Computed tomography of the anterior ethmoid sinuses and its adjacent structures for endoscopic sinus surgery

Forty adult cadavers were examined by computed tomography (CT) imaging with special attention to the pneumatization of the anterior ethmoid sinus for endoscopic sinus surgery. The study of the specimen was done using coronal section and axial section, sagittal reconstructed images were obtained from the data acquired in the axial plane. The cells of anterior ethmoid sinus were classified into four sub-groups, namely, the pre-infundibular cell (appearance rate 87.5%), the lateral infundibular cell (82.7%), the post-infundibular cell (86.3%) and the bulla cell (100.0%), and the anterior ethmoid sinus was classified into two types, namely, intraethmoid type (71.2%) and extraethmoid type (28.8%). The results shows that CT can display the sub-group and the type of the anterior ethmoid sinus and its adjacent structures clearly. The significance of endoscopic sinus surgery was discussed.     

Computed tomography in the elderly

In a chemically defined serum-free culture system, platelet-derived growth factor (PDGF) as the only externally applied growth factor, in concert with corticosterone, 3-isobutyl-1-methylxanthine (IBMX) and low insulin (1nM), stimulates adipose conversion of 3T3-L1 preadipocytes. Omission of PDGF during the induction period results in loss of differentiation competence and apoptotic cell death. Induction of apoptosis is shown to be clearly mediated by PDGF withdrawal, since neither corticosterone nor IBMX affect the apoptotic behaviour of 3T3-L1 cells. Cell viability in the absence of the survival factor PDGF could be achieved by application of high insulin (1 microM) or ectopical expression of the anti-apoptotic proto-oncogene Bcl-2. However, PDGF-independent suppression of cell death does not trigger adipose conversion in the presence of corticosterone and IBMX. Therefore, we conclude that suppression of apoptosis per se is not permissive for differentiation of 3T3-L1 preadipocytes and PDGF might exert some additional differentiation-promoting effect(s).     

Trans-facial approaches of cancers of the ethmoid]

The development of a workload management system for use in the accident and emergency department is described. The system is capable of capturing the work all professional groups, allowing the user to roster staff according to anticipated workload, and gives accurate information on whether staffing requirements are sufficient to provide the desired standard of care.     

Computed tomography and pulmonary measurements

This study examines characteristics of Arbisi and Ben-Porath's (1995) MMPI-2 Infrequency-Psychopathology scale, F(p), in a sample of individuals admitted for inpatient treatment of chemical dependency. The F(p) scale, designed to detect deviant response biases in settings characterized by high base rates of psychopathology, was found by Arbisi and Ben-Porath (1995) to have good construct and incremental validity with psychiatric inpatients. Comparisons of the F(p), Infrequency (F), and Infrequency-Back (Fb) scales' means and relationships to indices of psychopathology in the current study provide evidence supporting the F(p) scale's validity in populations of chemically dependent inpatients with and without concurrent psychiatric diagnoses.     

Computed tomography in the postoperative patient

Nine cases of patients in whom intracranial infection was suspected after operation are presented. Lesions with ring enhancement were seen in all of these patients. The differentiation of enhancement, seen as a normal postoperative phenomenon, from residual neoplasia and cerebral abscess can be difficult. This can be resolved by serial and sequential-delayed CT, and thus unnecessary re-exploration may be prevented.     

Computed tomography in the emergency department

We report a neonatal case of severe, life-threatening Kasabach-Merritt syndrome that was successfully treated with interferon-alpha: This patient had a huge hemangioma of the right leg and a general bleeding tendency. Although the condition initially responded to steroid and radiation therapy, after a relapse, no therapy including steroids, radiation, aspirin, and dipyridamole was effective. Because of severe thrombocytopenia and extension of the hemangioma to the pelvic region, surgical intervention was not indicated. Interferon-alpha therapy was started on day 61 of life. During the therapy the platelet counts increased by more than tenfold and reached the normal level in a month. The size of the hemangioma dramatically decreased. The administration of interferon-alpha might be indicated as a therapy for severe, life-threatening Kasabach-Merritt syndrome, especially when there is resistance to steroid or radiation therapy.     

Computed tomography and positron emission tomography in the pre-operative staging of oesophageal carcinoma

Because patients with carcinoma of the oesophagus usually present with advanced disease and surgery has a high mortality with cure in less than 10% of patients, pre-operative staging to select appropriate patients is necessary. Computed tomography (CT) plays an important role in staging but has well recognized limitations. Positron emission tomography (PET) which provides physiological information may therefore be a better alternative. OBJECTIVE: To compare the findings of CT and positron emission tomography (PET) with 2-[18fluorine]-fluoro-2-deoxy-D-glucose (FDG) in the pre-operative staging of oesophageal carcinoma. MATERIALS AND METHODS: Twenty-five patients with biopsy proven oesophageal cancer had pre-operative staging using CT and FDG-PET. The studies were read independently and full histological confirmation was obtained in 19 patients. Four parameters were studied: the primary tumour, peri-oesophageal lymph nodes, liver metastases and left gastric lymph nodes. RESULTS: PET visualized all primary tumours; CT missed one. CT identified 4/8 patients with involved peri-oesophageal nodes and PET 3/8. CT identified 5/9 patients with left gastric adenopathy and PET 1/9. PET visualized a liver metastasis missed on CT and appeared to be better in assessing residual tumour. PET did identify distant metastases not seen on CT in seven patients. CONCLUSIONS: The two techniques are both effective in showing the primary tumour and about equally sensitive in the demonstration of peri-oesophageal nodes. PET is probably more sensitive than CT for the detection of distant metastases.     

Computed tomography of the tongue and floor of the mouth

The anatomy of the tongue and floor of the mouth is readily discernible by computed tomography (CT) because of low-density fascial planes that outline the extrinsic musculature, lingual arteries, and hypoglossal nerves. Although the tongue is accessible to the examining finger, few patients can tolerate a detailed palpation. In planning for a partial glossectomy, CT scanning aids the surgeon who must be sure that the tumor is unilateral or that at least one lingual artery and one hypoglossal nerve can be preserved. The CT scans of 30 patients were reviewed for background anatomy. Pathologic changes are summarized for 16 extrinsic lesions and 11 intrinsic tumors. The status of the midline could be confirmed in 28 of the 30 patients. The fascial plane distortions by malignant intrinsic and extrinsic lesions are discussed.     

Computed tomography of systemic lupus erythematosus

Computed tomographic (CT) findings in 14 patients with systemic lupus erythematosus are correlated with clinical symptomatology. Microinfarction (manifested by perisuical atrophy) large infarcts, and hematomas are the major abnormalities demonstrated by CT. The neuropathology of these changes is discussed.     

Computed tomography in metastatic disease of the brain

15 male undergraduates were presented with 10-sided random forms which they explored visually, or one-handed haptically, or two-handed haptically. Forms were exposed for various durations and subjects were required to draw each form immediately after its removal. The results indicated that 30 sec. of one-handed exploration and 20 and 30 sec. of two-handed exploration produced performance comparable to just 2 sec. of visual exploration. Two-handed exploration was significantly superior to one-handed exploration only at the 20-sec. exposure duration. These results illustrate the disparity in the information-gathering capabilities between the visual and haptic systems.     

Computed tomography in the diagnosis of buccal space masses

BACKGROUND: Despite ongoing intensive research using sophisticated new molecular tools and methods, the pathogenesis of autoimmune diseases such as rheumatoid arthritis (RA) is still not completely understood. HYPOTHESES: In this paper the two favorite hypotheses of the pathogenesis of rheumatoid arthritis currently discussed are introduced and compared. Hypothesis 1 is focussing on the central role of the T cells and T cell dependent phenomena in the pathogenetic scenario of RA. In contrast, hypothesis 2 stresses the role of altered synovial fibroblasts and their specific features critical for the destruction of inflamed joints. Both hypotheses are thoroughly discussed and suggestions for further research activities are made. CONCLUSION: Insights in the pathogenesis of RA provide options to develop new therapeutic strategies aimed at the inhibition of pathogenetic relevant processes.     

Computed tomography scanning and delirium in elder patients

OBJECTIVE: 1) To examine the ordering of head CT scans in elder patients with delirium and cognitive impairment; and 2) to report CT scan findings associated with these conditions. METHODS: This was a 2-part study. Part 1 was a prospective, observational study of 560 adults > 70 years of age evaluated at 3 separate EDs using a 200-hour stratified sampling process at each ED. During Part 1, the frequencies of specific findings (i.e., delirium, impaired consciousness, and impaired cognition) and CT scan rates for these groups were determined. Part 2 was a retrospective analysis of CT scan reports and medical records (n = 279) for patients > 70 years of age in the prospective sample (n = 79) and from a sample (n = 200) of CT scans obtained at a fourth ED. Part 2 examined clinical findings detected in the ED to determine those factors that were associated with acute findings on CT scan. RESULTS: Part 1: There were 333 (59.4%) patients prospectively classified as having impaired cognition, impaired consciousness, or delirium; 79 (23.7%) of these patients had a head CT scan. Of these 3 groups, delirious patients were more frequently scanned (p < 0.001). Part 2: Of 279 CT scans, 42 (15.0%) were positive for an acute condition (hemorrhage, hematoma, space-occupying lesion, infarct). Of 42 positive scans, 40 (95.1%) were found in the 102 (36.6%) patients with either impaired consciousness or a new focal neurologic finding detected in the ED. CONCLUSIONS: Considerable variability in ED CT scan ordering exists for elder patients with neurologic findings. Impaired consciousness and/or new focal neurologic signs are associated with acute findings on CT scan in elder patients. Acute CT abnormalities are uncommon in elder ED patients with other neurologic findings. Additional prospective evaluation is warranted prior to guideline development for CT scans in this patient population.     

Computed tomography of the normal feline nasal cavity and paranasal sinuses

We studied physical, cognitive, emotional and quality-of-life changes noted by relatives in a sample of 65 severely traumatic brain injured (TBI) patients several years after injury. The purpose of the present study was to evaluate the families perception of these changes and their need for information concerning the consequences of TBI. Our results indicated that the perceived changes in behavioural and affective symptoms and in the patient's quality of life were most closely associated with the need expressed by family members for information concerning, TBI. We also found that family relationships were especially affected by problems in the behavioral and affective domain, and the decrease in patient quality of life, as reported by relatives. These findings underline the importance of providing the relatives of TBI patients with information about the consequences of the injury with particular emphasis on behavioural and emotional disturbances, in order that they might cope better with these problems.     

The ovary. Computed tomography and magnetic resonance imaging

CT and MR imaging can both contribute valuable clinical information in women with benign and malignant ovarian masses; the superior soft tissue contrast and multiplanar capabilities provided by MR imaging make it a valuable tool to evaluate the normal ovary, polycystic ovaries, endometriosis, and disorders of sexual differentiation. CT is currently the recommended modality to stage ovarian carcinoma, and peritoneal implants as small as 5 mm can be visualized. With the addition of contrast-enhanced images to conventional MR sequences, however, improved visualization of intratumoral architecture has also allowed for accurate MR characterization of benign versus malignant ovarian masses. Fat saturation techniques used with conventional MR sequences can also be used for definitive characterization of benign fat-containing teratomas and differentiate these tumors from hemorrhagic ovarian cysts or endometriomas. Finally, the detailed visualization of the normal-sized ovary on MR images provided by both the body coil and the new phased-array coil allows detection of the normal ovaries, ovarian follicles, and ovarian cysts throughout the premenopausal and postmenopausal years. Findings of polycystic ovarian syndrome, which cannot be evaluated by CT, are characteristic on MR images. MR is unparalleled in the evaluation of disorders of sexual differentiation because MR images can depict ectopic and normally positioned gonads and provide multiplanar depiction of the other pelvic organs and perineum as well. CT and MR imaging can provide valuable and specific clinical information about the ovary and benign and malignant ovarian disease.     

Computed tomography of sternoclavicular joint lesions in spondylarthropathies

To evaluate the computed tomography (CT) findings of inflammatory lesions of the sternoclavicular joints (SCJ) in spondylarthropathies. DESIGN AND PATIENTS: CT scans of the SCJs were obtained in 23 patients (group 1) with inflammatory SCJ lesions in spondylarthropathies. These scans were reviewed by four readers and compared with the CT scans of 23 matched controls (group 2). Each reader had to complete a 27-item grid. RESULTS AND CONCLUSION: In the 23 patients of group 1, the mean number of observed signs was 5.3 +/- 4.2 higher (P < 0.01) than in the group of 23 matched controls (2.4 +/- 1.6). Four signs were more frequently observed (P < 0.05) in group 1: surrounded subchondral clavicular erosions and cysts, surrounded subchondral sternal cysts and sternal bone sclerosis. A cyst and/or an erosion was associated with hyperostosis and/or bone sclerosis in 9 of 23 patients in group 1. This association was not observed in group 2; the difference was significant (P < 0.001). A cyst and/or an erosive lesion was observed 18 times in group 1 versus 11 times in group 2; the difference was significant (P < 0.05). Conversely, signs of degenerative lesions (osteophytes, subchondral sclerosis, unevenness of joint surface) were no more frequently observed in controls than in group 1. This study emphasizes the diagnostic value of CT, in particular in the identification of inflammatory lesions, even when pre-existing degenerative disease is present.     

Computed tomography in a case of pseudomembranous colitis

Pseudomembranous colitis (PMC) is an infectious colitis usually occurring as a complication of antibiotic therapy. The computed tomography (CT) findings of 10 patients with PMC are reviewed. All patients demonstrated an abnormal large bowel wall with an average thickness of 13 mm (range 7-31 mm). Additional, but less frequent findings included mesenteric inflammation, ascites, pleural effusions, and dilatation of the large or small bowel. Pancolonic involvement was seen in 7 cases, while three patients had focal colitis. Although the CT appearance of PMC is not specific, the diagnosis may be suggested in the proper clinical setting.