Xanthoma disseminatum of the central nervous system and cranium.

Xanthoma disseminatum is a rare normolipemic histiocytic disorder of non-Langerhans cell origin. It is a chronic systemic disease with a benign course, characterized by disseminated, yellow-orange-colored papules on the face, flexures, and mucosal membranes. We report 3 patients with xanthoma disseminatum, who presented primarily with central nervous system disease and a multitude of imaging findings throughout the craniospinal axis.

Evaluation of the role of ultrasound machines as a source of nosocomial and cross-infection.

RATIONALE AND OBJECTIVES: To evaluate the potential role of ultrasonography probes and coupling gel for cross-infection in patients undergoing ultrasonography; to describe a cost-effective method of probe handling; and to emphasize the importance of position of the probes in the boxes. METHODS: Cultures were taken from 43 probes used in different scanning regions. Cultures were also taken from probe boxes and coupling gel. RESULTS: After abdominal scanning, cleaning with paper seems to be effective, but even wiping with alcohol is insufficient for inguinal and axillar regions. Before scanning of these areas is started, cleaning the inguinal and axillar regions with alcohol reduces the contamination risk. Placing the probes downward in boxes also increases the risk of contamination. CONCLUSIONS: Wiping the probes with dry paper seems to be effective only for abdominal scanning; for inguinal and axillar scanning, cleaning the region with alcohol before scanning seems more appropriate. Placing the probes downward in boxes may also be a source of contamination.

Central nervous system involvement of polyarteritis nodosa: a case report.

Polyarteritis nodosa (PAN) is a necrotizing vasculitis involving small and medium-sized arteries and it affects multiple organ systems in the body Central nervous system (CNS) involvement appears less frequently, and usually develops after the disease is established. Although aneurysms are common in visceral arteries in PAN, intracranial aneurysms are uncommon and have been documented rarely. This case is reported to raise awareness among radiologists as it has characteristic and rare, if not specific, imaging findings of CNS involvement of PAN.

Sildenafil citrate for penile hemodynamic determination: an alternative to intracavernosal agents in Doppler ultrasound evaluation of erectile dysfunction.

OBJECTIVES: To suggest a new noninvasive method for penile Doppler ultrasound (PDU) evaluation of erectile dysfunction using oral sildenafil citrate as an erection induction agent. METHODS: A total of 20 patients admitted with the complaint of erectile dysfunction were evaluated by the short form of the International Index of Erectile Function. A total score of less than 25 was accepted as erectile dysfunction and PDU was performed. The initial penile study consisted of PDU examination under visual sexual stimulation (VSS), and the peak systolic velocity, end-diastolic velocity, and resistance index were recorded. Measurements of all the parameters were repeated on the same patients after intracavernosal papaverine, intracavernosal prostaglandin E(1) (PGE(1)), and oral sildenafil citrate administration, plus VSS. All patients had these four tests in the same order at weekly intervals. Sildenafil citrate was given orally 45 minutes before Doppler investigation, and patients had VSS during the waiting period. The patients were asked about their satisfaction and comfort after each test. Statistical analysis was performed using the Wilcoxon and Mann-Whitney U tests. RESULTS: The measurements with papaverine, PGE(1), and sildenafil citrate were significantly different from those after only VSS (P <0.008); however, the papaverine, PGE(1), and sildenafil citrate results were not different from each other according to the peak systolic velocity, end-diastolic velocity, and resistance index measurements (P >0.008). Patients commented that although PGE(1) was the strongest erectogenic agent, sildenafil citrate was the most convenient. CONCLUSIONS: Since the results of PDU with oral sildenafil citrate in association with VSS were not statistically different, we suggest a new noninvasive erection induction method for the purpose of PDU evaluation of erectile dysfunction.

MRI of three siblings with Sjögren-Larsson syndrome.

Sjögren-Larsson syndrome (SLS) is a rare disorder with autosomal recessive inheritance. Its clinical, pathological, genetic, and biochemical manifestations have been thoroughly evaluated, but there is little imaging data, especially regarding MRI. We present brain MRI of three siblings with SLS and discuss our findings.

Primary posterior chest wall echinococcosis.

Hydatid cyst is not mentioned among the chest wall tumours in areas not known to harbour echinococcosis. One of the uncommon sites for echinococcosis even in endemic countries is the chest wall. The striking resemblance between neoplasm and hydatid cysts forms a diagnostic dilemma and makes the correct diagnosis essential before surgery.

Contrast enhancement in the craniopharyngioma cyst wall caused by irradiation.

PURPOSE: To report the occurrence, degree, frequency, and duration of contrast enhancement in the craniopharyngioma cyst wall as caused by irradiation. MATERIAL AND METHODS: Eight patients with cystic craniopharyngiomas had comparable CT or MR studies before and after either external irradiation of the cyst (n = 5) or 32P instillation into the cyst (n = 3). RESULTS: A minimal to marked increase in cyst-wall enhancement was seen at 66-157 days after 32P instillation in 3/3 cases and at 112-495 days after external irradiation in 3/5 cases. The increased enhancement was always associated with a variable interim increase in the thickness of the enhanced cyst wall. CONCLUSION: CT or MR imaging after the irradiation of cystic craniopharyngiomas usually demonstrated an increase in thickness and enhancement in the cyst wall. Such changes may be due to the irradiation alone and do not necessarily represent infection or increased neoplastic activity. The timing is uncertain as to the earliest possible development of such changes and their maximum duration, but they were seen as early as 66 days post-irradiation and as late as 495 days post-irradiation.

Colonic hamartomatous polyposis associated with hypertrophic osteoarthropathy.

A 7-year-old girl with an unremarkable family history was admitted with complaints of diarrhea containing mucus and blood, abdominal pain, weight loss and fever for 10 months. Although her symptoms, physical examination and laboratory results were highly suggestive of inflammatory bowel disease, radiologic studies and colonoscopy demonstrated multiple colonic polyps. A bilateral and symmetric lamellar periosteal reaction and osteopenia were present on her extremity radiographs. The chest radiograph and thoracic CT scan were normal. The histologic nature of the polyps was determined as hamartoma. One month after subtotal colectomy, the patient's symptoms resolved and she gained 7 kg in weight. The association of generalized juvenile polyposis and hypertrophic osteoarthropathy has previously been described in five cases; arteriovenous malformations were present in four of them. In our case the polyps were hamartomatous and localized in the colon, without associated arteriovenous malformation.