False left ventricular aneurysm with ventriculo-bronchial fistula and massive haemoptysis.

An intravenous drug user presented with bacteraemia and massive hemoptysis 10 years after a penetrating cardiac injury. He was found to have false left ventricular aneurysm with ventriculo-bronchial fistula. The clinical course suggests that the aneurysm became infected and that the inflammatory process weakened the aneurysmal sac and led to the development of fistula. Prompt recognition of the aneurysm with appropriate surgical repair resulted in a successful outcome.

Three-dimensional computerized tomography: a quantum leap in diagnostic imaging?

Ever since the discovery of radium by Madame Curie, men and women of vision and science have labored to improve radiation technology. Over a period of approximately 85 years, we have gone from this initial discovery to three-dimensional computerized transmission tomography; one of the latest techniques in modern day x-ray imaging. Its uses are vast and unparalleled in many facets of medicine and surgery, outlining pathology as never before seen, and possibly, never before completely understood. Three-dimensional computerized tomography is rapidly gaining popularity in cross-sectional imaging of the foot and ankle. It has proven invaluable in elucidating osseous and soft tissue pathology. Abnormalities of the musculoskeletal system that exhibit complex anatomy are often difficult to interpret using standard radiographic techniques. Overall, three-dimensional computerized tomography has established itself as a means by which clinicians may appreciate the three-dimensional disposition of anatomy and disease.

Neonatal magnification radiography using standard-focus x-ray tubes.

Radiographic examination of the chests of premature newborn infants is complicated by the small size and poor object contrast of the structures to be evaluated. Magnification radiography can improve image quality significantly in this situation. Unfortunately, high-quality magnification radiography requires dedicated microfocus equipment that is not available in most neonatal intensive care units. The use of standard-focus x-ray tubes (up to 1 mm focal spot size) for moderate magnification radiography (1.5 times) by using the anode side of the x-ray field of the standard mobile x-ray unit is proposed. In addition to the cost advantage of using existing standard mobile x-ray equipment, the high tube current allows for short exposure times and long target-film distances. This reduces most motion unsharpness and allows for a large air gap that results in improved image contrast. Although focal spot size at the anode side of the field is smaller in only one dimension, the magnification radiographs are superior to those obtained using the central part of the x-ray beam and superior to standard contact radiographs using the same equipment. Improvement in image quality is due primarily to decreased noise and improved contrast in the magnified image.