In the evaluation of patients with musculoskeletal trauma routine X-ray studies are often limited by difficulty in delineating overlapping structures and tissues of similar density. Computerized axial tomography (CT) has proven to be of great value in many diagnostic situations in orthopaedic surgery, particularly in the evaluation of mass lesions. This new technique resolves many of the problems of standard X-rays. It is noninvasive, and can be safely employed in the evaluation of critically ill patients. To assess the usefulness of this technique to trauma, computerized axial tomography has been employed in the diagnosis of injuries of the spine and acetabulum. CT studies of 26 patients with spinal injuries demonstrated accurate localization of displaced bone fragments and other elements of fracture anatomy, obviating the need for myelography. CT scanning of 28 fractures of the acetabulum defined intra-articular fragments and precise details of fracture lines. The additional data provided by CT scanning in these patients was a major asset in the management of their injuries. It influenced the decisions in regard to the need for surgery, and when surgery was indicated, the data helped to define the most appropriate operative approach. Use of the CT did not delay therapy or cause any complications. This experience with spinal injuries and fractures of the acetabulum indicates that computerized axial tomography is a valuable adjunct to the management of musculoskeletal trauma.

Acetabulum↗

PubMed1981

Response of lymph node metastasis to sequential estrogen and radiation therapy in prostate carcinoma.

Increasingly sophisticated diagnostic studies have shown a high incidence of tumor spread to the regional lymph nodes. The status of the lymph nodes has been evaluated by noninvasive diagnostic procedures such as lymphangiography and computerized axial tomography. The applicability of these procedures has been enhanced by the use of stringent criteria. Gross lymph node metastasis can be diagnosed with considerable confidence. Serial observations of lymphangiograms and computerized axial tomograms before and two months after the administration of estrogens provide an added dimension to the interpretation of lymph node metastasis. The nature and range of the response of lymph node metastasis were observed. Survival of patients with gross lymph node metastasis treated by sequential estrogen and radiation therapy was evaluated. A total of 11/18 (61 per cent) of patients remained free of symptoms, 8/11 (74 per cent) with a favorable lymph node metastasis responsive to estrogen therapy, and 3/7 (42 per cent) with lymph node metastasis refractory to estrogen therapy. Follow-up computerized axial tomograms of the lymph nodes done at one and two years after irradiation showed a persistent favorable response. Five patients are alive with disease, and 2 patients died of the disease.

Aged↗

PubMed1977

Coronary artery bypass grafting--the nurse's role.

Explore the source record for details and available documents.

Coronary Angiography↗

PubMed1977

Western equine encephalitis with rapid onset of parkinsonism.

A patient with confirmed western equine encephalitis had the rapid onset of postencephalitic parkinsonian sequelae. This observation corroborates similar previous but rare reports. Response to therapy with levodopa, dopa decarboxylase inhibitor, and trihexyphenidyl was dramatic. However, remission maintained for 12 months without medication suggests that the parkinsonism would have remitted spontaneously. In either case, this has not previously been reported with the western equine togavirus.

Adult↗

PubMed1976