Hungarian Radiology

[Peritoneal encapsulation associated with lipophage and foreign body granulomas]

SZÁNTÓ Dezső, SZŰCS Gabriella, DITRÓI Edit

OCTOBER 20, 2003

Hungarian Radiology - 2003;77(05)

[INTRODUCTION - Peritoneal encapsulation is a rare developmental anomaly in which the ileal loops are encased in an accessory peritoneal compartment between the omentum and mesocolon. CASE REPORT - A 44 year old foreign female patient presented a history of recurrent abdominal pain, distension, constipation and suppurative inflammation of abdominal anterior wall. She had a 2nd type diabetes and three similar episodes in the last nine months from her abdominomural war-injury, only. Extension revealed an independent of peristaltic rushes protrusion in the left anterior abdominal wall. On the abdominal plain films we saw a metaloid foreign body in the left subcostal plane and a globular calcareous deposit in the intertubercular one. The family physician of the patient informed us about the further follow up. At the laparatomy peritoneal encapsulation furthermore foreign body and lipophage granulomas were found. Histology of these granulomas proved the diagnosis. CONCLUSION - The speciality of case is the association of an uncommon developmental anomaly with lipophage and foreign body granulomas with pyogenous inflammation of the abdominal wall.]



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[The possibilities of CT and MR imaging in hydrocarbon research]

BOGNER Péter, FÖLDES Tamás, ZÁVODA Ferenc, REPA Imre

[INTRODUCTION - Cross-sectional medical imaging techniques were applied on geological samples (cores) in order to reveal their morphological and functional properties. Our aim was to reveal those CT and MRI methods that are capable to characterize certain petrophysical parameters and can be correlated with core morphology. MATERIALS AND METHODS - Similarly to pre- and postcontrast scanning in human diagnostic imaging CT scans of core samples were obtained in dry and flooded state, that helped to define and calculate morphological and functional parameters. Several MRI sequences were also tested, mainly spin-echos with short echo time. RESULTS - Several hundred meters of core samples have been examined in the last three years. Effective porosity can be calculated from CT data, that characterizes oil/gas storage capacity of the given geological formation. CT information is superior to conventional petrophysical methods due to its spatial resolution. Nevertheless, we can not quantify permeabilty yet, but describe it qualitatively. We found only limited use of medical MR imaging methods. DISCUSSION - Cross-sectional imaging, primarily CT scanning was introduced to the Hungarian oil and gas industry in the last three years. It seems that the method will be used more and more frequently through the entire process of oil/gas exploitation. Our further goals include the implementation of the CT measurements in other areas like environment control, and further develope measurement conditions.]

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[Introduction of the small size, portable ultrasound machines opened new opportunities in ultrasound imaging. The optimal application of these equipments and the new problems related to the use are widely discussed in the literature. This brief review summarizes the advantages, main indication and limitations of the method. The single most important aspect for the patient is that emergency ultrasound examination should be available regardless of the profession of the doctors. The most difficult question is how to provide and control an optimal education and training for the doctors. Possible solutions are also discussed. It is predictable that the availablity of the portable ultrasound studies will significantly increase the number of examinations, therefore economical consequences must also be considered. The author disagree with the conception, which states that ultrasound machine can be used as a stetoscop in the doctor's pocket.]

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[A paradox of articular protective phenomenon: more serious-damaged rudimentary hand in rheumatoid arthitis]

SZÁNTÓ Dezső, SZŰCS Gabriella, DITRÓI Edit

[INTRODUCTION - The joints have been secured from rheumatoid arthritis by diminution of biomechanical effeciency. This effect was analyzed and named articular protective phenomenon three decades ago. CASE REPORT - A case of bilateral rheumatoid arthritis associated with unilateral developmental abnormality hand and bronchial asthma in a 35 year old female patient is presented. Her left 2nd, 3rd, 4th and 5th metacarpal bones moreover her fingers had not evolved. The patient has been treated by antiasthmatic steroid drugs for five years. Rheumatoid disorders of the affected left hand were more severe, than the abnormality of the normal upper limb. Eight years later the most severe bony lesions (ankylosis and mutilation) appeared on this side, only. CONCLUSION - The patient's hand was not saved by inborn bone defect in rheumatoid arthritis. The absence of articular protective phenomenon can be explained by the undisturbed innervation of limb, the motility of hypotrophic carpus besides to steroid-induced suppression.]

Clinical Neuroscience

Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithy­mia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share com­mon pathology of neuroanatomical structures. We hypo­thesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship bet­ween WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.

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Clinical Neuroscience

[What happens to vertiginous population after emission from the Emergency Department?]

MAIHOUB Stefani, MOLNÁR András, CSIKÓS András, KANIZSAI Péter, TAMÁS László, SZIRMAI Ágnes

[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmel­weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]