Anatomical Shape of the Airways in Two Different European Populations

Lateral radiographs of the airways were taken in 20 men and 24 women lying supine with the neck in the normal position. The mean configuration of the airways for men and women is presented in a standard coordinate system. The results (contours of the airways) are compared to those of a Swedish study since the same method was applied in order to find out, if the established model is valid for other populations. Significant differences were found between the two population groups as well as between males and females. This indicates both inter-racial and inter-sexual modification of the anatomical shape of the airways.

Asthmatic bronchitis for 2 years: A case report

Longstanding asthmatic bronchitis, without evidence of underlying disease, occurring in middle-aged patients, is usually attributed to chronic obstructive pulmonary disease and is treated appropriately.

We report a case of 2-year asthmatic bronchitis with recurrent attacks of wheezing, in a 60-year-old patient. He had three repeated hospitalizations, in different institutions, where he was treated for exacerbations of chronic bronchitis complicated by lower respiratory tract infections. During his final hospitalization, a tracheal hamartoma was found and removed, releasing him from his symptoms.

Male-female differences in the risk of tuberculosis in dialysis patients

AIM

To define any gender-related differences in the prevalence and risk for tuberculosis (TB) in hemodialysis (HD) patients.

METHODS

All active TB cases were recorded during a 36-month follow-up of 272 (193 male and 79 female) HD patients. Entering the study, HD patients were tested with tuberculin and 2,4-dinitrochlorobenzene, and a cell-mediated immunity (CMI) index was estimated. Relative risks (RR) for TB were calculated considering subjects from the background general population as a reference group. The independent effect of age, BMI and tuberculin sensitivity was determined using Cox's proportional hazard model.

RESULTS

Female HD patients presented significantly lower CMI indices and rates of positive Mantoux tests, but higher rates of DM, as compared to males. The male:female ratio in TB for the general and HD patients population was 1.8 and 0.6, respectively. There was a significantly lower TB prevalence in male as compared to female HD patients (7.7% vs. 11.3%), and a subsequent female predominance in risk for TB in those HD patients aged <49 and 50-69 years (M:F adjusted relative risk 0.67 and 0.53) was recorded.

CONCLUSIONS

In contrast to the general population, there is a female predominance among dialysis TB patients younger than 70 years associated with the coexistence of DM. Female gender should always be considered as a risk factor when evaluating diabetic HD patients for active TB.

Cystic thymoma coexisting with vascular dysplasia

We report the case of a 23-year-old female patient, who was admitted to our hospital because of aggravating pain in the right shoulder, right chest and ear accompanied by cough and dyspnea. Imaging revealed a soft tissue mass in the mediastinum in close relation with an additional large mass extending in the right upper thorax, right axilla and neck. The tissue obtained during surgery showed the former mass to be a cystic thymoma, being in contact with an extensive vascular dysplasia. The characteristic clinical presentation, the contribution of imaging, the results of operation, and the follow-up are rather unique. The review of the literature did not reveal similar cases.

Risk of tuberculosis in dialysis patients: association of tuberculin and 2,4-dinitrochlorobenzene reactivity with risk of tuberculosis

BACKGROUND

Dialysis patients are at increased risk of tuberculosis (TB) and anergy due to attenuated cellular immunity.

AIM

To define specific risks of TB in anergic and non-anergic dialysis patients.

METHODS

A total of 272 dialysis patients were enrolled in this prospective study over a 36-month follow-up. Entering the study, participants had Mantoux and 2,4-dinitrochlorobenzene skin tests and their cell-mediated immunity (CMI)-index was estimated. Patients were classified as anergic (CMI-index<or=2 and Mantoux<or=4 mm) or non-anergic. Specific relative risks of TB were then calculated, using data from both the general population and 49 non-uremic health care workers. The independent effect of sex, age and diabetes mellitus was determined using Cox's proportional hazard method.

RESULTS

Among the 116 (42.6%) anergics 13 (11.2%), and among the 156 non-anergics 11 (7%) developed active tuberculosis. Anergics had a significantly higher risk of TB than non-anergics (Adjusted Relative Risks, 98.3, 95% CI 58.65-113.6 versus 61.6, 95% CI 13.6-72.1, P=0.003). Tuberculin reactivity was weakly associated with the subsequent risk of TB (r=0.51). The latter showed a steadily decreasing trend with increasing CMI-index (r=-0.99).

CONCLUSION

Anergy distorts the association of tuberculin reactivity with risk of TB. Anergic dialysis patients are at increased risk of developing active TB and chemoprophylaxis is justified in them too.

Spinocerebellar ataxia and hypergonadotropic hypogonadism associated with familial sensorineural hearing loss

Cerebellar ataxia has been described as being associated with hypogonadism for almost 100 years. In the majority of cases, hypogonadism is hypogonadotropic. The association of cerebellar ataxia with hypergonadotropic hypogonadism is a rare genetic disorder with a recessive mode of inheritance. Cerebellar ataxia and hypogonadism can also occur associated with a large spectrum of additional clinical manfestations, including mental retardation, sensorineural deafness, choroidal dystrophy, ectodermal dysplasia and short stature, and polyneuropathy. We report the case of a woman with early-onset spinocerebellar ataxia, primary amenorrhea due to hypergonadotropic hypogonadism, and late-onset sensorineural hearing loss. Additional family members from the father's side are affected with late-onset hearing loss, suggesting a dominant mode of inheritance.

An asymptomatic pulmonary hilar mass: a case report

Pulmonary vein varix is a rare benign abnormality, either congenital or acquired, usually presented without symptoms. It is most frequently discovered by chance on a chest radiograph, whereas computed tomography defines the special characteristics of the lesion. Angiography is considered the method of choice for final diagnosis. The authors present the first case of a patient with pulmonary vein varix accompanied by interatrial communication.

Asthmatic bronchitis for 2 years. A case report

Longstanding asthmatic bronchitis, without evidence of underlying disease, occurring in middle-aged patients, is usually attributed to chronic obstructive pulmonary disease and is treated appropriately. We report a case of 2-year asthmatic bronchitis with recurrent attacks of wheezing, in a 60-year-old patient. He had three repeated hospitalizations, in different institutions, where he was treated for exacerbations of chronic bronchitis complicated by lower respiratory tract infections. During his final hospitalization, a tracheal hamartoma was found and removed, releasing him from his symptoms.

Ovulation induction with pulsatile gonadotropin-releasing hormone (GnRH) or gonadotropins in a case of hypothalamic amenorrhea and diabetes insipidus

Hypothalamic amenorrhea is a treatable cause of infertility. Our patient was presented with secondary amenorrhea and diabetes insipidus. Cortisol and prolactin responded normally to a combined insulin tolerance test (ITT) and thyrotropin-releasing hormone (TRH) challenge, while thyroid-stimulating hormone (TSH) response to TRH was diminished, and no response of growth hormone to ITT was detected. Both luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels increased following gonadotropin-releasing hormone (GnRH) challenge. No response of LH to clomiphene citrate challenge was detected. Magnetic resonance imaging findings demonstrated a midline mass occupying the inferior hypothalamus, with posterior lobe not visible and thickened pituitary stalk. Ovulation induction was carried out first with combined human menopausal gonadotropins (hMG/LH/FSH) (150 IU/day) and afterwards with pulsatile GnRH (150 ng/kg/pulse). Ovulation was achieved with both pulsatile GnRH and combine gonadotropin therapy. Slightly better results were achieved with the pulsatile GnRH treatment.

Infantile hemangioendothelioma. A case report

The case of a 3-month-old boy with a hepatic infantile hemangioendothelioma is reported. There was no previous history of disease and no symptoms, only an incidentally found abdominal mass. The case is presented as an example of establishing the diagnosis, deciding upon the treatment, and performing the follow-up using only non-invasive imaging techniques.

Diaphragmatic haemangioma. A case report

The case of a 4-year-old patient with a diaphragmatic haemangioma is reported. There were no symptoms and the only clinical finding was prominent subcutaneous vessels on the abdominal wall. The lesion was revealed by imaging and was excised. The findings and the differential diagnosis are discussed.

Milk of calcium cysts masquerading as renal calculi

Milk of calcium renal cysts contain a colloidal suspension of calcium crystals. By routine radiography and sonography in supine position this rare condition may be misinterpreted as renal lithiasis for which an unnecessary surgical intervention may be performed as it happened in our two cases that are presented here. Postoperatively, the characteristic finding of half-moon contour on upright abdominal plain views was lacking in one case, but in both cases computed tomography revealed the typical calcific suspension layering. However, upright plain views and computed tomography are not routinely performed in patients in whom a renal stone has initially been considered. This entity should be considered in the differential diagnosis of renal paracalyceal calcifications of obscured origin.

Anatomical variations of the human vestibular aqueduct. Part II. A radioanatomical study

The human vestibular aqueducts are classified into 3 types and into the types hyper-, normo- and hypoplastic. The types correspond with each other up to over 85%. For a better understanding of the radioanatomy and for the proper interpretation of radiograms, we describe the presence of a flat recess-like widening of the peripheral portion of the aqueduct, as well as other findings.

Anatomical shape of the airways in two different European populations. A radio-anatomical study of the airways

Lateral radiographs of the airways were taken in 20 men and 24 women lying supine with the neck in the normal position. The mean configuration of the airways for men and women is presented in a standard coordinate system. The results (contours of the airways) are compared to those of a Swedish study since the same method was applied in order to find out, if the established model is valid for other populations. Significant differences were found between the two population groups as well as between males and females. This indicates both inter-racial and inter-sexual modification of the anatomical shape of the airways.

Dual-energy X-ray absorptiometry in rheumatoid arthritis: comparison between axial and appendicular skeleton findings

Bone mineral density was measured by dual-energy x-ray absorptiometry (DXA) at the lumbar spine, both hips and distal radius in 10 postmenopausal patients with rheumatoid arthritis (RA). DXA values at the lumbar spine and distal radius were compatible with osteoporosis in all but 1 patient. Only 4 patients had osteoporosis of the hip, and 3 of these were over 65. Preliminary results over this small population suggest that in RA a correlation may be expected between DXA values in lumbar spine and distal radius, but not between either of these and the hip.

False aneurysm of splanchnic arteries--a scintigraphic pitfall

A 99mTc-DTPA flow study fo the abdominal aorta in a 56-year old woman gave a false-positive image of an aneurysm at the site of the celiac axis or superior mesenteric artery.

[Diagnostic and therapeutic problems in the treatment of tumors of the epiphyseal region of the brain]

The case is described of a 17 year-old male, who was treated because of a large tumour in the region of the pineal gland. The diagnostic and therapeutic problems are presented and discussed.