Introduction: colon cancer is one of the main causes of cancer death. Diagnosis requires the examination of the entire large bowel by means of radiological or endoscopic techniques. Many patients suspect of colon cancer are referred for colonoscopy but nevertheless this suspicion is not confirmed after endoscopic examination. The objective of this study is the evaluation of the reliability of abdominal ultrasound in the diagnosis of these tumors.Material and method: we selected patients suspect of colon cancer referred to the endoscopy unit for a colonoscopy. An abdominal ultrasound was carried out on all patients prior to the endoscopy. Considering the endoscopic examination as a gold standard, the sensibility, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ultrasonography were evaluated. Likewise, a series of analytical and clinical parameters were evaluated, in an attempt to establish associated factors of a colon cancer. The statistical analysis was carried out by means of the statistical package SPSS 12.0 for Windows.Results: 145 patients were included in the study (56.6% males) with an average 66.72 years of age (22-89). A cancer was diagnosed in 42 cases (28.9%). In the diagnosis of colon cancer, abdominal ultrasound presents a sensitivity of 79.06%, a specificity of 92.15%, a PPV and a NPV of 80.9% and of 91.2%, respectively. Excluding from the analysis lesions of the rectal ampulla, which cannot be adequately evaluated by means of ultrasound, the figures for sensitivity, specificity, PPV and NPV increase to 91.8, 92.1, 80.9 and 96.9% respectively. The univariate analysis showed that an age over 65 years and the presence of microcytosis are associated to a greater risk of colon cancer while after multivariate analysis only the presence of microcytosis resulted to be an independent predictive factor of cancer.Conclusions: abdominal ultrasound presents high sensitivity, specificity, PPV and NPV in the diagnosis of colon cancer. The combination of an ultrasonography and a rectoscopy permits us to rule out the presence of a colorectal carcinoma. In patients with microcytosis of 65 years and over, if there is strong clinical suspicion, a negative ultrasound may not be sufficient to rule out a colorectal neoplasia.

Endoscopy with biopsy sampling is the gold standard used in gastric cancer diagnosis. However, the positive predictive value of signs and symptoms for the diagnosis of carcinomas is quite limited, and, therefore, many patients are subjected to non-diagnostic endoscopies, especially when symptoms are not so specific. This study shows that ultrasonography is sensitive enough for the diagnosis of gastric cancer, and, therefore, use of this technique would further ensure a better selection of patients for endoscopy. The study included 143 patients (86 men and 57 women, with an average age of 68.6 years) who were suspected of having gastric cancer. The diagnostic accuracy of ultrasonography was evaluated in a blind study. The conventional technique was used in all cases. Demographic parameters and a series of other clinical-analytical variables were studied to look for possible gastric cancer predictive factors, which when present would make ultrasonographic results irrelevant. Statistical analysis was done using SPSS 12.0, wherein a value of P < 0.05 was considered to be statistically significant. Of the 143 patients studied, 40 were diagnosed to have gastric cancer. Sonography was able to diagnose 37 cases correctly, while there were three false negative findings and eight false positive findings. This results in 92.5% sensitivity, 92.2% specificity, 82.2% positive predictive value, 96.9% negative predictive value, and a global accuracy of 92.3%. Univariate analysis showed that persistent vomiting (P = 0.021), hemoglobin level of less than 8 g/dl (P = 0.045) and a positive ultrasonography result (P < 0.0001) were associated with a higher frequency of gastric cancer. Multivariate analysis showed that persistent vomiting, with an odds ratio for gastric cancer of 3.68 (95% confidence interval 1.15-11.79; P = 0.039), and a positive ultrasonography result, with an odds ratio for gastric cancer of 117.78 (95% confidence interval 32.45-427.49; P < 0.0001), could be considered as independent predictive factors for gastric cancer. It was concluded that ultrasonography is a very sensitive and specific technique for diagnosing gastric cancer. Gastric cancer was found to be present in just 28% of the patients studied, and their condition was suspect because of the clinical manifestations. Only vomiting and a positive ultrasonography result can be considered as independent predictive factors of gastric cancer.

Extreme similarities in the anatomy and physiology of the feto-placento-uterine unit in baboons and humans make the baboon an ideal model to investigate various aspects of reproductive physiology. Thirty-six amniotic fluid samples from 30 normal baboon pregnancies ranging in length from 50 to 173 days (term=180 days) were analyzed to obtain baseline data.Amniotic fluid volume as determined by para-aminohippurate dilution ranged from 126 to 380 ml, with a mean ( ' S D ) of 269'77.6 ml. Volume did not vary significantly over the period of the study. It correlated well with the volume determined at cesarean section by aspirating all the fluid prior to incising the uterus (r=0.65). Osmolality averaged 273'8.3 mOsm/kg (range:252-287). Creatinine (C) concentration ranged from 0.23 to 1.51 mg/dl and increased linearly with gestational length (G): C=0.008 G0.09, r=0.63, Syx=0.248. Protein (P) concentration ranged from 0.022 to 1.229 g/dl and increased as a power function of gestational length: P=0.022 G'. ~, r=0.88,. A spectrophotometric absorption peak was identified at 400 nm rather than at 450 nm: AOD400 averaged 0.047 '0.0686 (range: 0-0.290) and did not vary with gestational length.While these values are of the same order of magnitude as those observed in human amniotic fluid, the data suggest that baboon amniotic fluid differs from humans' in a number of respects.NEONATAL EFFECTS OF SEVERE MATERNAL HYPERTENSION BEFORE 36 WEEKS GESTATION Jane E Braz V i r i n i a 1260 L i t t l e , Jud Grimm (Spon, d i y j T k iUniversity M m cent&, Dept. o f Pediatrics, Durham, NC. Neonatal problems associated w i t h an abnormal f e t a l environment have been well documented f o r i n f a n t s o f d i a b e t i c mothers, b u t the e f f e c t s o f severe hypertension upon the i n f a n t have n o t been w e l l defined. Twenty-eight i n f a n t s 27-35 weeks o f gestation, delivered o f mothers w i t h d i a s t o l i c hypertension 2 110 mmHg (IHM) and 28 gestational age-matched control i n f a n t s (C1)'delivered o f normotensive mothers without t o c o l y t i c therapy were compared t o determine the e f f e c t s o f severe hypertension and i t s therapy on the preterm neonate. Eight hypertensive mothers (HM) were eclampt i c ; a l l HM received magnesium sulfate; 32% sedatives; and 79% antihypertensive medications. Thrombocytopenia and marked LDH elevation occurred i n 50% o f hypertensive mothers. 39% o f IHM and 0% CI were small f o r gestational age (p < .001); 29% and 0% were microcephalic a t b i r t h ( p < .01). Other s i g n i f i c a n t d i fferences between the two groups o f i n f a n t s were noted i n the i ncidence o f hypotonia, ileus, delayed s t o o l i n g , delayed respirat o r y adaptation, thrombocytopenia, leukopenia, neutropenia, patent ductus arteriosus and b i r t h asphyxia. Maternal thrombocytopenia and enzyme elevations were s i g n i f i c a n t l y associated w i t h growth retardation, microcephaly, thrombocytopenia, neutropenia and b i r t h asphyxia i n the i n f a n t . Gastrointe...

Infants with acute heart failure due to perinatal asphyxia may have elevation of systemic blood pressure from adrenergic stimulation. This afterload elevation is probably deleterious for myocardial function and tissue perfusion. Treatment needs to be directed towards increasing cardiac contractility and reducing afterload. Dopamine and chlorpromazine were given at 2-8 and 1-2 ugm/kg/min respectively, to 6 preterm infants with hypertension following severe perinatal asphyxia. This therapy improved hemodynamics in all infants: the heart rate did not increase significantly, mean arterial pressure decreased from 52+4 to 46+4, and skin PC02, obtained with an unheated electrode, zecreasez by 8%. These results suggest that improvement in hemodynamics and tissue perfusion occurred without production of myocardial stress by tachycardia. or hypotension. The use of an inotropic agent alone for heart failure in the presence of hypertension, may worsen the condition. Five six-hour daytime studies on each of 13 preterm infants,6 healthy (HPTI) and 7 with previous persistent oxygen dependency (PPOD) were carried out between 36 weeks GA and six months post term and compared with those in normal term infants (NTI) . All babies showed a rise in heart rate between term and one month with a subsequent fall to six months. Only the early heart rates were higher in preterm infants and highest in PPOD infants [e.g. Trancutaneous p02 was measured continuously during consecutive control and infusion periods of equal length in low birth weight infants given intravenous fat emulsion at a rate of 195 f 24 mg/kg of triglyceride per hour for 5 hours. The infants averaged 1000 gms. (range 750-1480 gm) and 28.1 weeks gestation (range 25-31 wks.) at birth, were studied at age 7-21 days, and were on stable FIO2 and/or ventilator settings during the study periods. Plasma triglycerides were measured before the infusion, at 3i0.5 hours during the infusion, and 4 hours post-infusion for each patient. TCpO2 values for each patient were matched at corresponding 30 min. intervals (i.e., at 0-30 mins.., 30-60 mins., etc) for 69 control and 69 infusion periods of 30 mins. each, a i : d the matched periods were analyzed by a paired t-test, as shown: Triglycerides, mg/dl TCPOZ, m H 9 Before 39f18*1p<0.001Control (n=69 62.4f12.0*1p=n~s~ During 93i22 )p<0.001Infusion (n=69) 62.5i14.3 After 56f19 *Mean S.D. In 6 infants breathing spontaneously, respiratory rates were 55f ll/min. during control periods and did not increase during fat infusions. Apneic spells occurred during 11% of control periods (8/69) and 7% of infusion periods (5/69). Low birth weight infants>l week of age and in stable respiratory condition appear to tolerate intravenous fat at 200 mg/kg/hr with no clinically detectable effects on respiratory rate, frequency of apnea, or 02 transport to tissues as estimated by TCpO2.EilDOGEHOUS OPIATES CAUSE NEOiTATAL DEPRESSIO1.I FOLLOW-1267 Ii4G FETAL ASPHYXIA. Victor Chernick and Randy J. Craig Univ. of Manitoba, Dept. of Peds., Winnipeg, Manitoba. Nalo...