the bowel, may be helpful in diagnosing PI on ultrasound using HRUS.

Chordomas are rare bone tumors of notochord remnants that may occur anywhere within the axial skeleton. The standard of care is complete surgical removal. Proton beam irradiation is commonly used when the tumor is inaccessible or has recurred. Chemotherapy has been used in the treatment of patients at relapse but it has been generally proven ineffective. We report a 7-month-old infant with a clival chordoma who responded to combination chemotherapy consisting of cycles of vincristine/cyclophosphamide/doxorubicin alternating with etoposide/ifosfamide. She has been off chemotherapy for 2 years and is well at age 5.

We present the previously unreported CT appearance of a Wilms' tumor which extended down the ureter and protruded into the bladder as a botryoid mass. The tumor apparently arose from an intralobar nephrogenic rest and demonstrated local invasion into renal sinus vessels and papillae. There was no tumor invasion into the wall of the ureter or bladder, and therefore, the extension into the ureter and bladder did not upstage the tumor. This report adds to the list of differential diagnoses of a botryoid bladder mass in a child and demonstrates yet another unusual manifestation of Wilms' tumor.