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Biomedical subjects

S I Schabel

Publications and source records attributed to S I Schabel.

At least 19 recordsLinked to original sources
PubMed1998

"Tower vertebra": a new observation in sickle cell disease.

BACKGROUND: Skeletal abnormalities are common in sickle cell anemia. Ischemia, infarction, and growth disturbance of the thoracic and lumbar vertebral bodies are among the most common abnormalities, and can suggest the diagnosis radiographically. DESIGN AND PATIENTS: We recently encountered two adult patients in whom vertebrae had grown abnormally in height adjacent to infarcted short vertebrae. We then reviewed the thoracic and lumbar spine radiographs of 54 more adult patients with sickle cell anemia. RESULTS AND CONCLUSION: A total of eight patients (14%) displayed infarcted vertebrae with compensatory vertical growth of at least one adjacent vertebrae. These resemble the elongated vertebral bodies associated with other conditions. We can find no prior report of this finding in association with sickle cell anemia.

Adolescent↗
PubMed1997

Translational injuries in posterior elbow dislocation.

We describe a new plain radiographic finding in posterior elbow dislocation: a defect in the nonarticular posterior surface of the capitellum caused by impaction of the radial head during dislocation. The defect was visible on a lateral view unobscured by overlying bony structures in the unreduced state and confirmed on both an axial view after reduction and by magnetic resonance imaging. We propose that this lesion is analogous to the Hill-Sachs/Bankart lesion complex seen in translational glenohumeral injury.

Accidents, Traffic↗
PubMed1997

Is there an anatomic explanation for chest pain in patients with pulmonary sarcoidosis?

BACKGROUND: Chest pain (CP), its cause unknown, is a common and often prominent symptom of sarcoidosis. METHODS: We determined the frequency and character of CP in patients with pulmonary sarcoidosis and examined its relationship with (1) length of time since diagnosis, (2) roentgenograhic stage, and (3) radiographic abnormalities on spiral chest computed tomography (CT). RESULTS: Twenty-two patients were studied: 14 of 22 patients (64%) had CP, with 4 of 14 (29%) identifying pain as their primary symptom. Eleven of 14 (79%) had pleuritic CP; 12 of 22 (54.5%) described CP as substernal; and 5 of 22 (22.7%) described CP between the scapula. There was not a significant correlation between CP and the presence or degree of lymphadenopathy. There was no significant correlation between CP and the presence or location of pleural disease. Abnormalities of other thoracic structures also had no significant correlation with the presence of CP. CONCLUSIONS: We conclude that there is no "anatomic reason" for CP in patients with pulmonary sarcoidosis that is evident on chest CT.

Adult↗
PubMed1996

Multicentric Castleman's disease: imaging findings.

Multicentric Castleman's disease is an unusual lymphoproliferative lesion typically associated with systemic manifestations and specific histopathology. We describe two cases of pathologically proven multicentric Castleman's disease along with radiographic and ultrasonographic findings.

Adult↗
PubMed1996

Pseudostripe sign in lobar collapse.

The stripe sign in perfusion lung scanning refers to an area of focal hypoperfusion that fails to extend to the pleural surface, leaving a peripheral rim of perfused parenchyma. Although experimental evidence suggests that the stripe sign is caused by central pulmonary emphysema, we report a case of an identical perfusion defect related to a completely collapsed left lower lobe. This etiology should be considered in the differential diagnosis of the stripe sign.

Adult↗
PubMed1995

Multiple symmetrical lipomatosis: computed tomographic appearance.

In a case of localized multiple symmetrical lipomatosis (Madelung's disease), we examined the cervical fat accumulation by computed tomography. We describe the radiographic features of this process and briefly review the pathophysiology of this rare disorder.

Head and Neck Neoplasms↗
PubMed1993

Acquired microileum: a companion to microcolon?

Acquired microcolon results from a lack of distension by the fecal stream because of a proximal obstruction or diversion. We report a case of acquired microileum, which we believe resulted from a similar mechanism, that is, lack of distension by the intestinal fluid column after a proximal ileal diversion.

Adult↗
PubMed1991

Fatal reactions to intravenous nonionic contrast material.

Three cases of fatality related to the use of low-osmolality contrast material (LOCM) are presented. LOCM definitely reduces unpleasant side effects and serious reactions, but data are currently insufficient to determine whether the death rate is any different from that associated with high-osmolality contrast agents. If the present trend toward universal conversion to LOCM continues, an enormous cost for little, if any, lifesaving benefit may be incurred.

Aged↗
PubMed1991

High resolution computed tomography in early scleroderma lung disease.

Seventeen patients with early systemic sclerosis (SSc) underwent high resolution computed tomography (HRCT) of the chest to evaluate dyspnea and/or abnormal pulmonary function tests (PFT). All patients were assigned a dyspnea score and each had routine chest radiography (CXR). Bronchoalveolar lavage (BAL) was performed on 10 patients. HRCT was abnormal in 15 patients (88%), while CXR was abnormal in only 10 patients (59%). Mediastinal lymphadenopathy was detected in 7 patients (41%). Disease duration, dyspnea score, and forced vital capacity (FVC) did not correlate with HRCT score. However, trends toward higher total BAL cell counts and higher BAL neutrophil counts were noted in patients with ground glass opacities on HRCT, and BAL lymphocyte counts were significantly higher in such cases. HRCT is superior to CXR for detecting early interstitial lung disease in SSc, but patient history and FVC correlate poorly with HRCT findings. Ground glass opacities on HRCT may reflect active alveolitis, and mediastinal lymphadenopathy associated with SSc lung disease may be a consequence of pulmonary inflammation.

Adult↗
PubMed1990

Diverticular complications of renal failure.

Ten patients with chronic renal failure presented with complications of colonic diverticula. Five had acute diverticulitis, 4 perforated diverticula, and 1 lower gastrointestinal hemorrhage. Symptoms were less severe than expected. In 3 the diagnosis was first suspected when free intra-abdominal air was detected. Seven patients had laparotomy, 5 emergently. Radiologists should be aware of the potential for diverticular complication in patients with renal failure, even with minimal or absent symptoms. Suspicion of colonic pathology either clinically or radiographically should be evaluated promptly so that aggressive therapy can begin.

Acute Disease↗
PubMed1990

Evaluation and management of scleroderma lung disease using bronchoalveolar lavage.

PURPOSE: Bronchoalveolar lavage (BAL) was performed in 43 nonsmoking patients with scleroderma (systemic sclerosis) to determine the frequency of alveolitis, the status of BAL findings over time, and the relationship of such findings to pulmonary status initially and at follow-up. PATIENTS AND METHODS: Forty-three nonsmoking patients with systemic sclerosis underwent extensive pulmonary evaluation including pulmonary function tests, chest radiographs, and BAL with analysis of cells, IgG, albumin, immune complexes, and fibronectin. RESULTS: Alveolitis was detected on initial BAL evaluation in 21 patients (49%). Alveolitis was characterized by hypercellular lavage fluid, due to an absolute increase in alveolar macrophages and due to an increase in both the absolute number and percentage of granulocytes (neutrophils and eosinophils). Patients with systemic sclerosis had significantly higher levels of IgG and immune complexes in BAL fluid than did control subjects, and alveolar macrophages from patients with systemic sclerosis released higher amounts of fibronectin in vitro. In serial studies, alveolitis was found to persist. Patients with alveolitis had greater dyspnea than patients without alveolitis (p = 0.02), and they had greater reductions in lung volumes and carbon monoxide diffusing capacity (DLCO) (p = 0.004). Furthermore, patients with persistent alveolitis had significantly greater reductions in pulmonary function over time than patients without alveolitis (forced vital capacity [FVC]: -0.69 L versus -0.05 L, p less than 0.001; DLCO: -2.94 mL/minute/mm Hg versus +0.16 mL/minute/mm Hg, p = 0.03). BAL was used to select patients with alveolitis and at risk of pulmonary deterioration, and treatment was instituted with cyclophosphamide and prednisone, resulting in significant improvement in dyspnea (p less than 0.001) and the rate of change of FVC (p = 0.02) and DLCO (p less than 0.001). CONCLUSION: We conclude that alveolitis occurs frequently in systemic sclerosis and that BAL is useful in identifying such patients who are at risk for a further decline in pulmonary status. Preliminary observations suggest that treatment of patients with active alveolitis may result in improvement in pulmonary status.

Adult↗
PubMed1990

Lung disease associated with progressive systemic sclerosis. Assessment of interlobar variation by bronchoalveolar lavage and comparison with noninvasive evaluation of disease activity.

Progressive systemic sclerosis (PSS), or scleroderma, is a disease of unknown etiology that involves many organ systems, including the lungs. The interstitial lung disease of systemic sclerosis is becoming an increasing cause of morbidity and mortality. This process has been previously evaluated with single-site bronchoalveolar lavage (BAL), gallium scanning, pulmonary function testing, and, occasionally, by open lung biopsy. As BAL has been shown to correlate well with open lung biopsy in systemic sclerosis, we sought to determine if single-site BAL accurately reflects alveolitis in a second site in the lung, and if BAL results correlate with other noninvasive tests of lung inflammation: gallium uptake, chest radiography, or arterial blood gas analysis. We performed 17 studies in 13 patients with scleroderma and found no significant lobar differences in lavage results or gallium scanning. By our criteria for normal versus active alveolitis, only two of 17 patient lavages would have been classified as normal by one side and abnormal by the other side. Although percent gallium uptake was equal bilaterally and supported the concept of alveolitis uniformity, gallium uptake intensity did not correlate with activity as measured by BAL. Furthermore, chest radiograph and arterial blood gas analysis did not correlate with BAL results or gallium scanning. We believe these data support the suitability of single-site lavage in the investigation of systemic-sclerosis-associated alveolitis and diminish the importance of gallium scanning in the investigation of systemic sclerosis pulmonary disease.

Blood Gas Analysis↗