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At least 1,405 records · Page 78Linked to original sources
PubMed1993

[Measurement of the hip joint space using automatic digital image analysis].

Joint surface area (JSA) and mean joint space width (MJSW) at the hip were measured using a ICMS-Techline computer program to analyze digitalised frontal weight-bearing roentgenograms of the pelvis. With this technique, the portion of joint space studied is always the same in a given patient and is enclosed within an acute ECS angle whose apex C is the center of the head of the femur and whose ends E and S are the lateral rim of the acetabulum and the highest point of the homolateral sacral wing respectively. ECS varies across individuals but remains constant in a given hip. Twenty hips were included in the first part of the study. For each hip, three roentgenograms were taken at five-minute intervals by three different radiologists who used their own constants (settings, position of the subject). JSA and MJSW are determined five times on each film by two different observers who had no information on the films under study. The interobserver coefficient of variation (CV) was 4.7% for JSA and 3.3% for MJSW. Intra-observer CVs were 2.97 and 3.54% for MJSW and 4.32% and 5.13% for JSA. There was a very close correlation between MJSW and JSA (r = 0.87, p < 0.0001). MJSW was then determined for roentgenograms of 30 hips with osteoarthritis. Results were compared with the values obtained using Lequesne's method of joint space measurement at the site of maximum narrowing. Measurements were performed in a double-blind fashion by two observers. The correlation coefficient was r = 0.89 (p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1976

Technetium Tc 99m macroaggregated albumin lung scans. Use in chronic childhood asthma.

Serial roentgenograms and technetium Tc 99m macroaggregated albumin lung scans were done simultaneously in 30 bronchodilator-dependent asthmatic children and young adults during both relative remission and attacks of status asthmaticus. When chest roentgenograms showed air trapping and increased peribronchial vascular marking associated with persistent perfusion defects, the children benefited from further laboratory studies and continuous comprehensive therapy. Serial scans provided information about underperfusion that was not discernible either by roentgenograms or by usual blood gas studies. Also, lung scans are easier to obtain in children with long-standing asthma than are detailed pulmonary tests. In our study, technetium Tc 99m macroaggregated albumin scans showed persistent regional perfusion defects in 20 children wiht chronic asthma during relative remission and exacerbations.

Acute Disease↗
PubMed1994

[Study of two cases of active pulmonary tuberculosis complicated by lung cancer].

In this study, we report on two patients diagnosed with active pulmonary tuberculosis who later developed complications of lung cancer. In both instances, lung cancer was not detected until after cessation of tuberculostatic drugs. Both patients were initially considered to be experiencing exacerbation of pulmonary tuberculosis. Patient 1 was a 77-year-old female. A roentgenogram of her chest revealed a cavitary lesion with infiltration into the right lung field. Her sputum tested positive for acid-fast bacilli. Although she was treated with isoniazid (INH), rifampicin (RFP) and streptomycin sulfate (SM), the RFP and INH treatments had to be discontinued due to liver dysfunction. Her general condition was deteriorated, and pleural effusion appeared on a subsequent chest roentgenogram. Primary squamous-cell lung cancer was confirmed by conducting a transbronchial biopsy. Patient 2 was a 59-year-old male. A roentgenogram of his chest revealed multiple cavitary lesions with infiltration into the bilateral lung field. His sputum also tested positive for acid-fast bacilli. Although he was treated with INH, RFP and SM, INH and RFP treatment had to be discontinued due to liver dysfunction and high fever. The shadow infiltrating the left lung field subsided, but a massive shadow appeared in the right lung field. Primary small-cell lung cancer was confirmed after conducting a sputum cytology. The patients was then administered cisplatin and etoposide. Patient 1 was diagnosed with lung cancer five months after being admitted to the hospital, and Patient 2 ten months after admission. Both patients succumbed due to lung cancer at seven and 26 months, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[A case of chronic lung abscess showing a cloudy shadow of the right upper lobe, diagnosed by transbronchial aspiration cytology].

A 58-year-old healthy woman was admitted to our hospital on 8th October, 1991 for detailed investigation of an abnormal shadow on chest roentgenogram, which was detected by mass survey. The chest roentgenogram showed a cloudy shadow of the right upper lobe, and retrospectively, this abnormal shadow had been present since 1986. Flexible fiberoptic bronchoscopy showed complete obstruction of right B1b bronchus by regenerated bronchial mucosa. Aseptic pus was detected in the obstructed bronchus by means of transbronchial aspiration cytology (TBAC) and chronic lung abscess was diagnosed. The chest roentgenograms of this case is very unusual, and we were unable to find a similar case of chronic lung abscess diagnosed by means of TBAC.

Biopsy, Needle↗
PubMed1977

Calcification in retinoblastoma.

Review of 40 cases of retinoblastoma revealed that histologic evidence of calcification was noted in 38 of the 40 tumors, whereas only three of 16 roentgenograms were positive for calcium. Calcificaton detected by roentgenograms and histopathologic examination correlated poorly with quantitative determination for tumor calcium. Compared to control eyes, however, eyes with retinoblastoma contain large amounts of calcium (1.2 vs. 218 mug/ml. ash). This calcification, though frequently not observed in standard roentgenograms, should be detected by the newer diagnostic modalities such as hypocycloidal polytomography, computerized transaxial tomography, ultrasonography, and radionuclide scintigraphy with technetium diphosphonate, a bone-scanning agent.

Adolescent↗
PubMed1993

The role of CA 125 and conventional examinations in diagnosing progressive carcinoma of the ovary.

The clinical significance of the serum marker CA 125 and conventional examinations in diagnosing progressive disease was evaluated in 98 patients. The examinations included CA 125, gynecologic and complete physical examination, abdominal computed tomography (CT), roentgenogram of the chest, second look operation and serum biochemistry profile. Progressive disease occurred in 49 patients and the time to progression was a median of 12 months (range of four to 52 months). At the time of progression, an elevated CA 125 was found in 73 percent of the patients, and in 63 percent of the patients, CA 125 increase preceded clinical progression for a median of four and one-half months (range of 0.5 to 29.5 months). A positive gynecologic examination at progression was found in 67 percent of the patients, physical examination and abdominal CT scan were positive in 30 percent, intervention operation in 14 percent and roentgenogram of the chest in 12 percent of the patients. With the combination of serum CA 125, gynecologic and general physical examination, progressive disease could be diagnosed in 92 percent of the patients. The false-positive rate in the 49 patients with no evidence of disease was 1.6 percent for CA 125, 2.0 percent for gynecologic examination, 4.0 percent for physical examination, 14.0 percent for CT scan and 2.0 percent for roentgenograms of the chest. Serum CA 125 is the most reliable examination to detect progressive disease early. With the combined use of serum CA 125 and the gynecologic and general physical examination, progression of the disease can be detected in about 90 percent of the patients.

Adenocarcinoma↗
PubMed1993

Roentgenographic densitometry of bone adjacent to a femoral prosthesis.

A digital imaging method was developed to quantitate the stress-related changes in roentgenographic bone density after total hip arthroplasty. A technique termed "histogram-directed equalization" was used to compensate for differences in postimaging data caused by the effects of variable quality obtained from ten patients. Quantitative change due to variation in delivered energy was decreased by 7% for roentgenograms obtained with a 2 kVp variation and 31% for roentgenograms obtained with a 4 kVp variation. The method allowed the authors to accurately describe the changes observed on annual postoperative roentgenograms obtained over the past decade. The utility of the method was demonstrated in 15 of the senior author's long-term cases treated with fully porous-coated implants. These cases were divided into two groups based on the diameter of the prosthetic stem implanted in each case. Five patients were grouped with small-diameter stems and ten with large-diameter stems. Both groups showed substantial decrease in roentgenographic bone density (from 11% to 28%) in the medial and lateral proximal regions. The large-diameter group had an overall larger decrease in roentgenographic bone density at two and five years. Roentgenographic bone remodeling changes were most pronounced in the first two years. Changes between two and five years progressed at a slower rate. The results also confirmed the predicted effect of stem diameter on bone remodeling patterns.

Absorptiometry, Photon↗
PubMed1977

The spectrum of extrapulmonary tuberculosis.

The incidence of new cases of extrapulmonary tuberculosis has remained constant, despite the decline in new cases of active pulmonary tuberculosis. This might be due to a delay in recognition, and particularly a lack of consideration of tuberculosis when the presenting symptoms are other than respiratory. Extrapulmonary tuberculosis should be considered in the differential diagnosis of bone, joint, genitourinary tract and central nervous system (CNS) diseases. To determine factors that might delay recognition and identification, 62 patients having extrapulmonary tuberculosis during 1969-1972 at the Los Angeles County-University of Southern California Medical Center were studied.Three quarters of these patients had had CNS, skeletal or genitourinary tuberculosis in equal distribution or 25 percent each. CNS involvement was seen frequently in the disseminated form. Presenting symptoms were protean and not specific, such as fever, anorexia, weight loss, cough, lymphadenopathy and neurologic abnormalities. Roentgenograms of the chest were abnormal in most. When a roentgenogram of the chest suggests pulmonary tuberculosis, signs and symptoms in other body systems should suggest extrapulmonary tuberculosis. If no abnormalities are seen on a roentgenogram of the chest, however, this does not preclude the diagnosis of extrapulmonary tuberculosis. Neither does a negative tuberculin skin test exclude the condition. Abnormal laboratory findings are common, especially in disseminated tuberculosis. These include various anemias, bone marrow disorders, hyponatremia due to inappropriate antidiuretic hormone syndrome. Analyses of pleural, peritoneal, pericardial and joint fluid usually show an exudate high in lymphocytes and occasionally low in glucose. Similar findings are seen in spinal fluid. The histological features of caseous or noncaseous granulomas are suggestive of but not specific for tuberculosis. Only culture of mycobacteria from sputum, urine, spinal fluid, pleural and other effusions and tissue biopsy specimens will yield a definitive diagnosis. Physicians must have a high index of suspicion to diagnose extrapulmonary tuberculosis, as it can resemble any disease in any organ system. Immediate therapy in the disseminated variety, sometimes even before a definite diagnosis can be made, may be lifesaving.

Adolescent↗
PubMed1996

[Acute pulmonary disease in systemic lupus erythematosus successfully treated with prednisolone pulse therapy].

A 46-year-old man was admitted to the hospital because of chest pain and left pleural effusion. Fever and dyspnea developed on the third hospital day. Interstitial shadows and pleural effusions in both lower lung fields appeared on chest roentgenograms. Microscopic examination of transbronchial lung biopsy specimens taken on hospital day 5 showed thickening of the alveolar walls and desquamation of macrophages into the alveolar spaces. Analysis of bronchoalveolar lavage fluid revealed many cells and macrophages. Tests for anti-nuclear antibody and anti-DNA antibody were positive, which, in addition to serositis and proteinuria, established the diagnosis of systemic lupus erythematosus. The interstitial shadow on chest roentgenograms was believed to have reflected an acute pulmonary manifestation of systemic lupus erythematosus. The symptoms and the abnormality on chest roentgenograms were relieved within 1 month of the start of pulse therapy with prednisolone.

Acute Disease↗
PubMed1996

Anisotropy measurements obtained by fractal analysis of trabecular bone at the calcaneus and radius.

The resistance of bone tissue is influenced not only by bone density parameters but also by bone architecture parameters, such as the microarchitecture and anisotropy of trabecular bone. We have developed and validated a fractal analysis method for studying bone microarchitecture on roentgenograms. This technique provides reproducible measurements of the fractal dimension (D) of bone, which reflects bone texture. The fractal dimension is determined in 36 different directions; the mean of these 36 values is representative of the image. A polar diagram gives the value of D according to the angle of analysis. By decomposing this diagram using polar Fourier Transform analysis, the parameters related to the shape of the polar diagram can be determined. This diagram image analysis technique has been used for other similar diagrams and applied to the results of our fractal analysis method. Diagram shape characterization may provide information on the angular distribution of results and therefore on the anisotropy of the images under study. The purpose of this study was to compare roentgenograms of the calcaneus and radius in the same subjects to determine whether texture and anisotropy parameters discriminated between these two bones. Roentgenograms of the calcaneus and radius were obtained in ten nonosteoporotic subjects. The radius had a smaller fractal dimension than the calcaneus (mean +/- standard deviation: 1.215 +/- 0.025 and 1.285 +/- 0.066, respectively; p = 0.014). Differences in the shape of the polar diagram were found between the two bones. The mean Fourier coefficient ratio C2/C4 was considerably smaller at the calcaneus (0.63 +/- 0.50) than at the radius (4.88 +/- 3.45; p = 0.005). Our method allows quantitative characterization of texture and anisotropy differences between the calcaneus and radius. The smaller fractal dimension of the radius probably reflects the simpler architecture of this non weight-bearing bone. The differences in polar diagram shape allow to evaluate anisotropy differences between the calcaneus and radius.

Adult↗
PubMed1975

Frontal sinus cancer manifested as a frontal mucocele.

During the period 1972 to 1974, 12 frontal mucopyoceles were seen. Subsequently, three were shown to have an underlying neoplasm. Evaluation of the roentgenograms demonstrated minor differences between those with and those without a malignant basis. In previous reports of frontal sinus cancer, the descriptions of the roentgenograms suggest that it is possible that these features were also present. The difficulty in deciding the sinus of origin in such cancers has often been discussed, but the possibility that neoplasms of the orbital lobe of the lacrimal gland may occur in the frontal sinus is usually not considered. Anatomically, the intimate proximity of this lobe to the frontal sinus suggests that a neoplasm could develop in this manner. I believe that this was true in two of the patients reported herein.

Adenocarcinoma↗
PubMed1981

Arthrotomography of the temporomandibular joint.

Temporomandibular joint (TMJ) dysfunction may cause facial or aural pain. Conventional roentgenograms are useful to define bony pathologic conditions. However, TMJ arthrotomography may disclose joint meniscus abnormalities in two thirds of patients with persistent dysfunction despite normal roentgenograms.

Cartilage, Articular↗
PubMed1994

Neurologic sequelae secondary to atlantoaxial instability in Down syndrome. Implications in otolaryngologic surgery.

OBJECTIVE: A comprehensive overview of atlantoaxial instability in Down syndrome as it relates to head and neck surgery and recommendations as derived from a review of the literature. DATA SOURCES: English-language literature: otolaryngologic problems in Down syndrome and atlantoaxial biomechanics. DATA SYNTHESIS: Children affected with Down syndrome frequently require otolaryngologic procedures such as myringotomy with ventilation tubes or adenotonsillar surgery. Atlantoaxial instability occurs in 10% to 20% of patients with Down syndrome who are at risk for atlantoaxial subluxation and subsequent complications during anesthetic induction and during positioning and manipulation associated with surgery. To identify patients who are at risk for atlantoaxial subluxation, guidelines have been adapted from the recommendations of the American Academy of Pediatrics and the Special Olympics Inc, which include preoperative neurologic assessments and cervical roentgenograms in the neutral, flexion, and extension positions. Children with an atlantodental interval of greater than 4.5 mm or with peripheral neurologic findings should have further evaluation. CONCLUSIONS: A small percentage of patients with Down syndrome are at risk for atlantoaxial instability and subluxation. All patients with Down syndrome should have a preoperative neurologic assessment screening by the operating surgeon and/or a cervical roentgenogram in the lateral, extension, and flexion positions. Any abnormality should be investigated before surgery.

Anesthesia, Inhalation↗
PubMed1994

Ethmoid bone sandwich grafting for caudal septal defects.

OBJECTIVE: To evaluate a new technique for correction of severe caudal septal defects. DESIGN: For all patients, preoperative photographs were graded with regard to the severity of caudal septal defects. Preoperatively, nasal airway breathing surveys were conducted and nasal tip projection (NTP) measurements were recorded. The caudal septal defects were then repaired with use of the ethmoid bone sandwich grafting technique. Photographs, NTP measurements, and an airway survey were then repeated 6 and 12 months postoperatively. Preoperative and postoperative assessments were compared and analyzed. Lateral nasal roentgenograms were obtained in five of 10 patients to assess resorption of the bone grafts. Complications were noted if present. SETTING: Urban medical center. PATIENTS: Ten volunteers with severe caudal septal defects causing both cosmetic and functional problems. All patients had undergone at least one previous submucous resection. OUTCOME MEASURES: Durability and degree of correction, maintenance of NTP, airway improvement, and morbidity. RESULTS: After 1 year, all patients maintained satisfactory correction of their caudal septal defect based on postoperative photographic grading and physical examination findings. The NTP was maintained in eight of 10 patients. Two patients experienced loss of NTP after 1 year that was not present 6 months postoperatively. Average airway improvement was 126.7% after 1 year. Postoperative roentgenograms showed only minor (< 10%) bone graft resorption. The only complication was a granuloma. CONCLUSIONS: The ethmoid bone sandwich grafting technique corrected severe caudal septal deviations while maintaining or strengthening structural support of the caudal septal strut without loss of NTP, airway compromise, or morbidity.

Adult↗
PubMed1979

Miliary tuberculosis in children. Clinical and laboratory manifestation in 19 patients.

The clinical course of 19 children with miliary tuberculosis was studied. Complaints were nonspecific and included fever, anorexia, weight loss, and night sweats. Although all but one child had a miliary infiltrate visible on the chest roentgenogram, only 13 had a positive reaction to the purified protein derivative of the tuberculin test at admission to the hospital. Outcome was excellent unless the child also had tuberculous meningitis or was in a far advanced state of the disease. Miliary tuberculosis continues to be a rare but important cause of illness in the pediatric population. Seriously ill children with undiagnosed conditions of febrile disease deserve an aggressive evaluation for miliary tuberculosis, including an epidemiological survey, serial chest roentgenograms, and extensive, repeated culturing.

Adolescent↗
PubMed1982

Children with brain tumor headaches. Distinguishing features.

We analyzed the history, physical examination findings, and skull roentgenograms of 72 children with headaches secondary to brain tumors to determine distinguishing features. Of 56 children, skull roentgenograms were abnormal in 54% (30). Abnormal findings from either the neurologic or ocular examination were present in 68 (94%) of these children at the time of brain tumor diagnosis. These abnormalities developed in 51 of 60 children (85%) within two months of the onset of their headaches. Clues for earlier diagnosis were frequently present in those patients whose conditions were diagnosed more than four months after the onset of their headaches. Recognition of those findings could have resulted in the diagnosis of brain tumor in 69 of 72 children (96%) within four months of the onset of headaches. During the first four months of headache complaints, children should be monitored closely.

Adolescent↗
PubMed1985

Edetate sodium aerosol in Pseudomonas lung infection in cystic fibrosis.

In vitro and animal experimental data suggest the combination of edetate sodium (EDTA) by aerosol plus oral antimicrobials might be effective in the treatment of chronic Pseudomonas infection in patients with cystic fibrosis (CF). For six months we studied the effects of edetate sodium administered by ultrasonic nebulizer to ten children with CF and chronic Pseudomonas aeruginosa infection in a double-blind, placebo-controlled, crossover study. The children had evidence of mild to moderate disease at entry in the study, with a mean (+/- SD) forced expiratory volume in the first second of 85% (+/- 18%) of the predicted value and a mean (+/- SD) Shwachman-Kulczycki score of 83 (+/- 7)/100. Each child was on a three-month regimen of aerosolized edetate sodium plus oral tetracycline twice daily followed by three months of placebo aerosol plus tetracycline or vice versa. Progress was assessed by measurement of pulmonary function, physical examination, and sputum cultures at four weekly intervals, plus chest roentgenograms on entry and after each of the three-month treatment periods. Daily symptoms were assessed using a diary card system. Two patients could not complete the study, one because of severe respiratory relapse, the other because of antibiotic side effects. Of the remaining eight patients, none showed any improvement in pulmonary function, weight gain, or growth acceleration, and none was rendered free of Pseudomonas lung infection. Daily symptom scores and chest roentgenograms were unaltered by edetate sodium. We conclude that the combination of aerosol edetate sodium plus oral tetracycline over a three-month period does not modify the clinical course nor the pulmonary flora in patients with CF with chronic Pseudomonas lung infection.

Administration, Oral↗
PubMed1986

Bone disease induced by anticonvulsant therapy and treatment with calcitriol (1,25-dihydroxyvitamin D3).

To evaluate the effects of calcitriol (1,25-dihydroxyvitamin D3) therapy for the bone disease induced by long-term treatment with anticonvulsants, we reviewed the medical records of 330 institutionalized oligophrenic children and young adults under 26 years of age to identify the 144 children who required anticonvulsant therapy. Of this latter group, 52 children were found to have serum alkaline phosphatase levels elevated more than 2 SDs above normal and were enrolled into this prospective three-year study. To achieve rapid resolution of the bone disease, we elected to use calcitriol at 0.25 to 0.75 micrograms/d. After 1195 patient-months of treatment, our data suggest that the dystrophic process was reversed in 42.3% of the cases, as judged by decreases in serum alkaline phosphatase levels at six months, 65.4% of cases at 12 months, and 83.3% of cases at 13 to 18 months. By 30 months of follow-up, all patients showed significant lowering of serum alkaline phosphatase levels. The improvements were slow and gradual. Twenty-six patients in the treatment series of 52 patients initially showed signs of rickets or osteomalacia on roentgenograms of the wrists. Of these 26 patients, 12 (46%) showed improvement on roentgenograms within 24 months of the beginning of treatment. With reference to complications, hypercalcemia (calcium level, greater than 11 mg/dL [2.74 mmol/L]) was encountered at the rate of one episode per 44 patient-months of treatment. Our results strongly suggest that calcitriol is effective in healing anticonvulsant-related osteomalacia among children and youths, with a low incidence of complications.

Acid Phosphatase↗