Objectives-(I) to evaluate regional cerebral blood flow (rCBF) with single photon emission computed tomography and 99mTc-hexamethylpropyleneamine oxime in patients with the idiopathic adult hydrocephalus syndrome (IAHS); (2) to examine regional cerebral blood flow (rCBF), gait, and psychometric functions before and after CSF removal (CSF tap test); (3) to assess abnormalities in subcortical white matter by MRI. Methods-Thirty one patients fulfilling the criteria for IAHS (according to history and clinical and neuroradiological examination) were studied. Quantified gait measurements, psychometric testing, and rCBF before and after removal of CSF were obtained. Pressure of CSF and CSF outflow conductance were investigated with a constant pressure infusion method. Brain MRI was used to quantify the severity of white matter lesions and periventricular hyperintensities.In

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One hundred and fifty-six patients with simple renal cysts had either a percutaneous puncture alone, percutaneous puncture combined with bismuth-phosphate instillation or no intervention at all. At follow-up, 25% of the cysts in which there was no intervention had grown and the mean size showed a slight increase. Ten per cent of the cysts which were only percutaneously punctured disappeared, while the mean size was reduced up to 24 months after puncture. Later, there was no statistically significant difference in change in mean size between punctured cysts and cysts that had no intervention. When puncture was combined with bismuth-phosphate instillation, a gradual reduction was seen in the mean size during the entire follow-up time and 44% of the cysts disappeared. Thirty-six or more months after puncture and instillation, the mean size was only 21% of the original size. It was concluded that percutaneous puncture combined with a bismuth-phosphate instillation is a meaningful treatment of simple renal cysts.

Liver transplantation is the only effective treatment of familial amyloidotic polyneuropathy type I (FAP). The aim of the present investigation was to identify factors at the time of submission for transplantation that had impact on survival, with special reference to gastrointestinal disturbances. All 28 liver-transplanted FAP patients evaluated at Umeå University Hospital were included in the study. A modified body mass index was used to assess nutritional status. Intestinal examinations were performed to diagnose bile acid malabsorption, gastric retention, and bacterial contamination of the small bowel. A significantly improved survival rate was found for patients in a good nutritional state (P = 0.002). Peripheral neurological symptoms were unrelated to survival, whereas increased mortality was found for patients with bile acid malabsorption (P < 0.05). Bacterial contamination and gastric retention were common complications of the disease. In conclusion, malabsorption and malnutrition have a profound impact on the outcome of liver transplantation for familial amyloidotic polyneuropathy.

A case of massive hemorrhage from pelvic fractures was controlled by embolization of the internal iliac artery with autologous blood clots. Later an infarct of the bladder wall developed, probably because of embolic material in the capillary system preventing adequate collateral supply. It is concluded that collateral flow should be considered before embolization and that the technique of embolization must be adapted to the individual case.