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http://www.webmedcentral.com/images/Header_Logo.giftext/html2013-06-25T04:55:12+01:00http://www.webmedcentral.com/Dr. Gentian VyshkaEvaluation and Ultrasound Follow-up of Gallbladder Polyps
http://www.webmedcentral.com/article_view/4297
Gallbladder polyps are growing masses inside the wall of the gallbladder. In the majority of patients, the diagnosis represents an incidental finding of a routine abdominal ultrasonography, or following cholecystectomy for gallstones. The overwhelming majority of these lesions are non-neoplastic therefore called as pseudo-tumor. The widespread use of ultrasonography has made the diagnosis of polypoid lesions of the gallbladder increasingly frequent.text/html2011-11-29T16:54:25+01:00http://www.webmedcentral.com/Prof. Syed A GilaniSonographic Finidings in Idiopathic Systemic Capillary Leak Syndrome (ISCLS) in Patients of Dengue fever in the city of Lahore, Pakistan.
http://www.webmedcentral.com/article_view/2523
Idiopathic systemic capillary leak syndrome (ISCLS) is a rare disorder characterized by episodes of severe hypotension, hypoalbuminemia, and hemoconcentration [1,2]. During "attacks" of ISCLS, profound derangement of the vascular endothelium results in leakage of plasma and proteins into the interstitial compartment [1,2]. Episodes vary in severity and frequency and may be fatal. ISCLS was first described by Clarkson in 1960 and is variably referred to as Clarkson's disease or syndrome.EpidemiologyApproximately 150 cases of ISCLS have been reported worldwide [3,4]. These have been diagnosed primarily in middle aged adults, although cases in children as young as five months old have been reported [5-8]. There is no apparent gender predilection.PathogenesisThe vascular endothelium is a semi-permeable barrier that controls the passage of fluid and macromolecules between the intravascular and interstitial spaces. Dysfunction of this barrier leads to leakage, with loss of intravascular fluid and protein into the interstitial compartment. The resulting intravascular fluid depletion can cause hypotension and impair the delivery of oxygen to the tissues. The capillary leak is often severe and results in significant hypotension and shock. Cells and platelets are generally retained within the vasculature, resulting in elevations in white cell, red blood cell, and platelet counts.There are many causes of capillary leak, which can be categorized as follows: Increased hydrostatic pressure within the capillaries can force fluid and protein through the endothelial barrier and into the interstitium. This is the mechanism of capillary leak in heart failure, renal failure, hepatic venous obstruction (eg, cirrhosis), and lower extremity deep vein thrombosis. Decreased capillary oncotic pressure may fail to retain fluid within the vascular space. This is the mechanism of capillary leak in conditions characterized by albumin loss (e.g., nephrotic syndrome, protein losing enteropathy) or decreased albumin synthesis (e.g., liver disease). Increased capillary permeability allows fluid and protein to readily pass through the endothelial barrier and into the interstitium. This is the mechanism of capillary leak in many medical conditions, including sepsis, the systemic inflammatory response syndrome, acute pancreatitis, anaphylaxis, snake bites [9,10], and certain infectious syndromes (eg, Dengue hemorrhagic fever, brucellosis [11], hantavirus cardiopulmonary syndrome [12]).Objectives:1) To confirm the relation of Dengue fever with Idiopathic systemic capillary leak syndrome (ISCLS).2) To assess the role of ultrasonography in early detection of Idiopathic systemic capillary leak syndrome (ISCLS) in Patients of Dengue fever during recent epidemic spread in the city of Lahore, Pakistan.3) To correlate the incidence of Idiopathic systemic capillary leak syndrome (ISCLS) with number of attacks of Dengue fever.text/html2012-03-02T11:20:41+01:00http://www.webmedcentral.com/Prof. Bilgin Kadri AribasReview of Percutaneous Biliary Drainage in Malignant Biliary Obstruction and Accompanying Bilomas
http://www.webmedcentral.com/article_view/3123
In this review, we have discussed efficacy of percutaneous biliary drainage not only in cases with malignant biliary obstructive jaundice, but accompanying bilomas as well. Percutaneous biliary drainage is mostly successful. Direct bilirubin levels can be decreased significantly as in our previous series, which has a success of 89.5% of malignant biliary drainages and all associated bilomas. Percutaneous biliary drainage is an effective interventional radiological method in palliation therapy of malignant biliary obstruction and associated bilomas. Key Words: Bile ducts, Percutaneous, drainage, Biliary, malignant, Bilomatext/html2012-10-12T18:24:04+01:00http://www.webmedcentral.com/Dr. Robert HurwitzSonography of the Pediatric and Adolescent Breast
http://www.webmedcentral.com/article_view/3767
The intense world awareness of carcinoma of the adult breast has led to unfounded concerns about lumps and asymmetric findings in children and adolescents. Carcinoma of the breast in adolescents is a rare exception. The numerous benign findings in young people are best evaluated by inexpensive sonographic imaging with clinical correlation. This avoids unnecessary exposure to the radiation of a mammogram. Even fine needle aspiration and ultrasound guided core biopsy can have an adverse effect on the normal growth of the breast of an adolescent female. In a busy ultrasound practice, there is never less than two children/day requiring evaluation with appropriate counseling of parents and referring physicians.text/html2013-04-05T19:54:18+01:00http://www.webmedcentral.com/Dr. Gentian VyshkaDeep venous thrombosis in a subject with agenesis of inferior vena cava
http://www.webmedcentral.com/article_view/4180
Agenesis of inferior vena cava (IVC) is a rare anomaly associated with idiopathic deep venous thrombosis, particularly in young people. We present the case of a 30 year old male, admitted with fever, low back pain irradiating to both thighs and gait difficulty. Abdominal CT revealed agenesis of pre-renal part of IVC as well as retroperitoneal collaterals, associated with deep venous thrombosis. Plasma protein C and S, factor V, anti-thrombin III, anti-phospholipids’ and anti-cardiolipin antibodies were within normal values. He was treated with heparin and antibiotics and symptomatology was resolved within few weeks. Life-long treatment with oral anticoagulants was recommended.text/html2013-08-03T07:54:45+01:00http://www.webmedcentral.com/Dr. Gentian VyshkaThe Role of Ultrasonography in the Diagnosis of Pleural Disorders
http://www.webmedcentral.com/article_view/4359
Ultrasonography of pleural space is playing an increasingly great role in the diagnosis of panoply of pleural disorders. In fact, ultrasonography is a reliable and simple procedure, free from side effects, non invasive and painless. Its reliability has been contradicted mainly because of the non-specific data gathered, but plain chest radiographies, so largely used, do not offer a higher specificity or sensitivity. It remains however valid the fact that ultrasonography of pleural space has to be made from a well trained imaging specialist, able of contouring and separating anatomical structures and changes found herein. A summary of other imaging procedures is discussed as well, with computerized tomography, magnetic resonance imaging and nuclear imaging procedures offering other possibilities, but lacking overall availability and immediate applicability. text/html2011-01-05T20:46:16+01:00http://www.webmedcentral.com/Dr. Gayathri S RaoEvaluation Of Adult Cortical Bone Mass As Measured By Panoramic Mandibular Index - A Radiological Study
http://www.webmedcentral.com/article_view/1447
Background: In human beings the loss of bone mass with increasing age is a universally observed phenomenon. Human bones decrease in density & increase in porosity beginning at about the third decade of life. Various techniques have been used to assess the bone mass. Panoramic mandibular index is one of the radiomorphometric indexes which are based on the linear measurements of cortical bone. Therefore a study was undertaken to evaluate the adult cortical bone mass using Panoramic Mandibular Index (PMI) and to identify the normal ranges and to investigate their relationship with age, and gender. Methods: A radiological study was conducted on 100 healthy individuals aged 30 - 60 years, with each of 50 males and females. Panoramic radiographs of 100 individuals was obtained and the bone mass was measured using panoramic mandibular index (PMI).Results: The mean PMI of the selected population was 0.275 (range 0.185 - 0.476). The mean PMI of males and females was 0.276& 0.274 respectively. Males of age group 30 - 40 years, 40 - 50 years and 50 - 60 years showed mean PMI of 0.285, 0.277 and 0.267 respectively. Similarly in females of age group 30 - 40 years, 40 - 50 years and 50 - 60 years, the mean PMI was 0.271, 0.286, and 0.265 respectively.Conclusion: This study revealed that with the advancing age the bone mass decreased. The bone mass of both the genders was almost equal and the bone mass after menopause decreased.
text/html2011-04-16T12:41:45+01:00http://www.webmedcentral.com/Dr. Antonio ManentiGrey-Turner\'s Sign Radiological Equivalent at Computed Tomography in Acute Pancreatitis
http://www.webmedcentral.com/article_view/1871
In case of acute pancreatitis, the radiological equivalent of Grey-Turner’s sign, even in absence of its clinical appearance, can be detected by Computed Tomography (CT) as a necrotico -hemorrhagic collection in the subcutaneous space of the flank. It is correlated with a high severity of the disease.text/html2011-04-17T12:42:25+01:00http://www.webmedcentral.com/Mr. Anthony Kodzo - Grey VenyoEnlarging Superior Mesenteric Artery Aneurysm Successfully Treated By Selective Angiography And Embolization With Terumo Hydrocoil: A Case Report And Review Of The Literature
http://www.webmedcentral.com/article_view/1689
“Background”Aneurysms and pseudo-aneurysms of the superior mesenteric artery are rare and potentially lethal. Such aneurysms may be found incidentally or they may be diagnosed after complications have occurred.“Aims” To report a case of Superior Mesenteric Artery Aneurysm, diagnosed incidentally, and successfully treated by Selective Angiography and EmbolizationTo review the literature on Superior Mesenteric Artery aneurysms“Case Report”A lady who has been followed up for hepatitis C and cirrhosis of liver had MRI scan of the abdomen which showed a 1.9 cm lesion in her liver which was consistent with hepato-cellular carcinoma. She had previously had ultrasound scan of her liver and liver biopsy which confirmed cirrhosis of liver and no evidence of malignancy. She successfully underwent 3 sections of selective angiography and embolization of the hepatocellular carcinoma with disappearance of the tumour. During the process of the embolization of the hepato-cellular carcinoma the patient’s previous MRI scans and CT scans were reviewed and these revealed that the patient had a Superior Mesenteric Artery Aneurysm which had enlarged over a period of 3 years. Selective Superior Mesenteric Artery Angiography and embolization of the aneurysm was successfully carried out using Terumo hydro-coil. Literature review revealed that cases of Superior Mesenteric Artery Aneurysms are rare and they have been treated traditionally by means of open surgery however, some cases of Superior Mesenteric Artery Aneurysms have been treated recently by embolization but coil migration has been reported. Conclusions:With developments in interventional radiology and coil technology selective superior mesenteric artery angiography and embolization of superior mesenteric artery aneurysm has become a safe alternative modality of treatment instead of open surgery.This technique has the added advantage of: avoiding general anaesthesia and laparotomy; being less invasive; being associated with low morbidity; short period of hospitalization.The Terumo hydrocoil which is now available for such embolizations has the added advantage of expanding to fill up the aneurismal cavity up to 5.8 times more than conventional coils and it does not dislodge easily.Key Words: Superior Mesenteric Artery Aneurysm; Selective Angiography; Embolization; Azur Terumo Hydrocoil;
text/html2011-07-28T18:49:09+01:00http://www.webmedcentral.com/Dr. C Surendranath SinghAdult Intussception : A Case Report
http://www.webmedcentral.com/article_view/2052
Intussusception in adults is rare. This is a case of ileo-colic intussusception in a 65 year old lady with characteristic radiological signs on plain x-ray, Ultrasonogram, barium enema and contrast enhanced CT. The lead point could be identified and was suspected to be a MALTOMA.text/html2011-09-16T10:53:15+01:00http://www.webmedcentral.com/Dr. Sameer R VermaCase Report- Wegener\'s Granulomatosis in a Young Adult Patient
http://www.webmedcentral.com/article_view/2210
Wegener's granulomatosis is an uncommon autoimmue disease with multi-system involvement that manifests as vasculitis, granulomatosis and necrosis. While its standard form involves the upper and lower respiratory tracts and kidneys, it may essentially involve any organ. We present a case in a young male adult patient presenting with symptoms of chronic sinusitis having extensive sinosal and nasal disease on initial CT, with detection of lung lesions and renal involvement on further investigations and pathological confirmation by antineutrophil cytoplasmic antibody positivity and nasal biopsy findings based on radiological and clinical suspicion.text/html2011-12-26T14:23:42+01:00http://www.webmedcentral.com/Dr. Kruthika S GuttalAssessment of Variables in Mesioangular Impactions and Vertically Erupted Mandibular Third Molars
http://www.webmedcentral.com/article_view/2791
Background - Impacted third molars may be responsible for various problems within the oral cavity. Impaction may be due to inadequate space or varied angulations. Assessment of variables contributing for impaction may influence the fate of impacted third molars.Methodology- Retrospective analysis of panoramic radiographs of adolescents in Indian population subpopulation was done to evaluate angulation, mesiodistal width of crown, retromolar space, gonial angle among the mesioangular impacted teeth and vertically erupted teeth. Patients with syndromes associated with impactions were excluded from the study.Results - In the impacted group angle of inclination was more, mesiodistal dimension and gonial angle was more compared to the non impacted group.Conclusion- The factors associated with impaction varies in different populations. The importance of assessment of the variables associated with impaction may facilitate to decide whether the impacted third molars have chances of eruption or need to be surgically removed to prevent unnecessary clinical problems.text/html2012-03-19T07:07:31+01:00http://www.webmedcentral.com/Dr. Rash B DubeyNew Technology in Medical Imaging
http://www.webmedcentral.com/article_view/3167
Biomedical images of the human body are an invaluable source of information that clinicians can use in order to make a correct and final diagnosis. Computer-aided diagnosis (CAD) is used by radiologists as a second opinion has become one of the major research areas in medical imaging. The computer assisted diagnosis need not be comparable to that of physicians, but is surely complementary. PACS (picture archiving and communication system) are computers or networks that present, distribute, store, and retrieve images from one or more medical imaging instruments, i.e. mammogram, ultrasound, endoscopy, magnetic resonance, etc., and are viewed on monitors along with a patient’s clinical details and radiological reports. By using PACS the medical image interpretation may be changed from conventional hard copy images to soft-copy studies and viewed on the systems workstations. Keywords: CAD, PACS, image processing, medical imaging and multimodality.text/html2012-03-22T16:07:36+01:00http://www.webmedcentral.com/Dr. Antonio ManentiComputed Tomography Interpretation in Colonic Cancer: Let there be more Exhaustive
http://www.webmedcentral.com/article_view/3181
Computed Tomography (CT) of colonic cancer(CC), when correctly performed, permits a precise pre-operative staging, demonstrating lymph nodal, peritoneal or retroperitoneal possible involvement, and also secondary or concomitant vascular pathology. Today these findings are essential for an adequate therapeutic choice.text/html2012-06-08T14:15:03+01:00http://www.webmedcentral.com/Dr. Antonio ManentiSmall Bowel Mechanical Occlusion and Computed Tomography Severity Indicators: What to Look for
http://www.webmedcentral.com/article_view/3459
Computed Tomography (CT) allows detecting different aspects of small bowel pathology in course of mechanical obstruction, principally correlated to circulatory disturbances, giving useful indications for a surgical treatment.text/html2013-10-29T04:49:07+01:00http://www.webmedcentral.com/Dr. Sander KolaRole of Ultrasonography in the diagnosis of the gallstones
http://www.webmedcentral.com/article_view/4432
Ultrasound examination is a routine examination, non–invasive, low cost and technically easy to achieve. Ultrasound examination marked a hitch leap in the diagnosis of diseases of the biliary tract and gallbladder. As a harmless examination for the health and with a high specificity on diagnosis, this examination has left almost in the past the time of conventional radiologic examinations like cholecystography prioral or venous. This examinations with high costs, health hazards and technically difficult to be realized, nowdays are referred for the development of radiology values. Ultrasound examinations nowdays is used not only for the diagnostic purposes, but also therapeutic purposes. With the help of this examinations enable the drainage of collections and also percutaneous drainage of hepatic ductuses. Ultrasound examination has a sensitivity of 89% and specificity of 88% on the gallstones.text/html2014-09-01T06:15:45+01:00http://www.webmedcentral.com/Dr. Atanas D HilendarovMD Spiral CT appearances of pancreatic tail insulinoma
http://www.webmedcentral.com/article_view/4688
Introduction. Pancreatic endocrine tumors (PETs) are primarily well-differentiated tumors composed of cells that resemble normal islet cells but that arise from pancreatic ductal cells. They are classified as functioning or nonfunctioning according to their associated clinical symptoms; insuli­noma, gastrinoma, and glucagonoma are the most common function­ing PETs. Insulinomas are the most common category of pancreatic endocrine tumors, with an annual incidence of 1-4 cases per million people. Most are intrapancreatic, benign and solitary. Therefore, they have an excellent prognosis after surgical resection. However, the localization diagnosis of insulinomas still poses a challenge to surgeons and radiologists.
Case Report
A 36-years old man presented with a one-month history of fainting attacks and dizziness, symptoms of hypoglycemia such as hunger, sweating, palpitations, loss of consciousness and syncope.
We were asked to locate the tumor. The ultrasound examination showed no expansive formations in the pancreatic area (Fig. 1). We tried abdominal enhanced spiral CT to localize the tumor, but that wasn’t successful. Therefore, we tried a new method of MD spiral CT scanning and localized the tumor.
Discussion
Insulinomas are the commonest islet cell tumors of the pancreas, followed by gastrinomas. Preoperative localization is very helpful in planning theoperation: it allows the surgeon to determine whether simple tumor resection or partial pancreatectomy is likely to be required.
The imaging algorithm usually starts with US, followed by helical CT. Angiography and portal venous sampling may be useful in cases where CT is negative. Endoscopic US is also a newer and sensitive modality for pre-operative localization
The advent of spiral MDCT has improved the detection of insulinomas compared with conventional CT.text/html2016-02-17T04:47:54+01:00http://www.webmedcentral.com/Dr. Mohammad Fawad KhattakBilateral Chest X-Ray Shadowing and Bilateral leg lesions - A case of Pulmonary Kaposi Sarcoma
http://www.webmedcentral.com/article_view/5051
We report a case of a 30 year old gentleman seen on the respiratory ward with no significant past medical history presenting with a three week history of worsening dyspnoea, productive cough, fever, bilateral leg swelling and bilateral leg swelling. Initial differential diagnosis included community-acquired pneumonia, cellulitis and deep vein thrombosis. After much investigation a diagnosis of AIDS-related kaposi's sarcoma with visceral manifestations was made.