The anatomic features of a 5,300-year-old mummy, the iceman, were documented with conventional radiographic, portable computed radiographic, and conventional and spiral computed tomographic images obtained between September 1991 and June 2001. A team of scientists and radiologists from Austria, Italy, and the United States supervised the examinations and interpreted the images. The images demonstrated excellent preservation of the mineralized skeleton with profound dehydration of the soft tissues. The skeleton exhibited several types of trauma, including (a) healed rib fractures, (b) hairline skull fractures and a compression deformity of the thorax, probably acquired while encased in the glacier, and (c) damage acquired during the effort to recover the corpse. Skeletal variants were present, as was evidence of degenerative arthritis, frostbite, vascular calcification, and adaptation to cultural and geographic influences. In terms of anatomy and apparent health-related conditions, the iceman was very similar to modern humans. An arrowhead lodged between the rib cage and the left scapula was the probable cause of the iceman's death. Study of the images also provided insight regarding postmortem processes that led to the iceman's mummification.
Patients older than 60 years are at risk for disturbances of renal perfusion as assessed by the resistive index, and 45% of these patients have new onset hypertension within 26 months of treatment.
Graft-versus-leukemia (GvL) has been shown to be an important immune- mediated antitumor effect in hematologic malignancies. It is still unknown whether such an immunemediated antitumor effect has clinical implications in patients with solid tumors. A 32-year-old woman with inflammatory breast cancer received a bone marrow transplant (BMT) from her HLA-identical sibling. During graft-versus-host disease (GvHD) cytotoxic T lymphocytes were grown and tested in a chromium-release assay against B and T lymphocytes of the patient and donor and against a panel of breast cancer cell lines. Resolution of liver metastases was observed simultaneously with clinical GvHD in the first weeks after transplant. In addition, minor histocompatibility antigen (MiHA)- specific and major histocompatibility complex (MHC) class I antigen- restricted cytotoxic T lymphocytes recognizing breast carcinoma target cells were isolated from the blood of the patient. Pretreatment of such target cells with tumor necrosis factor (TNF)-alpha but not with interferon (IFN)-alpha or IFN-gamma increased susceptibility of these cells to lysis by cytotoxic T lymphocytes. Clinical course and in vitro results suggest that a graft-versus-tumor (GvT) effect might exist after allogeneic BMT for breast cancer. However, clinical experience on a larger scale would be required to determine the clinical efficacy of GvT effects in patients with solid tumors.
Contradictory results have been obtained in classifying various renal diseases when trying to use the resistive index measured by duplex Doppler technique in renoparenchymal arteries. These measurements may have been influenced by the lack of standardization of the anatomic site at which the renoparenchymal artery is sampled. To elucidate this influence, we measured the resistive index, peak systolic velocity, end diastolic velocity, and pulsatility index in 120 healthy kidneys at three different positions of the renal vasculature. The resistive index at the level of the interlobar-arcuate arteries proved to be the parameter with the most consistent results and should be preferred in clinical applications.
The aim of our study was to evaluate the striated urethral sphincter (rhabdosphincter) in incontinent females by means of intraurethral ultrasound (IUUS). Thirty-four incontinent and 11 continent female patients were examined by means of 12.5-MHz endoluminal ultrasound (US). The distance between the inner contour of the sphincter muscle and the US catheter was measured in the contracted and the non-contracted condition. The US findings were correlated with those obtained by urodynamic studies. Partial or complete loss of sphincter function was detected in patients with stress urinary incontinence (SUI). Reduced sphincter function was not observed in patients with urge incontinence and continent volunteers. The findings on US were found to correlate well with the grade of SUI. The IUUS technique offers the benefit of direct visualization of the sphincter mechanism. Therefore, endoluminal US may become an important adjunct in the diagnostic evaluation of SUI and will possibly provide new insights for a better therapeutic strategy.
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