Biomedical subjects
Publications and source records attributed to K Shaffer.
We report a patient with myelofibrosis, granulocytopenia, and septic arthritis, in whom lithium carbonate induced a more appropriate granulocyte count. Further evaluation of the use of lithium carbonate in granulocytopenic states seems warranted.
Radiographic findings previously thought pathognomonic for juvenile nasopharyngeal angiofibroma are anterior bowing of the posterior wall of the maxillary antrum on plain films or tomography, and a dense homogeneous blush on angiography. Two patients presented with nasopharyngeal masses which mimicked angiofibroma radiographically: one mass was a lymphoepithelioma and the other was a fibrous tumor. Constitutional symptoms and atypical physical findings should alert the physician to a diagnosis other than juvenile nasopharyngeal angiofibroma.
Pneumocele of the maxillary sinus is a recently described disease, first noted in 1974. Three subsequent cases have been encountered. Pneumocele refers to an expansile cystic air-containing mass, occupying the entire maxillary sinus, and lined by the original attenuated mucous membrane. It is analogous to mucocele, but containing air rather than fluid content. Radiologic signs are diagnostic, and it is the purpose of this presentation to enumerate these radiologic findings.
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We present the imaging findings in 13 patients with nonmyxomatous primary neoplasms of the heart and pericardium. Ten patients had abnormal chest films. While echocardiography was useful for determining origin of the tumor, CT (computed tomography) and MRI (magnetic resonance imaging) were better at delineating extent of disease. The radiographic appearance of these rare neoplasms of the heart and pericardium is varied. Cross-sectional imaging plays a crucial role in the surgical planning and management of these patients.
OBJECTIVE: Primary mediastinal large cell lymphoma is a distinctive subtype of non-Hodgkin's lymphoma. Computed tomography (CT) has become an integral part of the evaluation of these patients at presentation and after completion of therapy. The purpose of this study is to identify CT features that predict increased risk of relapse. METHODS: A retrospective study of patients with primary mediastinal large cell lymphoma who underwent CT scans of the thorax. RESULTS: Tumor volume greater than 100 ml after completion of therapy was a statistically significant predictor of increased risk of relapse (p=0.02, Fisher exact test). Other measurements (obtained at presentation and after completion of treatment) were not statistically significant in predicting relapse. CONCLUSION: CT plays an important role in predicting outcome in primary mediastinal large cell lymphoma. Large residual tumor volume after completion of treatment predicts an increased risk of relapse.
A key precipitating factor in the pathogenesis of acute bacterial sinusitis (ABS) is ostiomeatal obstruction. It has been postulated that ABS cannot resolve until the sinus ostium is patent. The primary purpose of this study is to quantify sinusitis resolution after temporary ostial occlusion in a rabbit model. A secondary aim is to quantify bacterial clearance with and without antimicrobial therapy in Staphylococcus aureus infected sinuses. A blinded, placebo controlled study in 10 New Zealand white rabbits was performed using Merocel as a temporary maxillary sinus ostial obstruction. Computerized tomography (CT) of the maxillary sinuses was obtained before and after bilateral ostial occlusion; sinuses were cultured and then the left sinus was injected with approximately 10(8) cfu/mL S. aureus. CT imaging and sinus cultures were obtained and then the ostial plugs were removed. Serial CT and cultures were done until sinusitis resolved and cultures were negative for S. aureus. Mean CT sinusitis scores increased with ostial obstruction and decreased with ostial plug removal (P < 0.0001 and P < 0.001). Injection of S. aureus did not significantly change mean CT sinusitis scores despite being cultured from 45% of sinuses. Antimicrobial therapy was not significant in reducing mean CT scan sinusitis scores or positive cultures. Resolution of mucosal swelling is more dependent on relief of ostial obstruction rather than antimicrobial therapy in this rabbit model.
A prospective computed tomographic and complex-motion tomographic evaluation was performed in 18 suspected or proven cases of otosclerosis. Although there was good agreement between both methods, there was no greater diagnostic accuracy with computed tomography. However, computed tomography demonstrated the changes better than complex-motion tomography.