Biomedical subjects
Publications and source records attributed to Z Salimi.
Though there have been a number of articles on lympho-venous anastomoses, there have been no reports of the opposite situation, namely veno-lymphatic communication. A case of veno-lymphatic communication is presented, and possible explanations for this finding are described.
The CT examinations of 26 consecutive alcoholic patients with focal fatty infiltration of the liver were analyzed. Five different patterns of focal fatty infiltration were noted. In most alcoholic patients these appearances present no diagnostic problem and further confirmation can be obtained by repeating the CT scan within 1-2 weeks to see if interval resolution occurs following enforced abstinence. In select instances, more invasive and definitive procedures such as superselective angiography or liver biopsy may be necessary to differentiate these findings from other more serious diseases they may closely resemble, such as primary or secondary liver neoplasms.
The computed tomography and ultrasound findings of two patients with malacoplakia of the bladder, both at the time of initial diagnosis and following response to treatment, are presented. Because bladder wall involvement is demonstrated by these modalities in female patients with repeated episodes of urinary tract infection, this entity should be entertained in the differential diagnosis.
Fifty-nine patients with primary or recurrent carcinoma of the cervix were evaluated by computed tomography as part of their presurgical evaluation. The computed tomography staging results were compared with the surgical staging. Computed tomography staging was accurate in 71% (42 of 59), whereas clinical staging was accurate in 66% (39 of 59). In assessing paraaortic nodes by CT, there were 10 true-positive, 20 true-negative, 1 false-positive, and 2 false-negative results (sensitivity, 83%; specificity, 95%), for an overall accuracy of 91%. For pelvic nodes, there were 10 true-positive, 11 true-negative, 3 false-positive, and 6 false-negative results (sensitivity, 62.5% specificity, 78%), for an overall accuracy of 70%. Excretory urograms and barium enemas provided no information not obtained by computed tomography and are probably unnecessary if computed tomography is used as a routine staging examination. At present, computed tomography should not replace clinical assessment of extent of the disease. Its chief advantage over clinical staging is its ability to detect metastases beyond the true pelvis.
The computed tomography and ultrasound appearance of a case of squamous cell carcinoma of the kidney is reported and the relevant clinical and urographic findings in this rare entity are reviewed.
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A significant right-to-left shunt at the atrial level was diagnosed by radionuclide angiocardiographic examination in a patient with hypoxemia whose perfusion scan showed no pulmonary uptake. The shunt occurred through a patent foramen ovale due to increased right ventricular afterload, subsequently confirmed at autopsy. It is concluded that radionuclide angiocardiography with technetium 99m macroaggregated albumin (99mTc MAA), followed immediately by a perfusion lung scan, may have a place in the evaluation of patients with refractory hypoxemia, since pulmonary embolism and/or right-to-left shunting are two of several causes of hypoxemia in the absence of congenital heart disease. A review of the literature on different pathophysiologic factors is presented and some therapeutic implications, specifically the adverse effect of PEEP in such situations, are discussed.
Liver disease occurring as a manifestation of secondary syphilis is unusual, and this association is not readily recognized or considered in the differential diagnosis of obscure hepatic disease, thereby causing delay in treatment. We describe a case of liver involvement in secondary syphilis with computed-tomography and ultrasound findings. This entity should be considered in patients with hepatomegaly coexisting with the clinical stigmata of secondary syphilis, as treatment with penicillin results in rapid improvement in both the clinical and biochemical findings.
Unilateral focal areas of intense, increased renal uptake of Tc-99m oxidronate sodium (technetium-99m HDP) were incidentally detected in the bone scan of a female patient who subsequently gave a history of recent trauma to her flank. Increased renal parenchymal uptake of Tc-99m HDP in this patient was thought to be due to kidney contusion. The case is interesting in itself and for its possible implications regarding the use of radio-labeled phosphate compounds for detection of renal contusion.
Technetium-99m pertechnetate scintigraphy was performed in the involved extremities of six patients with severe frostbite of the hands (six cases) and feet (one case). There was good correlation between the scintigraphic findings and the extent of deep tissue ultimately requiring surgical resection. Technetium-99m pertechnetate imaging distinguishes viable from dead tissue in frostbite in a simple, noninvasive manner, and findings are easy to interpret. A persistent perfusion defect is seen in nonviable tissue.
We report the CT findings in a patient with adenocarcinoma of the appendix. Previously reported cases are reviewed, and a CT appearance which is suggestive of adenocarcinoma of the appendix is presented.
3 patients with histologically proven hepatocellular carcinoma in whom ultrasound demonstrated portal vein thrombosis are presented. Sonography is a simple, noninvasive method of screening patients with primary hepatocellular carcinoma for the presence of portal vein thrombosis.
In computed tomography of the skeleton, as in other radiologic modalities, recognition of normal skeletal variants is essential for defining the extent and type of injury or neoplasm. Computed tomography findings, because of the unique use of cross-sectional anatomy, must be carefully studied to avoid labeling a normal variant as an abnormal entity. We describe here an observation of a normal variant--distal femoral, anterior articular (trochlear) groove--found in a patient with an osteochondral fracture and loose intra-articular bony fragment.
Computed tomography in a case of tuberculous psoas abscess is described. Additional information useful in planning surgical drainage was obtained by intraabscess contrast medium injection through a draining sinus.
Cervical abortion is a spontaneous abortion of a normal intrauterine pregnancy into the cervical canal where the abortus is retained by a closed external os, causing distention of the cervical canal. This entity closely simulates ectopic cervical pregnancy clinically. The ultrasonic findings in four patients with cervical abortion are described and these could alert the physician to the possibility of this condition.
Emphysematous pyelonephritis is a rare but frequently fatal complication of renal infection in the diabetic patient. The diagnosis is usually only made roentgenographically. We present a patient in whom the initial plain abdominal film was normal and renal sonogram was nondiagnostic. The correct diagnosis was made only on the subsequent CT scan.
The radiographic and CT appearance of air within the mammary parenchyma is described along with a discussion of the possible routes of dissection of gas from regions of subcutaneous emphysema into the breast tissue.
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