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PubMed1975

The Mayo Lung Project for early detection and localization of bronchogenic carcinoma: a status report.

The Mayo Lung Project (MLP) is a screening program designed to detect bronchogenic carcinoma at a curable stage. Screening tests include chest roentgenograms, three-day "pooled" sputum cytology studies, and lung-health questionnaires. These are being applied every four months to a study population of outpatients who have a high probability of developing lung cancer. Initial patient acceptance of the screening program has been excellent. Small asymptomatic lung cancers have been detected both roentgenographically and cytologically. The two procedures have complemented each other with little overlap. Chest roentgenography has proved most useful in diagnosing peripherally situated cancers, whereas sputum cytology studies have been most effective in identifying early squamous cancer involving major airways. At present, more cancers have been detected roentgenographically than cytologically, but the cytologically detected cases appear to have a better prognosis. Roentgenographically occult cancers have been localized with regularity, although the localization process is complicated. Theoretically, vigorous application of radiologic and cytologic screening, combined with optimum use of localizing procedures and treatment, could increase the five-year survival rate among lung cancer patients to nearly 50 percent. However, the actual survivorship attained will ultimately be determined by currently imponderable factors such as patient acceptance of longterm screening, frequency of multicentric respiratory cancers, and incidence of noncancerous smoking-related diseases, especially chronic obstructive pulmonary disease and ischemic heart disease.

Aged↗
PubMed1975

Pericardial cyst ten years after acute pericarditis.

A case of pericardial cyst development in the years after an episode of acute pericarditis is reported. The method of diagnosis allowed confirmation of the condition without thoracotomy. These aspects of the case are relevant to the genesis of pericardial cysts in general and establish ultrasound and subsequent contrast roentgenography are advocated as adequate means of diagnosis in this condition.

Aged↗
PubMed1979

Major dehiscence of a prosthetic aortic valve: detection by echocardiography.

A 21-year-old man had acute aortic insufficiency three months after insertion of an aortic valve prosthesis. Chest roentgenography demonstrated abnormal orientation of the prosthesis. M-mode echocardiography showed dense, linear echoes from the prosthetic valve between the interventricular septum and the mitral valve, along with loss of normal poppet motion within the aortic root. At surgery, the prosthesis was found to be extensively disrupted, resulting in prolapse into the left ventricular outflow tract. Another valve replacement was performed with patient survival. Echocardiography appears to be a useful adjunct to established roentgenographic procedures in the diagnosis of major dehiscence of prosthetic aortic valves.

Acute Disease↗
PubMed1986

Sleep in Pierre Robin syndrome.

Eight patients (aged 8 to 22 years) with the Pierre Robin syndrome underwent sleep studies. Seven demonstrated significant although minor degrees of increased sleep disturbances and apneas, and less time spent in the rapid-eye-movement (REM) stage of sleep. One patient who had previously undergone mandibular corrective surgery had major sleep abnormalities (central apnea index of 81.7 although an obstructive sleep apnea index of only 1.9). The patients had small mandibles, as demonstrated by lateral cephalometric roentgenography, and mildly increased right ventricular diastolic dimensions, as shown by M-mode echocardiography. Snoring was present in all of these patients and in 13 of 22 patients questioned from our Pierre Robin clinic. We conclude that minor abnormalities in sleep, mandibular size, and right ventricular size persist well into adolescence in the majority of patients with Pierre Robin syndrome. These appear to be clinically insignificant; however, a small percentage of such patients may continue to have major sleep disturbances.

Adolescent↗
PubMed1988

Pseudoaneurysm of the ascending aorta following cardiac surgery.

Pseudoaneurysm of the ascending aorta is an unusual and potentially fatal complication of cardiovascular surgery. Most pseudoaneurysms are associated with aortic valve or coronary artery bypass graft surgery and are often mycotic in origin. Chest roentgenography and aortography have been the principle methods of diagnosis. Recently, contrast enhanced computed tomography (CT) has proven to be a useful means of diagnosis, providing a less invasive method of distinguishing pseudoaneurysm from other causes of fever and mediastinal widening in the postoperative cardiovascular patient. Thirty one cases of postoperative pseudoaneurysm of the ascending aorta occurring since 1963 are reviewed, including seven cases from our experience.

Adolescent↗
PubMed1988

Transbronchial mediastinal cystography.

This article demonstrates a new method applied to two patients suffering from a subcarinal, mediastinal cyst, which, however, remained undetected by routine roentgenographic tests. In the first case, transbronchial needle aspiration was applied to remove the content of the cyst and injecting an x-ray contrast material (Endocistobil) for contrast roentgenography, whereas in the second patient the same x-ray contrast substance was injected by using an ultrathin catheter introduced through an opening which connected the cyst with the bronchial system. This method represents progress in the preoperative diagnosis of subcarinal mediastinal cysts.

Adult↗
PubMed1975

Physical and radiological findings specific for medullary carcinoma of the thyroid gland.

Preoperative physical and radiological findings, if specific to a certain extent, are important for detecting patients with sporadic form of medullary thyroid carcinoma and especially for the first patient in the family having a hereditary form of medullary thyroid carcinoma and pheochromocytoma syndrome. To delineate clinical features of medullary thyroid carcinoma, a total of 9 patients with this tumor were reviewed retrospectively. In most patients, the thyroid lesions were located in the upper two thirds of the lobe, which was determined by careful palpation or 131I scintiscanning of the thyroid. The primary lesion in the thyroid could be felt more or less as a round, sharply demarcated nodule with fairly good mobility. These findings suggested rather a benign thyroid nodule when there was no lymph node involvement. However, it could be considered a sign suggesting medullary thyroid carcinoma when accompanied by marked lymph node metastasis. In our recent 2 cases, the diagnosis of medullary thyroid carcinoma was strongly suspected on these clinical bases, one of the cases being presented in detail. In 4 patients, lymph node metastasis in the central neck extended to either submandibular or upper mediastinal regions or both. In about one third of the patients, calcified deposits were shown in the cervical roentgenograms. With the use of soft tissue roentgenography, grossly punctate calcific deposits associated with psammoma-like shadows were recognized and the pattern was a criterion for definitive diagnosis of medullary thyroid carcinoma.

Adult↗
PubMed2005

Assessment of the radial artery and hand circulation by computed tomography angiography: a pilot study.

OBJECTIVES: The radial artery (RA) is increasingly being used as a coronary bypass graft. Results of a previous study using Doppler ultrasound and histopathologic examinations indicated that the RA has a higher incidence of preexisting intimal hyperplasia, medial calcification, and atherosclerosis than the internal thoracic artery. The aims of this study were to evaluate the use of computed tomographic angiography (CTA) to display hand collateral circulation, to define the criteria for an abnormal CTA test result, and to demonstrate usefulness of CTA as an alternative to conventional angiography for evaluation of the radial artery. MATERIALS AND METHODS: Sixteen patients scheduled for coronary artery bypass grafting entered this study. We performed 32 examinations of forearm and hand arterial anatomy in these patients. CTA was performed in patients with a normal Allen test result, except 1 patient who had a persistent median artery. Soft tissue density forehand roentgenography was performed in all patients before the CTA evaluation. There was no selection of patients in relation to patient characteristics. As a risk factor for radial artery calcification, 6 of the patients had diabetes mellitus, 6 had aortofemoral occlusive disease, and 4 had a history of smoking. RESULTS: Bilateral forearm arteries were visualized in all patients. Severe RA calcification was found in 1 patient, and distal occlusion was found in another patient. Focal RA calcification was noted in 2 patients. In the remaining patients no radial artery calcification or occlusion was noted. Anatomic variation of the upper limb arteries was shown in 2 patients; these variations were persistent median artery with absence of the radial and ulnar arteries and high bifurcation of the radial artery from the brachial artery. CONCLUSION: CTA is useful and safe for detection of radial artery calcific disease and assessment of the forehand circulation and its anatomic variations. Preoperative imaging of the RA is a means to avoid unnecessary forearm exploration or inadvertent use of a diseased conduit in coronary artery bypass candidates with multiple risk factors such as diabetes mellitus.

Age Factors↗
PubMed1991

Diagnostic value of integrated ultrasonic backscatter in congestive cardiomyopathy.

Congestive cardiomyopathy is a fatal myocardial disease which can be diagnosed by clinical findings, electrocardiography, roentgenography and echocardiography. Tissue characterization and pathology have been determined recently using histogram methods to analyze ultrasonographs. In this study ultrasonic backscatter analysis for differentiation of normal and diseased myocardium was tested. Two-dimensional echo data and radio frequency signals of long-axis views of the left ventricular posterior wall of 10 healthy children and 14 patients with congestive cardiomyopathy in systolic and diastolic phase were digitized online into the computer memory. Cyclic variation was obtained in the control group but no variation was detectable in myopathic hearts.

Cardiomyopathy, Dilated↗
PubMed1998

Endogenous amino acids in budgerigars (Melopsittacus undulatus).

To determine the amount of endogenous amino acids in budgerigars (sekiseiinko, Melopsittacus undulatus), as the first step of evaluating amino acid requirements, three experiments were conducted. In Experiments 1 and 2, transit time of the feeds through the digestive tract in budgerigars was studied. The birds were given free access to a corn-based diet containing 50% barium sulfate in Experiment 1, and Japanese millets (hie, Echinochloa utilis) with 0.5 ml of 50% barium sulfate solution in Experiment 2. At intervals of 0.5 to 2 hr, roentgenography was conducted to identify the position of the barium sulfate in the digestive tract. The results showed that the transit time of pellets and millets in the digestive tract was within 24 and 27 hr, respectively. In Experiment 3, to determine the amount of endogenous amino acids in budgerigars, the excreta were collected for 24 hr, from 27 to 51 hr after fasting. The excreta were hydrolyzed with 6 N hydrochloric acid at 110 degrees C for 22 hr for the determination of amino acids by HPLC. The endogenous Ala, Arg, Leu, Lys, Phe and Val were estimated to be 34.9, 36.8, 18.5, 20.3, 15.3 and 18.9 micrograms/day/BW0.75, respectively, which were higher than those in adult roosters.

Amino Acids↗
PubMed1983

[Studies on the serum aldolase activity in workers with muscle disorders caused by vibration work].

Recently, vibrating tools such as chain saws, pneumatic hammers, rock drills, riveters, and grinders have been widely introduced in various industries in order to increase efficiency and to reduce the burden of labor. The disease due to hand-arm vibration often causes serious damages to the operator's body, more particularly of the circulatory, peripheral nervous, osteo-articular and muscular systems. Many kinds of examinations such as roentgenography, electromyography, and sthenometry have been used to diagnose the damage to the musculoskeletal systems. Among these, the measurement of muscular strength, evaluated by grip and pinch strength, is widely used in mass examinations of vibration hazards but this is not always effective in precise recognition of the decrease in muscular strength. In the present study, therefore, in order to diagnose the severity of muscle disorders objectively, serum activities of aldolase (ALD), creatine phosphokinase (CPK) and lactate dehydrogenase (LDH), which are called "muscle enzymes," were determined in 260 chain saw operators aged 40 to 59 years. The same tests were performed for 46 healthy subjects (controls) of a similar age-range, who had a very short experience handling bush cleaners. All chain saw operators were classified into four groups according to the total chain saw operating time (TOT): 1) 58 operators with up to 2,500 hours' experience, 2) 70 with 2,500-5,000 hours' experience, 3) 74 with 5,000-10,000 hours' experience, and 4) 58 with over 10,000 hours' experience. The relationships were investigated in their enzyme activities on the one hand, and their TOT, muscular strength and numbness and pain symptoms related to muscle disorders of the upper extremities on the other hand. The following results were obtained: 1) Serum ALD and LDH activities in chain saw operators increased in proportion to the decrease in muscular strength. The activity of ALD showed a tendency to increase with increased TOT. The ALD activity in the group with over 5,000 hours' experience was significantly higher than that in the control group. However, no relationships were observed between CPK, LDH activities and TOT. 2) In chain saw operators with numbness and pain symptoms, ALD activity in the group with 2,500 hours' experience was significantly higher than that in the control group. However, no obvious relationships were found between CPK, LDH activities and numbness and pain symptoms. 3) In chain saw operators with muscular weakness in addition to numbness and pain symptoms, ALD activity in the group with over 2,500 hours' experience was significantly higher than that in the control group.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1999

Mandibulofacial dysostosis--variability in facial morphology and growth: a long-term profile roentgenographic and roentgen stereometric analysis of three patients.

OBJECTIVE: To monitor and compare facial morphology and growth in three individuals with variable expression of mandibulofacial dysostosis (MFD) in terms of changes in the skeletal profile and in terms of growth in the circummaxillary sutures and temporomandibular joints (TMJs). DESIGN: Retrospective conventional profile roentgenography (mean age 9 to 18 years) and prospective roentgen stereometric analysis (RSA) (mean age 7 to 17 years). SETTING: Center for Craniofacial Anomalies and Department of Plastic and Reconstructive Surgery, Malmö University Hospital, Sweden. PATIENTS: The first three MFD patients seen by one of the authors (B.R.). INTERVENTIONS: Surgery was performed at the Department of Plastic and Reconstructive Surgery. Implants were inserted at surgery under general anesthesia. Roentgen examinations were performed in connection with continued clinical evaluations and treatment. MAIN OUTCOME MEASURES: All profile roentgenograms were traced and measured by one of the authors (K.-V.S.) using a conventional point-based analysis. RESULTS: The more afflicted patient showed a greater total difference in profile morphology and growth from the norm and more pronounced effects of articular growth restriction. Little change in the skeletal profile was associated with considerable displacement of the jaws. CONCLUSIONS: The variability in MFD expression and surgical procedures in our patients is reflected less in the skeletal profile morphology and growth and more in the displacement of the jaws.

Adolescent↗
PubMed2000

Facial growth in a cleft palate patient treated with the Herbst appliance: a long-term profile roentgenographic and roentgen stereometric analysis of profile changes and displacement of the jaws.

OBJECTIVE: To monitor facial development in a patient with cleft palate who was treated with the Herbst appliance. Monitoring was in terms of changes in the skeletal profile and growth in the circummaxillary sutures and temporomandibular joints (TMJs). DESIGN: Prospective profile roentgenography (between the ages of 6 and 20 years) and roentgen stereometric analysis (between the ages of 8 and 19 years). SETTING: Center for Craniofacial Anomalies and Department of Plastic and Reconstructive Surgery, Malmö University Hospital, Malmö, Sweden. PATIENT: Boy with cleft of the soft and posterior part of the hard palate and marked facial convexity. INTERVENTIONS: Surgical repair of the soft palate at age 9 months, velopharyngeal flap at age 8 years, and insertion of implants under general anesthesia and treatment with the Herbst appliance at age 11 years. Roentgen examinations were performed in connection with continued clinical evaluations and treatment. MAIN OUTCOME MEASURES: Profile roentgenograms were traced and measured by one of the authors using conventional point-based analysis. Stereo roentgenograms were digitized by the Department of Orthopedic Surgery, Malmö University Hospital. RESULTS: The direction of profile changes was partly discordant with the direction of articular growth in the circummaxillary sutures and TMJs. The successful treatment result was accomplished by a temporary influence on sagittal growth direction in the circummaxillary sutures and on rotational growth direction in the TMJs, combined with a favorable natural remodeling and articular growth pattern. CONCLUSIONS: The mode of growth by which treatment aims were reached was partly unexpected, i.e., discordant with the generally accepted principal concept that treatment with the Herbst appliance positions the mandible forward.

Adolescent↗
PubMed1982

Diagnosis of submucosal tumors by injecting a water soluble contrast medium: basic research and imaging of tumors.

With the aim of adequately distinguishing gastric submucosal tumors from other lesions such as gastric polyps, gastritis, and protuberances due to extragastric pressure, a new method was developed. A water soluble contrast medium is endoscopically injected into a submucosal lesion followed immediately by the application of roentgenography, thereby obtaining X-ray pictures of the lesion through frontal and lateral projections. Since the contrast substance is water soluble, the method can visualize submucosal microchanges. Highly diffusible, the substance usually has a fading time of about 40 min, the present method is convincingly free of danger. This paper provides the results of basic research performed using adult mongrel dogs together with some comments on the applicability of the method in clinical use.

Adult↗
PubMed1982

Diagnosis of submucosal tumors by injecting a water soluble contrast medium: diagnosis of tumors and clinical presumption of their development patterns.

So far there have been no clinical methods claiming reasonable estimation of the patterns of submucosal tumors. In an attempt to shed some light on this difficult task, we have elaborated an endoscopical procedure; injecting a water soluble contrast medium into the submucosa and immediately applying roentgenography, we have obtained an X-ray image of the object lesion, visualizing its frontal and lateral aspects, which could help us outline the intramural characteristic of the tumor, informing us of its development mode. The device suggests its far-reaching contributions to the possible diagnosis of submucosal tumors prior to treatment and confirmation of their indications adequate for endoscopical treatment. Our method may potentially represent an ideal step to the consummation of endoscopic treatment of tumors, the success of which is dependent on the prevention of major bleeding and perforation.

Adolescent↗
PubMed1994

Micromotion of femoral stems in total hip arthroplasty. A randomized study of cemented, hydroxyapatite-coated, and porous-coated stems with roentgen stereophotogrammetric analysis.

The fixation of the femoral stem in a total hip arthroplasty was studied in sixty patients (sixty-four hips) with use of roentgen stereophotogrammetric analysis. The hips were randomly stratified on the basis of the age, sex, and weight of the patient; the roentgenographic quality of the bone; and the reason for the operation (primary or secondary osteoarthrosis). The hips were then randomly assigned to one of three types of fixation of the femoral component: insertion with cement, hydroxyapatite coating, or porous coating. Examinations with roentgen stereophotogrammetry were done as long as two years after the operation. Micromotion of the prostheses was evaluated in terms of subsidence or proximal migration and rotations and translations of the proximal-lateral (shoulder) and distal (tip) parts of the prostheses. The clinical results at the two-year follow-up evaluation did not differ significantly between the groups with regard to the Harris hip score or the pain score (p > 0.05 for both; Wilcoxon rank-sum test). There were small or no differences in rotations and micromotions of the shoulder and the tip of the prostheses. Increased subsidence of 0.1 to 0.2 millimeter was recorded for the cemented and the porous-coated prostheses (p = 0.002 and p = 0.02, respectively; Wilcoxon rank-sum test). Thus, proximal hydroxyapatite coating seems to enhance the early fixation of the stem. Conventional roentgenography revealed an increased number of radiodense lines surrounding the porous-coated prostheses. Distal hypertrophy of the femoral cortex was found mainly around the hydroxyapatite-coated prostheses. Proximal resorption of bone and heterotopic ossification occurred to approximately the same extent regardless of the type of fixation used.

Adult↗
PubMed1996

A fibrous histiocytoma with a polypoid pattern of growth in a major bronchus.

A 47-year-old man was admitted to our hospital for abrupt onset of hemoptysis and dyspnea. Chest roentgenography revealed a left lower mass shadow with obstruction of the left main bronchus. However, on the third hospital day, he expectorated a coagulum-like substance which resembled bronchial tree, and his symptoms then dramatically subsided. Except for small amounts of bleeding from left B10a, the endobronchus was intact on bronchoscopic examination, and the pathologic diagnosis of the tumor using resected material was fibrous histiocytoma of low-grade malignancy. In addition, given the similarity in histologic findings between the expectorated substance and resected tumor, the expectorated substance was considered to be a part of the tumor which had grown along the endobronchial tree.

Bronchi↗
PubMed1996

Primary lung cancer associated with diffuse granulomatous lesions in the pulmonary parenchyma.

A 60-year-old man was admitted to our hospital for productive cough. Chest roentgenography and CT scan disclosed a left hilar tumor invading the mediastinum, with mediastinal lymphadenopathy and diffuse micronodular shadows in both lung fields. A biopsied sample of the tumor revealed squamous cell carcinoma, while noncaseating epithelioid cell granulomas were observed in the samples obtained by transbronchial lung biopsy. The granulomas in the pulmonary parenchyma were determined to be sarcoid reactions secondary to lung cancer, since there was no evidence of sarcoidosis. Combination chemotherapy was effective for the tumor, and the granulomas disappeared after completion of the chemotherapy. These findings suggest the presence of a relationship between sarcoid reactions and lung cancer in this case.

Carcinoma, Squamous Cell↗