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PubMed2001

[A case of Mycobacterium intracellulare infection complicated by immotile cilia syndrome].

A 25-year-old woman with a history of immotile cilia syndrome (ICS) was admitted to our hospital with dyspnea. Chest roentgenography revealed dense infiltrates in both lower lung fields in addition to bronchiectasis and small nodular opacities, which had been observed previously. Transbronchial lung biopsy demonstrated evidence of non-caseating epithelioid cell granuloma. Sputum specimens were examined, and isolates were identified as Mycobacterium intracellulare. The patient was given antituberculous therapy and clarithromycin, which induced clinical improvement. It is well known that bronchial mucociliary transport is severely impaired in patients with ICS. However, to our knowledge, cases of M. intracellulare infection complicated by ICS have not been reported in Japan. We must pay close attention to the concurrence of these diseases.

Adult↗
PubMedDate not supplied

Diagnosis of haemodynamically significant patent ductus arteriosus in neonates-- is the ECG of diagnostic help?

The presence of a haemodynamically significant patent ductus arteriosis (PDA) in the premature newborn may contribute to the development of brochopulmonary dysplasia, intraventricular haemorrhage and necrotising enterocolitis. It is therefore essential that the diagnosis of such a PDA be made in time in order to intervene medically or surgically. Echocardiography is at present the prime diagnostic tool, but it is mainly available in tertiary hospitals. Chest roentgenography is of little diagnostic value especially in the presence of respiratory disease, which is often present in premature babies. Very little is known about the diagnostic value of the electrocardiogram (ECG) in premature babies. The aim of this study was to describe the standard 12-lead ECG findings in low-birth-weight babies with haemodynamically significant PDAs. Thirty-two babies with haemodynamically significant PDAs, as established by echocardiography, were included in the study. Standard 12-lead ECGs were done in all these babies. In 15 patients ECG abnormalities were found; only 22% had left atrial and left ventricular enlargement indicative of significant left-to-right shunting, while 78% had no ECG changes indicative of left-to-right shunting. In conclusion, the ECG cannot be used to identify haemodynamically significant PDAs.

Cardiovascular Surgical Procedures↗
PubMed2001

Pneumocystis carinii pneumonia in systemic lupus erythematosus: a report of two cases.

Patients with systemic lupus erythematosus (SLE) have increased susceptibility to infection by Pneumocystis carinii, but this condition has rarely been reported in Taiwan. Here, we describe two cases of patients with SLE who developed Pneumocystis carinii pneumonia (PCP). The first patient was a 39-year-old woman presenting with fever and dyspnea that had lasted 2 weeks. Chest roentgenography disclosed bilateral interstitial and alveolar infiltrates. The second patient was a 22-year-old woman presenting with a 4-day history of malaise, cough, dyspnea, and fever. She had concomitant Mycobacterium tuberculosis infection. Both patients had been treated with varying doses of corticosteroids and/or cytotoxic drugs within 4 months before presentation. Diagnosis was established based on the findings of bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB). Both patients received trimethoprim-sulfamethoxazole (20 mg.kg-1.d-1 trimethoprim), but finally died of nosocomial septicemia (Acinetobacter baumanni and Pseudomonas aeruginosa bacteremia in one, P. aeruginosa bacteremia in the other). These two cases demonstrate that PCP should be included in the differential diagnosis of patients with SLE presenting with pneumonic processes. In addition, a second opportunistic pathogen should be suspected. Bronchoscopic examination should be performed if the diagnosis is not clear and should include TBLB and BAL.

Adult↗
PubMedDate not supplied

[Roentgenomorphological correlations in the diagnosis of pneumonias in patients with combined, craniocerebral, thermal injury and exogenous poisonings].

The clinical roentgenological and postmortem morphological data were analyzed and correlated in 219 patients with combined (60), craniocerebral (38), thermal (46) injury and exogenous poisonings (75), who developed pneumonias in the course of the treatment. All the patients underwent chest roentgenography in the anteroposterior projection and in the supine position. The rate of intravital identification of pneumonias accounted for 73.3% in combined, 63% in craniocerebral, 65.2% in thermal injury, and for 77.3% in exogenous poisonings. The roentgenological and morphological characteristics common to the development of pneumonias in different injuries were revealed and the causes of diagnostic discrepancies were analyzed.

Adolescent↗
PubMed2001

Diagnosis and treatment of bronchial rupture from blunt thoracic trauma.

OBJECTIVE: To evaluate the diagnosis and management of bronchial rutpture from blunt thoracic trauma. METHODS: A group of 31 patients with bronchial rupture was involved. Chest roentgenography, tomography and bronchoscopy were performed on all patients. The surgical technique and complications were described. RESULTS: Diagnosis was confirmed by tomography and bronchoscopy in all the patients. End to end anastomosis was used in 26 patients. Four patients were operated with total pneumonectomy. One patient was repaired with an intercostal muscle and rib flap with blood supply. Of the 31 patients, one died of adult respiratory distress syndrome after operation. Most patients had excellent surgical outcomes. 81% (25/31) of the bronchial rupture were delayed in diagnosis and treatment. The classic symptoms and signs of bronchial rupture included subcutaneous emphysema, dyspnea and an intermediate coma interval. The roentgenogram showed mediastinal emphysema, pneumothorax, "drop lung" sign and marked radiodensity of hilum widened mediastinum. CONCLUSION: Bronchoscopy is a useful and accurate method to diagnose and treat the bronchial rupture, with which surgeons can easily locate the rupture site during surgery. Surgical treatment could restore pulmonary function in most patients.

Adolescent↗
PubMed2001

[Mediastinal tumors and tumor-like formations in children].

Twenty-five years experience of diagnosis and results of treatment of 143 childs aged from 10 days to 15 years with sizable mediastinal formations was summarized. Benign tumor was revealed in 50 (34.96%) childs, malignant one--in 93 (65.04%). Groups of most important symptoms were suggested: generally somatic, compressive, neurological. Principal method of diagnosis of mediastinal tumor in children--the survey roentgenography of thoracic organs in two projection. Immediate and late follow-up results of operative intervention were estimated, diagnostic mistakes were analyzed.

Adolescent↗
PubMed1975

[Diagnosis of osteoporosis by measurement of 125I-absorption of the finger (author's transl)].

Quantitative measurement of radiation absorption of an external 125I source does not give information about calcium decrease of the skeletal system in an individual case. Of 50 patients under an age of 40 years who demonstrated osteoporosis by roentgenography, only 19 patients had absorption coefficients of the spongiosa in a pathological range. However there was a significant decrease of the absorption coefficients in two patients collectives with decreased calcium bone diseases. The insufficient diagnostic information in an individual patient is explained by the overlap of absorption values in normals and patients with decreased calcium. This is caused by the difficulties to determine the absorption of the finger and the insufficient discrimination of scattered radiation.

Absorption↗
PubMedDate not supplied

Carcinoid of the ileocaecal valve: a case report.

The authors present a case of carcinoid of the ileocaecal valve. The patient complained for over one year of mild pain in the right lower quadrant of the abdomen. Colonoscopy had shown hyperaemia on the colic side of the ileocaecal valve which appeared substenotic and biopsy revealed micronodules formed by chromogranin-A-positive neuroendocrine cells. Roentgenography of the small bowel and barium enema revealed a specular filling defect in the caecum and in the terminal ileum near the ileocaecal valve. Right hemicolectomy was performed and the definitive diagnosis was carcinoid of the ileocaecal valve. The tumour had spread to all layers of the intestinal wall and 4/19 lymph nodes were metastatic. The patient refused an oncological examination; however, three years after surgery there are no signs of recurrence. Carcinoids have been included in the APUD system and usually present endocrine activity. The 5-year survival of patients with gastrointestinal carcinoids is 80% when located in the appendix and rectum as against 50% in the stomach, jejunum and colon, because the localisation in the appendix and rectum is marked by clinical signs of appendicitis and rectal bleeding, which suggest diagnostic examinations useful for an early diagnosis. Radical operations according to the rules of oncologically correct surgery are the treatment of choice, while complementary treatments have yet to be codified.

Aged↗
PubMed1975

Rheumatoid wrist deformities and their relation to ulnar drift.

With a new technique of roentgenography to reveal more accurately the degree of ulnar drift and radial deviation in hands of patients with rheumatoid arthritis, it was shown that the radial deviation was less marked than would be ascertained with conventional roentgenograms. Therefore radial deviation probably does not constitute a cause for ulnar drift. The study led to clinical implications as regards the position of splinting (with the wrist in ulnar deviation) and as regards operations to correct deformities of the wrist due to rheumatoid arthritis.

Adult↗
PubMed2001

[A case of pulmonary eosinophilic granuloma arising rapidly 30 years after the start of smoking and remitting spontaneously without smoking cessation].

A case of pulmonary eosinophilic granuloma which arose rapidly after 30 years of smoking and remitted spontaneously without smoking cessation is reported. The patient was a 54-year-old man complaining of a dry cough who had been smoking 30 cigarettes a day for 30 years. Chest roentgenography showed multiple nodular shadows and cystic lesions in the upper and middle fields of both lungs. Chest computed tomography revealed multiple small cysts and small nodular lesions, mainly in both upper lung fields. CT findings strongly suggested pulmonary eosinophilic granuloma. A transbronchial lung biopsy (TBLB) was performed and 4 specimens were obtained, of which 3 showed granulomatous lesions with eosinophils and histiocytes. Furthermore, the granulomatous lesions were positive for S-100 protein staining. The symptoms and radiographic findings improved markedly within about 6 months after the onset of symptoms without treatment. Many cases of this disease were diagnosed in the past by open lung biopsy, but the number of cases diagnosed by TBLB is now increasing. The effectiveness of open lung biopsy has been emphasized in the diagnosis of pulmonary eosinophilic granuloma, but TBLB is also useful for diagnosis, especially in the active or early stage of the disease.

Eosinophilic Granuloma↗
PubMed2000

Effects of two epiphyseal-stimulating procedures on local growth of long bones in rabbits.

OBJECTIVE: To study the effects of two epiphyseal stimulating procedures on local growth of long bone in rabbits. METHODS: Osteotomy was performed in the metaphysis near the proximal tibial epiphyseal plate and hemicircumferential periosteal excision was made on the proximal tibial epiphysis. Tibia roentgenography, tetracycline labelling, histological method and electron microscopy were used. RESULTS: The local stimulating effect following the hemicircumferential periosteal excision was more remarkable than the osteotomy. CONCLUSIONS: Periosteal excision is a better treatment for children's knee deformity.

Journal Article↗
PubMed1975

A reappraisal of staging and therapy for patients with cancer of the rectum. I. Development of two new systems of staging.

Existing systems of staging for patients with rectal cancer depend almost exclusively on anatomic evidence. Consequently, the stages cannot be determined in advance of therapeutic decisions and cannot be used for patients treated without surgery. Furthermore, the stages contain no provision for important prognostic distinctions, that cannot be discerned from anatomic data. After preparing a taxonomy for hiterto unclassified medical data, we developed and tested two new systems of staging in a cohort if 318 patients. The first system which can be applied before treatment, is divided into four composite stages that contain elements of symptomatic, chronometric, co-morbid, and para-morbid data, as well as information obtained from physical examination, sigmoidoscopy, and roentgenography. The second system, applicable to patients with resected tumors, is based on a combination of pre-therapeutic clinical information and post-surgical anatomic evidence. The two systems produce prognostic gradients that are clinically distinctive and statistically efficacious.

Humans↗
PubMed1975

[Effect of certain professions on the structure of the cervical portion of the spine].

The roentgen-anatomical study of the cervical portion of the vertebral column (fluorography and roentgenography in 2 projections followed by morphometrical treatment) was performed in 603 representatives of different professions: turners, milling-machine operators, craftsmen, mechanicians, jugglers, engineers and constructors. The following facts were established: asymmetry of bodies CIV and CV of vertebra in turners and milling-machine operators; differently pronounced cervical lordosis in persons of different professions; specific features in the architectonics of the spongy substance of the cervical vertebra bodies.

Adult↗
PubMed2002

[Mode of new bone formation following distraction osteogenesis in mandibular lengthening].

OBJECTIVE: To investigate the mode and influential factor of new bone formation following distraction osteogenesis in mandibular lengthening. METHODS: Corticotomy was performed on bilateral mandibles in twelve adult male goats. A custom-made distractor was used to lengthen the mandible at a rate of 1 mm/day for 10 days (total 10 mm elongation). Four goats were sampled respectively at 2, 4 and 8 weeks after completion of distraction. The lengthening mandibles were examined by roentgenography and histology. RESULTS: Newly formed callus was observed in the distraction gap after mandibular lengthening. The new bone exhibited intramembranous ossification generally, but cartilage islands could be found in the specimen that distractor loosed. CONCLUSION: The above findings indicate that the mode of new bone formation in mandibular lengthening following distraction osteogenesis appears to be intramembranous ossification and that endochondral ossification takes place in case distractor has loosened.

Animals↗
PubMed2002

[Experimental study on subcutaneous bone formation by marrow stromal osteoblast-cancellous bone matrix compound artificial bone].

OBJECTIVE: To investigate the feasibility of using marrow stromal osteoblast (MSO) as bone derived cell and using cancellous bone matrix (CBM) as scaffold for bone tissue engineering, the subcutaneous osteogenesis of MSO-CBM compound artificial bone (MCCAB) was observed in the experiment. METHODS: The marrow stromal cells of adult New Zealand rabbits cultivated and induced in vitro were used to form MCCAB by mixing, seeding and solidifying methods assisted by alginate. The MCCABs were auto-transplanted subcutaneously into the rabbits for 4 to 8 weeks. The alginate-cancellous bone matrix composites or the cancellous bone matrix alone were implanted as control. The effectiveness of bone formation was assessed by means of roentgenography, histology and computerized histomorphometry. RESULTS: The osteogenesis of MCCABs was better than that of the alginate-cancellous bone matrix composites and of the cancellous bone matrixes. In the MCCABs, both intramembranous and cartilaginous osteogeneses were seen but the former was obvious. In the control, only slight cartilaginous osteogeneses were seen. CONCLUSIONS: The osteogeneses of the MCCABs constructed by using tissue engineering method were obvious when transplanted subcutaneously. The MSO and CBM can be used as good bone-derived cell and scaffold material respectively for tissue-engineered bone construction.

Animals↗
PubMed1975

[Influence of gravitational overload and hypokinesia on the structure of the vascular bed of the stomach].

Under study were effects of gravitation stresses, total hypokinesia and their combinations on blood vessels of the stomach. The work was carried out in 130 rabbits, 16 of them being used to study the normal structure of the gastric vascular bed. The vascular bed was injected with the Gerota's mass followed by clearing, making histological preparations and roentgenography. The investigation has revealed both quantitative and qualitative changes in the structure of the gastric blood vessels. The maximum endurable stress of the ventro-dorsal direction causes morphological shifts less pronounced than stresses of longitudinal directions. With prolonged terms of hypokinesia (1-12 weeks) morphological changes became more pronounced in all the layers of the stomach. A combination of successive gravitation stresses and hypokinesia during 4-12 weeks aggravated morphological changes which occurred after exposure to isolated above factors. The animals subjected to maximum endurable stresses before and after 4-week hypokinesia developed vascular changes more typical for the effects of gravitation. The pretraining of animals did not give a pronounced positive effect on the changes of the angioarchitectonics of all the gastric layers after a repeated stress following 4-week hypokinesia.

Animals↗
PubMed1975

[Traumatic rupture of the diaphragm. Clinical experience (author's transl)].

The increased number of automobile casualties increases the frequency of traumatic rupture of the diaphragm. Because of associated serious lesions, diagnosis is easily overlooked. The authors report on 11 cases and give an appraisal of the literature. In 6 patients, diagnosis was made late. The authors discuss the physiopathology, symptoms, clinical data and means of diagnosis. Roentgenography is very important. Surgical cure is always recommended because of the danger of delayed strangulation of the hernia.

Accidents, Traffic↗
PubMed1975

[Problems in the diagnostic of primary gastric stump cancer and recurrences of gastric cancer. A comparison of X-ray diagnostic and endoscopy (author's transl)].

X-ray findings and gastroscopic findings of patients with primary gastric stump cancer and recurrences of gastric cancer are compared. These findings are compared with the observations of operations. The reasons of false diagnoses and doubtful tentative diagnoses were analyzed. In the analysis of X-ray pictures especially the benign operative caused and the postoperative alterations of the wall and mucosa of the stomach must delimit from infiltrative and polypous increasing tumors. The postoperative control examination may be valuable for the diagnosis, because it gives the possibilities for comparison. Roentgenography in double contrast relieves the diagnosis. Stenosing processes of the cardia and anastomose causes difficulties in differential diagnosis in gastroscopy opposite to scared alterations. The aimed biopsy improves the tumor protection. Both examination techniques shows difficulties in recognition of recurrences, which develop from the duodenal stump. Only a special examination technique leads to an improvement of the results. The instruction and experience of the examiner, the knowledge of tumor diagnostics and of the methods of operations and of the postoperative alterations are for the diagnosis of these processes of decisive importance. X-ray examination and endoscopy are two supplementing examination methods.

Endoscopy↗