Biomedical subjects
Publications and source records attributed to S Eustace.
Two patients are described in whom sciatica was caused by non-Hodgkin's lymphoma involving the spinal epidural space. Systematic investigation revealed no evidence of lymphoma in other sites.
Twelve patients with systemic lupus erythematosus (SLE) who developed major acute cerebrovascular episodes are described. All patients were female, with a mean age of 43.3 years and they had suffered from SLE for between 1 month and 22 years (mean 9.3 years) at the time of stroke. All patients had multiple clinical and laboratory features of systemically active SLE. Stroke was the initial neurological feature in nine patients. Cerebral infarction was confirmed in eight patients and cerebral haemorrhage in two; the two remaining patients had convincing clinical evidence of thromboembolic neurological complications. Characteristic clinical and serological features of antiphospholipid antibodies were observed in six patients (50 per cent). Five patients died as a direct result of stroke and two other patients died within one year.
Victor and his associates coined the term oculopharyngeal muscular dystrophy to describe a clinical syndrome characterised by dysphagia and ptosis. Subsequent authors have traced a large series in French Canadians to a single Quebec isolate and have emphasized that the condition is usually inherited as a dominant trait. In 1974 Fried reported two isolated cases in an Ashkenazi Jewish family of Hungarian extract in whom the condition was recessively inherited. In this paper we report an Irish family from North Cork with typical features of oculopharyngeal muscular dystrophy in whom the inheritance pattern is dominant with incomplete expression. In reporting such cases the ethnic and genetic heterogeneity of oculopharyngeal muscular dystrophy is highlighted. Case Report 1. A 68 year old farmer was admitted for investigation of recurrent chest infections. He complained of a 20 year history of progressive difficulty swallowing, productive cough and impaired vision. On examination he had a gaunt expressionless appearance with bilateral ptosis to mid pupillary level. Both right and left gag reflexes were noted to be reduced and sluggish, and on swallowing fluids were noted to regurgitate through his nostrils. Chest examination revealed the presence of bibasal coarse crepitations suggestive of aspiration. No further physical abnormalities were noted. On investigation, full blood count, urea, and electrolytes, liver function tests, sedimentation rate, thyroid function tests, muscle enzymes (PK, LDH) and electrocardiogram were normal. Chest radiograph confirmed aspiration. Tensilon test was negative. Oesophagoscopy outruled organic obstruction, and confirmed sluggish pharyngeal muscular activity. A clinical diagnosis of oculopharyngeal dystrophy was made on the basis of associated ptosis and dysphagia occurring in the presence of a supportive family history.(ABSTRACT TRUNCATED AT 250 WORDS)
Aplastic anaemia is recognised to occur following the use of some non-steroidal anti-inflammatory drugs. We report a case of fatal aplastic anaemia following prolonged administration of diclofenac in a 77 year old lady with rheumatoid arthritis. To our knowledge this is the first report of fatal aplastic anaemia associated with diclofenac use in an elderly patient.
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Ten thousand seven hundred fifty-six patients underwent cardiac bypass surgery at the Mater Hospital national cardiac unit between September 1979 and April 1993. Of this group, 49 patients were identified who had developed postoperative gastrointestinal complications leading to 16 deaths. Twenty-five patients developed gastrointestinal hemorrhage, eight patients developed gallbladder disease, five patients developed phlegmonous pancreatitis, eight patients developed bowel perforations, and three patients developed intestinal pseudoobstruction. The particular radiological features that lead to diagnosis in each case are discussed and relevant literature is briefly reviewed.
BACKGROUND: To review the clinical impact of vertebroplasty in osteoporotic and myelomatous compression fractures METHODS: Eleven compression fractures in eight patients were treated by percutaneous cement vertebroplasty over a three-year period, May 2000 to May 2003. RESULTS: Successful percutaneous stabilisation and cement injection was performed in all compression fractures. In five of eight patients (eight of eleven compression fractures) injection of cement yielded dramatic reduction in pain within 24 hours of the procedure. CONCLUSION: Preliminary experience suggests that percutaneous cement vertebroplasty is an effective well tolerated method of stabilisation of spinal wedge compression fractures resulting in dramatic reduction in associated pain in most cases.
BACKGROUND: Osteoid osteoma is a painful benign bone tumour. Previously the standard therapy was surgical excision. Image guided radiofrequency ablation can be clinically applied to ablate the tumour in a minimally invasive manner. AIMS: We present a case of an 18-year-old boy who presented with features of chronic left hip arthropathy secondary to intra-articular osteoid osteoma, subsequently successfully treated by percutaneous CT guided radiofrequency ablation. RESULTS: The CT guided radiofrequency ablation was technically successful as a day case procedure without complication. The patient returned to normal function within one week. No recurrence occurred in the three-year follow-up period. CONCLUSION: Radiofrequency ablation is a safe, minimally invasive and effective technique for treatment of osteoid osteoma.
We present the computed tomography (CT) findings of a hamartoma of the epiglottis occurring in a 58-year-old man. Although hamartomas are particularly uncommon in this site. CT identification of fat within the complex mass facilitated diagnosis without recourse to an invasive biopsy.
We present the imaging findings of a 29-year-old man with an intralobar sequestration of the posterior segment of the left lower lung lobe, occurring distal to and sharing parasitized blood supply with a proximal occluding endobronchial carcinoid tumor. The etiology and pathogenesis of intralobar bronchopulmonary sequestration are discussed.
Plain film radiographs and computed tomography scans of sacroiliac joints in 65 asymptomatic patients with known inflammatory bowel disease were performed and evaluated by two radiologists. Computed tomography revealed the presence of asymptomatic sacroiliitis in 21 (32%) of the 65 patients (New York grades 2 to 4); asymptomatic sacroiliitis was identified by plain film radiography in only 10 (18%) of 57 patients (p < 0.001). No correlation was observed between the presence or absence of sacroiliitis, and the age and sex of patients, disease type, or duration of disease. The prevalence and diagnostic value of computed tomography in the detection of asymptomatic sacroiliitis in patients with inflammatory bowel disease are discussed.
Chondrosarcoma is a malignant tumor of cartilaginous origin, and the second most common primary malignant bone tumor in the United States. Only approximately 10% of chondrosarcomas occur in the head and neck region, and of these the hyoid bone is a rare site of involvement. This report describes such a case, as well as the radiographic features as seen by CT scan.
MR imaging of a dedifferentiated chondrosarcoma of the humerus is presented and correlated with gross and microscopic histology from the surgical specimen. The classification of chondrosarcoma and specific MR signal characteristics that suggest dedifferentiation are discussed.
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OBJECTIVE: We report two cases of cystic renal masses considered indeterminate on sonography and CT, in which haemorrhagic contents were demonstrated on MRI. MATERIALS AND METHODS: Spin echo T1-weighted axial and coronal (TR 700 ms; TE 17 ms) and T2-weighted axial (TR 3,000 ms; TE 90 ms) upper abdominal scans were obtained on a 1.5 T MR machine. RESULTS: Cyst contents were of high signal on both T1- and T2-weighted sequences, indicating internal haemorrhage, which was confirmed at surgery. CONCLUSION: There is a high propensity for haemorrhagic renal masses to mask carcinoma. By distinguishing blood from other contents, MRI had a noninvasive role in diagnosis and further management.
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The clinical and radiographic features of 83 patients with a diagnosis of Ankylosing Spondylitis conforming to Rome criteria were reviewed. There was 64 males and 19 females attending for a mean duration of 13 and 11 years. Females presented with more peripheral arthritis (X2 = 3.15464, DF = 1, P < .05 (one sided) and more asymptomatic sacroiliitis (X2 = 6.70172; DF = 1, P < .01 (two sided)). Spinal involvement occurred with a similar frequency in men and women, no increase in cervical spine involvement in women was identified. Four males and one female of 83 patients, developed radiographically proven spinal fusion. One male patient developed upper lobe pulmonary fibrosis, one male patient developed the cauda equina syndrome, one male patient required a total hip replacement. No statistically significant difference in the rate of complications in men and women was identified.