A patient with the clinical features of pseudohypoparathyroidism and elevated concentrations of serum CK and LDH, which normalized after successful therapy, is described. Clinical signs of myopathy did not exist. The bioptical material from the m. tibialis anterior was microscopically normal. The biochemical analysis revealed a reduced phosphorylase-a-activity with the total phosphorylase-activity (a and b) being within the normal range. The significance of these findings as well as possible pathogenetic mechanisms are discussed.
Abdominal ultrasonic screening of patients clinically asymptomatic of abdominal disease was performed in 5 720 subjects. In these asymptomatic persons pathological ultrasonic findings were reported in 47.1% of all cases, but these were mostly without clinical relevance. This is especially true for diffuse liver disease (30.9%), asymptomatic gallstones (6.1%), and typical renal cysts (5.7%). Asymptomatic malignant abdominal tumours (0.2% or 13 cases) were detected very rarely, and were found to be mostly renal carcinomas.
Forty-two patients with an abdominal aortic aneurysm that had not been treated surgically were repeatedly examined by ultrasonography. The average observation time of all patients was 3.1 years. The total observation period including follow-up times of all patients adds up to 129 "patient years". Within this time none of the 35 asymptomatic abdominal aneurysms with transversal diameters of maximally 5 cm ruptured. Three patients of seven with larger and symptomatic aneurysms died in consequence of a rupture. Small asymptomatic abdominal aortic aneurysms seem to have a better prognosis than previously supposed. The question whether all abdominal aneurysms should be operated on needs reconsideration, especially in the elderly.
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