Roentgen Study Research Articles

Legal requirements in roentgen studies for age determination

Legal requirements in roentgen studies for age determination

Radiology in the Nazi era: part 3. Roentgen studies and national health: radiology and roentgenology in the Nazi eugenics policy.

Radiology in the Nazi era: part 3. Roentgen studies and national health: radiology and roentgenology in the Nazi eugenics policy.

In utero defecation of the nondistressed fetus: A roentgen study in the goat

An experimental study was performed to investigate gastrointestinal motility and meconium passage, with simultaneous blood gas measurements, in the fetuses of eight pregnant goats at 110 to 114 days' gestation (full term, 147 to 155 days). With the goats under halothane anesthesia, a nasogastric tube and a heparinized central venous catheter were inserted into the fetuses. 24 hours after surgery, 10 mL of gastric juice from the fetus was replaced with a nonhydro-soluble contrast medium, and serial roentgenograms and blood samples (for pH, Po 2, and Pco 2 easurement) were taken every 4 hours. All fetuses began to pass the contrast medium into the amniotic cavity within 16 to 22 hours, and central venous blood gas values were normal. The results of this study suggest that the fetus, which urinates routinely, also defecates routinely into the amniotic cavity, even in the absence of distress. The increased incidence of meconium staining in fetal distress conditions may be indicative of impaired clearance of amniotic fluid.

Antibiotic therapy of life-threatening infectious diseases in the emergency department

Initial therapy in acutely ill septic patients is necessarily empiric. Although a specific etiologic infectious diagnosis is rarely made in an acute situation, a treatment decision must be made and must be developed from history, physical examination, and minimal laboratory and roentgen studies. Three life-threatening syndromes are discussed: febrile-neutropenic patients with cancer, immunosuppressed patients with fever and lung infiltrates, and patients with acute community-acquired meningitis.

A Statistical Survey on Japanese Patients with Malignant Exophthalmos

The results of the statistical survey on Japanese patients with malignant exophthalmos performed in 1978 are reported.While 15,442 patients with Graves' disease were seen in 9 thyroid clinics, 121 cases (0.8%) were diagnosed as malignant exophthalmos. Exophthalmos was present in 30.1% of 8,801 cases of Graves' disease.Two hundred and twelve patients with malignant exophthalmos reported from 13 institutions were analyzed. The male-female ratio of the patients was 1 : 1.06, and 22.2% of them was not associated with hyperthyroidism. The age distribution of the patients' first visit peaked at the 5th decade.A family history of thyroid disorder was found in 11.8%. Twenty-one percent of the patients had previous treatments for hyperthyroidism. Aggravation of eye symptoms was reported in some patients treated with antithyroid drugs or radioiodine. Goiter was not palpable in 16% of the cases, and estimated weight of the thyroid was smaller in patients without hyperthyroidism. The consistency of the goiter was elastic firm in 35% of the cases. Thyroid histology revealed Hashimoto's thyroiditis in 6 out of 20 patients studied. Thyroid function varied widely from hypothyroid to hyperthyroid ranges, being mostly in euthyroid or mildly thyrotoxic ranges. Few patients showed a normal TRH-test or T3 suppression test. Antithyroglobulin and antimicrosomal antibodies by TRC were detected in 17.8% and 63.5%, respectively.The grade of proptosis ranged up to 29mm with the maximum right-left difference of 7mm. The incidences of eye symptoms were as follows : pain 30.5%, conjunctival injection and chemosis 89.3%, diplopia 66.3%, restriction of eye motion 51.6%, lagophthalmos 27.0%, corneal lesion 44.4%, visual field defect 9.4%. Upper and lateral gaze was most often limited.Abnormalities on funduscopy, roentgen study and CT were found in 18%, 5%, and 94% respectively. A follow up study up to 5 years revealed amelioration with treatment in 36%, no change in 55%.The treatment reported effective included adrenocortical steroids, radiation and thyroid hormones, however, the effect of steroids and radiation on proptosis was considered temporary in most cases.

The Pediatric Tracheostomy

Following tracheostomy, simple roentgen studies coordinated with decannulation permit accurate evaluation of the pediatric patient. These studies require alertness to the child's clinical condition as well as a selective, monitored roentgen technique. The conventional lateral neck radiograph and the high-kV frontal tracheogram complete the evaluation in most cases. Fluoroscopy and xerography can be of additional value if decannulation is difficult, though xerography should be used only to confirm the presence of a granuloma seen on the conventional radiograph.

Transfer of cefazolin into human milk

phate load will be rapidly excreted by the kidney in the presence of normal glomerular and tubular function, but only in conjunction with a cation to preserve electroneutrality. This is a possible explanation for the large concentration of cations (sodium and potassium) noted in the random urine specimen obtained at the time of the initial admission. In the presence of extracellular volume contraction and increased aldosterone production, a significant proportion of this cation loss could be potassium. The use of enemas, especially hypertonic phosphate enemas, has become routine in pediatrics in preparation for roentgen studies and in the treatment of chronic constipation. Although enemas given to normal individuals usually do not cause electrolyte imbalance, children with abnormal colons or impaired renal function are especially prone to fluid and electrolyte disturbances following the administration of enemas. If the chronic use of enemas cannot be avoided, such patients should be monitored with periodic determinations of serum electrolyte, phosphorus, and calcium concentrations.

Abnormalities of tooth development in pituitary dwarfism

Roentgen studies of the jaws and teeth were performed in forty-eight cases of pituitary dwarfism. Found in all cases were delayed shedding of the deciduous teeth, marked delay in eruption of the permanent teeth and retention of them in the maxillary and mandibular shafts, development of the apical parts of the roots of retained teeth, obvious underdevelopment of the maxilla and mandible, and complete absence of third molar tooth buds.

Late complications of abdominal aortic reconstructive surgery: roentgen evaluation.

During a 5-year period from 1969 to 1974, 53 (8.5%) of 631 patients developed late complications following abdominal aortic reconstructive surgery. Occlusion was the most frequent complication and occurred in 4%. Others included stenosis, false aneurysm, enteric fistula and infection. Late complications were demonstrated by roentgenographic methods. Angiography was the most valuable roentgen study. It is indicated in all patients suspected of having delayed complications except those with unstable life-threatening hemorrhage. Additional roentgenographic studies including the barium enema and barium meal may help make the diagnosis and exclude other entities. In any patient with an abdominal aortic graft and gastrointestinal bleeding, the diagnosis of an aorto-enteric fistula should be considered until otherwise proven.

The reconstructed esophagus.

Reconstruction of the esophagus has been used for more than half a century. Benign as well as malignant diseases are treated in this manner. Viscera used for reconstruction are: colon, jejunum, and stomach. The different modalities of surgical intervention have been briefly summarized. Complications have been enumerated with the major ones stressed in more detail. The exact nature of surgical procedure should be known before attempting to evaluate roentgenologically a reconstructed esophagus. Preoperative roentgen evaluations, including barium study and angiography, are indicated for better postoperative results. Postoperative roentgen studies are needed to detect most of the postoperative complications.

Renal osteodystrophy in patients on hemodialysis as reflected in the bony pelvis.

Roentgen studies in a group of 131 patients on maintenance hemodialysis reveal renal osteodystrophy in 25 patients (19 per cent). In 24 patients of the latter group (98 per cent), the various manifestations of renal osteodystrophy appear in the bony pelvis. These include: osteomalacia; osteitis fibrosa; osteosclerosis; dialysis osteopenia; and extraosseous calcifications. Some of the changes, i.e., bending of bone, Looser's lines, metaphyseal fractures and dialysis osteopenia, are due, at least in part, to the weight bearing nature of the bony pelvis. These findings are ararely, if ever, seen in the digits or in other non-weight bearing bones. It is therefore proposed to evaluate the bony pelvis, together with the magnification digital roentgenogram, when a less costly and less time consuming skeletal survey is needed in hemodialized patients.

Bleeding Meckel's diverticulum diagnosed by arteriography and radioisotope imaging

Preoperative demonstration of a bleeding Meckel's diverticulum represents a challenging diagnostic problem. Unfortunately, these lesions often are not detected by conventional roentgen studies. The bleeding is nearly always associated with ectopic functional gastric mucosa within the diverticulum (1), which causes ulceration of the diverticulum or adjacent ileum. The present report describes a patient with massive intestinal bleeding from a Meckel's diverticulum diagnosed preoperatively by both abdominal arteriography and radioisotope imaging with technetium pertechnetate.

The increased incidence of carcinoma of the colon following ureterosigmoidostomy.

Presumably induced tumors of the sigmoid colon, often in young patients, are now a well documented complication of ureterosigmoidostomy.The physician must be aware of this association and should obtain appropriate roentgen studies.

Congenital Porencephaly

Congenital porencephaly originates early in fet al development as a component of diffuse cerebral malformation. In infancy the patients have clinical manifestations of local or generalized cerebral disease. Convulsions, delaved growth and development and focal motor deficits are the most common clinical findings. Skull films, transillumination and brain scanning are useful methods of examination. Intracranial pneumography is the definitive means of diagbnosis. Roentgen studies in unilateral cases demonstrate characteristic changes. This pattern consists of ipsilateral calvarial enlargement and thinning, bilateral ventricular dilatation and contralateral shift of midline structures. Other anomalies of the cerebrum and meninges are often demonstrated on roentgen studies. The prognosis in these patients is guarded. Significant mental and motor retardation occurred in nearly all cases.

Clearer Roentgenographic Visualization of the Colon: A study of a conveniently packaged kit for preparing the colon, and its effect on electrolyte balance

The standard preparation for barium enemas with castor oil and cleansing enemas often results in unsatisfactory roentgen studies, particularly in institutions where large numbers of elderly or debilitated patients are cared for. The evaluation of a newly available commercial “kit” for preparation of patients was conducted using an investigator blind control situation, and the results were compared with the usual and standard preparation. In addition, possible electrolyte disturbances with the use of this kit was also studied. A review of the results and their evaluation leads us to the opinion that the kit type of preparation utilizing large quantities of fluids and a bowel evacuant of magnesium citrates, citric acid, and sodium citrate, followed by phenolphthalein tablets, and potassium bitartrate and sodium bicarbonate suppositories, resulted in considerably improved barium enema studies, was more readily accepted by patient and nursing staff than the standard preparation, resulted in a smaller percentage of repeat examinations, and had no adverse effect on the alteration of serum electrolytes.

TRANSPORTATION OF THE TRAUMATIZED PATIENT

Although some progress has been made in the last decade as evidenced by a recent survey of patient transport techniques, it is embarrassingly evident that at least half of our traumatized patients are still being transported in a crude manner. The 24 assorted devices which are now commercially available do reduce the number of hand moves by one, but we still need a better transport system. By not having an effective transport system, the management of the patient is jeopardized; and certainly the roentgen examinations suffer as well. If a good commercial patient transport system could be developed similar to the one described, embodying a removable stretcher top, adaptable to any radiographic and/or other hospital tables, and if this system could be made at such a price as to be within the capabilities of the average American hospital, the overall management of our acutely injured patients would be significantly improved. Our present technique of manual transport is not only uncomfortable for the patient but is a potential source of additional trauma. In addition, the problem of finding suitable personnel to make these transfers is sometimes difficult in small hospitals at night and certainly it must be admitted that roentgen studies are often compromised because of the difficulties of moving and positioning an acutely injured patient. Patient transport can be looked upon as a "disease," the treatment of which lies in the development of a better transport system.

Roentgen Studies of Stomach Ulcer in Advanced Age

Roentgen Studies of Stomach Ulcer in Advanced Age

Roentgen Studies of Stomach Ulcer in Advanced Age

Roentgen Studies of Stomach Ulcer in Advanced Age

The aging skull: Comparative roentgen study 25 to 34 year interval

Skull radiographs were compared in 72 adults at intervals ranging from 25 to 34 years. It was found that the paranasal sinuses became larger in 100 per cent and the cranial vault in 71 per cent of the cases; the cranial tables became thicker in 64 per cent and an enlargement of the sella turcica was detected in 45 per cent. Occasionally, an osteoporosis of the dorsum sellae was observed on the follow-up study. The findings confirmed a continuous activity of the growth hormone in the aging skull.

Roentgenologic examination in the diagnosis and treatment of colon volvulus.

The common occurrence, diagnosis and treatment of colon volvulus pose problems to the radiologist as well as to the surgeon. Roentgenologic examination was diagnostic in 75 per cent of the 100 cases, and barium enema examination was of value in the treatment program in 5 pen cent.The most valuable type of roentgen study is a plain film noentgenogram (in upright and lateral decubitus projections) of the abdomen. Barium enema examination may reveal the diagnosis and be a satisfactory method of treatment, but must be considered temporary. Definitive sungical treatment is recommended to prevent recurrence and the increased mortality found with conservative management.