Philippe L'Heureux

Roentgenographic features of American Burkitt's lymphoma.

Studies of American Burkitts lymphoma in 12 children showed a high incidence of abdominal involvement, including ileocecal masses with intussusception, retroperitoneal extension, and diffuse bowel involvement. Pleural effusions were common, and 2 patients had pulmonary nodules. Three patients had diffuse renal involvement. The mandibles and other bones were not affected in any of the 9 patients tested. The first 2 patients survived 0.5 to 8.5 months; the last 2 were treated much more aggressively and were still free of disease at the time this paper was written, 14 and 16 months after treatment, respectively. Hopefully, early recognition of the clinical and roentgenographic features of American Burkitts lymphoma will contribute to improved survival.

Hydrothorax: A Complication of Hyperalimentation with Radiologie Manifestations

Two cases are presented of massive hydrothorax secondary to intravenous hyperalimentation. Sudden and severe respiratory distress developed in both infants. This complication has not been previously reported in infants.

Pulmonary Complications Associated with the Prune-Belly Syndrome

Eight patients are presented who demonstrate many of the pulmonary complications seen in the prune-belly syndrome. The patients are divided into two major groups: Group I includes pulmonary hypoplasia; Group II includes lobar atelectasis and pneumonia. The etiology, pathogenesis, and radiographic features of these complications are discussed. Pulmonary complications become more important as renal dialysis and transplantation spare more of these patients from an early uremic death. Prompt recognition of the type and the extent of pulmonary disease in patients with the prune-belly syndrome may lead to increased survival.

Regional Pulmonary Function Evaluation Using Xenon 133, a Scintillation Camera, and Computer'

FOR THE PAST three years, xenon 133 and a scintillation (Anger) camera have been used extensively in our Nuclear Medicine Clinic to evaluate pulmonary function and measure regional blood flow (1–3). This report is a follow-up of these studies in selected patients with pulmonary disease, including our experience with the use of a computer2 for data processing. Materials and Methods One-curie ampules of 133Xe are received at weekly intervals from Oak Ridge National Laboratories. The gas is transferred into sterile saline solution in concentrations up to 5 mCi Xe/ml. Details of the technic involved have been discussed elsewhere (1,2). Our scintillation camera is equipped with bi-alkali cathode photomultiplier tubes which have a relatively low work function for electron release; for this reason, acceptable statistical information concerning the positioning of individual scintillations is obtainable despite the relatively low energy of the gamma rays emitted by 133Xe (81 keY). These cathode tubes, together wit...

Regional Ventilation in the Differential Diagnosis of Pulmonary Embolism

In the diagnosis of pulmonary embolism by lung scanning, clinical errors of interpretation may arise. Diseases that affect the distribution of pulmonary blood flow, such as pulmonary emphysema and bronchial asthma, may be confused with pulmonary embolism.With the addition of ventilation studies with 133xenon to the perfusion scans, distinct differences appear between patients with emboli and those with obstructive lung disease. In patients with pulmonary emboli, ventilation is preserved in the areas of decreased perfusion, whereas patients with obstructive lung disease show both decreased ventilation and perfusion in the affected areas.

Giant-cell containing "fibrous" lesion of the sacrum. A roentgenographic, pathologic, and ultrastructural study of three cases.

Three similar and unique, predominantly osteolytic lesions are reported in young patients between the ages of 4 and 19 years. Progressive back pain and neurologic deficits were the principal clinical features. The initial roentgenographic impression was that of a malignant tumor either primary or metastatic. Despite incomplete resections of a firm, intraosseous and extradural tumor, healing has occurred during the follow-up interval with one interim exception. A spindle-cell stroma containing a variable number of giant cells was the consistent microscopic finding. Ultrastructural studies of one case revealed that the mononuclear spindle cells and giant cells contained cytoplasmic microfilaments similar to those of the myofibroblast. The possible relationship of this tumor to nodular fasciitis and desmoplastic fibroma is hypothesized in the light of the role of the myofibroblast in the fibromatoses and nodular fasciitis.

CLINICAL CORRELATES OF NECROTIZING ENTEROCOLITIS |[lpar]|NEC|[rpar]|

Of 720 newboms admitted to our NICU in a recent 38-month period, 54 (7.5%) developed NEC. In an attempt to better define the etiology of NEC, the acute course of these patients was compared to 98 control patients matched for birth weight. Survival was 37% in NEC as compared to 65% in control patients. The frequency of RDS (74%) and of perinatal asphyxia (32%), hypotension (20%) and hypothermia (20%) was comparable in the two groups. Stool cultures showed no predominance of a single organism in either group. Although DIG (48%) and sepsis (38%) both occurred three times as often in NEC patients as in controls, their onset usually coincided with, rather than preceded, the onset of NEC. On the day of life that NEC occurred, all 54 NEC patients and 63% of controls were receiving formula feedings, both at 80 cal/kg/day. 96% of NEC patients had umbilical arterial (UA) catheters and 78% were still in place within 24 hours of onset of NEC; 73% of controls had UA catheters. Average duration of UA catheters was 7.7 days in NEC as compared to 5.4 days in controls (P=.05). 69% of NEC and 43% of control patients (P=.05) had UV catheters. NEC patients were indistinguishable from controls prior to the onset of NEC. Although our data does not define one single etiology of NEC, the high incidence of formula feedings in NEC patients does suggest that formula feedings may be related to the etiology of NEC as well as to the extent of intramural gas.

Regional Evaluation of Pulmonary Function in Chronic Obstructive Pulmonary Disease

Abstract Use of xenon 133, a scintillation camera, and computer-analyzed data in the evaluation of regional pulmonary function is reviewed. Data from 17 normal subjects and 12 patients with chronic obstructive pulmonary disease are presented. One case report is given in detail to fully illustrate the applications of the technique.

Prolonged membrane oxygenator support in a child with severe respiratory insufficiency

Extracorporeal membrane oxygenation (ECMO) systems are now available in many centers for treatment of respiratory insufliciency unresponsive to conventional therapy.’ 4 Very little Itnformatton is available thus far, however, regarding the potential reversibility of pulmonary fibrosis present prior to beginning ECMO. The patient reported in detail here is a 3.8 year old child with presumed viral pneumonia supported by ECMO for 21 days. The preECM0 open lung biopsy revealed severe pulmonary fibrosis and tibroblastic proliferation. The autopsy findings consisted of even more extensive pulmonary fibrosis. Additional data is needed in order to better define the extent of early fibrosis that can be considered reversible.

Emulsified ethiodol as a bronchographic contrast agent. Preliminary observations.

Abstract The authors describe their experience using an emulsion of Ethiodol and Dextran 40 as a contrast medium. Of the bronchographic agents tested, a 1:1 emulsion of these two substances appeared to have superior coating properties, probably because of its small particle size. Further study of possible toxicity is recommended prior to use in human patients.