Computerized tomography (CT) was performed on 256 children with seizure disorders. The incidence of abnormal scans was closely related to seizure type, and permitted separation of patients into a low-yield and a high-yield group. Low-yield groups included children with idiopathic generalized seizures, children in whom both the neurologic examination and electroencephalogram (EEG) were normal, and children with a generalized seizure of unknown etiology in whom the neurologic examination and the EEG were normal. The high-yield groups included children with partial seizures with elementary symptomatology, partial seizures with complex symptomatology, generalized seizures with known etiology, neonates with seizures, and children whose seizures began as neonates. The overall incidence of abnormalities in the entire group was 33 percent. An abnormal neurologic examination increased the incidence of abnormal CT scans to 64 percent. EEGs were abnormal in 65 percent of the children, but only focal slowing resulted in a significant increase in the incidence of abnormal CT scans. Seven children (2.7 percent) had intracranial abnormalities requiring surgery. If the neurologic examination and EEG were normal, the yield of abnormal CT scans was only 5 percent of the total.
The ability of the distal lung epithelia to actively transport Na+, with Cl− and water following, from the alveolar spaces inversely correlates with morbidity and mortality of infants, children, and adults with alveolar pulmonary edema. It is now recognized, in contrast to many other Na+ transporting epithelia, that at least half of this active transport is not sensitive to amiloride, which inhibits the epithelial Na+ channel. This paper reviews amiloride-insensitive Na+ and fluid transport in the mammalian distal lung unit under basal conditions and speculates on potential explanations for this amiloride-insensitive transport. It also provides new information, using primary cultures of rat fetal distal lung epithelia and alveolar type II cells grown under submersion and air-liquid interface culture conditions, regarding putative blockers of this transport.
Real-time sonography was performed during spinal surgery in eight adult patients with seven different types of lesions. Cervical, thoracic, and lumbar lesions were included. All were examined prior to dural opening, using the saline-filled wound for water-path imaging. Five extramedullary masses and two intramedullary cavities were well delineated, allowing optimal surgical access to be determined at the moment of approach. Sonography also was abnormal in one case of diffuse spinal cord expansion, but no tissue sonographically distinguishable from spinal cord substance could be identified. Adequacy of surgical treatment was evaluated by repeat sonography before dural closure in one case of extramedullary mass and two cases of intramedullary cavities. Sonography is both reliable and beneficial during surgery for a variety of intraspinal lesions.
Acute ischemic cholecystitis is not an uncommon complication after TACE. However, it is self-limiting and does not seem to require any intervention or surgery.
Eight patients who had facial nerve neuromas were examined, and the radiographic findings are reported. Thin section tomography, high resolution computed tomography, posterior fossa computed tomography, and cerebellopontine angle cisternography using Pantopaque (iophendylate) demonstrated bone erosions and soft tissue masses conforming to the course of the facial nerve. The lesions generally exhibited either a proximal or a distal pattern of nerve involvement. Radiologic imaging frequently permits a correct preoperative diagnosis and accurate definition of the extent of facial nerve neuromas, assessments that are important for proper patient management.
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