The sensitivity of 18F-FDG PET for the imaging of HCC is low. Nevertheless, in patients with moderately or poorly differentiated HCC, tumors >5 cm, or with markedly elevated AFP levels 18F-FDG PET may contribute to an effective noninvasive staging.

We report a fatal case of invasive pulmonary aspergillosis in a severely ill neonate and review 43 additional cases of invasive aspergillosis reported from 1955 through 1996 that occurred during the first 3 months of life. Eleven of the 44 patients had primary cutaneous aspergillosis, 10 had invasive pulmonary aspergillosis, and 14 had disseminated disease. Most infections were nosocomial in origin. Prematurity (43%); proven chronic granulomatous disease (14%); and a complex of diarrhea, dehydration, malnutrition, and invasive bacterial infections (23%) accounted for the majority of underlying conditions. At least 41% of the patients had received corticosteroid therapy before diagnosis, but only one patient had been neutropenic. Among patients who received medical and/or surgical treatment, outcome was relatively favorable, with an overall survival rate of 73%. Invasive aspergillosis may occur in neonates and young infants and warrants consideration under certain circumstances. Current therapeutic approaches consist of high-dose amphotericin B and appropriate surgical interventions.

Visualization of the right adrenal gland is almost always possible by transabdominal ultrasound, while its detection by EUS is successful only in some cases. The left gland is more difficult to detect by transabdominal ultrasound, while it can nearly always be seen using EUS. Therefore, a combined transabdominal and endoscopic ultrasonographic approach is useful for visualization of the adrenal glands and may enable diagnosis of even small adrenal masses.

Nucleotide sequence analysis of hepatitis C virusHepatitis C virus (HCV) infection often progresses to (HCV) strains showed substantial variability leading to chronic hepatitis, cirrhosis, and possibly hepatocellular carcia classification into several genotypes and subtypes. The noma. [1][2][3] Using phylogenetic analysis of the viral 5-noncoding data correlating HCV genotypes and subtypes with hep-region, a classification of HCV strains into six major types atitis C viremia levels, demographic characteristics of (HCV-1 to -6) has been introduced. Analysis of the more varipatients (age, mode of transmission, duration of infec-able coding regions of the viral genome (core, envelope, nontion), and severity of liver disease are conflicting. The structural [NS]-3, and NS-5) indicated that major genotypes interpretation of several studies is further complicated are composed of two or more distinct subtypes, termed 1a, because the molecular methods used lacked specificity 1b, 2a etc. 4,5 The geographic distribution of HCV genomes for genotyping/subtyping and underestimated viremia differs considerably. In Europe and the United States, sublevels, especially in patients infected with HCV geno-types HCV-1a and -1b, HCV-2a and -2b, and HCV-3a are types 2 and 3. In the present study we investigated 97 most abundant, whereas in Japan HCV subtypes 1a and 3a consecutive patients with chronic hepatitis C using mo-are virtually nonexistent. Type 4 genotypes are common in lecular ''gold standard'' methods. HCV subtyping was patients from Northern Africa and the Middle East, and types performed by sequence and phylogenetic analysis of the 5 and 6 have been identified in serum samples obtained from nonstructural (NS)-5 region and serum HCV-RNA con-South Africa and Hong Kong, respectively. Sequence analysis centration was assessed by a validated genotype-inde-of HCV isolates from Vietnamese blood donors revealed addipendent quantitative reverse-transcription-polymerase tional major genetic groups (HCV-7, -8, and -9).6-8 chain reaction assay using an internal RNA standard.Several 9-12 but not all studies 13,14 have indicated a correlaPatients infected with subtypes HCV-1b, HCV-2a-c, and tion between HCV genotypes/subtypes and serum HCV-RNA HCV-4 were older than patients infected with HCV-1a concentrations. The data associating HCV genotypes/suband HCV-3a. Serum HCV-RNA levels ranged from 1.5 1 types and/or hepatitis C viremia levels with demographic, 10 4 to 1.0 1 10 8 copies/mL with no significant differences biochemical, or histological characteristics of chronically inbetween median serum HCV-RNA concentrations in pa-fected patients are conflicting. [15][16][17][18][19][20][21][22][23][24][25][26] These issues are further tients infected with different genotypes/subtypes. Al-complicated by recent evaluations showing that common gethough patients infected with HCV-1b were older, no notyping methods lack specificity 12,27 and that quantification biochemical or histological evidence was obtained that systems underestimate high virem...