Endometriosis of the bowel

One hundred sixty-three cases of endometriosis of the bowel (5.4% of 3037 laparotomies for endometriosis at the Ochsner Foundation Hospital) were reviewed to assess the management of this complication. Colon and rectal surgeons performed bowel resections of the colon in 30 cases and resections of the ileum and/or cecum in 11 cases. Gynecologic surgeons resected bowel implants, often multiple, in 153 patients, and also performed other necessary surgery, either ablative (with removal of uterus, tubes, and one or both ovaries; 58.8%) or conservative (with preservation of reproductive potential; 41.2%). The bowel mucosa was opened in 15% of implant resections. Complications included transient pulmonary febrile responses in 43%, two pelvic infections, and one hematoma. Ileus was not a problem, and there were no deaths. Resection of intestinal implants appears to be a safe procedure.     

Thrombosis at venous insertion sites after inferior vena caval filter placement

Color Doppler flow imaging or compression ultrasound (US) was used to prospectively determine frequency of thrombosis at 54 venous insertion sites (47 in common femoral veins, seven in right internal jugular veins) after percutaneous placement of Greenfield filters for interruption of the inferior vena cava. Fifty-one filters were successfully placed in 51 patients with a dilator set or a balloon angioplasty catheter. Nine focal thrombi were detected in the common femoral vein (19%) and one in the right internal jugular vein (14%). Use of dilators induced eight thrombi (24%), compared with two (10%) from balloon catheters. The left common femoral vein had a high frequency of thrombosis, regardless of dilation technique (five of nine). Of nine patients with acute common femoral vein thrombosis, four became symptomatic within 10 days after the procedure. Patients may remain asymptomatic or have delayed symptoms; thus, US is valuable for determining patients at risk of thrombosis of the common femoral vein.     

Fracture resistance of Kevlar-reinforced poly(methyl methacrylate) resin: a preliminary study

The reinforcing effect of Kevlar fibers incorporated in processed poly(methyl methacrylate) resin samples was studied using 0% (controls), 0.5%, 1%, and 2% by weight of the added fibers. The samples were subjected to impact testing to determine fracture resistance, and sample groups were statistically compared using an ANOVA. Each reinforced sample had significantly greater fracture resistance (P less than 0.05) than the control, and no difference was found either within or between control groups. The use of reinforcing Kevlar fibers appears to enhance the fracture resistance of acrylic resin denture base materials.     

Pulmonary histiocytosis X: comparison of radiographic and CT findings

The authors retrospectively evaluated radiographs, computed tomographic (CT) scans, and results of pulmonary function tests (when available) for 17 patients with biopsy-proved pulmonary histiocytosis X. In 11 patients, high-resolution CT was used. In 12 patients, CT demonstrated cystic air spaces, usually less than 10 mm in diameter. In three of these 12, cysts were the only abnormality, but in six others, nodules (usually less than 5 mm in diameter) were also present. Two patients had only nodules and one, only emphysema. CT showed that many lesions that appeared reticular on plain radiographs were actually cysts. CT showed no central or peripheral concentration of lesions, but it did reveal that many small nodules were distributed in the centers of secondary lobules around small airways. CT findings correlated better with the diffusing capacity (rho = -0.71) than did the plain radiographic findings (rho = -0.57). Thus, CT was better than radiography at showing the morphology and distribution of lung abnormalities.     

B-cell lymphoproliferative disorders in children after bone marrow transplantation: radiologic manifestations

The radiographic findings in five pediatric patients in whom unregulated B-cell lymphoproliferative disorders developed following bone marrow transplantation are described. Four patients received T-cell-depleted bone marrow from mismatched donors and one received nondepleted marrow from a matched sibling donor. These disorders are similar to B-cell lymphoproliferative disorders that have been described in other immunosuppressed hosts. They are associated with Epstein-Barr virus and range from polyclonal proliferation without cytogenetic abnormalities to monoclonal lymphoma with clonal cytogenetic changes. Unlike other postallograft lymphoproliferative processes, B-cell lymphoproliferative disorders in these patients have not responded to antiviral therapy, immunologic therapy, or chemotherapy. The radiographic patterns of disease include diffuse or focal hepatic involvement; gallbladder wall thickening; and pulmonary, soft-tissue, and basal-ganglion masses. These radiologic findings are not specific and evaluation of tissue histology is required for diagnosis.     

New catheter design and placement technique for pulmonary arteriography

An improved catheter for pulmonary arteriography via the antecubital approach is described. The catheter has been used successfully in 56 patients.