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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to elaborate an epidurographic technique, the water-soluble contrast substance (verografin), oil solution of iodine, iodolipol and air were used in experimental studies on animals and in cadavers. The studies demonstrated that oil and gaslike contrast substances penetrate into the vein and create a threat of embolia formation. For epidurography the most acceptable are water-soluble contrast substances. The method of an ascending verografin epidurography was elaborated and used in clinical practice. Some indications and contraindications for epidurography are outlined. A group of 396 patients with osteochondrosis of the lumbar part of the spine was examined. The method allowed a topic diagnosis of the disc hernia not only along the spine, but in the cross-section of the motor segments (median, paramedian and lateral hernias). The studies make it possible to exclude a disc prolapse in a nonhernial form of osteochondrosis. In 32 patients with spinal tumors epidurography permitted to determine the initial growth of the tumor, its size and relation to the dura mater.
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PMID:[Verografin epidurography in the diagnosis of spinal and spondylogenic diseases]. 45 88

The morbidity and image quality after administration of three different contrast media were compared in 229 patients referred for herniography. Sixty patients received metrizoate 150 mg I/ml, 92 received metrizoate 200 mg I/ml, and 77 patients, ioxaglate 200 mg I/ml. Patient discomfort was single-blindedly assessed based on an arbitrary verbal rating scale. The number of patients with pain increased with the osmolality of the contrast media. Metrizoate 200 induced pain in 57% of the patients, metrizoate caused pain in 39%, and ioxaglate 200 in 18%. Hernia patients who received metrizoate 200 had pain significantly more often (72%) than patients without hernia (45%). Seven patients, predominantly young men, had a vasovagal reaction associated with the administration of contrast media. The image quality was sufficient after all injections of 200 mg I/ml. The results indicate that low osmolality contrast media with an iodine concentration of about 200 mg I/ml are well suited for herniography.
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PMID:Herniography: comparison of morbidity and image quality after use of high and low osmolality contrast media. 371 Jul 42

This randomized prospective study examines the efficacy of intravenously administered heparin as prophylaxis against deep-vein thrombosis, detected isotopically with iodine 125, in 37 patients scheduled to undergo major abdominal procedures. Twenty patients were given 5000 units of sodium heparin on opening the abdominal cavity, while 17 patients who did not receive heparin acted as controls. The effect of heparin was reversed at the end of the operative procedure by protamine. Three control patients had deep-vein thrombosis postoperatively but only one heparin-treated patient did. Complications in the treated group included excessive blood loss intraoperatively in one patient and an incisional hernia postoperatively in another. Although the results are not statistically significant, this study suggests that a single dose of heparin given intravenously during operation is a safe and effective means of prophylaxis against deep-vein thrombosis in patients who undergo general surgical procedures. Studies are now being carried out to determine the optimal dose of heparin, time of administration and duration of anticoagulation.
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PMID:Intraoperative single-dose heparin prophylaxis against deep-vein thrombosis. 638 Jun 92

This is a report of myelography findings obtained in 50 patients with B 15000 (Iopamidol), a new non ionic water-soluble contrast medium. The procedure was easily carried out with a tilting table wired to a TV image amplifier. The dose of contrast medium injected intrathecally was 10 divided by 15 cm3 of a preconstituted solution containing iodine 200 or 300 mg/cm3. There were no accidents or major complications. The myelograms obtained with the test material afforded accurate diagnosis of intramedullary and extramedullary lesions, and signally of intervertebral disk protrusion and hernia.
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PMID:[Myelography with B 15000, a new nonionic water-soluble contrast medium. Technical aspects and preliminary clinical experiences (author's transl)]. 700 85

With the progress in laparoscopic techniques in recent years, there is an increased interest in laparoscopic hernia repair. The laparoscopic indirect inguinal hernia repair with simple closure of the internal ring seems feasible in childhood inguinal hernia repair; however, this technique carries the risk of postoperative patent processus vaginalis. In this-study we investigated the possibility of avoidance of this complication by chemical obliteration of processus vaginalis with 6% iodine solution in rats. The study population was comprised of three groups: simple suture of the internal ring, iodine application plus simple suture of the internal ring, and iodine application alone. While processus vaginalis was anatomically closed in 75% of the rats in the iodine plus simple suture of the internal ring group, it was closed in 10% of the iodine application alone group and was not closed in the simple suture of the internal ring alone group. No histopathologic injuries to the testis or cord were detected attributable to iodine. Our study showed that simple suture of the internal ring is not sufficient for hernia repair. Laparoscopic chemical agent application in addition to simple suture of the internal ring may be beneficial for successful laparoscopic indirect inguinal hernia repair in children.
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PMID:Experimental study investigating the feasibility of a new method for laparoscopic indirect inguinal hernia repair. 928 3

A female newborn was admitted with the symptoms of mild respiratory distress, protruding tongue, hypotonicity, cutis marmorata, sclerema, myxedema, abdominal distension, and feeding problems on the first day of life. She had a huge neck mass, a large anterior and posterior fontanel, and hoarse cry. She had no umbilical hernia or jaundice. A history of maternal potassium iodine (expectorant) usage without doctor's advice was obtained; the mother had not attended a clinic throughout the pregnancy. On ultrasonographic examination, the thyroid right lobe was 53 x 31 mm and the left lobe was 34 x 31 mm. The results of thyroid hormone tests on the first day were as follows: T3 20 ng/dl (normal: 32-216 ng/dl), T4 0.9 microg/dl (11.8-22.6 microg/dl), TSH 120 mIU/l (2.5-13.3 mIU/l). This patient is presented to emphasize the role of hypothyroidism in drug-induced neonatal goiter and to discuss the possibility of a life-threatening effect of congenital goiter, i.e. respiratory tract obstruction.
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PMID:Neonatal goiter caused by expectorant usage. 1159 76

The mediastinum is divided into compartments (anterior, middle, posterior) on the basis of lateral chest radiographs. Several anatomical and radiological classifications of the mediastinum are reported in the literature. Most mediastinal abnormalities are initially suspected following chest radiography; the need for further investigation and the most appropriate imaging modality are largely dictated by the tentative diagnosis made on this examination. Although routine chest radiography initiates the evaluation of mediastinal disorders, it is rarely diagnostic: notable exceptions are teeth or bones within a mass, which are diagnostic of a teratoma; air/fluid levels suggest an oesophageal origin, hernia, cyst, or abscess. Chest radiography is followed by spiral computed tomography (sCT). However, even sCT with contrast material is occasionally diagnostic (a confident diagnosis can be made of some lesions such as mature teratoma and mediastinal goiter) but is usually sufficient for preoperative evaluation before mediastinotomy or mediastinoscopy: it is instrumental in planning further diagnostic workup. In certain cases, magnetic resonance imaging (MRI) may be complementary to sCT, but its use is not considered routine. Besides, although the anterior mediastinum is suitable for sonographic examination, the diagnostic value of ultrasonography has not been fully exploited. Thyroid scanning with radioactive iodine is useful in identifying and evaluating masses of suspected thyroid origin. The role of fluorodeoxyglucose positron emission tomography (FDG-PET) in mediastinal diseases continues to be evaluated: it has potential for differentiating between benign and malignant disease and is expected to play a more extensive role in the imaging of mediastinal neoplasms in the future. In this paper, the radiological features of masses located in the anterior mediastinum are discussed, with particular reference to radiographic and CT patterns useful to the clinician's everyday practice.
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PMID:The anterior mediastinum: anatomy and imaging procedures. 1668 80

Congenital hypothyroidism (CH) occurs in approximately 1:2,000 to 1:4,000 newborns. The clinical manifestations are often subtle or not present at birth. This likely is due to trans-placental passage of some maternal thyroid hormone, while many infants have some thyroid production of their own. Common symptoms include decreased activity and increased sleep, feeding difficulty, constipation, and prolonged jaundice. On examination, common signs include myxedematous facies, large fontanels, macroglossia, a distended abdomen with umbilical hernia, and hypotonia. CH is classified into permanent and transient forms, which in turn can be divided into primary, secondary, or peripheral etiologies. Thyroid dysgenesis accounts for 85% of permanent, primary CH, while inborn errors of thyroid hormone biosynthesis (dyshormonogeneses) account for 10-15% of cases. Secondary or central CH may occur with isolated TSH deficiency, but more commonly it is associated with congenital hypopitiutarism. Transient CH most commonly occurs in preterm infants born in areas of endemic iodine deficiency. In countries with newborn screening programs in place, infants with CH are diagnosed after detection by screening tests. The diagnosis should be confirmed by finding an elevated serum TSH and low T4 or free T4 level. Other diagnostic tests, such as thyroid radionuclide uptake and scan, thyroid sonography, or serum thyroglobulin determination may help pinpoint the underlying etiology, although treatment may be started without these tests. Levothyroxine is the treatment of choice; the recommended starting dose is 10 to 15 mcg/kg/day. The immediate goals of treatment are to rapidly raise the serum T4 above 130 nmol/L (10 ug/dL) and normalize serum TSH levels. Frequent laboratory monitoring in infancy is essential to ensure optimal neurocognitive outcome. Serum TSH and free T4 should be measured every 1-2 months in the first 6 months of life and every 3-4 months thereafter. In general, the prognosis of infants detected by screening and started on treatment early is excellent, with IQs similar to sibling or classmate controls. Studies show that a lower neurocognitive outcome may occur in those infants started at a later age (> 30 days of age), on lower l-thyroxine doses than currently recommended, and in those infants with more severe hypothyroidism.
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PMID:Congenital hypothyroidism. 2053 82

Diiodomethyl-p-tolylsulfone (DIMPTS) was tested in developmental toxicity (DT) and reproductive toxicity studies. In the rat DT study, DIMPTS was administered at 0, 100, 300 or 1000 mg/kg/day. Maternal toxicity as evidenced by reductions in body weight gain or feed consumption at 1000 and, to a lesser extent, 300 mg/kg/day. The only developmental effect was umbilical hernia at 1000 mg/kg/day; therefore, NOELs for maternal and developmental toxicity were 100 and 300 mg/kg/day, respectively. In the rabbit DT study, NZW rabbits were gavaged with 0, 0.05, 0.5 and 2mg/kg/day DIMPTS. The NOEL for maternal toxicity was 0.5mg/kg/day, based on thyroid weight increase with histopathology. There were no observed developmental effects. In the two-generation study, CD rats were fed 0, 2.5, 10 or 40 mg/kg/day DIMPTS. Increased thyroid weight and histopathology were observed at all doses with associated pituitary findings in males. Reproductive toxicity at 40 mg/kg/day consisted of increased postimplantation loss, decreased gestation survival and two cases of dystocia, while litter size, pup survival/weight were affected at 10 and 40 mg/kg/day. The NOEL for parental toxicity could not be determined, while the NOEL for reproductive toxicity was 2.5mg/kg/day. The maternal thyroid and reproductive effects in this study were consistent with iodine toxicity.
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PMID:Assessment of the developmental and reproductive toxicity of diiodomethyl-p-tolylsulfone in rats and rabbits. 2217 71

I whole-body bone scan was performed for an adult male patient after postradioactive iodine ablation of thyroid carcinoma. Besides the small thyroid remnants in the neck region, an incidental detection of left inguinal hernia was made in the scan, which was later confirmed by clinical examination. Despite the large size of the hernia, the patient was unaware of the condition. It can be concluded that, similar to other imaging procedures, incidental detection of unrelated clinical problems is possible in I scan also, and such early diagnosis prevents further complications that the patient may develop in the future.
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PMID:Incidental detection of clinically nondiagnosed inguinal hernia in (131)I whole-body scan. 2364 Feb 39


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