Biomedical subjects
Publications and source records attributed to H Nahum.
This is apparently the first triplet pregnancy after four freeze-thawed embryos that terminated in a birth of three healthy infants, with relatively good birth weights and uneventful follow-up.
Symptomatic cholesterol granuloma developed in the middle ear cavities in three cases. At computed tomography (CT) after the administration of contrast material, the granulomas appeared as nonspecific, nonenhanced soft-tissue masses with variable bone erosion. These features are indistinguishable from those of other similar clinical entities, especially cholesteatoma, paraganglioma, and endaural brain hernia. At magnetic resonance (MR) imaging, cholesterol granulomas had a more characteristic appearance. In two cases, the granulomas were depicted as areas of high signal intensity with both T1- and T2-weighted sequences. In the third case, an expansile mastoid cholesterol cyst exhibited medium signal intensity on T1-weighted images, with only a small hyperintense area and a hypointense area located in the cystic wall. Correlations between CT, MR, and microscopic findings show that MR imaging is far superior to CT in tumoral characterization, which is crucial for planning surgical approaches. MR imaging has limitations, however, particularly its inability to depict subtle bone abnormalities.
A methodology to evaluate routine ultrasonography performed in liver pathology is described. The results of 62 autopsies, undoubtedly the most accurate anatomical reference, were compared to those of sonographic examination of the liver performed two months before death at the most. Discordance was found in 23 cases. False negative results in the detection of metastasis and thrombosis of hepatic veins or inferior vena cava were the major pitfalls. The reasons and the consequences of each error were determined for each case.
The purpose of this study was to show that clinical and biological data can help in the diagnosis of benignity and malignancy in liver tumors seen on ultrasound. Three hundred and ninety-four patients with liver masses detected by ultrasound (270 malignant, 124 benign) were prospectively studied. Clinical and biological data were tested by univariate and multivariate analysis. The most important variables were gamma-glutamyl-transferase, sedimentation rate, known primary cancer, proven cirrhosis, abnormal abdominal palpation, ascites and weight loss. A regression model was used and a score was defined with these variables. Using this score, 94.8 p. 100 of the liver masses were accurately classified as benign and malignant tumors.
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Modifications in beta-endorphin levels in cerebrospinal fluid have been described following lumbar puncture and metrizamide injection. Cerebrospinal fluid (CSF) samples were obtained from 19 patients before and after lumbar myelography. Two radioimmunoassays were used. One was a commercial kit; and the other one (developed in our laboratory) used a chromatographic removal from beta-lipotrophin. No definite variation of beta-endorphin was observed after myelography, using either the commercial kit or a more sophisticated procedure. Some controls were prepared by adding metrizamide or Iopamidol in vitro to CSF samples in order to evaluate a non specific effect of these contrast media. The results obtained with these controls suggest that the discrepancy of results may be explained simply by assay artifacts due to drug interferences when using the commercial methods.
AIDS-related Kaposi sarcoma is most often multicentric and extensive. Hepatic involvement is unusual and asymptomatic. An anicteric cholestasis may exist. Ultrasonography shows a pedicular echogenic infiltration and a heterogeneous parenchyma with small hyperechoic nodules. On CT, these hypodense lesions are related to the involvement of the hepatic pedicle. This is linked to angiosarcomatous tumorous tissue infiltration of the liver evolving along portal branches. In a patient suffering from cutaneous or digestive Kaposi sarcoma lesions, these radiological aspects are suggestive of hepatic involvement.
Intradural disk herniation is a rare condition. Most of reported cases involve the lumbar spine and have histories of chronic low back pain followed by an acute episode of radicular pain with neurologic deficit. The authors report the myelographic and lopamidol-CT findings in a case of a L4-5 intradural disk herniation. These two examinations demonstrated an intradural multilobular mass associated with an extradural component at the level of the disk space and with a same density as it. Anatomic adherences between dura-mater and posterior longitudinal ligament could explain the primary mechanism of these intradural disk herniations; but operative or traumatic antecedents are often noted. Most often operation discloses only the intradural component with a small anterior dural cleft, without extradural abnormalities. Postoperative follow up is usually good.
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The authors present four cases of tuberous sclerosis examined with MRI. The patho-anatomic aspects are reviewed and analysed with respect to MRI data. MRI appears superior to the CT particularly for imaging of cortical tubers, cystic lesions, and heterotopic clusters; these last two features were never described with MRI before. Here is also presented the second progressive case of giant intracranial aneurysm associated with tuberous sclerosis.
The authors present a case of massive bleeding from duodenal varices documented by selective portography and successfully controlled by percutaneous embolization.
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To assess the accuracy of computed tomography (CT) in the evaluation of bronchiectasis, we performed thin-section CT in 36 patients with clinical findings suggestive of this diagnosis. CT was performed with 1.5-mm section thickness and 10-mm intersection spacing. Bilateral (eight patients) and unilateral (28 patients) bronchograms were obtained. CT and bronchographic findings were correlated in 44 lungs. In 15 lungs no bronchiectasis was observed on CT scans and bronchograms. In 25 lungs both examinations accurately indicated the presence and extent of bronchiectasis. In two lungs the extent of disease was underestimated on CT, which failed to indicate bronchiectasis in one segment of the affected lobe. In one case CT findings suggested focal bronchial disease, but the lung was misinterpreted as not bronchiectatic; the bronchogram showed cylindric bronchiectasis. In one case CT disclosed cylindric bronchiectasis in a lobe that was bronchographically normal, but in this case the bronchogram was probably misinterpreted as false negative. In two cases lung findings were better visualized on CT scans than on bronchograms. It is concluded that thin-section CT is an accurate procedure in the recognition of bronchiectasis.