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[Traumatic laceration of the right middle lobar bronchus; report of a case].

We described the rare case of 26-year-old woman with a traumatic laceration of the right middle lobar bronchus. The patient suffered blunt chest trauma in a traffic accident. Chest roentgenography showed bilateral pneumothorax, right multiple rib and clavicle fractures and emphysema in the subcutaneous and mediastinal lesions. Bilateral thoracic drainages were performed under controlled mechanical ventilation. Massive air leakage from the right chest tube was observed. Bronchofiberscopy 2 days after the accident revealed laceration of the right middle lobar bronchus. A right middle lobectomy was performed via thoracotomy. The patient was discharged on hospital day 51. In terms of the rare bronchial laceration is discussed.

Accidents, Traffic↗

[Bone mineral density in cosmonauts after flights lasting 4.5-6 months on the Mir orbital station].

A technique of quantitative digital roentgenography (QDR) being a current modification of dual photon absorptiometry (DPA) was used to measure bone mineral density (BMD) in the crewmembers of the 6-9th expeditions onboard Mir orbital station after space missions of 132 to 176 days in duration. Total mineral losses were, on average, 0.4% of a preflight level, and in the most test subjects the postflight BMD of the skull, ribs and arms increased and that of lumbar vertebrae, pelvis and legs decreased. The most marked local postflight mineral losses occurred in the proximal femur bone (the femoral neck and the greater trochanter--up to 14%). The observed changes did not depend on flight duration. These findings are being compared to the results of similar studies conducted during the 120-day (NASA) and 370-day (IBMP) hypokinesia experiments. The possibility of existing the general mechanism of modifying mineral status of the skeleton due to different situation related deficiency of musculoskeletal load.

Absorptiometry, Photon↗

Synovial sarcoma. A clinicopathologic study.

Twenty-five cases of synovial sarcoma were reviewed clinically, roentgenographically, and pathologically. The histopathology of each tumor was classified as either monophasic (19 cases) or biphasic (six cases). A soft-tissue mass was seen on roentgenography in 70% of patients; calcification was present in 15% of cases. Treatment included surgery, with or without radiation and/or chemotherapy. Fifteen patients remained disease free at an average of 7.5 years, one patient had pulmonary metastasis, and nine patients have died. The critical prognostic factor was adequate surgical margins; there were no local recurrences with adequate tumor-free margins, but there was an 83% recurrence rate with inadequate treatment.

Adolescent↗

[Pyloric stenosis in infants. Contribution of ultrasonography and video-surgery].

Hypertrophic pyloric stenosis is the commonest condition requiring abdominal surgery in infancy. The Fredet-Ramstedt pyloromyotomy gives a very rare morbidity rate as shown by a review of 300 personal cases. The diagnostic value of sonography is gaining significance over contrast roentgenography, a pyloric diameter of more than 14 mm and a muscular thickness of more than 4 mm being required for the diagnosis. Over the last 18 months, we performed extramucosal pyloromyotomies using laparoscopy in 19 infants. This new surgical technique using laparoscopy with precautionary measures for the pneumoperitoneum appears to be very promising and should become a widespread technique in the future.

Gastroesophageal Reflux↗

Adenoviral pneumonia in children.

This report reviews the manifestations in fifteen children of proved adenoviral pneumonia. Patients' ages ranged from 43 days to 4 years and 1 month. Twelve cases were younger than 2 years old. Adenoviral infections were proved by positive viral cultures or a four-fold increase of the complement fixation titer. Prolonged fever and cough were found in all cases. In 13 patients, respiratory distress occurred; 5 needed mechanical ventilation. Injected throats, conjunctivae and ear drums were common. Other clinical pictures included abdominal discomfort, hepatomegaly, skin rash, convulsion and bleeding tendency. Abnormal laboratory findings were mild anemia, leukopenia, thrombocytopenia, elevated erythrocyte sedimentation rate and C-reactive protein, impaired liver function test, and prolonged prothrombin time and partial thromboplastin time. Anemia (11 cases), leukopenia (7 cases) and elevated transaminases levels (7 cases) were more common than previously reported. All patients had para-hilar peribronchial infiltrates in chest roentgenography. Segmental atelectasis and compensated hyper-expansion were found frequently. Pleural effusion were noted in six of our cases. Air leak syndrome occurred in three patients who had received mechanical ventilation. Three of the 15 patients expired: one had a preceding measles infection, all had disseminated intravascular coagulopathy. For patients with antibiotic-resistant pneumonia, adenoviral studies should be done. Extrapulmonary manifestations, and some abnormal laboratory findings, i.e., mild anemia, leukopenia, impaired liver function are clues to adenoviral infections, while bleeding tendency can be regarded as a poor prognostic sign for children with adenoviral pneumonia.

Adenoviridae Infections↗

Myositis ossificans of traumatic origin in the foot.

This case reviews a myositis ossificans of traumatic origin discovered beneath the fifth metatarsal in an adult male. Details of its anatomic appearance are illustrated with the assistance of plane film roentgenography and magnetic resonance imaging. Histologic sections are included to support the diagnosis and present characteristic cellular patterns. A review of the literature including etiology, clinical classification, and diagnostic criteria are also presented.

Aged↗

[Radiodiagnosis of a small amount of fluid in the pericardial cavity].

X-ray symptomatology of small pericardial effusions was studied on the basis of analysis of clinicoroentgenological and echocardiographic investigation of 173 patients with various chest diseases. Comparison of x-ray and USI results led to a conclusion of the effectiveness of polypositional roentgenography for the detection of small amounts of fluid in the pericardial cavity.

Adult↗

[Possibilities of restoration of the regional lymphatic channel by the use of sorbents in the treatment of experimental generalized purulent peritonitis].

Regional lymphatic bed in local application of mineral sorbent SUMS-2p in 80 white noninbred rats with experimental generalized purulent peritonitis is studied with the use of indirect intravital lympho-roentgenography. The correlation between lympho-dynamics and generalized purulent peritonitis stage was observed. It is shown that the peritoneo-sorption with the mineral sorbent SUMS-2p led to early restoration of lympho-drainage.

Animals↗

Proximal femoral bone density and its correlation to fracture load and hip-screw penetration load.

The bone mineral density of 22 random, fresh proximal human femora was estimated by roentgenography using the Singh index (SI) and measured using a regional bone mineral density computed tomographic protocol. Uniaxial compression was used to produce an impacted subcapital fracture. The femoral heads then were isolated and mounted on a sliding screw plate compression device and loaded to failure in a push-out or hip-screw penetration mode. Wide intraobserver variation, poor reproducibility, and poor prediction of the experimental fracture properties of the proximal femur were noted for SI values. Regional bone mineral density provided a reliable estimate of both the gross fracture loads and hip-screw penetration loads. In addition, there was a high correlation between trabecular density and the experimental fracture properties of the proximal femur. Therefore, The validity of the SI as an indicator of the mechanical properties of the proximal femur should be reconsidered.

Biomechanical Phenomena↗

Pulmonary changes seen in lung purpura and some of the other collagen diseases.

The physician who specializes in pulmonary diseases has a most helpful aid in the form of chest roentgenography. This examination is secured routinely in many hospitals and clinics today. The roentgenogram is very accurate in finding pulmonary lesions. Accuracy in determining the type of lesion depends on the experience of the physician who is studying the patient.Pulmonary lesions occur in many systemic diseases. They may occur in some of the collagen diseases and at times they may be the first and also the most striking findings noted during the examination of a patient. For this reason, attention is called to some of the pulmonary findings encountered in certain of these diseases. Some of the clinical, roentgenologic and pathologic manifestations of necrotizing alveolitis, periarteritis nodosa, glomerulonephritis, disseminated lupus erythematosus, rheumatoid arthritis, and scleroderma are described.

Arthritis, Rheumatoid↗

[Use of ultrasonography in morphofunctional evaluation of orthotopic neo-bladder].

Seventeen patients submitted to radical cystectomy and orthotopic bladder replacement according to Reddy's technique were studied at the 1, 3, 6 and 12-month, then annually follow-up by physical examination, intravenous pyelogram, cystourethrography, suprapubic and transrectal ultrasonography and complete urodynamics. Sixteen patients (94%) reported day-time urinary continence and twelve patients (70%) day-time and nocturnal continence. Cysto-manometry showed a mean bladder capacity of 450 cc with a maximal endocavitary pressure of 40 cm. H2O and satisfactory peak flow rate. Vesico-ureteral reflux was never detected at roentgenography. Ultrasonography may be useful in the study of a possible reflux or stenosis of the neovesico-ureteral junction by detecting renal scars or dilatation of the renal cavities. Sovrapubic ultrasonography can quantify the capacity of the neo-bladder (300-600 cc), study its shape, walls and contractions that do not cause the involuntary opening of the neo-bladder neck. Transrectal ultrasonography studies the bladder neck shape and its dynamic function. Residual urine volume never exceeded 50 cc. Ultrasonography demonstrated its effectiveness and reliability and limited the application of more invasive roentgenographic procedures.

Cystectomy↗

Preliminary studies of duration and intensity of ultrasonic treatments on fracture repair.

Bone formation of fractured fibulae stimulated by ultrasound was evaluated with roentgenography and fluorochromes labelling. The fibulae of male New Zealand rabbits were fractured to create a 3 mm-gap. Ultrasounds at 0.5 or 1.0 W/cm2 were applied for various durations, 5, 15, and 25 min/day for 4 weeks. Ultrasonic treatments at 0.5 W/cm2, 1.5 MHz significantly accelerated bone formation at the fracture site for all durations, whereas the higher intensity at 1.0 W/cm2 suppressed the bone formation of the treated fractured fibula. Ultrasounds at 0.5 W/cm2 were stimulatory to fracture repair, if given for 15 min/day, and were recommended for future clinical trials. However, ultrasounds at the intensity of 1.0 W/cm2 were deleterious to the treated fracture and not recommended for clinical trials.

Animals↗

[A case of bronchoplasty for endobronchial chondroid hamartoma].

A 62-year-old male was admitted to our hospital to investigate his obstructive pneumonia-like symptoms. A chest roentgenography, computed tomography revealed the tumor to be located in the left lower bronchus. Bronchoscopy showed endobronchial tumor at the level of the left lower lobe bronchus. Preoperative pathological confirmation was possible by transbronchial biopsy, pathological diagnosis of the tumor was endobronchial chondroid hamartoma. And then, bronchoplasty was performed. He was discharged from our hospital after operation, showing no evidence.

Bronchi↗

Transient osteoporosis of the hip misdiagnosed as osteonecrosis on magnetic resonance imaging.

A 34-year-old man developed idiopathic, bilateral, asynchronous transient osteoporosis of the hip. The symptoms included hip pain with activity, and roentgenography revealed osteoporosis of the femoral head and neck. Radionuclide bone scans showed increased uptake of the involved femoral head. Magnetic resonance imaging (MRI) early after the onset of right-side symptoms was characterized by decreased signal intensity on T1-weighted images and patchy areas of increased and decreased signal intensity on T2-weighted images; this was initially interpreted as being consistent with osteonecrosis. Despite evaluation by multiple physicians and imaging methods, including MRI, the correct diagnosis of transient osteoporosis of the hip was delayed until after resolution of the syndrome. Transient osteoporosis of the hip should be included in the differential diagnosis of hip pain.

Adult↗

[A case of nonbacterial thrombotic endocarditis presenting positive findings by two-dimensional echocardiography].

A 55-year-old woman was admitted to our hospital because of left hemiparesis. Brain CT and cerebral angiography demonstrated cerebral embolism due to occlusion of the sphenoidal part of the right middle cerebral artery. Two-dimensional echocardiography revealed mitral valve vegetation measuring 10 x 7 mm and slight mitral-valve regurgitation. Blood cultures were negative. She developed disseminated intravascular coagulation. Chest roentgenography and abdominal ultrasonography showed multiple liver and lung tumors, but she died before the primary lesion was detected. At autopsy, adenocarcinoma of the gall bladder was found. Friable vegetation was attached to the auricular surface of the mitral valve. Microscopic examination confirmed the diagnosis of nonbacterial thrombotic endocarditis. Although echocardiography is an important tool for diagnosing nonbacterial thrombotic endocarditis, few reports have described echocardiographic detection of nonbacterial thrombotic endocarditis. Because vegetation of nonbacterial thrombotic endocarditis is smaller than that of infective endocarditis (less than 3 mm), it is difficult for echocardiography to detect nonbacterial thrombotic endocarditis. Thus, a negative examination does not exclude the possibility of nonbacterial thrombotic endocarditis. To make an antemortem diagnosis of nonbacterial thrombotic endocarditis, we must perform echocardiography carefully in cases of cerebral infarction with carcinoma and/or DIC.

Adenocarcinoma↗

[The clinical aspects of the diagnosis of rheumatoid arthritis].

Altogether 212 patients aged 16 to 73 years with rheumatoid arthritis (RA) lasting 3 months to 32 years were examined. Of these, 78 patients had grade I, 111 grade II, and 23 grade III disease activity. 34 patients had stage I, 76--stage II, 56--stage III, and 24--stage IV disease. In 22 patients, roentgenography failed to reveal pathology of the joints. The reference group comprised 65 patients suffering from gouty arthritis, 46 having osteoarthrosis deformans with phenomena of secondary synovitis, 30 with Bekhterev's disease, 10 with systemic lupus erythematosus, 6 with Reiter's disease, 5 with psoriatic arthropathy, and 50 with non-rheumatic diseases. When trying the diagnostic criteria for ARA (revised in 1987), criteria 1-4 and 7 were found to be most sensitive (from 88.2 to 93.8%), criteria 5 and 6 appeared most specific (100 and 98.6%, respectively). The specificity of the remaining criteria ranged from 85.4 to 96.3%. The use of the revised criteria for ARA in clinical practice was dictated by the necessity of improving RA diagnosis.

Adolescent↗

[An x-ray study of the subcutaneous tissue using an artificial method of providing contrast].

The paper is concerned with the main methodological principles and potentialities of a radiocontrast study of subcutaneous fat to detect pathological changes in it. The proposed method consists in slow administration in the middle fat layers of 20-25% solution of verografin from not less than two points, and subsequent roentgenography in a necessary projection. The method was used in 15 patients with various orthopedic diseases for diagnosis of inflammatory, tumorous and degenerative-dystrophic diseases.

Adipose Tissue↗

Farmer's lung disease in north-western India--a preliminary report.

A study of farmer's lung (FL) disease was carried out in 197 subjects engaged in farming and having respiratory complaints of varying duration. It revealed that 13.2% of the subjects had precipitating antibodies against thermophilic actinomycetes, with Faenia rectivirgula (Micropolyspora faeni) alone accounting for 85% of the positive reactions. Precipitating antibodies against Thermoactinomyces vulgaris and T. thalpophilus were observed only in 1.5% and 0.5% of the subjects, respectively. Two subjects concomitantly demonstrated F. rectivirgula and T. vulgaris-specific serum precipitins. Sixty (30%) of the subjects related their respiratory symptoms to exposure to wheat straw/thresher's dust or other vegetable substrata in the working environment. Based upon a suggestive clinical history, roentgenography, pulmonary function studies and demonstration of serum precipitins against F. rectivirgula, FL was diagnosed in 4 subjects whose salient features are presented and discussed. To the best of our knowledge, this is the first authentic report on FL from India. A comprehensive epidemiological survey is indicated to determine the prevalence of FL in different geo-climatic regions of the country.

Adult↗