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Biomedical subjects

N D Hawass

Publications and source records attributed to N D Hawass.

16 recordsLinked to original sources

Symmetrical lesions in the basal ganglia.

Bilateral and symmetrical non-space occupying lesions in the basal ganglia of 27 cases were studied. Nine cases had low attenuation lesions while the remaining 18 had high attenuation lesions due to bleeding or calcifications. The clinical presentations and final diagnosis were collated and related to these changes. In the low-attentuation cases, definite hypoxic-ischaemic insults were the aetiological basis for low attenuation lesions in 3 cases; and hypothesised to be the basis in the remaining six. Amongst the high attenuation group, bleeding was noted in 4 cases with trauma or cardiac arrest. The remainder had calcifications. It is suggested that a hypoxic-ischaemic pathophysiological phenomenon might have also accounted for some of these calcifications. The co-existence of both low and high attenuation lesions in the same patients in some of our cases tends to lend credence to this hypothesis.

Adult↗

Foetal hepatic calcification.

Thirty-three cases of 1,500 spontaneously-aborted foetuses showed hepatic calcifications. The exact location of these calcifications were confirmed by contrast studies, anatomic dissection, and further histology when necessary. Of them, 18 were calcified hepatic vein thrombi (CHVT), 12 were calcified portal vein thrombi (CPVT), 2 were parenchymal calcifications, and one was mixed. Associated anomalies were high (85% of cases). No significant difference was found between the type and percentage of anomalies of those with CHVT and those with CPVT. The most common anomalies encountered in all cases were meconium intraluminal calcification (27%), cystic hygroma (18%), and metaphyseal defect (18%). In view of this, it is suggested that a variety of severe foetal illnesses predispose to CHVT and CPVT. At correlation with maternal factors, it was found that the highest incidence was in the third decade. A significant high percentage of mothers (33%) had been on contraceptive pills, and there was interesting inverse relationship of hepatic calcification with gravidity. Practically, it is also hoped that the awareness of the presence of various types of hepatic calcifications will help in their detection prenatally by ultrasound.

Abortion, Spontaneous↗

Horseshoe lung: differential diagnosis.

A detailed radiologic and anatomic study of one horseshoe lung syndrome has already been published from this centre. A further case of horseshoe lung, which was also diagnosed prospectively by radiology, is described. Alongside, this is a set of a group of three conditions: we describe a right accessory lung with a peculiar feeding arterial branch originating from the left basal pulmonary artery. The bronchogram and oesophagogram of this case were normal. The other is a case of bridging bronchus where the left lower lobe bronchus originates from the right main stem bronchus. This was discovered at post mortem bronchogram performed on a 19 weeks foetus. Finally, in the dog, we found that the pulmonary angiogram and bronchogram display close similarity to human horseshoe lung though the dog has two separate lungs. The common denominator of all above cases is the presence of a pulmonary arterial branch or bronchus crossing the midline from the ipsi to the contralateral side. Therefore, it may be concluded "in contradiction to the common belief" that pulmonary angiography or bronchography alone is not sufficient for the diagnosis of horseshoe lung. When only one of these investigations is available, computerized tomography is necessary to show the isthmic lung tissue before the diagnosis of horseshoe lung is confirmed.

Animals↗

Intrathoracic kidneys: report of 6 cases and a review of the literature.

Six cases of intrathoracic kidneys are reported: 1 bilateral; 1 on the right and associated with dextrocardia and possible right lung hypoplasia; the other 3 cases being on the left. Only 1 case on the left presented with symptoms that could be attributed to the intrathoracic kidney. The clinical features, associated anomalies, and diagnostic methods are discussed. Our cases include the 3rd case to be diagnosed by computerized tomography, the 4th case of bilateral intrathoracic kidneys and the 2nd case to be associated with dextrocardia.

Adult↗

Concomitant pulmonary arteriovenous and inferior vena cava malformations. A case report.

A case of pulmonary arterio-venous malformation (AVM) presenting with dyspnoea diagnosed by computer tomography (CT) and pulmonary angiography is reported. Venous anomalies in the form of agenesis of the iliac veins and the inferior vena cava (IVC), were discovered through femoral venograms performed after technical difficulties were encountered at pulmonary angiography performed via the femoral route. These venous anomalies co-existed with normal but dilated azygos and hemiazygos systems, and with the azygos appearing as a right hilar mass lesion which showed the "candy cane sign" on the lateral view on venography. A dilated varix at the confluence of the right renal vein and the IVC collaterals was also noted. This association of a pulmonary AVM and IVC agenesis has not been previously reported in the literature. The embryogenesis of the inferior vena cava and the azygos system is presented in an attempt to explain the rare association of these anomalies. The various techniques of diagnosing the disease entities, especially by CT, are discussed. The rare co-existence of pulmonary AVM and the absence of the IVC is emphasized.

Aged↗

Osteopetrosis: some unusual radiological features with a short review.

The radiological features of 27 cases of osteopetrosis were analysed retrospectively. The common features of generalized sclerosis of bones; with metaphyses showing characteristic widening, multiple transverse striations, cortical thickening and medullary calcifications as well as fractures, are seen in most cases. In addition to these changes, a number of rare features of osteopetrosis are seen, viz: medial and symmetrical metaphyseal cortical defects in the long bones (5 cases), excessive diaphyseal radiodense periosteal new bone formation (5 cases), bone-in-bone appearances (5 cases), and the presence of intracerebral and meningeal calcifications in 7 cases. The significance of these intracranial calcifications as a component of a particular autosomal recessive syndrome in which renal tubular acidosis and carbonic anhydrase II deficiency may co-exist, is discussed.

Bone and Bones↗

Lumbosacral plexus avulsion injury: clinical, myelographic and computerized tomographic features.

A rare case of lumbosacral plexus avulsion studied with computerized tomography (CT) in a 5-year old Saudi involved in a vehicular accident with resultant left lower limb monoparesis is presented. Myelography and CT were superior to electromyographic findings in this case. Such cases should be closely followed and surgical exploration and decompression offered if any evidence of cauda equina compression develops.

Child, Preschool↗

Ultrasound findings in childhood chronic liver parenchymal diseases. An analysis of 41 patients.

Forty-one children with liver disease were studied by ultrasound scan at King Khalid University Hospital, Riyadh, Saudi Arabia. Diagnoses were confirmed either by liver biopsy or specific laboratory tests. Sonograms were studied for liver size, beam penetration, echogenicity, vascularity, and biliary tree abnormalities. Different liver diseases, such as chronic hepatitis, biliary cirrhosis, Wilson's disease, familial idiopathic cirrhosis, type III glycogen storage disease, and secondary haemochromatosis revealed non-specific disease patterns. Four cases of biliary cirrhosis and two cases of glycogen storage disease showed periportal fibrosis. Two cases of familial idiopathic cirrhosis and a case of Wilson's disease revealed thickening of the gall bladder wall, which has not been described in the literature.

Adolescent↗

An association between 'desert lung' and cataract--a new syndrome.

Sixteen cases of desert lung with cataracts were previously reported on, and an additional 14 cases have now been encountered from the same area of which 13 had cataracts. The association of cataract with desert lung was not commented on in the previous report, because it was thought to be coincidental. It now appears to be real rather than coincidental. Analysis of these 33 patients showed the following: none had significant clinical signs; x-ray findings were mainly those of micronodular miliary infiltrates; 88% were found to have cataracts; 85% were females. The frequency of cataract among patients over the age of 50 years coming to the hospital for eye problems was 26%. These figures showed a distinct relationship between desert lung and cataract in the Arabian desert. The causal relationship is not as yet clear, but 'tandoor' baking is suggested as the main factor.

Aged↗

Case report of intraspinal lipoma.

The clinical diagnosis of intramedullary lipoma, an uncommon cause of spinal cord compression, is difficult pre-operatively. The lesion may mimic any cause of spinal cord compression including malignancy. The distinction from these other disease processes is so important regarding the prognosis. We report here such a case unsuspected pre-operatively and review the management, especially the possible role of computerized tomography (CT), in the diagnostic work-up prior to surgery.

Adult↗

Ultrasonographic diagnosis of schistosomal periportal fibrosis.

Hepatosplenic schistosomiasis results from infestation by Schistosoma mansoni, a blood fluke. Presinusoidal periportal fibrosis is invariably the result of this infestation. The ultrasonic pattern of schistosomal periportal fibrosis in 22 patients in whom schistosomal hepatic involvement was proven histologically is described. Echogenic areas of pipestem fibrosis seen as tubular shadows, some containing central lucencies, were present in every case. These tubular shadows conformed to the structure of the portal veins, producing a characteristic appearance. In endemic areas this appearance may be the only clue to the diagnosis of hepatosplenic schistosomiasis, because patients may remain asymptomatic for years after the onset of the disease.

Adolescent↗

False negative sonographic finding in emphysematous cholecystitis.

Two patients presented with fever and acute abdominal pain. Acute cholecystitis was diagnosed when ultrasound examination showed a double-contour gallbladder wall. Radiography showed gas in the gallbladder wall in both cases, indicating emphysematous cholecystitis. This demonstrated that gas in the gallbladder wall may go undetected by ultrasound at the time when it could still be detected by conventional radiography of the abdomen. Awareness of the value of conventional radiography in these cases has an important diagnostic significance which may affect patient management.

Acute Disease↗

Horseshoe lung with multiple congenital anomalies. Case report and review of the literature.

A detailed radiologic and anatomic study of a 20-week-old fetus is presented. In addition to conventional radiography, various contrast medium injection techniques were used. The findings were followed up at autopsy. The fetus showed multiple congenital abnormalities comprising phocomelia, horseshoe lung, horseshoe kidney, urethral stenosis with megacystis, bilateral hydronephrosis, hydroureters, imperforate anus, and a single tracheo-esophageal tube (persistent esophago-trachea). The association of horseshoe lung with persistent esophago-trachea, microurethra, megacystis, bilateral hydroureters, hydronephrosis and phocomelia is, we believe, the first ever to have been recorded in the literature. Twenty-one cases of horseshoe lung have been reported in the literature. These cases were reviewed and a comparison with the present case is presented. The embryologic basis for these anomalies is also briefly discussed.

Abnormalities, Multiple↗

Myelographic study of the spinal cord ascent during fetal development.

To assess the length of the spinal cord relative to the vertebral column during fetal development, we performed translumbar myelograms on 340 spontaneously aborted fetuses. Of these, 146 were selected for study. There were 76 males and 70 females, with fetal age ranging from 7 to 33 weeks. Significant variation in the level of spinal cord termination was found in fetuses between 12 and 25 weeks gestational age. In fetuses between 25 and 33 weeks gestational age, the cord ended at or above the third lumbar vertebra.

Embryonic and Fetal Development↗