Search PubMed⌕ Search

Biomedical subjects

H Nahum

Publications and source records attributed to H Nahum.

At least 73 records · Page 4Linked to original sources
PubMed1986

Pseudohypoaldosteronism type II: proximal renal tubular acidosis and dDAVP-sensitive renal hyperkalemia.

The mechanisms of metabolic acidosis and hyperkalemia were investigated in a patient with chronic mineralocorticoid-resistant renal hyperkalemia (5.3-6.9 mmol/l), metabolic acidosis (arterial blood pH 7.27, total CO2 17 mmol/l), arterial hypertension, undetectable plasma renin activity (less than 0.10 ng/ml/h), high plasma aldosterone level (32-100 ng/dl), and normal glomerular filtration rate (131 ml/min/1.73 m2). During the hyperkalemic period, urine was highly acidic (pH 4.6-5.0), urinary NH4 excretion (10-13 microEq/min) and urinary net acid excretion (19-24 microEq/min) were not supernormal as expected from a chronic acid load. During NaHCO3 infusion, the maximal tubular HCO3 reabsorption was markedly diminished (19.8 mmol/l glomerular filtrate), and the fractional excretion of HCO3 (FE HCO3) when plasma HCO3 was normalized was 20%. Urine minus blood PCO2 increased normally during NaHCO3 infusion (31 mm Hg), and the urinary pH remained maximally low (less than 5.3) when the buffer urinary excretion sharply increased after NH4Cl load. When serum K was returned toward normal limits, metabolic acidosis disappeared, urinary NH4 excretion rose normally after short NH4Cl loading while the urinary pH remained maximally low (4.9-5.2), the maximal tubular HCO3 reabsorption returned to normal values (24.8 mmol/l glomerular filtrate), and FE HCO3 at normal plasma HCO3 was 1%. Nasal insufflation of 1-desamino-8-D-Arginine Vasopressin (dDAVP) resulted in an acute normalization of the renal handling of K and in an increase in net urinary acid excretion. We conclude that: the effect of dDAVP on renal handling of K may be explained by the reversal of the distal chloride shunt and/or an increase in luminal membrane conductance to K; the distal acidification seems to be normal which in the event of distal chloride shunt impairing distal hydrogen secretion might be explained by the presence of systemic acidosis which is a potent stimulus of hydrogen secretion, and metabolic acidosis in the steady state was accounted for by the diminution of bicarbonate reabsorption and ammonia production in the proximal tubule secondary to chronic hyperkalemia.

Acid-Base Equilibrium↗
PubMed1986

[Spontaneous fracture of the sacrum due to "insufficiency". An overlooked cause of low lumbago in elderly women].

A case of insufficiency fracture of the sacrum is reported. These fractures usually occur in elderly women and are secondary to various conditions, mainly postmenopausal or steroid-induced osteoporosis and radiation therapy. They are often overlooked or confused clinically and radiographically with metastatic disease. Findings on plain films are often subtle. Radionuclide bone scan shows a characteristic H or butterfly shaped pattern of increased uptake in the sacral alae. The diagnosis is confirmed by conventional tomograms or CT which show the fracture always surrounded by prominent sclerosis.

Aged↗
PubMed1986

[Surgical treatment of hepatocellular carcinoma in cirrhosis. Value of peroperative ultrasonography].

During the past three and half years, 19 patients with hepatocellular carcinoma associated with cirrhosis were operated on. Pain was present in seven patients while 12 were asymptomatic. Alpha foeto-protein was negative in 7 patients. Intraoperative ultrasonography was performed in the last 15 patients. Three right hepatic resections, 5 left hepatic lobectomies and 11 segmentectomies or subsegmentectomies were performed. The operative mortality was 5 p. 100 (one patient). The long term survival in the 3 patients who underwent palliative resection was 6 months. Among the 15 other patients, four died from causes unrelated to their tumor; three patients with tumors larger than 8 cm died from recurrence 12 to 26 months after surgery; and the remaining 7 are still alive without evidence of recurrence 3 to 18 months after surgery. We concluded that in patients with cirrhosis, resection of limited hepatocellular carcinoma is possible, using intraoperative sonography, with low operative mortality. Early detection by repeated ultrasonic examination of the liver in patients with cirrhosis could be the best way to improve the surgical treatment of hepatocellular carcinoma.

Adult↗
PubMed1986

[Left inferior vena cava. Ultrasonic diagnosis].

A case of left infrarenal vena cava is detected by ultrasonography and confirmed inferior cavography. Embryogenesis of the inferior vena cava aids understanding of this type of congenital anomalies. Ultrasonographic diagnosis is based on the absence of right infrarenal vena cava, the presence of a vascular structure left to the abdominal aorta an a normal hepatic segment of inferior vena cava.

Humans↗
PubMed1986

[Magnetic resonance imaging in the study of pulmonary hilar involvement].

A retrospective analysis of results of magnetic resonance imaging (MRI) was conducted in 28 patients with uni- or bilateral pulmonary hilum lesions and findings compared with those of computed tomography (CT). All abnormal hilar masses examined were between 1 and 5 cm in diameter and were easily detected by transverse axial imaging. Contrast of their images was very high in relation to hilar bronchovascular elements in the two types of spin echo sequence with a short TR (0.5-0.7 s) and a long TR (1.5-2 s). Differentiation between tumoral or adenopathies and vessels was simpler than with CT with intravenous contrast. For screening of possible extension of hilar tumors. MRI appears to be superior to CT for providing data on vascular relations of lesions but inferior to CT for determining bronchial relations. Mediastinal extension of hilar tumors is easily defined by the short TR sequence but MRI supplies data of greater value than CT only in a low proportion of cases and then partly as a result of complementary coronal and sagittal imaging.

Adult↗
PubMed1986

[Bone metastases of bronchial carcinomas. 3 cases of subperiosteal cortical osteolysis].

The morphologic appearance of osseous metastasis may rarely suggest a specific site of origin. A subperiosteal location has recently been reported to be typical for metastatic lung carcinoma. We report three cases of such metastasis which destroyed the cortex so that it appears saucer shaped. The primary tumor was a bronchogenic carcinoma in every case. We conclude that in the cancer-age group cortical metastasis is a highly characteristic feature of lung carcinoma.

Adenocarcinoma↗
PubMed1986

[Modified profiles of the elbow in traumatology. The value of the radial head-capitellum view and a new coronoid-trochlea view].

2 modified lateral views of the elbow are described. They are accomplished by angling the tube 45 degrees cranially and ventrally, parallel to the arm. The first view, recently reported, shows the radial head and capitellum, free of overlap of other bones. The second view, first reported here, demonstrates well the coronoid and the trochlea. Some representative case reports are exposed. The usefulness of these view is discussed.

Adult↗
PubMed1985

Budd-Chiari syndrome: US evaluation.

Twelve patients with proved Budd-Chiari syndrome (eight acute and four chronic cases) were examined, using real-time ultrasonography (US). In all acute cases, US study showed at least one hepatic vein with findings suggestive of the syndrome, such as stenosis, dilatation, thick wall echoes, thrombosis, abnormal course, or extrahepatic anastomosis. In chronic cases, hepatic veins were usually not visible. Modifications of liver morphology were present in all patients except those with recent onset of the disease. Caudate lobe hypertrophy was present in only six cases. US study is therefore the procedure of choice for initial diagnosis of acute Budd-Chiari syndrome. Pitfalls were the failure to detect two caval thromboses and one hepatic vein web. Cavography should still be performed systematically, but hepatic phlebography is useful in selected cases only.

Adult↗
PubMed1985

Sonographic and computed tomographic evaluation of intrahepatic calculi.

Intrahepatic calculi in non-Asian patients were studied by sonography and computed tomography (CT). Three patients were studied by CT cholangiography also. In two cases, the calculi were consecutive to Caroli disease, and in two others, the biliary stones were formed proximal to a stenosis of a previous surgical anastomosis. Five patients spontaneously developed intrahepatic calculi. All sonograms were abnormal. Image specificity was good, even when bile ducts were not dilated, if appropriate technique allowed identification of a double-arc-shadow pattern. Sonography strongly suggested the diagnosis in eight patients and was nonspecific in only one. On CT, calculi had various densities, and they were not visible in two patients. CT cholangiography was not particularly helpful. Finally, CT added little more information when performed after sonography. Both examinations strongly underestimate the number of stones, and direct cholangiography remains indicated if surgery is planned.

Adult↗
PubMed1985

[Value of the sitting position for studying suprahepatic veins by ultrasonography].

Ultrasound imaging of suprahepatic veins was conducted in 50 patients in the sitting and lying down positions and under the same respiratory conditions. Results showed that the sitting down position was frequently useful during exploration of suprahepatic veins, and it should be performed whenever visibility in the lying down position in unsatisfactory.

Hepatic Veins↗
PubMed1985

[Type II pseudohypoaldosteronism: proximal tubular acidosis and distal tubular hyperkalemia corrected by DDAVP].

The mechanisms of metabolic acidosis and hyperkalemia were investigated in a patient with chronic mineralocorticoid-resistant renal hyperkalemia (5.3 to 6.8 mM), metabolic acidosis (arterial blood pH 7.27, total CO2 17 mM), arterial hypertension, undetectable plasma renin activity (less than 0.10 ng/ml/hr), high plasma aldosterone (32 to 100 ng/dl), normal GFR (131 +/- 2.5 ml/min/1.73 m2). During hyperkalemic period, urine was highly acidic (pH 4.6 to 5.0), urinary NH4 excretion (13 mumoles/min) and urinary net acid excretion (24 mumoles/min) were not supernormal as expected from a chronic acid load. During NaHCO3 infusion, maximal tubular HCO3 reabsorption (Tm HCO3) was markedly diminished (19 mmoles/liter GF), fractional excretion of HCO3 (FE HCO3) when plasma HCO3 was normalized, was 20%. Urine-minus-blood PCO2 increased normally (31 mmHg) during NaHCO3 infusion, and urinary pH remained maximally low (less than 5.3) when buffer urinary excretion sharply increased after NH4Cl load. When serum K was returned toward normal limits, metabolic acidosis disappeared, urinary NH4 excretion rose normally after short NH4Cl loading while urinary pH remained maximally low (4.9 to 5.2), Tm HCO3 returned to normal value (24.8 mmoles/liter GF), and FE HCO3 became nil. The renal handling of K was improved with acute NaHCO3 loading and normalized after DDAVP nasal insufflation.(ABSTRACT TRUNCATED AT 250 WORDS)

Acidosis, Renal Tubular↗
PubMed1984

[Cervical spondylolysis. 7 cases. Review of the literature].

Seven cases of cervical spondylolysis are reported one of them with cervical myelopathy, and the literature is reviewed. The particular anatomical features of the articular processes observed in 4 cases, as well as the many characteristics common to cervical and lumbar spondylolysis, suggest that both diseases might be caused by acquired fatigue fractures of the isthmus due to abnormal stress in patients predisposed by neural rich malformations.

Adult↗