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At least 1,531 records · Page 85Linked to original sources
PubMed1992

Ultrasonographic and radiologic evaluation of patients after laparoscopic cholecystectomy.

The first 30 patients scheduled to undergo laparoscopic cholecystectomy at the Kingston General Hospital, Kingston, Ont., were studied by abdominal ultrasonography and abdominal roentgenography 24 hours after the procedure. The ultrasonogram appeared normal in 21 of the 29 patients in whom laparoscopic cholecystectomy was successful. In six of the eight patients with an abnormal ultrasonogram a tiny collection of fluid was identified in the gallbladder fossa; in two patients retained intraperitoneal stones were identified (one of these patients also had a small fluid loculus); and one patient had a small amount of free fluid in Morrison's pouch. This last patient was subsequently found to have a retained common-bile-duct stone, which required endoscopic removal. Plain films showed moderate to large amounts of retained gas intraperitoneally in only three patients. Colonic distension was recorded in 23 of the 28 patients studied, suggesting a partial colonic ileus. Residual pneumoperitoneum and colonic distension did not correlate with any untoward clinical findings. This study demonstrates that most patients have complete reabsorption of their pneumoperitoneum within 24 hours of laparoscopic cholecystectomy and that small amounts of fluid in the gallbladder fossa and mild to moderate colonic distension are not significant in terms of operative complications.

Abdomen↗
PubMed2004

[Uremic pericarditis complicating cardiac tamponade: a case report].

A 29-year-old man developed diabetes mellitus in 1983 and diabetic nephropathy which gradually worsened from 1998. He was admitted to our hospital for initiation of peritoneal dialysis in May 2002. However, the efficiency of dialysis was not sufficient to improve elevated levels of blood urea nitrogen and serum creatinine. His body weight and cardiothoracic index by chest roentgenography gradually increased starting 9 days after admission. To improve the efficiency of dialysis, we tried to increase the dialysis fluid. Nevertheless, the efficiency of peritoneal dialysis remained low, and the patient complained of nausea 14 days after admission. Hypotension suddenly occurred 16 days after admission. Echocardiography showed massive pericardial effusion and collapse of the right ventricle. The diagnosis was cardiac tamponade. We performed cardiac centesis and pericardial drainage which revealed bloody pericardial effusion. Urgent hemodialysis was performed. The differential diagnosis of cardiac tamponade was established. After hemodialysis, the amount of pericardial effusion decreased, the gastro-intestinal symptoms disappeared, and the blood urea nitrogen and serum creatinine levels decreased. We speculated that the cause of cardiac tamponade was uremic pericarditis after ruling out infectious disease, collagen disease, malignant disease, and aortic dissection. Cardiac tamponade due to uremic pericarditis has become very rare since hemodialysis was developed.

Adult↗
PubMed2004

[Diagnosis and treatment of pulmonary heart before and after hospitalization].

Prevalence of pulmonary heart among patients with cardiovascular pathology is 5%. Clinical picture of pulmonary heart comprises symptoms of underlying disease and signs of pulmonary and cardiac failure. The following instrumental methods of investigation are very helpful for diagnosis of pulmonary heart: chest roentgenography, electrocardiography, echocardiography, pulmonary function testing, computer tomography. Pulmonary heart should be diagnosed during ambulatory examination. Hospitalization of patients with pulmonary heart is dictated by severity of clinical condition or presence of diagnostic problems. Radionuclide pulmonary scintigraphy, pulmonary angiography, right heart catheterization, lung biopsy can be carried out in hospital. Treatment should be directed at underlying disease, lowering of pulmonary artery pressure, alleviation of respiratory and cardiac failure.

Cardiac Catheterization↗
PubMed2004

[Possibility of diagnosis and treatment of thrombotic complications in primary mediastinal B-cell lymphosarcoma].

AIM: Efficacy of the treatment of primary mediastinal B-cell lymphosarcoma depends to a great extent on early diagnosis and treatment policy. In this study we evaluated possibilities of diagnosis and treatment of thrombotic complications of primary mediastinal B-cell lymphosarcoma (PMBL). MATERIAL AND METHODS: 61 patients were examined using roentgenography, computed tomography, chest ultrasound investigation,coagulogram, allelle specific polymerase chain reaction, ultrasound investigation of the jugular, subclavian, brachial veins, vena cava superior to detect mutation of genes II, V factors and methylentetrahydrofolatereductase. RESULTS: In 7 cases prechemotherapy examination detected thrombosis of the internal jugular and subclavian veins. In 4 of 7 cases there was a combined thrombosis of the left internal jugular and subclavian veins, in 3 cases one the vessels was affected with thrombosis. In 2 cases, in the course of polychemotherapy, there was recurrent thrombosis and development of pulmonary artery thromboembolism (PATE). In progression of the disease there was thrombosis of the left subclavian vein (1 case) and PATE (a case). Coagulologically, hypercoagulation syndrome signs were registered. 5 patients with PMBL complicated by thromboses showed gene mutations. CONCLUSION: In PMBL there is a tendency to formation of venous thrombosis and development of PATE. This is explained by tumor process and hereditary factors of thrombogenicity. Therefore, specific antitumor treatment should include anticoagulation therapy.

Adolescent↗
PubMed2004

[Expression of PRAME gene in multiple myeloma].

AIM: To determine clinical significance of PRAME gene expression in multiple myeloma (MM) and feasibility of its use as a marker of residual tumor clone. MATERIAL AND METHODS: 35 MM patients, of them 15 were newly diagnosed and 20 had resistance to previous therapy. PRAME was made if the patients received programmed therapy with high-dose chemotherapy (VD) and autologous transplantation of peripheral cell stem cells. 12 PRAME-positive patients were examined on the day +100, 5 patients--a year later. Monoclonal paraprotein was detected by electrophoresis and radial immunodiffusion of blood serum. Bone marrow affection was assessed at roentgenography and/or MRI. PRAME gene expression in bone marrow biopsy was measured by reverse transcription and PCR amplification. RESULTS: Activation of expression of PRAME gene in MM was found in 68.57% patients. It was higher in patients with MM duration more than 1 year and if they were treated before (85%) than in new cases (46.67%). Expression of PRAME tended to associate with activity of LDP of blood serum. After the above chemotherapy and autotransplantation transcript PRAME did not disappear in 8 of 12 cases. One year after the treatment, of 5 PRAME-positive patients 2 died, 1 had recurrence, 2 are in a compete clinicohematological remission. CONCLUSION: Frequent activation of transcription of the gene PRAME in MM, its assay can be used for monitoring of the disease course, assessment of remission completeness, detection of tumor cell contamination of preparations of autologous stem cells of peripheral blood.

Adult↗
PubMedDate not supplied

Elastic plastic tube for detecting exfoliative cancer cells in the esophagus.

A simple device for sampling esophageal lesions is described. The instrument, which is easy and inexpensive to make, consists of a single-lumen plastic tube covered with cotton thread. Once swallowed, the end of the tube can be drawn into a loop. The device has been used at locations with a high incidence of esophageal cancer and at our tumor hospital. A series of 746 cases examined had no complications. The tube has a positive diagnostic rate comparable to that of roentgenography, 96%, and seemed acceptable to both physicians and patients. When an obstruction is present, the instrument can easily pass through it and obtain exfoliated cancer cells, while the conventional method, the balloon cytologic smear, is unable to do so.

Cytodiagnosis↗
PubMed1992

Cartilage regeneration after proximal tibial osteotomy for medial gonarthrosis. An arthroscopic, roentgenographic, and histologic study.

High tibial osteotomy for medial gonarthrosis was performed in 28 patients (28 knees). At the time of surgery, arthroscopy was also performed and a cartilage-bone biopsy was obtained. Postoperatively, 15 patients were randomized to a cylinder plaster cast, whereas 13 patients had a hinged cast brace for early knee mobilization. At follow-up examination, two years after surgery, 16 patients accepted an arthroscopic examination with a cartilage-bone biopsy. In overcorrected knees, cartilage regeneration was found in eight of 14 patients on the medial tibial condyle and in nine of 14 on the medial femoral condyle. The main repair feature was proliferation of fibrocartilage, which covered bone and areas of fibrillated cartilage and filled vertical clefts in hyaline cartilage. The hyaline cartilage showed an increased cellularity with numerous nests of proliferating chondrocytes. No correlation was found between clinical outcome and the degree of cartilage regeneration as observed by arthroscopy, biopsy, or roentgenography. Knees with a brace postoperatively had better knee flexion two years after surgery. No difference in cartilage regeneration was recorded between knees with a plaster cast or a cast brace postoperatively.

Adult↗
PubMedDate not supplied

[Evolution of X-ray image receivers].

The evolution of X-ray image receivers of X-ray radiation for roentgenoscopy and roentgenography was analyzed for the period of the last century; prospects for the future are made.

Radiographic Image Enhancement↗
PubMedDate not supplied

[Digital X-ray unit ARC-01-"OKO"].

Presented is a description of a new roentgenographic unit ARC-01-"OKO" designed by the "Electron" Research and Design Company Ltd. for digital roentgenography (with X-ray transparent deck) of patients in the standing, sitting and lying positions. The unit enhances the capacity of X-ray examination room and makes almost unnecessary the use of X-ray films and chemicals. According to its medicals trials, the structural elements of the thorax, lungs, mediastinum, diaphragm, skull, lower and upper extremities, vertebral column, abdominal cavity and pelvis, when examined in different projections, are reproduced by the unit with good and excellent quality both at health and disease.

Humans↗
PubMed1992

Lateral condylar resection for bunionette.

Lateral condylar resection operations were performed in 21 feet in 16 patients with painful bunionettes. The mean follow-up period (examination and roentgenography) was 6.4 years (range, 2.3-12.4 years). The average forefoot score improved from 40.3 +/- 13.5 points to 68.3 +/- 11.7 points of a possible 75 points. The overall results were considered good in 15 feet, fair in three, and poor in three. The causes of failure were inadequate amount of resection, metatarsophalangeal joint subluxation, and severe forefoot splaying. Complications were infection, toe hypesthesia, and metatarsophalangeal joint subluxation. One patient required reoperation. Lateral condylar resection is simple and effective for most patients with bunionette, but limitations are recognized.

Adolescent↗
PubMed1992

Canine leg lengthening by the Ilizarov technique. A biomechanical, radiologic, and morphologic study.

The mechanical properties of canine tibias lengthened by the Ilizarov method as well as the degree of healing--as determined by the osseous appearance of the limbs using three imaging modalities--were examined as a function of fixator application time. Sixteen mongrel dogs had right tibial lengthening using a two-ring Ilizarov external fixator. The average lengthening was 27 mm. Four groups of four animals were killed at four, six, eight, and ten weeks after the completion of lengthening. The operated and contralateral tibias were examined with biplanar roentgenography, computerized tomography, and technetium scintigraphy. The torsional strengths of the tibias were then determined and histologic analysis was performed. There was considerable variation in the healing rate of the lengthening sites, both within and among groups. Histologic analysis and results of the imaging modalities revealed different degrees of development of the lengthening sites among members of the same group. Two types of mechanical behavior were seen, corresponding to completely and incompletely ossified lengthening zones. The strongest samples were those that had ossified across their lengthening sites by four or six weeks. The degree of recorticalization of the new bone and the extent of formation of a marrow space correlated well with increased torsional strength. The average strength of the fully ossified bones decreased progressively with time, paralleling a decrease in cortical thickness outside the lengthening zone. This seems to be a consequence of stress shielding by the fixator and disuse by the animal.

Animals↗
PubMed1992

Epiphyseometaphyseal cupping of the distal femur with knee-flexion contracture.

An 11-year-old child with a history of receiving megadoses of vitamin A as an infant, and a 4-year-old child with a history of fulminant staphylococcal septicemia with multiple joint involvement presented with recalcitrant knee-flexion contractures. Roentgenography revealed epiphyseometaphyseal cupping (ie, epiphyseal invagination) of the distal femur. Osteotomy resulted in only temporary correction. Our experience suggests that in the skeletally immature child, skin traction, physical therapy, splinting, and, in some instances, two-pin tibial traction should be the treatments of choice.

Bone Diseases↗
PubMed2004

Pneumothorax associated with tube exchanger-aided intubation following LMA-Fastrach placement in a patient during anesthesia induction.

The use of intubating laryngeal mask airway (LMA-Fastrach) is indicated to facilitate endotracheal intubation in a patient with cervical spine disorder or suspected difficult airway. A 65-year-old female patient was referred to our hospital for cervical spine surgery under general anesthesia. During anesthesia induction, an LMA-Fastrach was used to facilitate intubation and an airway exchange catheter (AEC) was used to exchange the accompanying armored silicone endotracheal tube for a polyvinyl chloride (PVC) endotracheal tube. However, the pulse oximeter showed a fall of oxygen saturation (SpO2) after insertion of the AEC. As massive pneumothorax associated with subcutaneous emphysema was disclosed by chest roentgenography, a chest drainage was performed immediately. This article discourses the possible mechanism, diagnosis and treatment of pneumothorax during the course of general anesthesia and the prevention of lower airway injury by AEC is also touched.

Aged↗
PubMed1992

[Zygomatic arch fractures; a neurosurgical viewpoint].

Depressed fractures of the zygomatic arch are often overlooked due to local swelling associated with the injury. However, such fractures are easily detected using roentgenography in superioinferior projection and/or bone image CT examinations of the zygomatic arch. Ten patients with depressed fracture of the zygomatic arch were treated surgically. Nine underwent an operation by the Gillies method within 15 days after the injury and showed good results. In the remaining patient, the operation performed on the 27th day after the injury failed to reconstruct the zygomatic arch perfectly, even when the open procedure was used. The most important point in these cases is the detection and surgical treatment of the fracture at an early stage. Patients with trismus and depressed fracture of the zygomatic arch should be operated on within two weeks after injury. During this period, the surgical method reported by Gillies can be performed easily and also produces successful results.

Adult↗
PubMed2005

[Effects of ovariectomy on fracture healing in female rats].

OBJECTIVE: To observe the effects of ovariectomy on fracture healing in female rats. METHODS: Thirty-six 6-month-old female SD rats were divided into OVX group and SHAM group. The osteoporotic model was established by ovariectomy. The right femur was broken by operation at 8 weeks later. The rats were killed in batches at the end of 2, 4, 6, 8 weeks postoperatively for study. The examinations included the bone roentgenography, the histological appearance of bone calli and the biomechanical properties of right femur. RESULTS: The density of calli was decreased obviously in OVX group. The line of fracture existed in OVX group while the line of fracture was unclear or disappeared in SHAM. In the OVX group, there were cartilages at the early callus formation stage, and there were small-sized osteoblasts and increased number of osteoclasts on the surface of osseous trabecula. The osseous trabecula became thinner and disrupted obviously in OVX group, and it became massive, thicker and closer gradually 8 weeks after fracture in SHAM group. The area of osseous trabecula in the SHAM group was bigger than that in the OVX group. CONCLUSION: After ovariectomy, the absorption of bone prevails over osteogenesis, the osteoporotic changes occur, and the fracture healing is poor in quality.

Animals↗
PubMed2005

[An experimental study on the gastroantrium-cholecystostomy using pylorus sphincter to replace Oddi sphincter for preventing reflux].

OBJECTIVE: This experimental study of gastroantrium-cholecystostomy was designed to identify the possible use of pylorus sphincter as a substitute for Oddi sphincter. METHODS: Fifteen prairie dogs were randomized to three groups. The dogs in the control group underwent sham operation. The dogs in the first experiment group were subjected to gastroantrium-cholecystostomy and gastrojejunostomy. Meanwhile, two thin tubes were placed in stomach antrium and duodenum separately for post-operative photography. One week after operation, 20% cyctografin (10 ml) was injected into the duodenum through the relevant tube so as to check whether any backflow came out from duodenum to the bile duct. Then, 20% cyctografin (5 ml) was injected into the stomach antrium so as to demonstrate how it went from stomach antrium into duodenum. The samples of liver, stomach, stomach antrium, gallbladder and extra hepatic duct were collected for pathological examinations. The dogs of the second experiment group underwent the same operations, but the samples for pathological examination were collected four weeks after operation. RESULTS: Roentgenography showed that there was no contrast medium backflowing into the stomach antrium, and the contrast medium could flow from stomach antrium into duodenum smoothly. The results of histo-pathological examination showed that there were no obvious changes in the liver, stomach antrium and bile duct. Under light microscope, a few inflammatory cells could be seen in the gallbladder wall, and the mucosa of stomach was slightly atrophic. CONCLUSION: The gastroantrium-cholecystostomy which uses pylorus sphincter to take over the functions of Oddi sphincter can effectively prevent intestinal juice from flowing back into the bile duct.

Anastomosis, Surgical↗
PubMed1992

The importance of stabilizing the specimen taken at needle localized biopsy of the breast for microcalcifications.

The specimen from a needle localized biopsy of the breast must be compared with its roentgenogram to locate the area of microcalcification within the specimen. Any errors in aligning the specimen to its roentgenogram could result in failure to sample and microscopically examine the area of the microcalcifications. The results of the current study show the importance of maintaining the orientation and position of the specimen from the time the roentgenogram is taken until it is examined by the pathologist. Each of 45 consecutive specimens taken at biopsy were secured to a square of cardboard immediately after excision from the breast to maintain the orientation of the specimen during the process of roentgenography. The histologic findings of this group (group 2) were compared with the preceding 87 biopsies (group 1) in which no effort had been made to immobilize the specimen for a roentgenogram. The presence of microcalcifications was confirmed roentgenographically in all the specimens of each group. Histologic confirmation of the presence of microcalcifications was obtained in 42 of 45 specimens in group 2 and only 71 of 87 in group 1 (p = 0.035). Thirty-one per cent of specimens in group 2 contained a carcinoma compared with 10 per cent in group 1. We conclude that fixing the position of the specimen after excision improves the ability of the pathologist to locate the suspicious area of microcalcifications within the specimen. This may lead to an increase in the yield of these biopsies and the identification of occult carcinomas that might otherwise be missed.

Adult↗
PubMed2005

Cutaneous lesions and visceral involvement of tuberous sclerosis.

BACKGROUND: Tuberous sclerosis (TS) is an autosomal dominant disorder with a significant range of clinical expressions. The involvement of vital organs, such as the brain, kidney, heart and lung is the main cause of death in patients with TS. The aim of this study is to summarize the characteristic cutaneous features and common extracutaneous involvement of TS, which are helpful to the early detection of visceral involvement. METHODS: The analyzed clinical data from 78 patients with TS included those from detailed history, physical and dermatological examination, cranial computed tomography (CT) and magnetic resonance imaging (MRI), abdominal ultrasonography, chest roentgenography, hand and foot X-ray and ophthalmologic examination. RESULTS: The skin, brain and kidney were involved frequently in TS patients. Hypomelanotic macules were the most common and earliest cutaneous lesions. Their number was more than 3 in 81.5% of the patients. They were followed by facial angiofibromas and Shangreen's patch in a decreasing frequency. Forehead plaque, facial angiofibromas and Shagreen's patch appeared in patients at mean age of 2.6, 6.0 and 8.1 years respectively. Cranial CT showed a high positive rate in TS patients. CONCLUSIONS: Cutaneous features of TS are helpful in the early diagnosis of the disease. Hypomelanotic macules are especially important for patients with epilepsy or babies whose number of hypomelanotic macules is more than 3. Cranial CT is of great value in the diagnosis of TS. The involvement of visceral organs such as the brain and kidney should be examined in TS patients.

Adolescent↗