An 87-year-old woman presenting with myocardial infarction and ST-segment elevation in the electrocardiogram suffered from pericardial effusion due to left ventricular rupture. After ruling out obstructive coronary artery disease and aortic dissection, she underwent cardiac surgery showing typical infarct-macerated myocardial tissue in situ. This case shows that even etiologically unclear and small-sized myocardial infarctions can cause life-threatening mechanical complications.
The value of xeroradiography in the diagnosis of peripheral skeletal lesions is illustrated by some typical examples and compared with standard radiographic procedures. The advantages of xeroradiography depend on its convenient format, easy appreciation of structural changes and easy viewing. On the other hand, density gradations are flattened. Compared with a technically satisfactory film examination, there is no increase in diagnostic information. Xeroradiography can therefore only be regarded as complementary to conventional radiography for the diagnosis of skeletal conditions.
The findings at bone marrow biopsies in 5,000 patients with systemic haematological diseases were compared with the radiographic appearances. Haemoblastic conditions produce diffuse involvement of the bone marrow, whereas conditions characterised by limited infiltration, such as Waldenström's disease or Brill-Symmers' disease, produce some osteoporosis and only rarely bone destruction. Haemoblastic diseases with additional focal proliferation, such as myelofibrosis or myelosclerosis, multiple myeloma, highly malignant lymphomas and malignant granulomatosis produce circumscribed changes in the spongiosa which are readily recognised radiologically. In addition to generalised osteoporosis or sclerosis, one finds local areas of osteolysis or osteoplasia. Bone marrow biopsies in above-mentioned conditions indicate that they progress in a series of stages which correlate well with the radiological findings.
A combination of roentgen cineradiography and functional scintigraphy of stomach evacuation, taken with a gamma camera, was used for assessing the success of organ-conservative surgery of ulcers (selective proximal phagotomy with or without pyloroplasty). This confirmed earlier results to the effect that surgical failure is not indicated with any measure of certainty by any individual roentgenologic symptom. However, the evacuation function is closely correlated with the pattern of clinical and subjective complaints. In most of the cases, rapid postoperative stomach evacuation results in freedom from complaints. Pyloric stenosis and retention point to the failure of the operation via the negatively effected subjective feeling of well-being. Hence, special importance must be attached to functional scintigraphy with regard to meaningful studies of the course and postoperative condition of the patient.
Xeroradiograms and conventional radiographs of the hands of 50 patients with chronic polyarthritis were performed. These were compared with regard to the features which are found in chronic polyarthritis. There were no significant differences between xeroradiography and conventional radiology. Xeroradiography was a little better for demonstrating changes in the soft tissues and erosions, but conventional radiographs were superior in showing osteoporosis, cysts and the absorption of subchondral lamellae. In general, xeroradiography and conventional procedures were of equal value in the diagnosis of chronic polyarthritis. For practical purposes, conventional radiography is to be preferred and xeroradiography may be regarded as an additional procedure, particularly for the investigation of soft tissue changes.
A 29-year-old man suffered from an industrial accident as a piece of metal of a die-cutter burst and shards of metal penetrated his right upper arm. One shard was localized via x-ray and computer tomography within the apex of the right ventricle. Here we report on a successful retrieval of this shard of metal by aspirating it via a 6F multipurpose (MP) catheter.
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