The clinicopathological features of a previously unrecognised type of acute encephalopathy prevalent among Japanese children is described by reviewing the records of 13 consecutive patients treated and 28 previously reported cases.
To evaluate findings of active pulmonary tuberculosis on computed tomographic (CT) scans and their sequential changes before and after antituberculous chemotherapy, 29 patients with newly diagnosed pulmonary tuberculosis and 12 patients with recent reactivation were studied prospectively. The diagnosis of active pulmonary tuberculosis was based on positive acid-fast bacilli in sputum (n = 29) and changes on serial radiographs obtained during treatment (n = 12). Twenty-six patients were followed up with CT during treatment for 1-20 months. Lungs from the cadavers of nine other patients, who died of pulmonary tuberculosis, were studied to provide a pathologic basis for diagnosis. At examination with CT, centrilobular lesions (nodules or branching linear structures 2-4 mm in diameter) were most commonly seen (n = 39 [95%]); in the 26 patients with follow-up, most of these lesions disappeared within 5 months after the start of treatment. In 11 of 12 patients with recent reactivation, CT clearly differentiated old fibrotic lesions from new active lesions. Lesions in and around the small airways appear to be the most characteristic CT feature of early active tuberculosis and may be a reliable criterion for disease activity.
Magnetic resonance (MR) imaging was performed in ten patients with pituitary stalk transection who had idiopathic pituitary dwarfism. Contiguous sagittal T1-weighted images were obtained in all cases, and, in some, axial or coronal images were taken for further evaluation. On MR images, normal anterior and posterior lobes of the pituitary gland can be clearly differentiated because the posterior lobe has a characteristic high intensity on T1-weighted images. In the ten patients, the high-intensity posterior lobe was not seen, but a similar high signal intensity was observed at the proximal stump in seven patients. This high-intensity area is the newly formed ectopic posterior lobe, which secretes antidiuretic hormone just as the posterior lobe would. When the ectopic lobe completely compensates for the impaired posterior lobe, endocrinologic data indicate normal posterior lobe function. However, MR imaging can reveal the transection of the pituitary stalk and formation of the ectopic lobe.
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