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Biomedical subjects

J J Pagani

Publications and source records attributed to J J Pagani.

10 recordsLinked to original sources

Temporal changes in the oxidation state in in vitro blood.

The rates at which the paramagnetic compounds deoxyhemoglobin (Hb) and methemoglobin (MHb) form in vivo within an area of hemorrhage are unknown. The present experiment establishes the baseline concentrations and rates of change in paramagnetic hemoglobin concentrations, as well as the pH in normal heparinized and clotted human blood maintained in vitro at 37 degrees C under anaerobic conditions over 30 hours. There was a moderate increase in Hb concentration in normal heparinized blood (average increase was 15.5%, rate = 0.50%/hour) and a slight increase in MHb concentration in the heparinized blood and clots (average increase was 1.4%, rate = 0.044%/hour). A second experiment was done to verify the activity of the RBC systems responsible for maintaining the hemoglobin molecule in the reduced state. Conversion of MHb to Hb in these samples proceeded at a rate of 5.6%/hour. In a third experiment, blood from 11 normal subjects maintained at 4 degrees C 25 degrees C was analyzed for MHb concentration over the course of 28 days. The level of MHb formation remained in the range of normal for at least 11 days in all subjects. The authors conclude that at basal conditions created in vitro, the blood levels of both Hb and MHb remain at relatively low levels. Therefore, if the accumulation of Hb and/or MHb occurs in acute in vivo hematomas it must be driven by intrinsic tissue factors.

Cerebral Hemorrhage

Pathophysiology of acute intracerebral and subarachnoid hemorrhage: applications to MR imaging.

In this review of the pathophysiology of acute intracerebral and subarachnoid hemorrhage, information from several disciplines is assembled to describe the bleeding process, hemostasis and coagulation, fibrinolysis, erythrocyte lysis, phagocytosis, and changes in the state of hemoglobin. The impact of these pathophysiologic processes upon MR imaging, CT, and angiography is noted.

Angiography

Nephromegaly in hyperalimentation.

Nephromegaly associated with hyperalimentation and its effect on renal function were studied. Renal size was determined in 44 patients receiving total parenteral nutrition (TPN). Of 26 patients in whom kidney size could be determined before and during TPN, all but one had normal-size kidneys before TPN. Six had no increase in renal size, and kidneys increased in size in 20. One or both kidneys became abnormally large in 9 patients. There was no detectable change in renal function and kidneys decreased in size upon discontinuation of hyperalimentation. Abnormal renal size bore no relation with weight gain or liver function tests.

Adolescent

Augmentation enterocystoplasty.

The anatomy and radiographic appearance of five types of augmentation enterocystoplasty (ileocystoplasty, cecocystoplasty, ileocecocystoplasty, sigmoidocystoplasty, and enterourethroplasty) are described. Retrograde cystrography is the procedure of choice for optimal visualization of an augmented bladder and most complications. Excretory urography is useful for following concurrent upper tract disease and ureteral stenosis. Critical factors in a optimal examination are maximal filling of the bladder and radiographs in multiple projections.

Cecum

Radiographic manifestations of bone marrow transplantation in children.

Radiographically detectable complications in 35 children after bone marrow transplant are reviewed. These complications are most frequently due to infection, chemoradiotherapeutic toxicity, and graft versus host disease (a transplant rejection phenomenon peculiar to bone marrow transplant patients). The pulmonary complications within the first 2 months are secondary to a form of interstitial lung disease. Interstitial lung disease has a strong correlation with graft versus host disease. Extrapulmonary visceral complications include hepatosplenomegaly, nephromegaly, and hemorrhagic cystitis. These are due to graft versus host disease, radiation, and chemotherapeutic toxicities, respectively. Sinusitis, cerebral atrophy, and intracerebral hematomas are less frequent complications. Osteoporosis due to steroids is the single most important osseous complication.

Adolescent

Lateral wall of the olfactory fossa in determining intracranial extension of sinus carcinomas.

The role of plain skull radiography and pluridirectional tomography in determining anterior cranial fossa extension of paranasal sinus tumors is reassessed. The lateral wall of the olfactory fossa, a thin bony plate forming part of the roof of the ethmoid sinuses, is routinely visualized on plain skull radiography and pluridirectional tomography in the coronal plane and serves as an indicator of intracranial tumor extension. In a series of 47 patients with paranasal sinus tumors, 100% true positive and 3% false negative interpretations of the integrity of the lateral wall of the olfactory fossa were made with pluridirectional tomography. Interpretations with plain skull radiography were 90% true positive and 3% false negative. Assessment of the integrity of the lateral wall of the olfactory fossa by these techniques provides an accurate evaluation of the presence of intracranial tumor extension by this route. Computed tomography in the coronal plane with contrast infusion is a useful adjunct.

Adult

Osteogenic sarcoma after retinoblastoma radiotherapy.

Development of osteogenic sarcoma after retinoblastoma radiotherapy in three patients, two of whom were siblings, is reported. Pluridirectional tomography and plain skull radiography demonstrated soft tissue masses, sinus opacification, and bone destruction and sclerosis in all three patients. Computed tomography reliably indicated the presence or absence of intracranial tumor extension in the two patients in whom it was performed. Radionuclide bone scanning was a useful adjunct for osteosarcomatous detection.

Eye Neoplasms

Thymoma metastatic to bone.

A patient with thymoma metastatic to bone is presented. The case differs radiographically and pathologically from one previously reported case in which the diagnosis was made during life. The diagnosis was obtained by percutaneous needle biopsy under fluoroscopic control.

Aged

Sjogren syndrome presenting as pulmonary pseudolymphoma: report of a case.

A case of pulmonary pseudolymphoma and Sjogren syndrome is presented. Unusually, the lung involvement preceded the salivary disease by more than two years. The initial gammopathy and abnormal serologies are more consistent with uncomplicated Sjogren syndrome, but were present when the pseudolymphoma was solely apparent.

Adult