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Biomedical subjects

Z L Deeb

Publications and source records attributed to Z L Deeb.

At least 37 records · Page 2Linked to original sources
PubMed1987

Thoracic fractures and dislocations in motorcyclists.

Motorcyclists who are involved in accidents generally suffer severe multiple injuries, some of which are not readily apparent on initial examination. One such subtle injury is fracture, with or without dislocation, in the upper thoracic spine. The severe spinal cord damage produced by the injury is often overshadowed by cerebral or cervical injury. Proper diagnosis is further hampered by the fact that the upper thoracic region is difficult to examine radiographically on plain films, particularly when using portable equipment. Of a group of 14 motorcyclists having 26 fractures and/or dislocations in the thoracic region, 12 had 24 injuries between T3 and T8. These 24 injuries represented 56% of the fractures and/or dislocations encountered in a larger study of trauma to the thoracic vertebral column. All of these were flexion injuries, suffered when the individual was thrown from the motorcycle and struck a large, solid object. In three cases, the diagnosis was delayed as much as 48 h because proper films were not obtained initially. Because of the serious consequences of delayed treatment, we recommend that all motorcyclists who have sustained severe trauma be examined by overpenetrated film of the upper thoracic region.

Accidents, Traffic↗
PubMed1987

The posterior vertebral body line: importance in the detection of burst fractures.

A review of the lateral radiographs and CT studies of 114 patients with burst fractures, 46 patients with combined injuries in whom bursting was a major component, and 82 patients with simple anterior compression fractures was performed to evaluate the integrity of the posterior vertebral body margin. This structure normally produces a single or bifid vertical line on the lateral radiograph. Disruption, displacement, or rotation of this line was found in all 114 patients with "pure" burst fractures. These abnormalities were also present in 36 of the 46 patients with combined burst injuries. In all patients with simple compression fracture, flexion, distraction or dislocation, and extension injuries, the line was normal. CT studies showed these abnormalities to be the result of retropulsion of one or more bone fragments from the posterior margin of the vertebral body. Disruptive abnormalities of the posterior vertebral body line are reliable plain-film signs that a burst fracture has occurred and that compromise of the vertebral canal and subarachnoid space is present.

Cervical Vertebrae↗
PubMed1986

Pseudofractures of the cervical vertebral body.

A lucency traversing obliquely across the inferior-posterior aspect of cervical vertebral bodies may be a normal variant due to osteophytes of the uncinate processes or transverse processes with a resultant Mach band phenomenon. This could be misinterpreted as a fracture of the vertebral body in a patient with a history of cervical injury. A review of normal lateral cervical vertebral films obtained on patients with no traumatic history showed this phenomenon to occur in 27% of adults. It was not observed in children. The proper interpretation is easily made when one considers the location and the fact that a cervical fracture does not occur in such a location as an isolated event.

Adolescent↗
PubMed1986

"Fingerprints" of vertebral trauma--a unifying concept based on mechanisms.

Vertebral fractures, like fractures in the peripheral skeleton, occur in predictable and reproducible patterns that are related to the kind of force applied to the affected bone. The same force applied to the cervical, thoracic, or lumbar column will result in injuries which appear quite similar. A review of 621 injuries to the vertebral column revealed that there are basically four mechanisms of injury: flexion, extension, shearing, and torque (rotation). These injuries may occur by themselves or in combination with one another. The severity and extent of damage produced by any mechanism is dependent upon the incident force, the position of the patient at the time of injury, and the velocity of the patient. Thus, there is a pattern of recognizable signs which span the spectrum from mild soft tissue damage to severe skeletal and ligamentous disruption. These patterns are termed the "fingerprints" of the injury, and this presentation illustrates the four basic types of vertebral injury producing those "fingerprints."

Biomechanical Phenomena↗
PubMed1986

Diagnosis of sacral perineural cysts by computed tomography.

Three cases of sacral perineural cysts associated with chronic low-back pain are described with their myelography, computed tomography, and plain film findings. Significant findings include multiple cystic dilatations of lumbosacral nerve root sheaths, enlargement of the sacral foramina by masses isodense with cerebrospinal fluid, and asymmetric epidural fat distribution. Recognition of these findings on unenhanced computed tomography scans should preclude further evaluation by myelography and intrathecal metrizamide (Amipaque) computed tomography. These cysts are usually not the primary cause of back and leg pain.

Aged↗
PubMed1986

Magnetic resonance imaging in the diagnosis of breast disease.

Magnetic resonance imaging (MRI) of the breast was performed in 10 volunteers and 102 women with suspected breast disease, using a 0.35-T superconducting magnet. All patients had prior x-ray mammography. MRI was superior to mammography in differentiating solid from cystic lesions and equivalent to mammography in providing information regarding different parenchymal patterns. Of 21 surgically proven carcinomas of the breast, MRI correctly identified 18 and mammography identified 19. The major disadvantage of MRI is its inability to show calcifications, benign or malignant. Future studies will be needed to show the relative values of sonography and MRI in detecting small cysts. In addition, MRI in future should be able to demonstrate small, noncalcified masses in mammographically dense, fibrocystic breasts.

Adenofibroma↗
PubMed1986

MRI in the detection of malignant infiltration of bone marrow.

Magnetic resonance imaging (MRI) at 0.35 T with a superconductive magnet was performed on 80 patients with known or suspected malignant disease of the bone marrow. The group comprised 50 patients with known primary malignancy and 30 with known multiple myeloma. The MRI scan was correlated with plain films and radionuclide bone scans. In 40 patients with suspected metastatic disease, areas of decreased signal intensity on T1-weighted spin-echo images were observed. Ten patients had no MRI evidence of metastasis, and the abnormalities suspected on bone scanning were shown to be due to other causes. All the myeloma patients had abnormalities demonstrated by MRI. This was significant, since most had normal bone scans. All diagnoses were confirmed by needle biopsy. MRI was shown to be a sensitive method of detecting areas of malignancy within the bone marrow toward which biopsy could be directed.

Bone Marrow Diseases↗
PubMed1985

Herniated thoracic intervertebral disks.

The diagnosis of herniated thoracic disks has historically been confusing for the clinician and difficult for the radiologist. Its protean manifestations lead it to mimic many diseases including spinal cord tumors and degenerative diseases. Radiographically, its diagnosis has been difficult by both routine radiography and myelography. Our two cases demonstrate post-metrizamide (Amipaque) myelogram computed tomography to be a valuable aid in the diagnosis of herniated thoracic disks.

Aged↗
PubMed1985

Intervertebral disk-space infection after chymopapain injection.

Four patients who had received chymopapain injections for treatment of herniated lumbar disks were evaluated by computed tomography (CT) because of persistent low back pain and suspicion of infection. Irregularity of the vertebral end-plate and a mottled appearance of the vertebral bodies suggested the diagnosis of disk-space infection in all four cases. CT-guided biopsy of the disk space was performed in each case, and bacterial cultures demonstrated staphylococcal infections, which were treated accordingly. Diskitis secondary to chymopapain injection is rare because of the precautions that are usually taken. No antibiotics are used routinely with such injections, although systemic antibiotics have been used in diabetics for prophylaxis.

Adult↗
PubMed1985

Fibrosis surrounding a silicone implant simulating recurrent orbital meningioma. Case report.

A patient with the preoperative diagnosis of recurrent orbital apical meningioma was found to have a fibrotic capsule surrounding a silicone plate implanted 3 years previously to reconstruct the orbital roof. Caution is urged in using alloplastic orbital implants for reconstructive purposes in patients undergoing orbital surgery, because associated fibrous capsule formation may mimic tumor recurrence.

Adult↗
PubMed1984

Computed tomography of spine trauma.

Nine patients admitted to the hospital for spine trauma were studied with computed tomography. The use of computed tomography minimized patient motion, allowed excellent definition of compromise of the spinal canal by fracture fragments, and better delineated fractures of the neural arches than plain films or tomography. Plain radiographs and computed tomography scans permitted complete evaluation of spine trauma with no additional investigations being necessary.

Adult↗
PubMed1983

Computed tomography in acute head injuries.

Computed tomography (CT) is ideally suited for detection of intracranial pathology, whereas plain radiography is limited to the bony structures. Distinguishing surgical and nonsurgical lesions is quite feasible with CT. Follow-up examinations are non-traumatic and carry minimal risk to the critically ill patient. In the great majority of head trauma cases, the recognition of pathology is unequivocal, thus facilitating proper management.

Acute Disease↗
PubMed1983

Radiographic signs of acute traumatic rupture of the thoracic aorta.

The initial chest radiographs of 54 trauma patients who were referred for angiography of the thoracic aorta were reviewed. Retrospective evaluation used eight radiographic signs that have been described in possible aortic injury. This review was undertaken to establish the occurrence and validity of these signs in the diagnosis of aortic tear. Results indicated that loss of the aortic arch contour and mediastinal widening were the most reliable signs of disruption of the aorta. In patients with at least one of these two signs, there was a high percentage of positive angiograms.

Acute Disease↗