Lung Abscess

Lung abscess was successfully treated with percutaneous drainage in 5 of 6 patients. Complete abscess resolution occurred in 4 patients, partial resolution in one, and no response in one. The duration of drainage ranged from 7 to 18 days (mean 15.5 days) in successful cases. The failure of drainage in one neurologically impaired patient was attributed to persistent aspiration. In 2 patients, concurrent pleural empyema was also cured. CT provided the anatomic details necessary for choosing the puncture site and avoiding puncture of the lung parenchyma. Percutaneous catheter drainage is a safe and effective method for treating lung abscess.

An experimental model of ischemia in rabbit hindlimb

This study was performed to establish an experimental model of ischemia for the investigation of new treatment modality of limb-threatening ischemia. We produced ischemia in the hindlimbs of 8 New Zealand white rabbits. Under general anesthesia, the left femoral artery was exposed, freed, and excised from distal external iliac artery to proximal popliteal and saphenous arteries. And then both hindlimbs were serially examined to assess the ischemia according to the time table until postoperative 6 weeks. We assessed clinical observation, blood pressure, radioisotopic perfusion scan, and angiography. Clinical ischemic changes of the operated feet were observed in 63%. The blood pressure of left calves was measurable on postoperative day 3 (p<0.05, vs preoperative day 2) and then gradually increased to reach a plateau in postoperative week 6. Radioisotopic arterial perfusion showed similar profiles as in blood pressure. Angiography of ischemic hindlimbs demonstrated a few collateral vessels arising from the internal iliac artery with the reconstitution of the posterior tibial artery in postoperative week 2. In postoperative week 6, collaterals remained the same in number. However, these became dilated and tortuous and showed reconstitution in distal hindleg. In conclusion, this is a reproducible, measurable, and economical animal model of hind limb ischemia.

Whole-body and pinhole bone scintigraphic manifestations of Reiter's syndrome: distribution patterns and early and characteristic signs

The characteristic whole-body and pinhole scintigraphic manifestations of osteo-enthesopathy and arthropathy in Reiter's syndrome (RS) are described, with an emphasis on early diagnosis. We analysed 59 sets of whole-body and pinhole bone scintigrams of 59 patients with RS. The population comprised 47 men and 12 women with an age range from 15 to 53 years (mean=29.4). Bone scintigraphy was carried out 2-2.5 h after intravenous injection of technetium-99m hydroxydiphosphonate using a single-head gamma camera (Siemens Orbiter Model 6601) with a low-energy high-resolution and a 4-mm pinhole collimator for whole-body and pinhole scintigraphy, respectively. In total 262 lesions of osteo-enthesopathy and arthritis were detected on 59 whole-body scintigrams, an incidence of 4.4 lesions per patient. As anticipated, the lesional distribution was asymmetrical: 68% were in the lower limb skeleton and 32% in the axial and upper limb skeleton. Pinhole bone scintigraphy, applied selectively to one region of interest in each case, enabled us to accurately diagnose arthritis and osteo-enthesopathy. It was noteworthy that osteo-enthesopathy, alone or in combination with arthritis, occurred in 78.9%, and had a strong predilection for the foot bones, especially the calcaneus (25. 6%). Pinhole scintigraphy detected enthesopathy in the absence of radiographic alteration in 14.1% of cases and portrayed characteristic signs of RS in 6.9%. Whole-body bone scintigraphy augmented with pinhole scintigraphy was found to be useful in order to panoramically display the systemic involvement pattern, to assess the characteristic bone and articular alterations and to detect early signs of RS.

Dual-head pinhole bone scintigraphy

This article describes dual-head pinhole bone scintigraphy (DHPBS), which makes use of two opposing pinhole-collimated detectors to obtain one pair of magnified images of bone and joint at one time. The aims are to reduce scan time and solve the problem of the blind zone that is created in the background in single-head pinhole bone scintigraphy.

METHODS

DHPBS was used for normal hip and knee joints and one case each of lumbar spondylosis, vertebral compression fracture and pyoankle. The gamma camera used was a digital dual-head SPECT camera (Sopha Camera DST; Sopha Medical Vision International, Buc Cedex, France) connected to an XT data processor and a printer. Each of two opposing detectors was collimated with either a 3- or 5-mm pinhole collimator. The scan was performed 2-3 hr postinjection of 12-25 mCi 99mTc-oxidronate. Some 1500-2000 Kilocounts were accumulated at 15-40 min per pair. Anterior and posterior views were taken for the spine and hip and medial and lateral views for the knee and ankle. DHPBS images were correlated to radiographs.

RESULTS

DHPBS produced a pair of high-resolution bone and joint images at one time, reducing scan time by nearly half for each image. The paired DHPBS images clearly visualized both foreground and background objects, which effectively eliminated the blind zone.

CONCLUSION

DHPBS can significantly improve efficiency and diagnostic acumen.

Pinhole SPECT imaging in normal and morbid ankles

Pinhole SPECT can generate sectional nuclear images of a normal and morbid ankle and hindfoot with remarkably enhanced resolution by portraying the topography and pathological alterations in great detail.

METHODS

Pinhole SPECT was performed using a commercially available single-head, rotating gamma camera system by replacing the parallel-hole collimator used for planar SPECT with a pinhole collimator. The images were reconstructed in the same way as in planar SPECT by using the filtered back-projection algorithm and a Butterworth filter. First, we compared the scan resolution between the planar and pinhole SPECT images of a thyroid phantom and a normal ankle and hindfoot by working out pinhole SPECT anatomy with CT validation. Second, the clinical usefulness was assessed in one case each of fracture, reflex sympathetic dystrophy syndrome and rheumatoid arthritis of the ankle with radiographic correlation. The resolution of the pinhole SPECT and planar pinhole images was compared for these diseases.

RESULTS

The resolution of the pinhole SPECT of a thyroid phantom and of a normal ankle and hindfoot was significantly enhanced compared to the planar SPECT although image distortion was seen in the periphery of the field-of-view. The pinhole SPECT resolution was such that most of the anatomical landmarks were sharply delineated in the ankle and hindfoot and some useful diagnostic signs in the diseased ankle were visible.

CONCLUSION

Pinhole SPECT can be performed using a single-head gamma camera system and filtered back-projection algorithm. It generates sectional scan images of both normal and morbid ankle and hindfoot with enhanced resolution portraying many anatomical landmarks and pathological signs in useful detail.

Prestenotic bronchial radioaerosol deposition: a new ventilation scan sign of bronchial obstruction

This study was performed to assess the diagnostic usefulness of aerosol ventilation scanning in bronchial obstruction and bronchial stenosis.

METHODS

Seven patients of bronchial obstruction and one patient with stenosis were studied. In each patient, obstruction was confirmed by bronchography, bronchoscopy and/or CT scan. Ventilation scanning was performed using the 99mTc-phytate aerosol generated by a BARC jet nebulizer. Scan manifestations were assessed in correlation with those of plain chest radiography, bronchography, CT scan and/or bronchoscopy.

RESULTS

In every patient, the ventilation scan showed characteristic intense aerosol deposition in a short, slightly dilated, clubbed, bronchial segment immediately proximal to obstruction or stenosis. Typically, it was accompanied by a distal airspace deposition defect.

CONCLUSION

Intense, segmental, bronchial aerosol deposition with distal lung defect was a specific finding of bronchial obstruction and stenosis. The sign was especially useful when obstruction was obscured by the associated, bizarre lung disease and in a small bronchus.

Computer-aided design optimization with the use of a fast dose model for linear-accelerator-based stereotactic radiosurgery

In order to efficiently plan non-spherical radiosurgical targets we have used computer-aided design optimization techniques with a fast dose model. A study of the spatial dose distribution for single or multiple non-coplanar arcs was carried out using a 18 cm diameter spherical head model. The dose distribution generated from the 3D dose computation algorithm can be represented by a simple analytic form. Two analytic dose models were developed to represent the dose for preset multiple non-coplanar arcs or a single arc: spherical and cylindrical. The spherical and cylindrical dose models compute dose quickly for each isocentre and single arc. Our approach then utilizes a computer-aided design optimization (CAD) with the use of two fast approximate dose models to determine the positions of isocentres and arcs. The implementation of CAD with fast dose models was demonstrated. While the fast dose models are only approximations of the true dose distribution, it is shown that this approximate model is sufficient to optimize isocentric position, collimator size and arc positions with CAD.

Bone pathologic correlation of multimodality imaging in Paget's disease

The pagetic bones in the active phase of the disease with brisk lysis and sclerosis manifest intense tracer uptake on planar bone and SPECT images. Intense tracer uptake, however, can occur also in infections, dysplasias and metastases. Pinhole bone scintigraphy has been shown to portray specific diagnostic signs in a number of skeletal diseases. In an effort to identify useful bone scan signs, we prospectively carried out 99mTc-oxidronate pinhole bone scintigraphy of the skull, vertebrae, ribs, humerus, sacrum and ilium in two patients with Paget's disease of the bone. The pinhole bone scintigraphy findings correlated with radiographic, CT and MRI findings and in the vertebra with the pathological study. Interestingly enough, pinhole bone scintigraphy revealed intense tracer uptake preferentially in the bone cortex and the rim of the affected bones. Thus, the cranial inner table, humeral cortex and vertebral endplates and rims were the seats of characteristic tracer uptake, respectively creating a scintigraphic version of the radiographic "cotton wool" sign, "casket" sign and "picture frame" sign. The pagetic lesions in the sacrum and ilium also showed intense cortical and rim uptake. Correlation of pinhole bone scintigraphy with radiography, CT and MRI indicated that such cortical or rim uptake is characteristic of Paget's disease.

Radioprotective effect of captopril on the mouse jejunal mucosa

PURPOSE

Captopril, an inhibitor of angiotensin I converting enzyme, has been shown to modify radiation damage and prevent radiation injury of normal tissue in rats and pigs. The present study was carried out to determine whether captopril would reduce radiation changes in the proximal small bowel in mice.

METHODS AND MATERIALS

Mice were subjected to whole body irradiation with 9 Gy or 15 Gy. Captopril was administered in drinking water at a regimen of 62.5 mg/kg/day (captopril group I) and 125 mg/kg/day (captopril group II), continuously from 7 days before irradiation to the end of each designed experiment. The jejunal damage was evaluated microscopically by crypt count per circumference and by histologic damage grading.

RESULTS

Crypt number in the sham-irradiated control was 133 +/- 6.8/circumference. In both captopril group I and II, crypt numbers and histologic scores were not significantly different from those in the normal group. The 9 Gy and 15 Gy radiation alone groups showed significantly lower crypt counts and histologic scores compared with the sham-irradiated control group (p < 0.05). The groups exposed to 9 Gy radiation plus captopril I and II showed significantly higher crypt counts and lower histologic damage scores on the third day, and lower histologic damage scores on the fifth day compared with the 9 Gy radiation alone group (p < 0.05). The 15 Gy radiation plus captopril I and II groups had significantly higher crypt counts and lower histologic damage scores on the third day than those of the 15 Gy radiation alone group (p < 0.05). All mice of the 15 Gy radiation group succumbed to intestinal radiation death.

CONCLUSION

Our results suggest that captopril provides protection from acute radiation damage to the jejunal mucosa in mice.

1H magnetic resonance spectroscopy characterization of neuronal dysfunction in drug-naive, chronic schizophrenia

RATIONALE AND OBJECTIVES

We investigated the proton metabolism of right prefrontal white matter in drug-naive, chronic schizophrenic patients (n = 23), compared with healthy normal control subjects (n = 10), by using localized, water-suppressed in vivo 1H magnetic resonance (MR) spectroscopy.

METHODS

All 1H MR spectroscopy examinations were performed on a 1.5-T MR imaging/MR spectroscopy system by using a point-resolved spectroscopy pulse sequence for localized volumes of 2 x 2 x 2 cm3. Proton metabolite ratios relative to creatine (Cr) were obtained using a Marquart algorithm.

RESULTS

Drug-naive, chronic schizophrenic patients demonstrated a decrease in the N-acetylaspartate (NAA):Cr and choline (Cho):Cr ratios and an increase of the complex of gamma-aminobutyric acid (GABA) and glutamate (Glu)-containing ratio [(GABA + Glu):Cr] as compared with normal control subjects.

CONCLUSION

Results suggest that the reduction of NAA and Cho may indicate neuronal dysfunction and that the elevation of GABA and Glu may play a role in chronic schizophrenia. 1H MR spectroscopy may be a useful modality in research and in the clinical evaluation of chronic schizophrenic patients.

Pinhole skeletal scintigraphic manifestations of Tietze's disease

Tietze's disease (TD) is a self-limited, non-specific, inflammatory condition of the upper costochondral junction (CCJ). Unlike in many other skeletal diseases, radiography plays a relatively minor role in TD because radiographic changes are frequently obscured by physiological costochondral calcifications. Bone scanning is a sensitive test for TD, but its specificity is low. The present study has been conducted to assess prospectively whether pinhole scintigraphy (PS) can enhance diagnostic specificity in TD. Both planar and PS bone images were obtained in seven ribs of five patients with TD. Scans alterations were analyzed and compared with the radiographic findings. Planar scans showed "hot" areas in the region of the CCJ in all seven ribs, these hot areas lacking textural patterns. However, the magnified PS images of the CCJ showed two characteristic uptake patterns: drumstick-like uptake in acute cases and C- or inverted C-shaped uptake in chronic cases. Radiographically, chondritic sclerosis could be seen when physiological chondral calcifications were minimal or absent, but was observed when the calcification was prominent. The correlation of PS and radiographic findings revealed that C- or inverted C-shaped uptake indeed faithfully reflected the inflammatory process in the CCJ, the medial border of which is concave. The further correlation of magnetic resonance and PS images of two lesions in one patient in whom histological examination was performed showed that C- or inverted C-shaped uptake is closely associated with hypervascularity of TD. Differential diagnosis between TD, fracture and metastasis is discussed.

Posterior lumbar apophyseal ring fractures: a report of 20 cases

Posterior apophyseal ring fracture (PARF) of the lumbar spine is an uncommon injury thought usually to occur in adolescence. We analysed CT findings in 20 cases (19 patients), whose age ranged from 16 to 45 years (average 30 years). The PARF could be divided into two distinct groups on the basis of the shape and location of the fracture and the defect of the vertebral rim. In group 1 (2 cases), PARF involved the central aspect of the inferior vertebral rim and bone fragments were large and broad-based. In group 2, PARF were located at the posterolateral margin of the superior vertebral rim and bone fragments were small and focal. The great majority of previously reported cases belonged to our group 1. A pathogenesis for each group is suggested.

Pinhole scintigraphic sign of chondromalacia patellae in older subjects: a prospective assessment with differential diagnosis

Chondromalacia patellae (CP) is an important cause of anterior knee pain. Two clinical types are known: one that typically affects young subjects and the one that affects older patients. The primary diagnostic approach is radiography reinforced with arthrography. A 99mTc-MDP bone scan is invaluable in the study of bone diseases especially when augmented with pinhole scintigraphy (PS). In this study previously unknown, specific sign of CP demonstrated by PS in six middle-aged and elderly patients is described.

METHODS

Noting an increased patellar uptake in a planar spot view, a medial PS scan of the patella was taken to detail the uptake pattern using a 3-mm or 4-mm aperture pinhole collimator. The uptake pattern was analyzed in terms of location, definition, mode, grade and other associated changes, and correlated with radiographic and CT scan alterations.

RESULTS

The planar views showed patellar uptake to be diffuse and nonlocalizing in five patients and ill-defined and spotty in the remaining patient. In contrast, PS revealed small, spotty uptake well localized in the central retropatellar facet in all but one patient in whom uptake was segmental. A control PS study of 16 patients with their patellas involved by osteoarthritis (n = 6), rheumatic arthritis (n = 5) and Reiter's syndrome (n = 5) also revealed retropatellar uptake with or without anterior patellar uptake in every patient. The CP with localized osteolysis or osteopenia accumulated tracer intensely, whereas those without showed mild to moderate uptake.

CONCLUSION

Spotty tracer uptake occurring exclusively in the central retropatellar facet without other knee joint alteration appears pathognomonic of CP in older patients.

Intussusception: characteristic radiolucencies on the abdominal radiograph

Six hundred and twenty-five sets of supine and erect abdominal radiographs of 288 patients with the confirmed diagnosis of intussusception (315 episodes) and 310 patients without intussusception were reviewed retrospectively to determine the characteristic radiographic features of intussusception. Among the patients with intussusception, 155 episodes (49%) showed a soft tissue mass and nearly half of these (71) showed characteristic radiolucencies (target, crescentic, or amorphous) in the soft tissue mass. Thirty-five episodes showed the radiolucencies on both the supine and erect radiographs; in 16 cases the type of radiolucency differed on the two films. In patients without intussusception, abnormal radiolucencies were seen in only seven cases (2.3%). Computed tomography performed prospectively in five patients showed the radiolucencies in the soft tissue mass to be intussuscepted mesenteric fat. We conclude that abnormal radiolucencies in the soft tissue mass on plain radiographs are characteristic of intussusception.

Lung abscess. Percutaneous catheter therapy

Lung abscess was successfully treated with percutaneous drainage in 5 of 6 patients. Complete abscess resolution occurred in 4 patients, partial resolution in one, and no response in one. The duration of drainage ranged from 7 to 18 days (mean 15.5 days) in successful cases. The failure of drainage in one neurologically impaired patient was attributed to persistent aspiration. In 2 patients, concurrent pleural empyema was also cured. CT provided the anatomic details necessary for choosing the puncture site and avoiding puncture of the lung parenchyma. Percutaneous catheter drainage is a safe and effective method for treating lung abscess.

Optimisation of dose distribution for linear accelerator-based stereotactic radiosurgery

The work presented in the paper addresses a method for obtaining the optimal dose distribution for LINAC-based stereotactic radiosurgery. As many targets have nonspherical or irregular shapes and three-dimensional dose calculations included in dose optimisation, long computation times are required to determine the optimum isocentre separation and collimator sizes to shape the irregular target using the multiple-isocentre approach, by trial-and-error types of method. The simple approach, using a computer-aided design optimisation technique and a fast approximate dose model, has been developed to find the optimum isocentre positions and collimator sizes quickly and automatically. A spherical dose model has been developed to represent the dose for a standard arc system with a single isocentre. The implementation of computer-aided design algorithms with the spherical dose model and their application to several cases are discussed. It is shown that the spherical dose model gives dose distribution similar to that of the exact dose model, which makes this simple dose model more efficient, with computer-aided design optimisation, in finding optimum isocentre positions and collimator sizes used in stereotactic radiosurgery.

CT analysis of intestinal obstruction due to adhesions: early detection of strangulation

We evaluated the CT of intestinal obstruction due to adhesions in 20 postoperative patients, with emphasis on early detection of strangulation. Ten patients with surgically proven strangulated obstruction (strangulation group) were compared with another ten patients (nonstrangulation group) in whom seven improved with conservative management and three had confirmed simple obstruction on surgical exploration. Beak-like luminal narrowing ("beak") was the most common CT finding at the obstructed site in both groups. The CT findings that suggested strangulated obstruction were serrated beaks, mesenteric edema or vascular engorgement, and moderate to severe bowel wall thickening. In contrast, simple obstruction could be assumed when the beak was smooth, there were no mesenteric changes, and the bowel wall was normal or mildly thickened. Computed tomography is a useful tool for detecting strangulation in patients with postoperative adhesive intestinal obstruction.

Use of film duplicator to lighten dark radiographs

The authors introduce a simple technique for lightening overexposed or overdeveloped dark radiographs. With the technique, an increase of exposure time in film duplicator allows production of duplicate radiographs with an appropriate tone. With this manipulation, image details are greatly improved, and the original radiograph is not damaged.

Pulmonary nocardiosis manifested as miliary nodules in a neonate--a case report

A case of pulmonary nocardiosis in a 18-day-old neonate is presented. The chest roentgenograms demonstrated the widespread nodularities, mimicking miliary tuberculosis. Nocardiosis is rare in childhood but should be included in the differential diagnosis of the disseminated nodularities seen in the chest roentgenogram.

Peripheral upper lobe collapse simulating pleural effusion

Two cases of segmental collapse of the upper lobe simulating an apical pleural effusion in association with pneumothorax are reported. Our cases differ from previously reported ones in that the peripheral collapse occurred in association with a pneumothorax without pleural adhesions, it was segmental rather than lobar, and was observed in adults.

Embolic control of lumbar artery hemorrhage complicating percutaneous renal biopsy with a 3-F coaxial catheter system: case report

A case is presented in which massive retroperitoneal hemorrhage from the left first lumbar artery complicating a percutaneous renal biopsy was successfully controlled by superselective embolization with microcoils. An anterior radiculomedullary artery (artery of Adamkiewicz) originated from the lumbar artery. To minimize the risk of ischemic damage to the spinal cord from embolization, the extravasating branch of the lumbar artery had to be superselectively catheterized using a 3-F coaxial catheter system. Computed tomography (CT) scan localized the hematoma within the left posterior pararenal space in the retroperitoneal space.

Struma ovarii simulating a teratodermoid cyst. Computed tomographic findings in one case

A case report is presented in which there were computed tomographic (CT) findings of struma ovarii (SO) simulating a teratodermoid cyst. The patient was a 73-year-old woman with a painful mass in the lower abdomen. CT revealed a large complex mass with multiple cystic and solid components. One of the cysts had fat-fluid level and minor calcification in the wall. The histological findings were struma ovarii. To our knowledge, these CT findings have not been described previously. Our case demonstrates the importance of including struma ovarii in the CT differential diagnosis of teratodermoid cysts.

Measure-set computed tomography in the diagnosis of herniated nucleus pulposus

The present study has been carried out to enhance the specificity of computed tomography (CT) in diagnosing herniated nucleus pulposus (HNP) of the lumbar spine by the application of measure-set (MS) technic. MSCT scans of 20 patients with proven diagnosis of HNP were reviewed prospectively to sort out features of diagnostic value. Eleven were men and 9 were women with the mean age being 40 years. MSCT scan revealed dislocation of the center of the nucleus pulposus (NP) in direction of herniation in 75%, "permeation" of the annulus fibrosus (AF) by HNP material and a clear disruption of the outermost layer of AF in all patients. The site and grade of the protrusion of HNP beyond the normal saliancy of AF could be easily evaluated in 90%. The present study saliancy of AF could be easily evaluated in 90%. The present study revealed that MSCT can demonstrate four characteristic findings of HNP enabling one to directly and semiquantitatively assess the pathologic changes of NP.

Measure-set computed tomographic analysis of internal architectures of lumbar disc. Clinical and histologic studies

Measure-set computed tomography (MSCT) scan was performed in 30 adult subjects (17 men and 13 women, mean age 42 years) and eight cadavers (five men and three women, mean age 42 years) to establish prospectively a normal CT pattern of the internal architectures of the lumbar disc. Based on the uniformity or nonuniformity of MSCT composition of the nucleus pulposus (NP) and annulus fibrosus (AF), and also on how well NP was discerned from the surrounding AF, the internal architecture could be categorized into well-defined (WD), intermediate (IM), and ill-defined (ID) types. An age and prevalence study of the categorized disc showed that, with age, the disc undergoes an architectural transformation from WD through IM to ID. In addition, 72.5% of WD-type discs and 72.1% of ID-type discs occurred in the third and fourth decades and in the sixth and seventh decades, respectively, suggesting that the former is a young form with mild degeneration and the latter an old form with advanced degeneration. Fifty-eight percent of WD-type discs and 60.4% of ID-type discs occurred at L1-3 and L4-S1 levels, respectively, regardless of age. This finding suggests the old form tends to occur at the lumbosacral junction, which is the site of maximum weight bearing in humans. The correlation of water content and histologic findings of degeneration with the three categorized disc types in cadavers showed that WD, IM, and ID discs were associated with the largest, intermediary, and least amount of water of NP, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Pinhole collimator scintigraphy in differential diagnosis of metastasis, fracture, and infections of the spine

The informational gains obtained by the use of pinhole collimator scintigraphy (PCS) have been well documented. The present study has been undertaken to prospectively investigate its efficacy in diagnosing several commonly occurring spinal diseases. Patient material consisted of metastatic cancer (39 vertebrae), compression fractures (33 vertebrae), tuberculous spondylitis (17 vertebrae), and pyogenic spondylitis (six vertebrae). PCS findings were characterized in terms of localization, appearance, and homogeneity of abnormal radionuclide accumulation. Thus, metastatic cancer manifested as diffusely or focally homogeneous accumulation within the vertebral body or as a typical short-segmental accumulation along the end-plate, whereas compression fracture manifested as characteristic board-like accumulation along the entire length of end-plates. Tuberculous spondylitis, on the other hand, revealed homogeneous accumulation throughout the vertebral body, and pyogenic spondylitis revealed accumulation at the end-zone of opposing vertebral bodies giving sandwich-like appearance. The disk space at the affected level was not narrowed in the former two diseases but it was narrowed in the latter two. It was concluded that PCS may be useful in differentiating metastatic cancer, compression fracture, tuberculous spondylitis, and pyogenic spondylitis.

Postural relief of food impaction in a patient with stenosed esophagus--a case report

A patient with past history of esophageal stenosis complained of sudden dysphagia in the erect position which was relieved transiently in the supine position. Initial esophagoscopy failed to detect any mass in the lumen. Esophagogram revealed shifting foreign body from lower stenotic site to upper dilated area with postural change from the erect to the supine position. A French bean was detected and removed during the second esophagoscopy.

Radiologic manifestations of epidemic haemorrhagic fever with renal syndrome

Epidemic haemorrhagic fever is a viral disease characterized by acute febrile onset followed by profound renal dysfunction. The endemic areas are widespread throughout the Eurasian continent and the Japanese islands. The patient with EHF usually seeks medical care as an emergency for an "acute abdomen". Consequently the X-ray examination becomes an essential part of the clinical study. We analysed the plain abdomen and chest films of 62 patients with this disease. The radiologic manifestations represented diffuse capillary damage with resultant oedema and haemorrhage, particularly in the retro-peritoneal space. Abnormal findings were seen in 94% of the patients on the plain abdomen, and in 63% on the chest film. The most significant finding was obliteration and blurring of anatomical detail in both intra- and retro-peritoneal cavities and renal enlargement. We believe that simultaneous presence of oedema and effusion in both intra- and retro-peritoneal cavities along with renal enlargement is in practice pathognomic of EHF. Obliteration of the renal outline and cardiomegaly with overt lung oedema was associated with the most severe renal dysfunction.

The air meniscus sign in sclerosing hemangioma of the lung

The air meniscus sign occurs in a number of lung conditions, including infection, benign and malignant tumors, and hematoma. Sclerosing hemangioma does not appear to have been implicated previously in this connection. Two such cases are described. Possible mechanisms of air meniscus formation and its diagnostic value in sclerosing hemangioma are discussed.

Tierexperimentelle Untersuchungen zur Knochenszintigraphie

Am 11. Tag nach manueller Fraktur von Tibia und Fibula einer hinteren Extremität von Ratten wurde der Einbau von 18F, 47Ca, 85Sr und 177Lu bestimmt. Die höchsten Einbauraten wurden bei 18F, 47Ca und 85Sr gefunden. Die größte Differenz zwischen der Speicherung im Kallusgewebe und der Einlagerung in gesunder Diaphyse ergab sich bei 18F. Die Speicherkurven von 47Ca und 85Sr lassen das Maximum zwischen 2 h und 24 h erkennen. Zu diesem Zeitpunkt ist die Aktivitätsdifferenz zwischen gesunder Diaphyse und Kallus am größten.