[Cassette for the intraoperative roentgenography of the kidney].
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It has been recommended that all children with a history of coin ingestion immediately undergo roentgenography to locate the coin, regardless of symptoms. We performed a prospective evaluation of these ingestions to determine the risk of asymptomatic esophageal impaction and the need for routine roentgenography. One hundred sixty-two children (mean +/- SD age, 3.6 +/- 2.1 years) were evaluated. All were referred for immediate roentgenography after ingestion and followed up daily by telephone for 5 days. Sixty-six patients (41%) did comply and 96 (59%) did not comply with the roentgenogram recommendation. A coin was visualized in the esophagus of 13 patients (20%); 11 were symptomatic and 2 were asymptomatic at the time of ingestion. Symptomatic patients had a 42% risk of a coin later being located in the esophagus compared with a 5% risk for asymptomatic patients. The asymptomatic patients with lodged coins passed them without difficulty after the administration of oral fluids. Nineteen percent of the patients who did not undergo roentgenography were symptomatic and all became asymptomatic within 24 hours of ingestion. There was no difference in morbidity between the group that underwent roentgenography and the group that did not undergo roentgenography at 5 days after ingestion. Children who are asymptomatic at the time of coin ingestion may not need routine roentgenography if they can tolerate oral fluids and telephone follow-up is available.
Umbilical vascular catheters are often necessary in the care of critically ill neonates. Position of the catheter tip is usually determined by roentgenography. Location of the umbilical arterial or venous catheter was determined by 2-dimensional echocardio/aortography in 55 consecutive infants and was compared to localization by thoraco-abdominal roentgenography. Most of the infants (76%) had respiratory distress syndrome or congenital heart disease. Echocaortographic localization of the umbilical arterial catheter correlated very closely (N = 50, sr = .90) with roentgenographic determination. For localization of the tip of the umbilical venous catheters, echocardiography was more accurate than roentgenography (employing contrast echocardiography for confirmation of cardiac chamber position). Two-dimensional echocardio/aortographic localization of the tip of indwelling umbilical vascular catheters is as accurate as roentgenography in the arterial system and more accurate than x-ray for umbilical venous catheters. Echocardio/aortography is superior to roentgenography (in localizing the catheter tip) because it 1) avoids ionizing radiation, 2) makes positioning of the patient unnecessary, 3) allows visualization of the catheter in relation to cardiovascular structures, and 4) may allow demonstration of intraarterial thrombo-emboli.
The purpose of the present study was to analyze the clinical pattern of neuroblastoma, the development of therapy, therapeutic results and the effect of neuroblastoma treated in childhood on the patient's later life. A retrospective series of 88 patient under 15 with primary neuroblastoma from years 1951-1978 was analyzed. The material was divided into two groups: patients admitted in 1951-1964 and those admitted in 1965-1978. Thirty three of the children (37.5%) were treated in 1951-1964 and 55 (62.5%) in 1965-1978. No statistical differences were seen between the therapeutic groups regarding age and sex distribution, site of the primary tumor and the histological and stage distribution. The mean age of all the patients on admission was 3.2 years (range 0-14.6 years). The age distribution was as follows: 24 (27.3%) 12 months, 18 (20.5%) 12-24 months and 46 (52.3%) over 24 months. There were 45 (51.1%) boys and 43 (48.9%) girls. All the histological specimens were reexamined. On the basis of histological differentiation, the series contained 67 (76.1%) neuroblastomas and 21 (23.9%) ganglioneuroblastomas. The localization of the primary tumors was the following: neck one (1.1%), mediastinum 17 (19.3%), elsewhere in the thorax 9 (10.2%), abdomen 15 (17.0%), pelvis 6 (8.8%), adrenal glands 31 (35.2%), dumbbell tumors 9 (10.2%). The stage distribution (Evans et al., 1971) was: stage I 6 (6.8%), stage II 20 (22.7%), stage III 36 (40.9%), stage IV 20 (22.7%) and stage IV-S 6 (6.8%). The diagnostic studies performed were chest roentgenography on 97.7%, skull roentgenography on 62.5%, pelvic roentgenography on 18.2%, spinal roentgenography on 23.8%, roentgenography of the long bones on 53.4%, and urography on 59.1% of the total. A bone marrow study was made on 36.4% of the cases. 24-hour urinary excretion of VMA was determined at the beginning of therapy for 78.2% and of HVA for 38.2% of the patients of the latter treatment group. The commonest general symptoms were anemia (34.1% of all patients), vague pyrexia (25.0%), lack of appetite, weight loss (18.2%) and poor general condition (15.9%). General symptoms were commonest in patients in stages IV and III (75.0 and 72.2%) and least frequent in stage I patients (16.7%). The average duration of the general symptoms in the survivors was 1.9 months and in the patients who died 1.7 months.(ABSTRACT TRUNCATED AT 400 WORDS)
Hualien, located in eastern Taiwan, is a relatively isolated district. The population is composed of different ethnic communities. Our hospital is the only medical center in eastern Taiwan, so is the most important referral hospital for epidemic diseases. After reviewing our collected cases of renal tuberculosis (TB), we observed a great diversity in staging and outcomes. The aim of this study was to classify different imaging presentations and clinical outcomes in the ethnic communities represented by these cases (non-aboriginal and aboriginal). We retrospectively reviewed 22 cases from 1991 to 2001. We reviewed laboratory data, radiologic reports, and clinical outcomes. Before TB was proved by biopsy or culture, patients were not treated with an anti-TB regimen. Roentgenography showed that 68% of patients had renal calcification, 59% had dilated calyces, 55% had lung involvement, and 41% had auto-nephrectomy. The proportion of mild and severe forms was significantly different between aboriginal and non-aboriginal groups (0.05 > p > or = 0.00409). From this series, we recommend routine plain film roentgenography, including chest roentgenography and kidney, ureter, and bladder or abdominal roentgenography, followed by intravenous urography or computerized tomography as investigative tools for renal TB. Based on the significantly different outcomes of the disease between aboriginal and non-aboriginal groups, a stronger health education program for the isolated district in eastern Taiwan is necessary.
RATIONALE AND OBJECTIVES: A new model was developed to study microcirculation in the intact heart of the anesthetized rat, and the effects of roentgenography and magnetic resonance imaging contrast media were investigated. METHODS: Roentgenography contrast media (600 mg iodine/kg), gadopentetate (0.25 mmol/kg), or physiological saline were injected intraarterially into anesthetized rats (N = 10) whose chests had been opened in a pressurized container. The effects on arterial and venous vasomotion and microhemodynamics of the capillary network were determined in vivo by combined incidental light-fluoroscopic microscopy using continuous 35-mm cine film and video recordings from 5 minutes before until 20 minutes after injection. The amplitude and frequency spectra were evaluated according to the Prony method and by Fourier analysis. Additionally, the number of perfused vessel bifurcations were counted. RESULTS: Gadopentetate exhibited no effects on microcirculation, and diatrizoate exhibited the largest ones. The deformation of the vasomotion spectrum reached 28%, and bifurcations were reduced by 21%. The effects were reversible within 10 minutes of injection. Iotrolan showed minimal disturbance. The other contrast media (iopromide, iopamidol, ioxaglate) fell between these two extremes. CONCLUSION: High-osmolar ionic roentgenography contrast media resulted in a transient deregulation of vasomotion and in a disturbed microcirculation in the rat heart. Isotonic or low-osmolar nonionic roentgenography contrast media or gadopentetate did not show this effect or showed it only to a minimal extent.
An in vitro study was performed to evaluate the accuracy of intravascular ultrasound imaging compared with roentgenography for determining the cross-sectional area of a lumen; and to determine if the functional significance of an irregular stenosis is predicted more accurately by intravascular ultrasound than roentgenography. Varying degrees of stenosis were made in 17 rubber tubings by adjusting a plastic constrictor. The cross-sectional areas at the normal and the stenotic segments were determined by intravascular ultrasound, roentgenography, and then measured directly from an acrylamide gel cast of the lumen. To evaluate the functional significance of a stenosis, the pressure drop across the stenosis was measured using a fluid pumping circuit. The actual pressure drop was then compared with the predicted pressure drop derived from hydrodynamic equations using cross-sectional areas obtained by intravascular ultrasound or roentgenography. There was an excellent correlation between the cross-sectional areas at the tightest stenosis measured by intravascular ultrasound compared with the area from the acrylamide cast (7.2 +/- 2.6 v 6.6 +/- 2.4 mm 2, mean +/- SD, r = .93). Measurements of cross-sectional area from the roentgenograms (10.9 +/- 3.9 mm 2) also provided a relatively good correlation with those from the acrylamide casts (r = .84); however, the roentgenograms consistently overestimated the cross-sectional area of the stenosis. The mean values of the actual pressure drop and the predicted pressure drop by intravascular ultrasound and roentgenograms were 15.7 +/- 13.5, 11.3 +/- 11.9, and 4.3 +/- 4.5 mmHg, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Eighty years have passed since 1896 when Tonkov first used X-rays in anatomy in our country. The first Roentgenological Institute was organized in the USSR in Leningrad in 1918 with the first roentgenanatomical laboratory in it. This laboratory has first developed methods of the roentgen-anatomical investigation of the vascular system such as roentgenarteriography (A. S. Zolotukhin), roentgenlymphography, tomography, microroentgenography, bukkigraphy and others (M.G. Prives and others). The article presents a review of the newest methods of roentgenanatomical investigations: roentgenography with direct magnification of the picture, roentgenography of soft tissues, electro-roentgenography, panthomography, coloured roentgenography, different kinds of artificial contrasting-pneumography of different kinds, partenography, roentgenostereography, newest kinds of arteriography, phlebography, portohepatography, lymphography, pharmaco-angiography, roentgenokinography and teleroentgenkinography.
The authors performed a survey in 3,615 Shinawatra employees aged 18-60 years to determine the abnormalities found with routine checkup. The annual checkup included: history taking. anthropometric measurement, physical examination, complete blood count, urine analysis, chest roentgenography, blood chemistry (fasting blood glucose, BUN, creatinine, uric acid, AST/ALT, cholesterol, triglyceride and HDL-cholesterol). The prevalence of abnormalities with management change detected by complete blood count, urine analysis was low and we did not recommend the routine use of complete blood count and urine analysis. The prevalence of hypertension was more common in males and the prevalence increased sharply after the age of 25 years in males and 40 years in females. The prevalence of abnormalities of BUN, creatinine (both males and females) and uric acid (in females) was very low. There was high prevalence of high AST/ALT which suggested hepatitis in our population, and the prevalence was more common in males beginning at a young age. Diabetes mellitus was more common in males especially after the age of 45 years. Chest roentgenography abnormalities were found in 9.4 per cent and the prevalence of abnormalities increased with age and was common after the age of 44 years. Most of the abnormalities found by chest roentgenography were pulmonary infiltration and cardiomegaly. The authors' findings did not recommend the routine use of complete blood count, urine analysis, fasting BUN and creatinine. We recommend routine blood pressure measurement in males aged 25 years or more and in females aged 40 years or more. We suggest routine blood cholesterol measurement in both sexes, blood triglyceride measurement in males aged 25 years or more and fasting blood sugar tests in males aged more than 44 years, chest roentgenography in males and females after the age of 45 years.
Results of roentgenography, performed in 92 patients with diabetes mellitus, complicated by purulent-necrotic affection of foot, and data of nuclear-magnetoresonance tomography (NMRT), conducted in 17 patients, were analyzed. In 70% patients tactics of their further treatment was influenced by presence of deformity and destruction of the foot bones and joints, revealed by roentgenography. Data of the foot roentgenography permitted to differentiate diabetic osteoarthropathy vs the foot bones osteomyelitis in 81% of observations. It is impossible to determine the bone integrity according to NMRT results, but inflammatory foci in bone may be revealed. In presence of obscure data of roentgenography and NMRT it is necessary to make diagnosis of osteomyelitis and to perform proper treatment during 3-6 weeks.
Proceeding from an x-ray examination of 143 patients with mandibular fractures, the most informative methods and projections as well as the order of their use with account of the site of a fracture, were determined. The most informative method in all fracture sites was orthopantomography; panoramic roentgenography was indicated only in fractures of the frontal part. If panoramic tomography cannot be done, roentgenography or electroroentgenography in the frontal-nasal projection is recommended. If panoramic roentgenography cannot be done, extraoral roentgenography is indicated in the diagnosis of fractures of the frontal part of the mandible.
OBJECTIVE: To evaluate the effectiveness of early detection of intrathoracic and bone metastases in reducing mortality in breast cancer patients. DESIGN: Randomized clinical trial allocating breast cancer patients to two alternative follow-up protocols (intensive vs clinical) for at least 5 years. SETTING: Twelve breast clinics (referral centers) in different areas in Italy. PATIENTS: A total of 1243 consecutive patients (either premenopausal or postmenopausal) surgically treated for unilateral invasive breast carcinoma with no evidence of metastases. The two study groups were well balanced in terms of clinical and prognostic characteristics. INTERVENTION: Patients in both treatment groups had physical examination and mammography, while patients of the intensive follow-up group had, in addition, chest roentgenography and bone scan every 6 months. MAIN OUTCOME MEASURES: Vital status at 5 years was the main outcome; information was available for all except five patients (0.4%). Relapse-free survival was also analyzed. RESULTS: Overall, 393 recurrences (104 local and 289 distant) were observed during the study. Increased detection of isolated intrathoracic and bone metastases was evident in the intensive follow-up group compared with the clinical follow-up group (112 vs 71 cases), while no difference was observed for other sites and for local and/or regional recurrences. The 5-year relapse-free survival rate was significantly higher for the clinical follow-up group, with patients in the intensive follow-up group showing earlier detection of recurrences. No difference in 5-year overall mortality (18.6% vs 19.5%) was observed between the two follow-up groups. CONCLUSIONS: Periodic chest roentgenography and bone scan allow earlier detection of distant metastases, but anticipated diagnosis appears to be the only effect of intensive follow-up, and no impact on prognosis is evident after 5 years. Periodic intensive follow-up with chest roentgenography and bone scan should not be recommended as a routine policy.
BACKGROUND: Interstitial lung disease (ILD) is characterized by inflammation within the alveolar walls and interstitium of the lungs. This causes increased alveolar-capillary membrane permeability. The diagnosis is made by clinical features, chest roentgenography, lung function tests, and high-resolution CT, and it is confirmed by lung biopsy. Radionuclide aerosol tracers such as Tc-99m DTPA show increased lung clearance in ILD. The clearance rate of microaerosol pertechnegas (modified Technegas) from the lungs in the assessment of ILD was evaluated. METHODS: Thirty-two patients (22 with ILD and 10 with non-ILD) were evaluated with pertechnegas. Pertechnegas is formed by adding 3% oxygen to technegas, a microaerosol ventilation agent. Regions of interest were then drawn around the lungs, and clearance rates were determined from the best exponential fit. RESULTS: The mean clearance rate of pertechnegas was significantly increased in ILD and measured 5.78 +/- 2.2 minutes compared with non-ILD, which measured 8.53 +/- 2.42 minutes (P < 0.001). The sensitivity and specificity rates of pertechnegas clearance (less than 8 minutes) in ILD were 90% and 60%, respectively. When combined with chest roentgenography, the sensitivity and specificity rates increased to 100% and 90%, respectively. CONCLUSIONS: Pertechnegas is highly effective in determining the presence of active ILD. It differentiates between active ILD and non-ILD, and it is highly sensitive and specific when combined with chest roentgenography. Its potential role in the management of ILD merits further investigation.
We report a case of cervical spondylitis that developed during treatment with a series of stellate ganglion blocks. A 65-year-old man was scheduled for 10 sessions of stellate ganglion block for treatment of right-sided deafness of sudden onset due to Ramsay Hunt syndrome. Administration of betamethasone was started 5 days before the first block and was continued for 6 weeks. After disinfection of the skin by povidone iodine, each stellate ganglion block was performed via the paratracheal approach. The first four block sessions were uneventful. However, during the fifth session, the patient complained of neck pain. After 10 sessions, the deafness improved and the patient was discharged from the hospital. Three weeks after discharge, he was readmitted for sustained neck and bilateral shoulder pain and numbness of the right hand. Cervical roentgenography and magnetic resonance imaging revealed spondylitis of C5 and C6. Antibiotics were administered for 2 weeks. The inflammatory variables on blood examination improved, but cervical roentgenography performed 8 weeks after the last block showed that the vertebral body of C6 was nearly completely destroyed. Four months after the last block, the vertebral bodies of C5 and C6 had fused. This case indicates that when stellate ganglion block is performed in patients who are taking a corticosteroid, the disinfection procedure must be strictly followed and that if the patient complains of neck or shoulder pain, cervical roentgenography or magnetic resonance imaging or both should be immediately performed to assess the presence of spondylitis.
Lymphography of 123 newly diagnosed patients with lymphoma was followed by staging laparotomy without intra-operative abdominal roentgenography. These patients were retrospectively evaluated for residual abnormal nodes with postoperative abdominal roentgenography. Sixteen patients with pathologically normal nodes at laparotomy had residual lymphographically abnormal nodes at postoperative roentgenography. Nine patients received less extensive irradiation than they would have if the remaining abnormal nodes had been biopsied and found to contain tumor. Two had shortened survivals as an apparent consequence.
Technetium 99m-polyphosphate bone images are correlated with bone roentgenography, and serum calcium, phosphorus and alkaline phosphatase in 91 patients with suspected bone metastasis. Technetium polyphosphate bone images are the most sensitive and serum level of calcium and phosphorus are the least sensitive indicator of bone lesions. Bone roentgenography is not as sensitive as technetium polyphosphate images. Abnormal bone images with normal or abnormal bone roentenography associated with increased alkaline phosphatase in the absence of liver metastasis are highly suggestive of metastatic bone disease. Abnormal bone images adjoining the joints, associated with normal serum alkaline phosphatase and abnormal joint roentgenography suggest arthritis. It is recommended that technetium 99m-labelled phosphate bone images are considered to be the diagnostic procedure of choice to detect skeletal lesions. Polyphosphate bone images are highly sensitive, with the combination of elevated alkaline phosphatase they become relatively more specific for a metastatic bone disease.
In the management of laryngeal cancer, roentgen examination is imperative in the evaluation of every lesion. The currently most commonly used roentgen techniques are lateral soft tissue roentgenography of the neck, frontal tomography of the larnyx, and contrast laryngography. Clinical application of these techniques depends upon the character and site of the lesion. Lateral soft tissue roentgenography of the neck can reveal tumor mass located mainly in the sagittal plane of the larynx. In addition, it is often relied upon for the detection of destruction of the thyroid cartilage. Frontal tomography is a static study of the larynx and usually demonstrates tumor mass in profile. Contrast laryngography allows a dynamic study of the larynx and is the most reliable roentgen technique for a precise delineation of the anatomical abnormalities and a clear evaluation of the functional alteration of the involved structures of the larynx. When used in combination, particularly lateral soft tissue roentgenography of the neck and contrast laryngography, these techniques yield invaluable information in the diagnosis of the laryngeal cancer.
OBJECTIVE: The purpose of this study was to observe the roentgenographic characters of distraction osteogenesis (DO) correction of cleft palate (CP), to study the expression of BMP proportional to fixation period time intervals, and to explore the new bone formation mechanism in Cleft Palate bone shelf. METHODS: 12 cats were used to establish the CP animal model surgically, and then were assigned randomly to (1) Experimental group (12 cats): CP defects were DO repaired at the rate and rhythm of 0.4 mm x 2/day. Specimen retrieval at 2, 4, 6, 8, 12 weeks after completion of distraction, roentgenography and Anti-BMP immunohistochemistry studies were performed; (2) Experimental control group (2 cats): CP defects without any treatment procedures, and (3) Empty control group of 2 cats. RESULTS: Anti-BMP immunohistochemistry study showed positive DAB dye in early 2 weeks and most extensively positive expression of BMP in 4 to 6 weeks. The expression of BMP wore off gradually through 8 to 12 weeks. The roentgenography showed that the newly mineralized bone was developed from the cut bone edges bilaterally to the central transparent zone, and the newly formed bone bridged the defect area completely at the end of the study. The CP bone defect was reconstructed and the distraction gap was filled with de nove osteogenesis. No new bone formation was observed in experimental control group. CONCLUSION: The process of new bone formation in the distraction area is dynamic. Being stimulated primarily, the process was kept highly active till quiescence phase finally. The X-ray examination shows that there is distinctively low roentgenopeque. Nevertheless, roentgenography is so far a very effective and convenient method to evaluate and monitor the DO correction efficiency.