Direct inguinal hernia containing bladder carcinoma: CT demonstration.
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Biomedical subjects
Publications and source records attributed to A Rozenblit.
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An unusual angiographic presentation of Leriche syndrome is described that demonstrates short segment occlusions of iliac arteries with bilaterally symmetrical post-stenotic dilatations.
A case report of complete testicular feminization is presented. The medical and radiological characteristics of this condition which distinguish it from male cryptorchidism and other disorders of sexual differentiation are discussed. To our knowledge, only three previous case reports have been published in the radiology literature. Our report is the first to describe MRI findings.
Infected aortic aneurysm is an uncommon, life-threatening disease. Early surgical treatment is crucial to survival. An early diagnosis could be made on CT in suspected cases, although CT features of infectious aortitis overlap with retroperitoneal fibrosis, hemorrhage, and lymphadenopathy. We report the case of an infected abdominal aortic aneurysm and describe the additional potentially useful CT finding of early infectious aortitis, which helps localize the abnormality to the aortic wall.
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PURPOSE: Nonenhanced CT scans through the kidneys commonly show a difference in radiopacity between the inner peripelvic portion of the renal parenchyma and the more peripheral regions of the renal parenchyma. This normal observation has not been described. METHOD: We reviewed 50 nonenhanced CT scans. Renal parenchyma was evaluated by both visual inspection and density measurements of inner and outer aspects of the kidneys in 38 and visual inspection only in 12. A narrower window was used to better show density differences (100 W, 35 L). We recorded the indication for the CT, history, and recent blood chemistries. RESULTS: The inner parenchyma was of greater radiopacity than the outer parenchyma in 35 of 50 cases by visual inspection and in all densitometry cases (38 of 38). There was no correlation with clinical history or blood chemistry. CONCLUSION: A difference in density between the inner and outer portions of the renal parenchyma is very common and will often be seen if one looks for it. We have not shown an etiology for this difference, and indeed, it may be physiological. One must be aware of this finding to avoid mistaking it for pathology.
BACKGROUND: Preclinical and early clinical trials suggested that the biologic agent interferon beta ser (IFN beta ser) may augment the anticancer activity of 5-fluorouracil (5-FU). The current studies were undertaken to explore the optimal schedule of IFN beta ser and to determine whether the hematopoietic growth factor sargramostim (granulocyte-macrophage colony-stimulating factor) could reduce the hematologic and gastrointestinal toxicities of the chemotherapy. METHODS: Three sequential, single-institution phase II trials using different regimens were initiated. Patients were required to have advanced, histologically documented colorectal carcinoma with no prior chemotherapy; to have adequate bone marrow, renal, and hepatic function; to be fully ambulatory; and to give informed consent. All patients received 5-FU, 750 mg/m2 intravenously as an infusion daily for 5 days, followed by 5-FU, 750 mg/m2, as an intravenous bolus every week beginning day 15. Patients in arm A received IFN beta ser, 9 MU subcutaneously, three times a week. Patients in arm B received IFN beta ser, 9 MU subcutaneously every day. Patients in arm C were treated exactly as in arm B but also received sargramostim, 250 micrograms subcutaneously on days they did not receive 5-FU. Beginning day 15, all patients received IFN beta ser exactly 10 minutes before receiving the 5-FU bolus. RESULTS: There were 81 patients enrolled: 19 in arm A; 40 in arm B; and 22 in arm C. Myelosuppression and diarrhea were the most common toxicities. Increasing the frequency of IFN beta ser administration in arm B resulted in a doubling of the rate of diarrhea from 11% to 22%, and the addition of sargramostim in arm C failed to reduce this. Sargramostim did reduce the incidence of grade 3 to 4 leukopenia, but this did not allow intensification of dosing or result in improved response or survival among patients in arm C. IFN-mediated fatigue was also common, occurring in 37% to 43% of patients. Patients receiving IFN beta ser on the intermittent schedule tolerated full-dose therapy longer than those on the daily schedule (10 weeks versus 5 weeks, P < 0.01). The response rates in the three arms were 21%, 35%, and 27%; there was no difference in median survival (15 months for all three arms). CONCLUSIONS: The combination of 5-FU and IFN beta ser was active in patients with advanced colorectal carcinoma, and survival with this regimen was comparable to or better than that with other modulating regimens. The intermittent schedule of IFN beta ser was better tolerated than than the daily schedule.