The computed tomographic (CT) and ultrasonographic (US) appearances of retained surgical sponges are described. In each case, the presence of a sponge was confirmed at repeat operation. CT examinations were performed in nine patients. In six cases, a low-density mass was demonstrated; in two cases, a complex mass with areas of both low and medium density was seen. The remaining case was a high-density mass. After intravenous administration of contrast material, dense and prolonged enhancement of the rim of the mass was noted in five of eight cases. Calcification was found in four cases, and spongiform gas in one. US performed in six patients revealed an echogenic area with strong acoustic shadowing in three cases and a complex mass, a hypoechoic mass, and a cystic mass with irregular internal echoes in one case each. Granuloma caused by a retained surgical sponge should be considered as a cause of an abdominal mass in patients with a history of prior abdominal surgery.
Nambu PVA gel which is produced by repeated freezing and thawing of PVA solution has overcome almost all of the problems which present substances have: It is close to human soft tissue in MRI parameters. MRI parameters (1H density, T1, T2) are adjustable to some extent. It has appropriate physical characteristics. The important problem with PVA gel is long-term stability. It is assumed that this problem can be solved by its periodic calibration and replacement.
Methacetin undergoes rapid O-dealkylation by hepatic microsomal enzyme systems, and the resultant CO2 is present in the expired air. The rate of O-dealkylation of methacetin was assessed by the [13C]methacetin breath test in seven healthy volunteers and 30 patients with histologically proven chronic liver diseases. The 30-min recovery of orally administered [13C]methacetin as 13CO2 in the exhaled air was significantly reduced in patients with chronic aggressive hepatitis and in those with liver cirrhosis but not in patients with chronic persistent hepatitis or healthy controls. Patients with either advanced cirrhosis or hepatocellular carcinoma showed significantly lower values than those with well-compensated cirrhosis. The levels in two patients with late primary biliary cirrhosis were reduced. These results show that the severity of liver damage can be effectively evaluated by [13C]methacetin breath test. In addition, this test is simple, safe, and time efficient.
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