Case report: superior vena cava obstruction: unusual CT findings due to venous collaterals.
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Biomedical subjects
Publications and source records attributed to S C Rankin.
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An examination of salmonella isolates collected by the Scottish Agricultural College Veterinary Services Division from April 1994 to May 1995 was conducted to determine the extent to which Salmonella enterica serotype Typhimurium phage type 104 (DT104) occurred and to investigate the antimicrobial resistance patterns of isolates. Typhimurium DT104 was the predominant salmonella and was isolated from nine species of animal. All isolates of this phage type possessed resistance to at least one antimicrobial and 98% of the isolates were resistant to multiple antimicrobials with R-type ACTSp the predominant resistance pattern. Various other resistance patterns were identified and transferable resistance to the veterinary aminoglycoside antimicrobial apramycin was demonstrated in three strains. A retrospective study for gentamicin resistance in isolates from the Scottish Salmonella Reference Laboratory collection revealed a human isolate of Typhimurium DT104 resistant to gentamicin but sensitive to apramycin and a bovine isolate with apramycin and gentamicin resistance.
One hundred isolates of Salmonella serotype Eimsbuettel from various human, animal and environmental sources in six countries were typed and shown to belong to five ribotypes, five biotypes and eight different ribotype/biotype groups, one of which, ribotype 3/biotype 5, was represented among isolates from all six countries. Most of the Eimsbuettel isolates from Scotland belonged to ribotype 1/biotype 3, which was the epidemic strain involved in a large outbreak centred in a Glasgow maternity hospital in 1986. That strain was also responsible for almost all the human infections that occurred in the west of Scotland in the years of this study. However, isolates from human cases in the east of Scotland belonged to either ribotype 2/biotype 1 or ribotype 3/biotype 5, groups not found in the west of Scotland. Representatives of all three ribotype/biotype groups causing human infection in Scotland were also found among isolates from poultry or poultry-associated materials. Plasmids were carried by only 14% of isolates and so provided little additional strain discrimination. However, plasmid analysis suggested that Salmonella Eimsbuettel of ribotype 2/biotype 1 had the potential to enter the human food chain in the UK via meat or bone meal, animal feed and poultry.
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Isolates of Salmonella serotype Livingstone (6,7:d:1,w) from man, water and various animals and animal products in Canada, England, France, Israel and Scotland were examined for ribotype, biotype and plasmid profile. Analysis by these methods indicated that an epidemic strain of Livingstone of ribotype 1/biotype 8/plasmid-type 6 was responsible for the major upsurge of Livingstone infection that occurred in man in Tayside (Scotland) between 1989 and 1991; that type was also isolated from spring water, animal feed and poultry. Livingstone isolates of ribotype 1/biotype 8 with plasmid profiles other than type 6 were also present in Scotland, England and France at that same time. Among representative Livingstone isolates from England, a strain of ribotype 2/biotype 1 was predominant in man and poultry products between 1988 and 1992, although strains of other ribotypes (1, 3 and 4) were also present. Strains of ribotype 3 of different biotypes were obtained from poultry and animal feed sources in Canada. A strain of ribotype 5/biotype 3 caused human infections in Israel between 1968 and 1992. Ribotyping, biotyping and plasmid profile analysis used together have helped to trace the sources and extent of spread of human infections caused by Salmonella Livingstone.
The occurrence of a Crohn's abscess involving the hamstring muscle group has not been reported previously. We report this diagnosis in a patient with ileocolonic Crohn's disease who had presented earlier with a presacral abscess.
Four hundred and thirty-four isolates of Salmonella enterica serotype Enteritidis were studied. They were grouped into five subsets defined by either the collection criteria or the parameter which formed the basis for subsequent analysis. Seventy-seven per cent harboured the serotype-specific plasmid (SSP). In 55% of the isolates this was the sole plasmid. Molecular variation in the SSP was detected in 17 (5%) of the isolates on the basis of restriction enzyme fragmentation pattern (REFP) analysis using Pst I and Sma I. The SSP variants were further characterized using additional restriction enzymes chosen to optimize the information content and analysed using a coefficient of similarity. A variant SSP designated pOG690 showed greater resemblance to the SSP of Salmonella enterica serotype Typhimurium than Enteritidis; 89% and 68% respectively for Pst I and 79% and 55% respectively for Sma I. In respect of the Pst I data pOG690 shared at least 55 kb of DNA with the Typhimurium SSP and 37 kb with the SSP of Enteritidis. This variant was associated with poultry (duck, goose, chicken) and all isolates belonged to phage type 9b. Other variants were associated with phage types 4, 6, 6a, 9a, 11, 15 and 24. The epidemiological implications of these results are discussed.
Oesophageal duplication cysts are very rare congenital abnormalities. We report a case of one sited in the middle third of the oesophagus causing stenoses of both pulmonary arteries, with collapse of the left lung due to left main bronchus obstruction.
We describe two patients who presented with acute renal failure secondary to aortocaval fistulae, which were demonstrated by computed tomography (CT) and confirmed at surgery. Renal function rapidly returned to normal following appropriate surgery. In addition to the expected CT findings of early equal enhancement of the inferior vena cava and aorta and dilation of the inferior vena cava, there was early enhancement of dilated renal veins despite poor contrast enhancement of the kidneys. It is postulated that retrograde flow of blood from the aortocaval fistula may cause renal impairment secondary to renal venous hypertension.
We report two cases of paraganglioma in which the tumour was situated adjacent to the head of the pancreas simulating a pancreatic mass lesion. The absence of biliary or pancreatic duct dilatation on ultrasound in the presence of a large mass suggested a retroperitoneal tumour rather than a pancreatic adenocarcinoma. Functional activity in these tumours is common and should be excluded before biopsy.
427 radionuclide brain scans, performed in 1981 at Guy's Hospital Nuclear Medicine Department, were reviewed retrospectively to define clinical circumstances in which the study provided useful information. It was concluded that the radionuclide brain scan was the appropriate first line investigation in patients with known non-cerebral malignancy, in whom the possibility of cerebral metastases exists; and in patients with a low to moderate probability of subdural haematoma. The radionuclide brain scan can provide a valuable alternative to computed tomography studies:--(1) in patients without known underlying disease who develop localising signs; (2) in patients with focal fits; (3) in patients with underlying vascular disease and gradual onset of localising signs; and (4) in patients with suspected inflammatory conditions of the central nervous system. Outside these groups, the radionuclide brain scan rarely provided useful information.
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Forty-three chest (noncardiac) and 75 abdominal computed tomographic (CT) examinations were studied by obtaining four sections of a pertinent area using 2.25-, 4.5-, 9-, and 18-second scan speeds. Chest scans obtained with the three faster speeds were perceived to be qualitatively similar to one another but were rated better than the 18-second sections. While these qualitative differences were statistically significant, most were relatively unimportant clinically. Analysis of the abdominal sections showed significant qualitative improvement with each successively faster scan speed. The only sections rated unreadable and/or showing large numbers of motion artifacts were abdominal studies, primarily 18-second studies. A statistically significant loss of diagnostic information was noted with 18-second scans, especially in the upper abdomen.
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PURPOSE: A new nonrigid registration method, designed to reduce the effect of movement artifact in subtraction images from breast MR, is compared with existing rigid and affine registration methods. METHOD: Nonrigid registration was compared with rigid and affine registration methods and unregistered images using 54 gadolinium-enhanced 3D breast MR data sets. Twenty-seven data sets had been previously reported normal, and 27 contained a histologically proven carcinoma. The comparison was based on visual assessment and ranking by two radiologists. RESULTS: When analyzed by two radiologists independently, all three registration methods gave better-quality subtraction images than unregistered images (p < 0.01), but nonrigid registration gave significantly better results than the rigid and affine registration methods (p < 0.01). There was no significant difference between rigid and affine registration methods. CONCLUSION: Nonrigid registration significantly reduces the effects of movement artifact in subtracted contrast-enhanced breast MRI. This may enable better visualization of small tumors and those within a glandular breast.
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