Angiographic embolization of bilateral internal iliac arteries to control life-threatening hemorrhage after blunt trauma to the pelvis.

Angiographic embolization of bleeding pelvic vessels is increasingly used in patients with pelvic injuries. Temporary angiographic embolization of bilateral internal iliac arteries (TAEBIIA) is occasionally necessary. From November 1991 to March 1998, 30 consecutive patients (mean age of 43 years, mean Injury Severity Score of 25) with complex pelvic fractures underwent TAEBIIA to control severe hemorrhage not responding to subselective embolization.

Differential sensitivities to risperidone and olanzapine in a human immunodeficiency virus patient.

Background: Neuroleptic sensitivity presents a considerable problem for the treatment of psychosis in the acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV)-positive patient population. As yet, there are few data on the response of these patients to newer atypical antipsychotic medications.

Methods: We present the detailed medication history of a 33-year-old man with AIDS, who had a prior history of extrapyramidal symptoms (EPS) with both typical antipsychotics and risperidone, and was treated with olanzapine for major depression with psychotic features.

Infant of diabetic mother: a continuing challenge for perinatal-neonatal medicine.

Current increase in the incidence of diabetes mellitus complicating pregnancy is of concern since it is associated with an increase in mortality and morbidity of the fetus and neonate. Pregnancy itself is diabetogenic caused by increased insulin resistance due to the production of hormones like estrogen, progesterone, cortisol, human chorionic somatomammotropin (hCS) and human placental lactogen (hPL). The latter increases lypolysis which provides free fatty acids and ketones as fuels for energy for the pregnant mother.

Radiographic cervical spine evaluation in the alert asymptomatic blunt trauma victim: much ado about nothing.

Objective: To evaluate the hypothesis that alert nonintoxicated trauma patients with negative clinical examinations are at no risk of cervical spine injury and do not need any radiographic investigation.

Design: Prospective study.

Setting: A university-affiliated teaching county hospital.

Carney complex: report of three cases.

The authors report three patients with features of the Carney complex: cardiac myxomas (n = 2), multicentric (n = 1) or recurrent (n = 1); pigmented skin lesions (n = 2); cutaneous myxomas (n = 2); melanotic schwannoma (n = 2); and sonographic evidence of multicentric, large cell, calcifying Sertoli cell tumors of the testes (n = 1). The initial component of the complex was cutaneous myxoma (n = 1), cardiac myxoma (n = 1), or psammomatous melanotic schwannoma (n = 1). Two patients died of metastatic schwannoma.

Angiomatosis of the abdominal wall: imaging findings in three adults.

Radiologic studies were reviewed of three men (aged 25, 26, and 53 years) with angiomatosis of the abdominal wall. Studies included plain radiography (n = 2), computed tomography (n = 3), magnetic resonance imaging (n = 2), and ultrasonography (n = 1). Intraabdominal (n = 3), scrotal (n = 1), and intrathoracic (n = 1) extension of the fatty infiltrating process was seen, with multiple serpentine structures, some containing calcified phleboliths, representing proliferating vessels.

Squamous cell carcinoma of the anus and rectum in homosexual men: CT findings.

Objective: Homosexual men are at risk for a variety of infectious and neoplastic diseases of the anus and rectum, many of which have been reported in the radiologic literature. The purpose of this study was to describe the CT findings in homosexual men with squamous cell carcinoma of the anus and rectum, a topic that has received little attention.

Materials And Methods: Computed tomography examinations of the abdomen and pelvis of nine homosexual men with squamous cell carcinoma of the anus and rectum were reviewed retrospectively.

Mycobacterial cervical adenitis in children: medical and surgical management.

This is a review of the treatment results of cervicofacial mycobacterial adenitis in 85 children and adolescents. Twenty-three patients were treated with only anti-tuberculous medications (Group A). Thirteen underwent surgical procedures at the time of presentation for drainage of abscess or diagnostic biopsy, followed by treatment with anti-tuberculous medications (Group B).

Open reduction and internal fixation of tibial plafond fractures. Variables contributing to poor results and complications.

In a retrospective study, 58 patients with 60 tibial plafond fractures were treated by internal fixation and reviewed over an average follow-up period of 2.5 years. There were three Reudi Type I, 27 Reudi Type II, and 30 Reudi Type III fractures.

Altered muscle metabolism shown by magnetic resonance spectroscopy in sickle cell disease with leg ulcers.

We performed 31P magnetic resonance spectroscopy of gastrocnemius muscle at rest in 7 normal volunteers and 12 patients with sickle cell disease (7 with leg ulcers and 5 without leg ulcers but with painful crises). We measured intracellular pH and ratios of Pi to ATP, PCr to ATP and PCr to Pi (Pi = inorganic phosphate, ATP = adenosine triphosphate, and PCr = phosphocreatine). Magnetic resonance arteriograms were also performed.

Contrast injection around mandril wire of an Accustick system using an extension tubing: technical note.

We describe a technique for injecting contrast material around a mandril wire of an Accustick access system through the outer 6 French sheath of this system, thus identifying the position of the wire. This is accomplished by using an extension tubing.

Disseminated histoplasmosis: abdominal CT findings in 16 patients.

Since the onset of the AIDS epidemic, disseminated Histoplasma capsulatum infection has been reported with much greater frequency in both endemic and nonendemic areas. Abdominal CT scans of 16 patients with disseminated histoplasmosis were reviewed retrospectively to identify radiologic features of this disease. The diagnosis was confirmed by autopsy (three patients), bone marrow biopsy (10 patients), lymph node biopsy (three patients), bronchoscopic biopsy (three patients), liver biopsy (two patients), and/or colonoscopic biopsy (one patient).

Ferromagnetism and magnetic resonance artifacts of platinum embolization microcoils.

We performed in vitro tests of ferromagnetism of platinum microcoils of two manufacturers. In addition, we performed in vitro magnetic resonance imaging (MRI) on these two devices to determine their levels of magnetic susceptibility artifact production. We found that both devices were nonferromagnetic and produced a very low level of artifact during MRI.

Intraarterial administration of lidocaine for analgesia in hepatic chemoembolization.

Hepatic chemoembolization (HCE) routinely results in severe pain requiring massive doses of intravenously administered narcotics. This study examines the efficacy and safety of lidocaine administered intraarterially for analgesia in HCE. In 45 HCE procedures, lidocaine was injected into hepatic arterial branches just prior to and during chemoembolization.

Metabolism of levonorgestrel, norethindrone, and structurally related contraceptive steroids.

There is limited information on the metabolism of levonorgestrel, norethindrone and structurally related contraceptive steroids. Both levonorgestrel and norethindrone undergo extensive reduction of the alpha, beta-unsaturated ketone in ring A. Levonorgestrel also undergoes hydroxylation at carbons 2 and 16.

Detection of c-K-ras mutations in fine needle aspirates from human pancreatic adenocarcinomas.

Formalin-fixed paraffin-embedded tissue specimens obtained by fine needle aspiration of pancreatic masses from 47 patients were examined retrospectively for cytology and the presence of mutant c-K-ras oncogenes. Point mutations of c-K-ras in codon 12 were detected by RNA-DNA RNAse A mismatch cleavage after in vitro DNA amplification of the cellular c-K-ras sequences by the polymerase chain reaction. Of the 36 patients with pancreatic adenocarcinoma, mutant c-K-ras oncogenes were detected in 18 of 25 (72%) with malignant cytologies, 2 of 8 (25%) with atypical cytologies, and 0 of 3 with benign aspiration cytologies.

Effects of food restriction and adrenalectomy in rats with VMH or PVH lesions.

The effects of adrenalectomy in rats with ventromedial or paraventricular hypothalamic lesions have been studied in two experiments. Rats with ventromedial hypothalamic lesions or lesions in the paraventricular nucleus were allowed to gain weight for fourteen days at which time they were adrenalectomized. Before adrenalectomy, animals with VMH lesions ate more, gained significantly more weight than animals with lesions in the paraventricular nucleus, and both were significantly heavier and consumed more food than sham-operated controls.

Hepatic epithelioid hemangioendothelioma.

Epithelioid hemangioendothelioma (EHE) is a rare, malignant neoplasm of vascular origin arising in soft tissues, lung, and liver. Four cases of hepatic EHE are reported, and 49 previously reported cases are reviewed. The tumor occurs in adults of all ages; 66% of patients are women.