clinical and radiological aspects of cannon balls in the chest x-ray

Twenty five consecutive patients with multiple cannon balls in the chest X-ray were studied. The commonest causes were choriocarcinoma, multiple hydatid cysts, and breast cancer. The absence of emaciation and weight loss were important clinical clues in Hydatid disease. Lesions in hydatid were mainly in the lower zones [especially the right]. The presence of oval lesions, with flattened adjacent edges and absence of lymphadenopathy all suggested hydatid disease, while malignant deposits were mainly rounded and more in both mid and lower zones. Cavities were present in all cases of hydatids but also in some tumours. Ultrasound of the liver detected hydatid cysts in all patients with multiple lung hydatids, while ultrasound of the pelvis was helpful in choriocarcinoma. Conventional lung tomography helped to define the radiological characteristIcs of cannon balls and demonstrated lesions which were not seen by plain chest-x-ray

Nifedipine in cor pulmonale

Twelve patients with cor pulmonale secondary to chronic obstructive pulmonary disease had their arterial blood gases and lung function tests measured before and three weeks after nifedipine 10mg tds. PaO2 increased from 66.43 +/- 11.9 mm Hg to 71.98 +/- 10.8 mm Hg[P< 0.05]. Pa 002 decreased from 60.56 +/- 9.1 mm Hg to 55.37 +/- 7.1 mm Hg [P<0.02]. The arterial saturation increased from 76.28 +/- 6.5% to 83.71 +/- 4.9% [P<0.001]. The FEVI, PEVI / PVC and MVV all improved but the change was not statistically significant. There was an over all improvement of symptoms in all patients

pattern of valvular heart disease in Iraqi patients attending a major cardiac center

Two hundred and twenty consescutive cases of valvular heart disease were studied. They constituted 20.8% of cardiac admissions and 5.4% of total admissions in the five medical units and cardio-thoracic surgical unit at the Medical City Teaching Hospital in Baghdad. About 1/3 of the patients were less than 20 years old. The overall sex ratio was about equal [112 males and 108 females] but under the age of 20 the M/F ratio was 2:1. The most frequent valve affected was the mitral valve [52%], followed by the aortic valve and combind aortic and mitral valve leasions [19% for each category]. Pulmonary stenosis constituted 5% of cases while mitral valve prolapse and non rheumatic tricuspid regurgitation constituted 2% each. The peak incidence of mitral stenosis was in the fourth and fifth decades, aortic stenosis in the 1st and 6th decades, while mitral regurgitation, aortic regurgitation and combind mitral and aortic valve lesions had a peak incidence in the 2nd decade. Fourty - two precent of patients were in grades III and IV according to the New York Heart Association functional classification. History of rheumatic fever was obtained in 46% of patients with a mean age of onset of 11.7 +/- 3yrs. and amean latent interval of 9 +/- 3.3 years between initial attack of rheumatic fever and appearance of cardiac symptoms. Only 30% of patients with rheumatic heart disease were taking adequate prophylaxis for rheumatic fever. Infective endocarditis was present in 31 patient [14%]. Systemic embolism in 8 patients [3.6%] and atrial fibrillation in 64 patients [29%]

Pulmonary aspergillosis: a case report

A case of aspergilloma is described in an asthmatic farmer previously treated for pulmonary TB. Clinically there was amphoric breathing in the right apex and the chest x-ray showed a typical appearance of a rounded shadow with a halo around it. Diagnosis was confirmed by culturing. A fumigatus from the sputum on two occasions