Biomedical subjects
Publications and source records attributed to J F Katz.
A 30-year-old man with acquired immune deficiency syndrome (AIDS) and Kaposi's sarcoma had a palpable thyroid mass and cervical lymphadenopathy. Nuclear medicine and ultrasound scans revealed multiple thyroid nodules. Results of biopsy showed Kaposi's sarcoma metastatic to the thyroid.
Uterine radioactivity uptake has previously been reported for a variety of radionuclide agents in the presence of uterine pathological disorders, such as leiomyomata as well as uterine and cervical neoplasma and infections. Activity within the normal uterus has also been reported in Meckel's scans using 99mTc-pertechnetate, but this has not been reported for other radionuclide agents. We report a case exhibiting radioactivity uptake within a normal uterus on a 99mTc-glucoheptonate scan of a renal transplant. Awareness of the possibility of radioactivity uptake in a normal uterus is important in order to avoid potential confusion with abnormal pelvic masses or fluid accumulations.
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A case report is presented in which malfunction of a peritoneovenous shunt was caused by subintimal dissection of the venous end of the shunt tubing. The radionuclide shunt patency study demonstrated a collection of radioactivity at the venous end of the tubing, representing the abnormal intramural collection of peritoneal fluid. Scintigraphic demonstration of this complication of a peritoneovenous shunt has not been reported previously.
Sonographic patterns of thyroid disease were correlated with pathologic findings. Twenty-eight cadaver thyroid glands were prospectively examined with a high-resolution real-time ultrasound scanner. Ultrasound findings were correlated in detail with gross and microscopic findings. Ultrasound is very accurate in detecting architectural variation, adenomatous goiter, and solitary nodules. Ultrasound cannot distinguish benign from malignant nodules, but it can be used to measure changes in nodule size. Glandular asymmetry and multiple solid nodules must be present for confident diagnosis of adenomatous goiter; hemorrhage, necrosis, and calcific spherules may be present in varying amounts. Fibrous septae, dilated follicles, and vascular calcification are found in normal aging thyroid glands. Using these criteria, ultrasonography is very accurate in the diagnosis of adenomatous goiter.
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Growth arrest lines and zones have been reinvestigated. Sequential studies after dietary deprivation reveal transformations of the physis with diminution in formation of the zone of cell columns, resorption of previously formed bone, and cessation of new bone formation. At 6 weeks post diet restriction, the physis is prominently narrowed with transversely oriented, thin bone plaque sealing it from the subjacent marrow. Initially, restoration of stock diet thickens the bony plaque, creating a growth arrest line. Later the zone of osteogenesis adds new bone as a dense metaphyseal band.
This case report of a 5-year-old girl describes a severely comminuted fracture of the cervical and trochanteric areas of the left proximal femur which required open reduction and internal fixation for stable realignment. At 7 months follow-up, angulational deformity was recognized due to partial growth arrest leading to valgus tilt of the proximal femoral epiphysis. After persisting 1 year, gradual spontaneous improvement occurred leading to total realignment with a normally wide growth plate at 36 months following injury. It is hypothesized that the valgus deviation of the femoral head, by causing a medial shift of the weight bearing axis, led to relative unloading of the lateral margin of the growth plate. It is suggested that this mechanical element contributed to the spontaneous release of the epiphyseal tether.
Ten adult mongrel dogs were given 500 mg of cefazolin intravenously, before and after tourniquet cuff inflation. Muscle tissue antibiotic levels were comparable to the control side when the antibiotic was administered prior to tourniquet inflation. Muscle tissue antibiotic levels were markedly diminished compared to the control limb when the antibiotic was given after the tourniquet was inflated. The low level of antibiotic appeared slowly and peaked at 60 minutes as a reflection of minimal limb blood flow. It was questionable whether the small antibiotic concentration in the latter situation served adequate protective cover.
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Psychotherapy and Clinical Fellows responded to a survey that requested them to recommend books they thought were of substantial help in training the prospective clinician to do psychotherapy. Responses indicated that there was little agreement among clinicians with regard to which books are helpful. Also, a minority of clinicians felt that no books were helpful. Those books found most helpful are referenced.
The hallmark of teratological congenital hip dislocation is its advanced severity at birth, signifying longer antenatal duration and accentuation of distortion. There may be contributions from a multiplicity of unrelated syndromes, such as local intrauterine factors, failure of proper formations early in the embryonic period, or genetically determined disorders. Treatment is generally difficult and the end result is uncertain.
Chiari osteotomy as the therapeutic approach in congenital hip dislocation has a special value in the adolescent patient with acetabular dysplasia and femoral head subluxation. The advantage is in the preservation of as much as possible of the modeling relationship of femoral head and acetabulum involved in hip joint motion while creating an effective lateral femoral head cover. Experience with Chiari osteotomy is described in a small group of adolescents (average age, 14 years) whose clinical problem is associated with limp, increasing fatigability and recurrent pain, with discussion of the complications contributing to significant morbidity, the technique of performance and the relative advantages and disadvantages of the procedure.
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Accurate radiographic demonstration of pelvic anatomical landmarks is predicated on proper positioning of the patient. Interpretation of acetabular abnormality especially may be difficult when to the artifact created by pelvic asymmetrical positioning there is added true femoral head displacement. A radiograph of hip joint abnormalities in a child with congenital hip dislocation where positional distortion was present served to illustrate the problem. To clarify the direction and magnitude of acetabluar alterations with specific pelvic positions, radiographs and photographs were taken of anatomic models outlined by suitably placed lead markers. Clues to inappropriate pelvic positioning are loss of symmetry in the widths of the iliac alae, sizes of the obturator foramina, and positions of the "tear drop" figures.
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