Biomedical subjects
Publications and source records attributed to B D Toombs.
A case of hepatic fracture is presented in which computed tomography (CT) played a major role in the diagnosis. The fracture, which was suggested on scintigraphy, was easily demonstrated on CT as a low-density hematoma. The advantages and potential use of CT in this clinical setting are discussed.
99mTc-albumin microspheres were administered intravenously and urinary radioactivity was determined for various periods up to 25 hours. The average accumulated urinary level was 0.68% of the injected dose at 1 hour and 18.6% at 24 hours. The averaged bladder wall dose was 101.98 mrad (1,019.79 muGy) based on an administered dose of 3 mCi (111 MBq). While the chemical state of the excreted 99mTc was primarily free pertechnetate, some reduced 99mTc species were also excreted. The appearance of 99mTc in the kidneys within the first 15 minutes following injection should not be considered unusual, nor necessarily indicative of right-to-left shunting.
Calyceal diverticula are infrequently seen during routine urography. When present, one must look for important associated complications. Two patients had ureteral obstruction in conjunction with "ballooned" calyceal diverticula. This rare combination may give rise to the erroneous diagnosis of a renal mass.
The configuration of the supradiaphragmatic segment of the inferior vena cava (SIVC) was evaluated on lateral chest radiographs to determine the clinical situations in which a posterior convex contour occurred. Of 34 patients with a convex SIVC, 31 had cardiovascular abnormalities. Left ventricular enlargement was present in 17 of 34 (50%), and right ventricular failure in 13 (38%). Valvular regurgitation, left-to-right shunts, narrow anteroposterior chest diameter, and chronic obstructive lung disease were also present. In 102 consecutive normal patients, the SIVC was visible in 97%; only 1 patient had a convex SIVC (p = 10(-7)). The results show that detection of a convex SIVC suggests associated abnormalities.
The effects of diagnostic ultrasound on growing asynchronous cultures of Chinese hamster ovarian cells were evaluated, with particular attention to possible synergism with ionizing radiations. Measurements of cellular growth rate/survival and changes in morphology indicated that synergistic biological effects were absent.
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Metastatic lesions to the breast are unusual. We add 21 cases to the previously reported 131 clinical cases. The most common sources are malignant melanomas and the lymphoma/leukemia group. Metastatic lesions to the breast tend to be painless discrete lumps that are generally small at the time of discovery. They usually occur in the upper outer quadrant and are commonly associated with axillary adenopathy. Occasionally, they are the initial manifestation of an occult extramammary primary cancer. Prognosis is poor but appears slightly improved since availability of more refined chemo- and immunotherapeutic regimens. The clinical, pathologic, and radiographic features of this problem are described.