Findings on computed tomography of the chest in lymphangiomyomatosis.
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Biomedical subjects
Publications and source records attributed to T Horwitz.
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A confusing early "benign" appearance which preceded subsequent radiographic progression of a case of massive osteolysis is presented. Proof of Gorham's disease was obtained by open biopsy of the left femur in this 21-year-old woman who presented with an unusual cortical lesion in the femoral shaft. The lesion initially was subtle in its radiological features but progressed considerably over a 2-year period before biopsy was undertaken.
Wegener's granulomatosis is a rare disease in children, with only 37 previous cases described in the literature. We report two new cases, one in an 11-year-old child who presented with cavitating nodules in the right upper lung field as well as a maxillary sinusitis and nasal perforation, and the other in a 16-year-old female who initially presented with a purulent maxillary sinusitis and only later developed an orbital pseudotumour.
A study was made of 52 patients with Haemophilus influenzae type B meningitis complicated by subdural collections of fluid to determine which of these collections were sterile (effusions) and which infected (empyema). This differentiation is important for the treatment which differs in the two conditions. Cranial computed tomography (CT) alone was not as reliable as the combination of CT associated with detection of Haemophilus influenzae capsular antigen, in accurately predicting if a subdural fluid collection was infected, or had a high probability of becoming infected.
Spinal cord involvement by Schistosomiasis is considered to be rare. We report a case of acute transverse myelitis due to Schistosoma mansoni in which treatment with praziquantal and steroids was started three days after the onset of a paraparesis, with complete neurological recovery.
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Peritoneoscopy was used to evaluate the liver in 35 previously untreated patients with Hodgkin disease. Four were found to have hepatic involvement. Of the 31 patients with normal peritoneoscopies, only one had liver disease demonstrated subsequently at confirmatory exploratory laparotomy. The diagnostic accuracy of peritoneoscopy was 93% for patients at high risk for hepatic disease and 97% for all patients studied. Morbidity from the procedure was minimal. There was no mortality. Peritoneoscopy is a highly accurate staging procedure that should be considered as an antecedent or as an alternative to laparotomy in patients with Hodgkin disease. Its accuracy and minimal morbidity should be considered in the critical selection process of determining which individuals should undergo laparotomy.
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The loss to continued follow-up of 25 of the 50 patients with chronic osteomyelitis complicating fractures who were treated surgically during the period January 1969 to December 1971 as previously reported, compromises the value of even a 6-year follow-up study. The group of patients lost to follow-up had dry asymptomatic wounds when last examined. However, late recurrence of drainage in 4 patients with dry healed wounds for as long as 15 to 36 months (Procedure 1 in 3, Procedure 2 in 1) demonstrates the uncertainty of the end results of even the most exacting techniques and appropriate antibiotics for the treatment of chronic osteomyelitis.