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PubMedDate not supplied

Two-dimensional echocardiographic evaluation of intracardiac transvenous pacemaker leads.

A two-dimensional (2-D) echocardiographic study was performed on 40 consecutive patients presenting for a routine check-up of their transvenous pacemaker devices, in order to assess the visibility of the intracardiac portion of the pacemaker lead. In 34 patients (85%) the presence of the lead could be demonstrated satisfactorily. In 4 of these 34 patients the entire intracardiac portion of the pacing wire was imaged, in 20 the distal fragment bearing the electrode(s) was seen, and in 10 an intermediate segment was visible. In 6 of the 40 patients (15%) the lead was not visible. In 3 of these 40 patients it was virtually impossible to image any cardiac structure. The less than 100% visibility of the pacing wire may be due to our randomized patient group with a high mean age of 75 years. We conclude that during follow-up examinations or when problems arise in patients with transvenous pacemakers, 2-D echocardiography may be an alternative to roentgenograms, especially if simultaneous information about heart function is desired or septal perforation is suspected. However, chest roentgenograms are still more accurate and remain the technique of choice under normal circumstances.

Aged↗
PubMed1985

Correlations of radiographic analysis of healing fractures with strength: a statistical analysis of experimental osteotomies.

The assessment of fracture healing strength using routine roentgenograms is difficult and controversial. There are few experimental data that correlate radiographic appearance with the actual quantitative strength of healing fractures. However, this method is widely used in clinical practice. A study is presented in which transversely osteotomized rabbit tibiae were allowed to heal for 3 to 8 weeks. A pair of orthogonal roentgenograms was taken of each bone and the bones were tested for strength in a dynamic torsion testing machine. Statistical analyses were done to study the correlations between the roentgenographic and strength parameters. Cortical continuity was found to be the best single predictor of strength of a healing fracture (correlation coefficient r = 0.80). The least important predictor was the callus area (r = 0.17). Fracture displacement, callus thickness, and callus diameter had negative correlations. From these experimental findings in an animal model, we conclude that even under laboratory conditions the information gained from plain radiographs is not sufficient to accurately predict the strength of a healing fracture.

Animals↗
PubMed1986

An assessment of the value of triple endoscopy in the evaluation of head and neck cancer patients.

The purpose of this study was to evaluate the role of triple endoscopy in the routine diagnostic evaluation of head and neck cancer patients to (1) ascertain the accuracy and safety of this approach in identifying multiple neoplasms and (2) determine if such an approach is justifiable rather than relying on radiographic examinations coupled with the routine head and neck exam including indirect laryngoscopy. In this series, the incidence of second malignancies was found to be 11.3%, consistent with other reports in the medical literature. There were no complications noted as a result of triple endoscopy. There were no instances where the second malignancy was not diagnosed prior to triple endoscopy with either the physical exam or routine roentgenograms. There were no incidences where the treatment program of the primary tumor was altered by the information obtained at triple endoscopy. The results of this single institutional study suggest that triple endoscopy need not be a routine component of the diagnostic evaluation of every patient with head and neck cancer. However, every patient should probably have a thorough physical examination coupled with chest and esophageal roentgenograms to search for a simultaneous secondary neoplasm.

Bronchoscopy↗
PubMed1995

Distal radioulnar joint subluxation and dislocation diagnosed by standard roentgenography.

The use of standard lateral roentgenography for diagnosing distal radioulnar joint (DRUJ) subluxation and dislocation was investigated. Using a wrist support, bilateral standard lateral roentgenograms of the wrist were obtained in 42 patients with normal wrists and in 56 patients with a unilateral wrist injury. In normal wrists the difference between the radioulnar distance in the right and the left wrist did not exceed 4 mm when the difference in the pisoscaphoid distance was less than 3 mm. Of the 36 patients with wrist injury whose difference in pisoscaphoid distance was less than 3 mm, 15 had a radioulnar distance of 5 mm or more, and computed tomography (CT) confirmed DRUJ dislocation in 14. Concordance between lateral roentgenograms and CT was present in 33 of 36 patients (92%). These results demonstrate the value of a standardized technique for bilateral lateral roentgenography in diagnosing DRUJ subluxation and dislocation.

Adolescent↗
PubMed1996

Radiographic evaluation of the upper cervical spine in rheumatoid arthritis: a retrospective analysis.

We analysed retrospectively 295 lateral roentgenograms of the cervical spine in 150 patients with classic or definite rheumatoid arthritis. In addition to measuring the atlantodental interval, measurements of the different vertical parameters described by McGregor, Ranawat and Redlund-Johnell and a new measurement method with high reproducibility were described and their results compared statistically. As a control group we analysed 100 lateral roentgenograms of the cervical spine in patients with no inflammatory disease, posttraumatic lesion, tumour or osseous deformity.

Adult↗
PubMed1988

Injuries of the lateral ligaments of the ankle joint. Operative treatment and long-term results.

Between 1980 and 1984, 268 patients with recent ankle ligament ruptures were treated with primary surgical repair at the 2nd Department of Trauma Surgery, University of Vienna. The decision for immediate operative treatment was based on clinical findings as well as on a positive stress roentgenogram. Ligament ruptures were diagnosed if the talar tilt on the injured side exceeded that on the uninjured side by 5 degrees or more or if the ventral subluxability of the talus was more than 5 mm compared with the uninjured side. One hundred twenty-two patients were followed up for 2-6 years after operation; follow-up included physical examination as well as standardized and stress roentgenograms. Good results were obtained in 80% of cases, moderate results in 17%, and poor results in 3%. All of the poor results were due to persistent radiological instability and/or arthrotic joint degeneration. The incidence of infection was 1.5%.

Adolescent↗
PubMed1988

Shaft fissures due to implantation of cementless total endoprostheses of the hip joint. An experimental study.

Since 1982, at the Orthopedic Department of the Pulmologic Center of the City of Vienna we have used the Zweymüller shaft system and the pyramidal threaded socket by Schwägerl when implanting cementless hip endoprostheses. Some patients repeatedly complained about pains in the shaft region within the first postoperative months, though these complaints could not be explained clinically or radiographically. On 15 human cadavers we implanted a total of 20 Zweymüller shafts and examined the femurs for ruptures of the shaft. Our special interest was the course of the fracture lines, their localization, and their display on roentgenograms. It appeared that fissures of the shaft are easily caused by the forced driving-in of the prosthesis. In about half of all cases the fissure cannot be seen on roentgenograms because of the site is covered by the implant itself. The fracture lines do not always begin intertrochanterally or from the calcar femoris; therefore, they cannot be recognized during surgery. This problem should be considered during implantation as well as during postoperative remobilization.

Aged↗
PubMed1979

[The significance of tomography in the x-ray diagnosis of coxarthrosis (author's transl)].

Authors have made besides routine roentgenograms tomograms too in 50 patients with coxarthrosis of various severeness. For an assessment of the diagnostic value of tomography the routine roentgenograms and the tomograms were analysed comparatively. The investigations have shown that the tomography may give in certain cases great help in the judgement of progression and in the correct indication of operative methods in hip surgery.

Adult↗
PubMed1979

Rickets: a roentgenographic scheme for diagnosis.

The roentgenograms in seventy-two (72) patients with all forms of rickets were reviewed in an attempt to determine whether specific forms of rickets could be identified and classified roentgenographically. All cases were clinically proven and after analyzing the roentgenographic changes in all of the patients, it was determined that such a scheme was possible. This scheme allows one to either diagnose the specific type of rickets or offer a short, pertinent differential diagnosis from roentgenograms alone.

Chronic Kidney Disease-Mineral and Bone Disorder↗
PubMed1984

Hepatic granulomatosis and sarcoidosis. Further observations.

The etiology of hepatic granulomatosis discovered in patients with normal chest roentgenograms is controversial. Among 18 such patients studied in recent years, sarcoidosis was identified as the cause in 15 by demonstration of granulomatous inflammation in extrahepatic tissues, employing a variety of biopsy methods. Serum angiotensin levels were raised in all 10 patients tested and gallium scans were helpful in four of six cases. Prolonged fever was the most common symptom, but three patients had severe right upper quadrant pain, a manifestation of hepatic sarcoidosis not previously described. Improvement on corticosteroids was observed in the 14 treated patients, but incomplete response led to use of cytotoxic drugs in three cases. Sarcoidosis presents with normal chest roentgenograms more often than is appreciated and appears to be a common cause of unexplained persistent hepatic granulomatosis. A firm diagnosis should be established since treatment is long and frustrating. The prognosis is good but treatment for years is required in most cases.

Adolescent↗
PubMed1992

Pulmonary nocardiosis manifested as miliary nodules in a neonate--a case report.

A case of pulmonary nocardiosis in a 18-day-old neonate is presented. The chest roentgenograms demonstrated the widespread nodularities, mimicking miliary tuberculosis. Nocardiosis is rare in childhood but should be included in the differential diagnosis of the disseminated nodularities seen in the chest roentgenogram.

Diagnosis, Differential↗
PubMed1982

The "free" routine postcatheterization urogram: a cost/benefit analysis.

Postangiography urography has become routine procedure in most centers performing cardiac catheterization in children. We analyzed the x-radiation dosage and clinical yield of this procedure. Using lithium fluoride thermoluminescent dosimeters, radiation exposure to the abdomen and gonads was measured in 35 children during postangiography urography. Results of 334 consecutive routine postangiography cine-urograms were evaluated based on clinical significance and compared to previous reports on this subject. Average absorbed abdominal radiation dosage was 241 mR +/- 240 from cine-urography, 16 mR +/- 13 from fluoroscopy, and 107 mR +/- 111 from a single abdominal roentgenogram. Gonadal dosage averaged 8 mR and was uniformly less than 27 mR. Of 334 routine postangiography cineurograms, 282 (84%) were normal, 30 (9%) were technically inadequate, 12 (3%) had abnormalities that were clinically insignificant or were falsely "positive" and in 10 (3%), clinically significant urologic conditions were confirmed. Because of the low yield of clinically significant anomalies and the added radiation exposure, we no longer perform routine postangiography cine-urography in children. Following cardiac angiography, the upper renal collecting systems are examined fluoroscopically. If abnormalities are suspected or fluoroscopy is equivocal, a single abdominal roentgenogram is performed. Using this procedure, mean average absorbed abdominal radiation dose can be reduced from 241 mR to 30.5 mR.

Cardiac Catheterization↗
PubMed1978

Rickets as a complication of intravenous hyperalimentation in infants.

Fifteen newborn infants developed roentgenographic evidence of rickets while on long-term intravenous hyperalimentation. In each instance, the initial diagnosis of rickets was suggested on the chest roentgenogram, where characteristic cupped and frayed upper humeral metaphyses were noted; subsequent knee and wrist roentgenograms substantiated these findings. Factors which may have predisposed to the development of rickets include inadequate doses of vitamin D, prematurity and a rapid change in body weight during hyperalimentation therapy.

Bone and Bones↗
PubMed1998

Successful management of left main bronchial stenosis as a rare complication of pericardiectomy.

We present a rare complication of pericardiectomy and the effective management thereof. A 67-year-old female with dyspnea and upper abdominal pain was received at our department upon referral. Chest roentgenogram and cardiac catheterization preceded a diagnosis of constrictive pericarditis. Pericardiectomy was performed subordinate to median sternotomy and left anterolateral thoracotomy. Extubation was carried out on day 2 but reintubation was necessitated on the same day as a result of progressive dyspnea. Chest roentgenogram revealed an atelectasis of the left lung. Fiberoptic bronchoscopy showed left main bronchial stenosis resulting from a pulsating external structure. A postoperative computed tomogram substantiated the stenotic left main bronchus between the dilated left pulmonary artery and the thoracic descending aorta. An expandable metallic stent for the treatment of this complication was selected over other invasive procedures. Two years of follow-up reveal no complications. Accordingly, an expandable metallic stent has demonstrated its effectiveness not only on bronchial stenosis due to malignancy or tuberculosis but on benign cases such as this as well.

Aged↗
PubMed2005

[Early chest tube removal after video-assisted thoracoscopic surgery. Results of a prospective randomized study].

BACKGROUND: Chest tubes frequently cause postoperative patient discomfort after video-assisted thoracoscopic surgery (VATS). Therefore, a prospective randomized study was conducted to analyze whether early chest tube removal within 2 h postoperatively is justified in VATS. METHODS: Ninety-three patients fulfilled the inclusion criteria (VATS including wedge resection, complete lung extension on postoperative chest roentgenogram) and showed no exclusion criteria (lung volume reduction surgery, extensive pulmonary fibrosis, pneumothorax, pleural effusion, air fistula). Randomization resulted in early chest tube removal in 48 patients and in conventional chest tube management in 45 patients. RESULTS: Pain intensity was significantly reduced after early chest tube removal (P=0.03, t-test). In consequence, the mean analgesic requirement was significantly reduced (P=0.0001, t-test). The number of postoperative chest roentgenograms was significantly reduced after early chest tube removal (P=0.0001, t-test). The mean postoperative length of hospital stay was 5.4 vs 6.7 days (P=0.11, t-test). No postoperative complication occurred after early chest tube removal, while postoperative complications were observed in six patients with conventional chest tube management (P=0.01, Fisher's test). CONCLUSION: Early chest tube removal after video-assisted thoracoscopic wedge resection is recommended. The inclusion and exclusion criteria of this study should be considered for future early chest tube removal. Long-term follow-up will clarify if early chest tube removal also leads to a reduction in chronic pain.

Adolescent↗
PubMed2002

Congenital unilateral pulmonary venous atresia: definitive diagnosis and treatment.

Three cases of unilateral right-sided pulmonary venous atresia were evaluated over an 18-year period. These bring the total number of cases to 25 in the literature. The clinical presentation of all these patients was similar and consisted of recurrent pulmonary infections, asthma-like symptoms, and exercise intolerance. The patients presented in 1982 (patient 1, a 12-year-old boy), 1994 (patient 2, a 9-year-old girl), and 1999 (patient 3, a 13-year-old boy). All patients were evaluated with a chest roentgenogram, and patients 1 and 2 had a ventilation and perfusion scan. Patients 1 and 3 also had cardiac catheterization and pulmonary angiography. Patient 2 had a magnetic resonance imaging study of the chest. Only patient 3 had wedge pulmonary angiography. Although a rare congenital defect, this diagnosis should be strongly suspected based on the typical clinical presentation and the preliminary studies, such as the chest roentgenogram and ventilation and perfusion scan. However, for definitive diagnosis, cardiac catheterization with wedge pulmonary angiography is necessary. Anastomosis of the atretic pulmonary veins to the left atrium is a theoretical consideration. However, this may not be feasible due to pulmonary venous anatomy or significant pulmonary dysfunction with pulmonary vascular changes. In these circumstances, we recommend performing pneumonectomy to remove the nidus for repeated bouts of pulmonary infections, to eliminate the left-to-right shunt, and to eliminate the dead space contributing to exercise intolerance.

Adolescent↗
PubMed1998

Cervical lung protrusions in children.

Two main types of cervical lung protrusion are seen in children. The first type, which is very uncommon, is a true herniation of the lung apex through a tear or defect in Sibson's fascia usually caused by a direct external local trauma. The second type, here called for convenience simple lung protrusion, is seen not uncommonly in lateral neck roentgenograms, especially in the first years of life, and is considered to be a normal finding or an anatomical variant. In the vast majority of cases these simple lung protrusions resolve spontaneously in early life; cases that fail to resolve may increase in size and become clinically significant. This paper reports on 54 children in whom the simple form of cervical lung protrusion was observed as an incidental finding in routine lateral neck roentgenograms, with a review of previous instances of cervical lung protrusions in children described in the literature.

Adolescent↗