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PubMed1991

[Periradiculographic and CT examination in the differential diagnosis of pain after intervertebral disk surgery].

Between February 1, 1982 and December 31, 1988 at the Neurosurgical Clinic of the Faculty Hospital and Policlinic in Kosice on account of justified suspicion of a relapse of discogenic compression of the lumbosacral spinal roots 102 patients were re-operated (38 women, 64 men) aged 18 to 65 years (mean 39.5 years). Of these three who were hypersensitive to iodine were reoperated at a time when the hospital did not yet possess a CT based on clinical symptoms. In 61 patients the indicated re-operation was supported by the conclusions of periradiculographic, in 21 of native CT and in 17 based on both mentioned examinations. Comparison of the surgical findings with the X-ray findings revealed that on periradiculography the conclusion was in complete agreement in 31 patients, in another 27 partial agreement (a total of 73.3% patients examined in this way), in those examined by CT there was complete agreement in 16 and partial agreement in 11 (i.e. 71.1% on this sub-group). Neither of the two examination methods was quite reliable for indication of re-pleration of intervertebral discs.

Adolescent↗

PubMed2004

[Reexpansion pulmonary edema after removal of a giant thoracic tumor associated with long-time lung collapse and mediastinal shift].

A 64-year-old woman was admitted to our hospital for removal of a thoracic tumor. Chest X-ray and computed tomography demonstrated a giant thoracic tumor occupying the right thorax, with the right lung almost completely collapsed and the mediastinum shifted to the left. Her preoperative pulmonary function studies revealed %vital capacity of 30%, and her oxyhemoglobin saturation was 92% (room air). Anesthesia was maintained with sevoflurane and fentanyl. The trachea was intubated with an armored tube because of severe tracheal shift. Operation was performed in the supine position. A Swan-Ganz catheter was inserted from the right femoral vein under fluoroscopy with stand-by of percutaneous cardiopulmonary support. The tumor was removed segmentally, and her right lung was inflated gradually. Two hours after removal of the tumor, PaO2 decreased to 74.2 mmHg (FIO2 1.0), and a large amount of sputum was suctioned subsequently. We suspected re-expansion pulmonary edema (RPE) and administered steroid with frequent tracheal suctioning. The patient was transferred to ICU without extubation. Postoperative X-ray demonstrated diffuse alveolar infiltrates over the right lung field. The patient was followed by respiratory management and body fluid management with diuretic drugs. The trachea was extubated on the following day, and her postoperative recovery was uneventful thereafter. We should consider the occurrence of RPE at removal of the giant thoracic tumor.

Anesthesia, General↗

PubMedDate not supplied

A re-examination of the effects of ionizing radiation on lifespan and transformation of human diploid fibroblasts.

Human diploid fibroblasts, strain MRC-5, were sequentially irradiated with 60Co gamma rays at intervals during their in vitro lifespan. The results indicate that 3 or 6 doses of 1 Gy can increase lifespan, and the same was true for cells treated with 3 doses of 3 Gy. Higher doses (5 x 3 Gy) did reduce growth potential, suggesting either that mid-late passage cells become more sensitive to radiation, or that doses beyond a given threshold reduce population lifespan by multiple cellular hits. The life extension induced by gamma rays might be due to an induced hypermethylation of DNA. Alternatively, oxygen radicals produced by irradiation might trigger an adaptive stress response which would remove damaged macromolecules and thereby increase the cells' growth potential. Whichever explanation is correct, the results show that the human fibroblast system is not appropriate for the study of the well known effect of ionizing radiation in shortening the lifespan of experimental animals. Contrary to earlier published results, populations of cells treated with cumulative doses of 15 Gy or 18 Gy and held for nearly 3 months after they had reached senescence (Phase III), produced no foci of transformed cells.

Cell Survival↗

PubMed2000

Pulmonary tuberculosis in Norwegian patients. The role of reactivation, re-infection and primary infection assessed by previous mass screening data and restriction fragment length polymorphism analysis.

SETTING: Norwegian patients with pulmonary tuberculosis notified to the National Tuberculosis Register in 1975, 1985 and 1995. OBJECTIVE: To assess the proportion of cases attributable to endogenous reactivation, exogenous re-infection and primary infection. DESIGN: We reviewed patients notified with sputum smear and/or culture confirmed pulmonary tuberculosis in 1975 (50% random sample, 95 cases), 1985 (133 cases) and 1995 (70 cases). Information on previous chest X-ray, tuberculin and BCG status was collected from mass screening data files. Strains from 54 patients in 1995 were analysed by IS6110 restriction fragment length polymorphism (RFLP) typing and compared with culture-positive patients notified between 1994 and 1997. RESULTS: Most patients had previously had tuberculosis (65% in 1975, 53% in 1985 and 61% in 1995), either notified with tuberculosis or with X-ray findings indicating previous tuberculosis. Another 10% had a prior infection, but normal X-rays. No previous tuberculosis infection or disease was found in 10% in 1975, 19% in 1985, and 16% in 1995. Of 54 patients with RFLP results, three were caused by laboratory contamination. Of the remaining 51, eight (16%) belonged to a cluster. Among 45 patients with results of both RFLP typing and mass screening, 37 (82.2%) were probably caused by reactivation, six (13.3%) by re-infection and two (4.4%) by primary infection. CONCLUSION: Pulmonary tuberculosis in Norwegian patients can mainly be attributed to reactivation, predominantly in persons with previous changes on chest X-ray.

Adolescent↗

PubMed2006

Relationships between SF-36 health profile and bone mineral density: the Hertfordshire Cohort Study.

We utilised the Hertfordshire Cohort Study (HCS) to relate bone mineral density (BMD) to SF-36 health-related quality of life scores. We studied 737 men and 675 women who had completed a home interview and clinic. Four hundred and ninety-eight men and 468 women subsequently attended for bone densitometry [dual-energy X-ray absorptiometry (DXA)]. SF-36 questionnaire responses were mapped to eight domains: physical function (PF), role physical (RP), role emotional (RE), social functioning (SF), mental health (MH), vitality (VT), bodily pain (BP) and general health perception (GH). Subjects with scores in the lowest gender-specific fifth of the distribution were classified as having "poor" status for each domain. Odds ratios (OR) for poor status for each domain were calculated per unit increase in lumbar spine or total femoral BMD t score. Among men after adjustment for age, BMI, social class, lifestyle (including physical activity) and known comorbidity, higher total femoral t score was associated with decreased prevalence of poor SF-36 scores for PF [OR 0.72 (95%CI 0.53, 0.97), p=0.03], SF [OR 0.70 (95%CI 0.53, 0.94), p=0.02] or GH domains [OR 0.74 (95%CI 0.56, 0.99), p=0.05], but no relationships were apparent between SF-36 scores and lumbar spine t score. Among women, the adjusted relationship between higher total femoral t score and decreased prevalence of poor PF was consistent [OR 0.71 (95%CI 0.50, 1.00), p=0.05], but no other relationships were significant. Poorer functioning (assessed by SF-36 questionnaire) is associated with lower total femoral BMD in older men (but less so in women) after adjustment for lifestyle factors and comorbidity.

Aged↗

PubMed2001

Homologous phases built by boron clusters and their vibrational properties.

We have found a series of new rare earth boron-rich solids in REBC(N) (RE: Y, Ho, Er, Tm, and Lu), systems and their structures are solved from single crystal and/or powder X-ray diffraction data. Structure analysis results show that they are homologous with B(4)C and also show trigonal symmetry. As the two basic structural units, boron icosahedra and octahedra in the new phases form in layers and stack in different sequences which form different phases. With increasing number of icosahedral layers stacking between two neighboring octahedral layers, the c-axis of the unit cell is increased and the other two edges of the unit cell are only changed slightly. Three monophases of the series have been synthesized both in powders and as single crystals. The vibrational modes of the homologous phases are analyzed from the Raman spectra and compared with that of B(4)C.

Journal Article↗

PubMed2003

Organic-organometallic crystal engineering: novel formation of a honeycomb supramolecular architecture of [Re2(mu-OMe)3(CO)6]- anions encapsulating a linear H-bonded chain of [DABCO-H]+ cations.

The title salt [Re(2)(mu-OMe)(3)(CO)(6)](-)[DABCO-H](+) (1) was prepared as colorless prismatic crystals by the reaction of DABCO with Re(CO)(5)(OTf) in refluxing methanol solution and was characterized by spectroscopic means including single-crystal X-ray diffraction techniques. The molecular structure of 1 revealed that a novel honeycomb supramolecular architecture of the anionic organometallic complex created a cavity with an effective diameter of 7.450(3) A that houses a linear H-bonded chain of [DABCO-H](+) in its center. This structure also represents the first example of the use of a linear chain of [DABCO-H](+) species as a countercation for a coordination compound.

Journal Article↗

PubMed2000

Cyclotriphosphorus complexes: solid-state structures and dynamic behavior of monoadducts with carbonyl fragments.

Treatment of the cyclo-P3 complexes [(triphos)MP3] [triphos = 1,1,1-tris(diphenylphosphinomethyl)ethane; M = Co (1), Rh (2)] with stoichiometric amounts of [M'(CO)5(thf)]n+ (n = 0, M' = Cr, Mo, W; n = 1, M' = Re) and [W(CO)4(PPh3)(thf)] yields the compounds [[(triphos)M](mu,eta 3:1-P3) [M'(CO)5]] [M = Co; M' = Cr (3a), Mo (3b), W (3c). M = Rh; M' = W (4)], [[(triphos)Co](mu,eta 3:1-P3)[Re(CO5)]]BF4.C7H8 (5) and [[(triphos)Rh](mu,eta 3:1-P3)[W(CO)4PPh3]].2CH2Cl2 (6). The X-ray structures of 5 and 6 have been determined. Crystal data: 5, monoclinic space group P2(1)/n, a = 14.754(2) A, b = 24.886(4) A, c = 15.182(2) A, beta = 103.38(1) degrees, Z = 4; 6, monoclinic space group P2(1)/n, a = 14.872(3) A, b = 27.317(6) A, c = 16.992(4) A, beta = 111.75(5) degrees, Z = 4. The effects of eta 1 coordination on the MP3 core are discussed by comparing the MP3 skeletons in the above structures with those of the previously characterized bis and tris end-on adducts of organometallic fragments of 1. Variable temperature NMR data for the compounds provide evidence for fluxional processes in solution that may be interpreted as [(triphos)M] rotation about its C3 axis and [M'(CO)5] or [M'(CO)4PPh3] scrambling over the P3 cycle. The activation parameters of the fragment scrambling process are determined.

Journal Article↗

PubMed1997

Use of Silicon-Based Tethers to Control Diastereofacial Selectivity in Azomethine Ylide Cycloadditions(1).

A novel approach to controlling the diastereofacial selectivity of intramolecular dipolar cycloadditions of azomethine ylides (cf. 9 --> 8) by varying the structure a silicon-based tether is described. A correlation is found between the length of the tether dipolarophile conjugate (TDC) and the observed sense of diastereocontrol. Azomethine ylides incorporating longer [OSiPh(2)OCH(2)CH(2)OCOCH=CH(2)], [OSi(i-Pr)(2)OSi(i-Pr)(2)OCH(2)CH=CH(2)], and [OSiPh(2)OCH(2)CH=CH(2)] TDCs favor endo-si attack (14 --> 16, 19 --> 20, and 21 --> 22) while the shorter TDC [OSiR(2)CH(2)CH=CH(2)] leads to a reversal in selectivity favoring the endo-re product (23a,b --> 24a,b). Structures of the cycloadducts have been assigned on the basis of selected X-ray diffraction data in combination with chemical/spectral correlation experiments. The work described herein represents a conceptually new approach to stereocontrol and extends the use of silicon-based tethers in asymmetric synthesis.

Journal Article↗

PubMed2001

Neutron diffraction study of phi-Bi(8)Pb(5)O(17): structure refinement and analysis of cationic ordering.

The triclinic crystal structure of the varphi phase in the structure of the Bi(2)O(3)-PbO phase diagram has been recently solved by the synergetic use of electron and X-ray diffraction on a polycrystalline Bi(8)Pb(5)O(17) sample. In the present work the problem is re-examined on the basis of powder neutron diffraction data: the structure has been confirmed and refined by the Rietveld method. The increased accuracy of the O-atom positions allowed the study of the cationic ordering in this structure by means of bond-valence calculations and charge distribution analysis. The results, confirmed by the refinement of the site occupancies, indicate that the structure is ordered to a large extent, with Bi and Pb atoms occupying preferentially different lattice sites. In this frame, the varphi phase being the most ordered one in the considered region of the Bi(2)O(3)-PbO phase diagram, it should represent the thermodynamically stable low-temperature polymorph.

Journal Article↗

PubMed2005

Evaluation of a synchronous twin-pulse technique for shock wave lithotripsy: the first prospective clinical study.

OBJECTIVE: To present the results of the first clinical study of a synchronous twin-pulse technique for extracorporeal shock-wave lithotripsy (ESWL), which is effective for in vitro stone fragmentation and safe when assessed in vivo on animal tissue. PATIENTS AND METHODS: Fifty patients with urinary stones (35 men and 15 women) were enrolled and treated with the TWINHEADS lithotripter. The entry criteria were: age > or = 18 years, with a radio-opaque single stone in the kidney or upper ureter, a normal laboratory profile (serum creatinine, liver function, blood, bleeding and clotting times, and prothrombin concentration). The exclusion criteria included lower ureteric stones, patients with urinary tract infection, obstructed urinary tract distal to the stones, or congenital abnormalities. All patients received one session and were evaluated by ultrasonography (US), urinary tract plain X-ray, and complete laboratory investigations before and immediately after treatment, and after 2, 14 and 30 days. Patients requiring re-treatment at the 14-day visit received a second session and were re-evaluated after 7 and 14 days. RESULTS: The mean (sd, range) stone size (longest diameter) was 12.3 (2.6, 9-18) mm. Intravenous sedation was used in 30 patients. There was mild haematuria in 25 patients on the day of treatment. During the follow-up there was no evidence of haematoma, gross renal injury, upper urinary tract obstruction or significant changes in the laboratory investigations. After 14 days, 17 patients (34%) were free of stones, with residual stones of < or = 5 mm in 20 (40%); they were free of stones at the 1-month follow-up. Thirteen patients (26%) had residual stones of 6-9 mm, but the stones were half or less of the original size. Patients with residual stones of > 5 mm had another ESWL session and were free of stones within 14 days. Thus all patients were rendered stone-free within 1 month. CONCLUSIONS: Synchronous twin-pulse ESWL is promising, seems safe and effective for treating patients with renal and upper ureteric lithiasis.

Adolescent↗

PubMed2005

Bone assessment in children: comparison of fan-beam DXA analysis.

The newest version of whole body dual-energy X-ray absorptiometry (DXA) analysis software from Hologic (Discovery 12.1) is designed to enhance bone detection in smaller subjects. We re-analyzed 1127 pediatric scans (ages 1.8-18.5 yr) previously analyzed using software version 11.2. Regression analysis compared new and original results for bone area (BA), bone mineral content (BMC), bone mineral density (BMD), and DXA-derived body weight. Changes in total and regional bone results were compared with age, weight, and height. New results were highly correlated with original analyses (R2 > or = 0.9), but there were large differences at the individual subject level. The BA and BMC values increased in subjects less than 40 kg weight, resulting in a lower BMD. Original and new results were equivalent by about age 14 yr in both genders. Regional bone data showed the greatest changes in the legs. The newest software produces significant changes in bone values in subjects weighing less than 40 kg, compared with earlier versions. This effect increases with decreasing body weight. This will impact interpretation of longitudinal pediatric DXA studies, as well as existing pediatric whole body bone reference databases. Investigators must recognize which DXAsoftware version they are using, and which version produced any reference database they may use for comparison.

Absorptiometry, Photon↗

PubMedDate not supplied

[A case of epithelial cyst of the spleen].

The Authors report a rare case of an epithelial cyst of the spleen treated successfully by splenectomy. The nomenclature, the diagnostic techniques and the therapeutic principles are discussed.

Adult↗

PubMed1996

[Adverse effects of low-dose methotrexate therapy in rheumatoid arthritis].

To analyze the possible adverse effects of low dose methotrexate (MTX) therapy, 276 patients with rheumatoid arthritis (RA) were examined retrospectively. One hundred and seven patients (39%) experienced 113 adverse events : 57 showed liver dysfunction, 24 gastrointestinal complaints, 13 cutaneous symptoms, 6 respiratory symptoms, and 6 malignancies. Interestingly, 3 patients developed a dry cough without infiltration nor interstitial shadow on chest X-ray. The cough was rapidly resolved by discontinuation of MTX, but it recurred in 1 patient when MTX was re-administered. This finding might suggest a close association between MTX administration and the occurrence of dry cough. Of the 6 patients with malignancies diagnosed during MTX therapy, 2 showed malignant lymphoma, 2 lung cancer, 1 breast cancer and 1 colon cancer. MTX might have an oncogenic potential in RA because the coincidence rate, especially with respect to lymphoma, was significantly higher than estimated in a normal population.

Adult↗

PubMed1998

Ligand Exchange or Reduction at Multiply Bonded Dimetal Units of Molybdenum and Rhenium by 2,6-Bis(diphenylphosphino)pyridine.

Reaction of 2,6-bis(diphenylphosphino)pyridine (bdppp or (Ph(2)P)(2)Py)) with K(4)Mo(2)Cl(8) in refluxing methanol gives Mo(2)Cl(4)(bdppp)(2) (1) with retention of the quadruple Mo-Mo bond. However, the quadruply bonded octachlorodirhenate(III) anion, Re(2)Cl(8)(2)(-), reacts with bdppp under similar conditions to afford Re(2)Cl(4)(bdppp)(2) (2), which has a triply bonded dirhenium(II) core, Re(2)(4+). An intermediate species, [Bu(n)(4)N][Re(2)Cl(7)(bdppp)] (3), containing an Re(2)(6+) core and only one bridging bdppp ligand has also been isolated. The crystal structures of complexes 1-3 have been investigated by X-ray crystallography. In all cases the potentially tridentate bdppp acts as a bidentate ligand using one N and one of the P atoms, leaving the second phosphorus atom noncoordinated. The crystallographic parameters for these structures are as follows: Mo(2)Cl(4)(bdppp)(2).2CH(2)Cl(2) (1.2CH(2)Cl(2)), monoclinic space group P2(1)/c with a = 15.475(2) Å, b = 11.5958(7) Å, c = 16.7637 (6) Å, beta = 98.178(5) degrees, Z = 2; Re(2)Cl(4)(bdppp)(2) (2), monoclinic space group P2(1)/n with a = 16.173(2) Å, b = 11.285(1) Å, c = 28.771 (4) Å, beta = 96.17(1) degrees, Z = 4; [Bu(n)(4)N][Re(2)Cl(7)(bdppp)].CH(2)Cl(2) (3.CH(2)Cl(2)), triclinic space group P&onemacr; with a = 16.054(2) Å, b = 18.562(3) Å, c = 20.205 (6) Å, alpha = 89.71(2) degrees, beta = 73.21(1) degrees, gamma = 73.47(2) degrees, Z = 4.

Journal Article↗

PubMed1989

[A case report of thoracic foreign body resembling fungus ball on chest X-P].

A case of a foreign body tumor resembling fungus ball pre-operatively diagnosed by bronchofiberscopic examination is reported. A 54-year-old male was referred with a complaint of fever. Chest X-ray and tomography showed a mass shadow with meniscus sign resembling fungus ball in the right lower lung field. Trans-bronchial lung biopsy revealed sulfur-granule of actinomycosis. In spite of local injection of sensitive antibiotics (ABPC) once a week for two months the mass shadow remained unchanged on X-ray. Bronchofiberscopic examination was performed again and a small piece of fibrous substance was obtained, which had been left in previous operation done 17 years before. Re-thoracotomy assured that the mass was a foreign body tumor caused by a gauze.

Bronchoscopy↗

PubMed2004

Intermetallics as zintl phases: Yb2Ga4Ge6 and RE3Ga4Ge6 (RE=Yb, Eu): structural response of a [Ga4Ge6]4- framework to reduction by two electrons.

Two new intermetallic compounds, Yb(2)Ga(4)Ge(6) and Yb(3)Ga(4)Ge(6), were obtained from reactions in molten Ga. A third compound, Eu(3)Ga(4)Ge(6), was produced by direct combination of the elements. The crystal structures of these compounds were studied by single-crystal X-ray diffraction. Yb(2)Ga(4)Ge(6) crystallizes in an orthorhombic cell with a=4.1698(7), b=23.254(4), c=10.7299(18) A in the polar space group Cmc2(1). The structure of RE(3)Ga(4)Ge(6) is monoclinic, space group C2/m, with cell parameters a=23.941(6), b=4.1928(11), c=10.918(3) A, beta=91.426(4) degrees for RE=Yb, and a=24.136(2), b=4.3118(4), c=11.017(1) A, beta=91.683(2) degrees for RE=Eu. The refinement [I>2 sigma(I)] converged to the final residuals R(1)/wR(2)=0.0229/0.0589, 0.0411/0.1114, and 0.0342/0.0786 for Yb(2)Ga(4)Ge(6), Yb(3)Ga(4)Ge(6), and Eu(3)Ga(4)Ge(6), respectively. The structures of these two families of compounds can be described by a Zintl concept of bonding, in which the three-dimensional [Ga(4)Ge(6)](n-) framework serves as a host and electron sink for the electropositive RE atoms. The structural relation of RE(3)Ga(4)Ge(6) to of Yb(2)Ga(4)Ge(6) lies in a monoclinic distortion of the orthorhombic cell of Yb(2)Ga(4)Ge(6) and reduction of the [Ga(4)Ge(6)] network by two electrons per formula unit. The results of theoretical calculations of the electronic structure, electrical transport data, and thermochemical and magnetic measurements are also reported.

Journal Article↗

PubMed2003

Radiation dose considerations in common paediatric X-ray examinations.

BACKGROUND: For paediatric radiology, diagnostic reference levels (DRLs) have been proposed by the National Radiological Protection Board and the European Commission, representing a baseline above which re-evaluation of the equipment and the techniques used is necessary. OBJECTIVE: To measure the entrance surface dose (ESD) in various paediatric radiological examinations carried out at a large paediatric hospital in Greece and compare them with the existing DRLs. MATERIALS AND METHODS: Measurements of ESD using thermoluminescent dosemeters were carried out in a sample of 168 paediatric patients who underwent various common radiological examinations (chest, skull, pelvis, lumbar spine, full spine). The patients were categorised according to age, and the mean ESD was calculated for each examination and age category. Additionally, the effective doses were estimated from measured ESD using appropriate conversion coefficients found in the literature. RESULTS: The mean ESD values were found to be well below the proposed DRLs for all the examinations studied except for the chest, owing to the low tube potential used and tube filtration. CONCLUSIONS: Even in examinations that did not exceed the DRL, patient protection can be optimised further by appropriate collimation of field size to that necessary for diagnosis.

Adolescent↗