Renal thorium deposition associated with transitional cell carcinoma: radiologic demonstration in two patients

Abdominal radiography, excretory urography, retrograde pyelography, and computed tomography were performed in two patients who had undergone retrograde pyelography with thorium dioxide (Thorotrast) approximately 40 years ago. Both patients developed a transitional cell carcinoma due to suburothelial thorium deposition. Typical thorium densities were demonstrated at CT in the peripelvicalyceal area as well as in retroperitoneal lymph nodes. Elderly patients in whom radiographic examination reveals retained Thorotrast in the kidney should be followed up because of the high risk of renal carcinoma.     

In-111-labeled leukocyte scintigraphy in suspected orthopedic prosthesis infection: comparison with other imaging modalities

When infection of prosthetic orthopedic implants is suspected, optimal management requires accurate confirmation or exclusion of infection. The authors retrospectively studied 98 patients with possible infection who underwent scanning with indium-111-labeled white blood cells (WBCs) and subsequently underwent surgery within 14 days. At surgery, 50 patients had infections, as determined by means of culture or histologic results. The diagnostic accuracy of In-111 scanning was compared with that of plain radiography, arthrography, three-phase bone scanning, and various clinical and laboratory findings classically associated with infection. Positive findings on In-111 WBC scans and elevated erythrocyte sedimentation rates were found to be the most predictive variables in the diagnosis of septic prostheses (P less than or equal to .001 and P less than or equal to .002, respectively). Likelihood ratio analysis more clearly demonstrated the superiority of In-111 WBC scanning, with positive and negative scans yielding likelihood ratios of 5.0 and 0.16, respectively.     

Temporomandibular joint arthrography: comparison of morbidity with ionic and low osmolality contrast media

We compared patient morbidity associated with temporomandibular joint (TMJ) arthrography using both meglumine/sodium diatrizoate (60%) and the new monoacidic dimer, Hexabrix, in a double-blind randomized clinical trial in 31 patients. Patients experienced maximal discomfort from TMJ arthrography with the initial joint filling and joint distension; this rapidly resolved over 10 minutes. Delayed exacerbation of pain is less than described for shoulder arthrography. The newer contrast media promise to decrease patient morbidity with arthrography.     

Differential diagnosis of salivary gland swellings (excluding neoplasms)--the ORL view (author's transl)]

Important investigatory methods for the diagnosis of non-neoplastic salivary gland disease are discussed. The difficulties found with these different methods are emphasized, and biopsy is recommended as the most reliable means for diagnosis. Some salivary gland disorders are caused by hypotensive drugs. Chronic recurrent parotitis is presented as an example of the difficulties in differential diagnosis and treatment.     

Diskussion zu den Vorträgen 49–53

Ohne Zusammenfassung     

Intracerebral pneumatocele: CT findings

Two cases of intracerebral pneumatocele following trauma are presented. One to two months after initial treatment both patients had deteriorating neurologic status. The diagnosis was made by radiography. When a pneumatocele is suspected clinically, computed tomography can play a vital role in determining the precise location of the gas collection, its relationship to the fracture site, and the amount of mass effect on the brain.     

Long-term results of hemigastrectomy with vagotomy in the treatment of bleeding peptic ulcers

Summary and conclusion A total of 102 patients who underwent hemigastrectomy and truncal vagotomy for bleeding peptic ulcers were followed for 6–12 years. Eighty per cent of these patients had a follow-up of 8 years or more. The recurrence of hemorrhage after this operation has been 6.8%. None of these patients bled massively or required a second operation. These results are notably more favorable than those previously reported. The relatively low mortality and the high rate of effectiveness of hemigastrectomy with vagotomy and gastrojejunostomy in the present series demonstrate the superiority of this procedure as the surgical treatment of choice for the control of bleeding from peptic ulcers.