Does ursodeoxycholic acid have a place in the treatment of amiodarone-induced cholestasis?
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Aged↗
Biomedical subjects
N Loberant
Publications and source records attributed to N Loberant.
Melanocytic schwannoma of the spinal cord: a case report.
Melanocytic schwannoma of the spinal cord is a tumour composed of Schwann cells capable of producing intracellular melanin. We present a case report of a 25-year-old male with melanocytic schwannoma of the 5th lumbar spinal cord root; the patient is alive and well 48 months after neurosurgical removal of the tumour. A review of the literature revealed 14 similar cases. These tumours have a local recurrence rate of up to 14%, and have a metastatic potential.
Adult↗
The "brown bowel syndrome" associated with jejunal carcinoma.
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Adenocarcinoma↗
[Intrabiliary rupture of hepatic echinococcal cyst].
Echinococcal disease of the liver generally presents as single or multiple hepatic cysts. Rarely, these cysts may rupture into the biliary tree and cause cholangitis, biliary tract obstruction, or biliary colic. These complications are accompanied by high morbidity, and in the case of biliary tract obstruction, mortality rates as high as 50% have been reported. We present a woman with a hepatic echinococcal cyst, biliary colic, and transient jaundice, who proved to have echinococcal involvement of the biliary ducts and gall bladder. Prompt diagnosis of hydatid disease of the biliary tree allows the physician to institute rapid, appropriate medical and surgical treatment.
Biliary Tract Diseases↗
Second cancer in patients treated for testicular seminoma.
The exact risk of developing a second primary cancer following radiotherapy for testicular seminoma is not known. At the Northern Israel Oncology Center, between the years 1968-1988, 75 patients with early stage (I,IIA) testicular seminoma were treated by orchiectomy followed by radiation therapy. The overall 10- and 20-year survival probability was 95% and 90%, respectively. Eight patients (11%) developed nine second cancers, with a cumulative rate of one case per 1,000 years of follow-up. The second primary cancers were: two bronchogenic carcinomas, one contralateral seminoma, one thymoma, one papillary carcinoma of the thyroid, one carcinoma of the stomach, one transitional cell carcinoma of the urinary bladder, one carcinoma of the colon, and one malignant melanoma. Three of these tumors developed within the irradiated field. Five of these eight patients are alive with no evidence of recurrent cancer. We conclude that patients treated for seminoma have an increased risk of developing a second cancer. There is a need for greater awareness of this possibility. The overall prognosis remains favorable.
Combined Modality Therapy↗
Closure of the ductus venosus in neonates: findings on real-time gray-scale, color-flow Doppler, and duplex Doppler sonography.
OBJECTIVE: Our objective was to document the anatomy, flow pattern, and time of closure of the ductus venosus in healthy full-term neonates. SUBJECTS AND METHODS: We examined the ductus venosus in 73 neonates by using gray-scale sonography, color flow imaging, and duplex Doppler sonography. Each neonate was examined 1-2 days after birth, 6-7 days after birth, and then every 3-4 days until closure was confirmed or the neonate was 18 days old. The length, width, and color flow and duplex Doppler characteristics of the ductus were noted. Closure of the ductus at 6-7 days after birth was examined with respect to birth weight, hemoglobin level, and gestational age. RESULTS: The ductus venosus, extending from the left portal vein to the inferior vena cava, was identified with all three techniques. The ductus was patent in all 73 neonates 1-2 days after birth. It was still patent in 41 (68%) of 60 neonates reexamined 6-7 days after birth and in two of three neonates (11% [7/60]) reexamined 17-18 days after birth. Blood flow within the ductus was cephalic, in a constant venous waveform. Initial flow velocity ranged from 0.15 to 0.70 m/sec and decreased consistently in subsequent examinations. There was no significant difference in birth weight, hemoglobin level, or gestational age between the group whose ductus was closed and the group whose ductus was open at 6-7 days after birth. CONCLUSION: The ductus venosus in neonates is consistently detectable on sonography. It is patent in a greater percentage of neonates, and for a longer time, than was previously shown with conventional radiographic studies with angiography.
Blood Flow Velocity↗
Systemic effects of rectally administered corticosteroids.
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Administration, Rectal↗
Emergency imaging of the urinary tract.
Conventional radiography remains the mainstay of emergency imaging of the urinary tract; however, computed tomography in trauma and ultrasonography in medical conditions have greatly improved the accuracy and speed with which diagnoses can be made and treatment instituted. This article reviews the imaging modalities available to the emergency department physician and their application in the most common emergency situations.
Diagnostic Imaging↗
Imaging considerations in the geriatric emergency department patient.
This article has reviewed the imaging modalities for clinical problems that are prevalent or problematic in the geriatric Emergency Department population. Geriatric patients may present with atypical symptoms that mask serious illness: diagnostic imaging begins with a high index of suspicion and the choice of the proper imaging modality. For certain problems, such as skeletal trauma and chest complaints, conventional radiography provides an excellent screening examination. For other problems--abdominal, vascular, and central nervous system disorders--computed tomography, ultrasound, and radionuclide scanning have become important primary imaging modalities. Since the emergency physician is in a position to direct the initial imaging of the patient, he or she must weight the factors of cost, invasiveness, and accuracy of the diagnostic modalities available at the institution. Emergency radiology is a growing field. References have been included in the reference list for general emergency radiology, specific modalities, and specific anatomic areas. In addition, there are resources that document pitfalls in imaging; the Keats volume is indispensable both in the Emergency Department and in the Radiology Department.
Aged↗
Acute focal bacterial nephritis: emphasis on imaging.
A case of acute focal bacterial nephritis in a child is presented. Imaging findings for various modalities are discussed (nuclear medicine, ultrasound, computed tomography, and conventional radiology) with a suggestion for optimal imaging strategy in these cases.
Acute Disease↗
Multiple primary thyroid and breast cancer in Israel, 1960-1976.
The occurrence of breast and thyroid multiple primary neoplasms has been evaluated using data from the Israel Cancer Registry. During the 16 years 1960-1976, 3,072 cases of thyroid cancer were registered in Israel. The occurrence of a second primary tumour was reported in 92 of these patients. In this latter group were 25 female patients (27%) with breast cancer, developing synchronously in 7 cases and metachronously in the remaining 18. The average age at the time of appearance of breast cancer was 50 years. Most of the patients (84%) were of European origin. The most common histological types were ductal and intraductal carcinoma and scirrhous adenocarcinoma. The possible aetiological factors common to breast and thyroid cancer are discussed. Efforts aimed at improving the survival of patients with thyroid cancer must incorporate strategies for the early detection and treatment of secondary breast cancer.
Adult↗
Nonocclusive ischaemic bowel disease in patients on chronic haemodialysis.
Six patients with chronic renal failure on longstanding haemodialysis are presented, in whom nonocclusive bowel ischaemia occurred as a rare complication of their underlying disorder. Factors implicated in the development of bowel ischaemia in these patients are chronic constipation resulting in increased intraluminal pressure on the bowel wall, premature and progressive arterial disease and bouts of hypotension accompanying the haemodialysis procedure. Contrast studies of the bowel and computed tomography examination can suggest the diagnosis, but angiography alone provides the exact answer in demonstrating nonocclusive mesenteric ischaemia. In patients with chronic renal failure and longstanding dialysis presenting with abdominal symptoms this diagnosis should be considered.
Aged↗
Data analysis for cervical spine injuries.
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Cervical Vertebrae↗
Postprandial dilatation of the gallbladder in cholelithiasis.
PURPOSE: We assessed the postprandial sonographic findings in patients with cholelithiasis whose gallbladders were completely contracted after fasting. METHODS: The gallbladders of 5 patients with recurrent abdominal pain were completely contracted despite overnight fasting and could not be adequately examined on sonography. The patients were given a fatty meal and re-examined after 30 minutes. RESULTS: In all patients, the gallbladder became distended after the meal, and gallstones were clearly demonstrated. CONCLUSIONS: Patients whose gallbladders are completely contracted after overnight fasting and cannot be adequately evaluated on sonography should be given a fatty meal and re-examined sonographically. This technique is efficient in preventing unnecessary additional patient visits for the evaluation of cholelithiasis.
Adult↗
Unilateral "vanishing psoas": an anatomic variant.
We report five patients found to have obvious asymmetry of the psoas muscles on abdominal computed tomography (CT) examination. In all five patients, the upper portion of the psoas muscle was normal, but the lower portion was significantly reduced in size. In no patient was there neurological or other disease that might explain this finding. No patient exhibited signs or symptoms secondary to psoas asymmetry. Asymmetry of the psoas musculature is apparently a benign anatomical variant that may be recognized on CT examination and must be differentiated from pathological conditions.
Diagnosis, Differential↗
Inflammatory pseudotumor of the liver.
We present a case of inflammatory pseudotumor of the liver (IPL), a rare benign hepatic lesion. A 66-year-old woman with fever, and right abdominal pain and mass underwent abdominal sonography and computed tomography. Both showed multiple hepatic masses. Ultrasound guided needle liver biopsy showed a dense chronic inflammatory lesion with innumerable foamy histiocytes and spindle fibroblasts consistent with IPL. She improved with conservative treatment. Clinical, pathologic, and imaging findings at IPL are reviewed.
Aged↗