High-resolution computed tomography findings in adult pulmonary tuberculosis: pictorial essay.
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Biomedical subjects
Publications and source records attributed to S A Merchant.
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In pancreatitis the involvement of adjacent vessels resulting in pseudoaneurysm formation is well known, though quite rare (Gadacz 1978, Kadell & Riley 1967). The diagnosis is usually established on angiography or surgery. We report here a case where the diagnosis of a splenic artery pseudoaneurysm incorporated within an infected pseudocyst, was made sonographically.
A case of ureteric obstruction in renal hydatid disease is reported. This unusual complication possibly occurred following surgery. To the best of our knowledge, this has not been previously reported.
Ultrasonography (US) remains underutilized as a guidance tool for performing fine needle aspiration cytology (FNAC) mainly because of a lack of understanding and experience in this technique. We describe here our experience in performing 346 FNACs. In our opinion, US guided FNACs are highly accurate and safe procedures which can be done on an out-patient basis, with routinely available equipment.
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The authors report two cases of congenital ureteral valves that were diagnosed preoperatively in adults. The radiologic, operative and histologic findings are described. A short review of the available literature is also presented. The importance of a confident radiologic diagnosis of this congenital anomaly is emphasized.
We consistently observed small "reflective channels" (RCs) in the splenic parenchyma in patients with portal hypertension (PHT). The purpose of this study was to investigate the frequency of this sign in PHT and in splenic disorders unrelated to PHT compared to normal controls. The significance of this sign in the diagnosis of PHT and in differentiating PHT splenomegalies from others was also assessed. A total of 337 patients underwent sonographic examination of the spleen: 147 normal, 75 non-PHT splenic pathologies, and 115 with PHT. The RCs were scored from grade 0 to 3 by counting the number in an area of 12 mm2 in the splenic parenchyma. Of 222 normal and non-PHT spleens, 174 (78%) showed grade 0, 44 (20%) grade 1, four grade 2 (1%), and none showed grade 3 RCs. Of 115 PHT cases, 17 showed grade 0, 25 grade 1, 44 grade 2, and 29 showed grade 3 RCs. The sensitivity of this sign was 0.85 with a specificity of 0.77 and an accuracy of 0.80 in detecting PHT (p < 0.001). The interobserver and intraobserver variation for grading was insignificant (p > 0.1). The RCs could be explained by periarterial fibrosis and dilatation of venous sinuses with increased collagen in their walls, which is known to occur in PHT. The vascular nature on ultrasound (US) was confirmed by the presence of flow on color Doppler. This sign is readily differentiated from the calcifications of tuberculosis, histoplasmosis, sickle cell infarcts, and phleboliths; it serves as a useful aid in diagnosing and differentiating PHT splenomegaly from non-PHT splenomegaly.
The computed tomographic (CT) appearance of chylous ascites is usually that of water with corresponding attenuation coefficients. This case report depicts the fat-fluid level sign on CT (shown by supine and decubitus scans), which is pathognomonic of chylous ascites.
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Selective Beta Blocker Tenolol (IPCA) 50 mg. (A50) and 100 mg. (A100) single dose drug therapy was tried in 25 cases of angina pectoris. Hypertensives were excluded from trial. There were 4 diabetics. Drug trial over a period of 4 weeks revealed subjective and objective improvement with A50 and A100 assessed at the end of 2 and 4 weeks. The average angina attacks/2 wks. was 13.12 +/- 11.26 in basal state whereas the reduction in angina attacks was 6.285 +/- 8.80 with Tenolol 50 mg. and 3.72 +/- 2.86 with 100 mg which was statistically significant. Objective assessment of each patient done by Computerised Stress Test (CST) at the end of 2 and 4 weeks of Tenolol 50 mg and 100 mg revealed statistically significant improvement in their ST depression i.e. 3.645 +/- 1.463 mm basal ST depression, 1.692 +/- 1.680 after Tenolol 50 mg and 2.318 +/- 1.270 after Tenolol 100 mg. There was statistically significant fall in systolic BP (SBP) and double product (DP) both with A50 and 100 mg. Only one patient had slow ventricular tachycardia and mild hypotension during CST.
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