Search PubMed⌕ Search

Biomedical subjects

B B Gosink

Publications and source records attributed to B B Gosink.

At least 37 records · Page 2Linked to original sources
PubMed1988

Gallbladder and bile duct abnormalities in AIDS: sonographic findings in eight patients.

Gallbladder and biliary tract abnormalities were observed on sonography in eight patients with AIDS. The studies were obtained to evaluate right upper quadrant pain (two patients), tenderness (three patients), and abnormal liver function tests (eight patients). The two major sonographic findings were gallbladder wall thickening (eight patients), which often was marked, and bile duct dilatation (two patients). Gallbladder wall thickness varied from 4 to 15 mm and was greater than 1 cm in four patients. Follow-up sonograms in five patients showed increasing wall thickness in four and decreasing thickness in one, but these findings did not correlate well with the clinical status of the patient. Pericholecystic fluid was shown in three cases. None of the patients had gallstones. Common bile duct dilatation varied from 12 to 15 mm; no specific cause for dilatation was found by cholangiography. Mycobacterium avium intracellulare was recovered from the gallbladder in one patient, and Cryptosporidium was recovered from the duodenum in two patients. AIDS should be considered in the differential diagnosis of gallbladder wall thickening or bile duct dilatation in the appropriate clinical setting. These findings may indicate opportunistic infection of the biliary tract. A disparity may exist between the mild symptoms and signs (or lack of symptoms and signs) related to the gallbladder and bile ducts and the sometimes marked sonographic abnormalities.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Sonographic evaluation of the fetal stomach: significance of nonvisualization.

The stomach was successfully visualized in 1051 (98%) of 1071 consecutive sonograms obtained in 995 fetuses after 14 weeks gestational age. All patients were studied prospectively. Stomach nonvisualization was associated with an abnormal outcome in 55% of the fetuses studied after 14 weeks and in 100% of the fetuses studied after 19 weeks. Fetal abnormalities included gastrointestinal and CNS malformations. Oligohydramnios was often present. The absence of a stomach on fetal sonograms obtained after 14 weeks gestational age strongly suggests fetal abnormality. Repeat sonograms should be obtained in all such cases.

Female↗
PubMed1987

Perfluorochemicals as US contrast agents for tumor imaging and hepatosplenography: preliminary clinical results.

In animals, perfluorochemicals (PFCs) are effective ultrasound (US) contrast agents that produce hepatic, splenic, and tumor enhancement. The use of Fluosol-DA 20%, an emulsion of perfluorodecalin and perfluorotripropylamine, was studied in nine non-critically ill patients with cancer who had liver lesions. US studies without Fluosol were compared with studies obtained 24, 48, and 72 hours after Fluosol infusion. Vital signs and extensive laboratory analyses are performed before and after Fluosol infusion. Liver metastases from colonic, pancreatic, and gastric carcinoma exhibited rim or diffuse enhancement after a Fluosol dose of 1.6 g/kg or greater. Fluosol produced echogenic enhancement of the liver and spleen relative to kidney at a dose of 2.4 g/kg, allowing the detection of nonenhancing lesions. In addition, Fluosol at a dose of 1.6 g/kg or greater allowed detection of lesions not seen before contrast medium was administered in three of the seven patients studied. There was a mild increase in the level of serum glutamic oxaloacetic transaminase in two patients, one given 2.4 and the other 3.2 g/kg of Fluosol. Mild and transient allergic reactions without change in vital signs were experienced by two patients.

Aged↗
PubMed1987

Sonography of thigh abscess: detection, diagnosis, and drainage.

Sonographic characteristics and percutaneous catheter drainage of thigh abscesses in 18 patients are described. Most of these patients had underlying diseases including osteomyelitis, trauma, diabetes mellitus, rheumatoid arthritis, leukemia, lymphoma, sepsis, bleeding dyscrasia, and autoimmune disease. Previous procedures on these thigh collections included seven operations and 12 nondiagnostic ward aspirations. All collections were shown by sonography to be either anterior or anterolateral. Two cases referred for drainage were posteromedial; sonography showed these to be mycotic pseudoaneurysms. The abscesses were either anechoic or hypoechoic, and occasionally had debris and septations. Abscesses associated with underlying osteomyelitis abutted the femur; those related to other causes generally were more superficial within muscle or fascial layers. Sonographically guided catheter drainage successfully cured all patients, even those in whom ward aspiration or formal surgery had been unsuccessful. Sonography is a simple and inexpensive method of imaging and guiding the drainage of thigh abscesses. Percutaneous catheter drainage is the treatment of choice in cases in which simple emergency room or ward incision and drainage are inadequate.

Abscess↗
PubMed1986

Unchanged size of a dilated common bile duct after a fatty meal: results and significance.

Sonographic measurement of common bile duct caliber alone is insufficient to ascertain the presence of obstruction. Fatty meal stimulation significantly improves diagnostic accuracy. An increase in caliber of a normal or slightly dilated common duct after the subject has ingested a fatty meal is a strong indicator of biliary obstruction, while a decrease in caliber indicates normal dynamics and virtually excludes obstruction. This study determines the significance of no change in the caliber of the dilated common bile duct of subjects who have eaten a fatty meal. Further imaging studies and clinical/laboratory follow-up of 31 patients showed that in 84% of the cases no obstruction was present. A dilated common duct that does not decrease in size after a fatty meal is not a specific indicator of obstruction. The use of invasive diagnostic procedures in these patients is not advised unless there is other evidence of biliary obstruction.

Adult↗
PubMed1986

Fluid in the female pelvis: cyclic patterns.

A total of 254 pelvic sonograms were performed on 40 volunteers in order to determine a cyclic pattern, if any, of free fluid in the pelvis in asymptomatic premenopausal women. Free fluid was observed during all phases of the menstrual cycle. The highest percentage of positive-for-fluid sonograms was observed within 5 days preceding onset of menses in both oral contraceptive users and non-oral contraceptive users. The second highest percentage was observed between days 13 and 21 in non-oral contraceptive users.

Adolescent↗
PubMed1985

Intrahepatic amebic abscesses: indications for and results of percutaneous catheter drainage.

Medical therapy is standard for intrahepatic amebic abscess and generally is effective. However, we have encountered a group of patients in whom percutaneous aspiration and drainage was indicated due to uncertainty of diagnosis or clinical deterioration of the patient. Twenty such patients underwent percutaneous drainage with ultrasound or CT guidance, and each patient was cured (appropriate antibiotics were administered concomitantly). The specific indications for intervention were to differentiate pyogenic from amebic abscess, pain and imminent rupture, poor response to medical therapy, false-negative results of serologic tests, noncompliance with medical treatment, left lobe abscess, and pregnancy. Diagnosis of amebiasis from examination of the fluid was seldom possible, while findings from core biopsy of the wall of the abscess led to diagnosis in three cases. Recurrence necessitating redrainage occurred in three patients; in each, catheters were removed the same day drainage was performed. There were three minor complications. Differences from percutaneous management of pyogenic abscesses included more rapid removal of catheters (four days), more frequent use of US guidance, and more common use of the prone angled approach to avoid pleural contamination. Catheter drainage may be curative and may expedite care for problematic amebic liver abscesses in selected cases.

Adult↗
PubMed1985

Characteristic sonographic signs of hepatic fatty infiltration.

Hepatic fatty infiltration sonographically appears as an area of increased echogenicity. When focal areas of fat are present in otherwise normal liver parenchyma, the fatty area may be masslike in appearance, leading to further imaging evaluation and sometimes even biopsy. This article discusses seven patients with focal fatty infiltration, who had sonographic signs that were highly suggestive of the fatty nature of the masses. These signs included angulated, geometric margins between normal and fatty tissue and interdigitating margins with slender fingers of normal or fatty tissue. These signs may be useful in diagnosing masslike areas of focal fatty infiltration and distinguishing these sonographically from other hepatic mass lesions.

Aged↗
PubMed1985

Coronal sonography: a review of abdominal applications.

Many abdominal structures are optimally imaged in the coronal plane because of their unique shape or environment. Routine application of coronal ultrasound scanning to the spleen, kidneys, and liver is advocated. Adjunctive coronal images of the biliary tract, inferior vena cava, aorta, and retroperitoneum complement or frequently provided diagnostic information unavailable in routine views. Inadequacy of acoustic windows or limitations of tissue-beam interaction encountered in transverse and sagittal projections may be overcome with coronal scans.

Abdomen↗
PubMed1983

Perfluorochemicals as liver- and spleen-seeking ultrasound contrast agents.

In this study, Fluosol-DA, 20 per cent (composed of perfluorodecalin and perfluorotripropylamine) was tested as a liver-specific ultrasound contrast agent. Twelve normal rabbits were scanned, utilizing the Picker Microview (10 MHz), prior to and two days following the intravenous administration of 24 ml/kg of Fluosol (or 4.8 g/kg of perfluorochemicals) emulsion to ten of the rabbits and 24 ml/kg of Ringer's solution to two rabbits as control. In all ten rabbits given Fluosol, liver echogenicity increased relative to that of the kidney, whereas the liver remained less echogenic than the kidney in the two rabbits given Ringer's solution. Four independent reviewers correctly identified all rabbits that received Fluosol and both rabbits that received Ringer's solution. It is demonstrated that, similar to PFOB, Fluosol serves as an echogenic contrast material for ultrasound and opacifies the normal rabbit liver.

Animals↗
PubMed1982

Retrospective study of ureteral obstruction following vascular bypass surgery.

Although several cases of ureteral obstruction after vascular bypass surgery for aortoiliac disease have been reported, the incidence of this potentially critical complication has not been established. In this study, 57 selected patients who had undergone vascular bypass surgery were examined with ultrasound for evidence of ureteral obstruction. Hydronephrosis was discovered in 1 of 57 patients (1.75 per cent) over-all (symptomatic and asymptomatic); no evidence of obstruction was found in the asymptomatic patients. These results fail to corroborate the impression of several investigators that undetected ureteral obstruction may be present in a significant number of patients after vascular bypass surgery.

Humans↗
PubMed1982

Perfluoroctylbromide: a liver/spleen-specific and tumor-imaging ultrasound contrast material.

The effect of perfluoroctylbromide (PFOB) on liver and tumor echogenicity was evaluated in rabbits. The echogenicity of the kidney, which is not affected by PFOB, was used as the basis for comparison in the liver studies. For the liver echogenicity study, sonography was performed on four rabbits, two with PFOB and two without PFOB, and four rabbits prior to and following the intravenous administration of 5 ml/kg PFOB. All livers were equal to or less echogenic than kidney in the control animals. All livers became more echogenic than kidney two days after administration of PFOB. The effect of PFOB on tumor echogenicity was evaluated in 18 rabbits with VX2 tumor implanted in the liver. Ultrasound studies of all rabbits were performed by the same physician before and two days after half the rabbits had received PFOB (5 ml/kg intravenously). The reviewers correctly identified all rabbits that received PFOB by visualization of an echogenic rim around the hepatic tumors.

Animals↗
PubMed1982

Ultrasound evaluation of the anterior musculofascial compartment of the leg following exercise.

An ultrasonic method is described to measure changes in width of the anterolateral leg compartment in its lower third following exercise. In 20 normal subjects, compartment widths increased an average of 8.6% following exercise, with joggers' compartments increasing 10.1%, as compared to 7.4% in nonjoggers. Control measurements of the compartment width in a cadaver leg showed excellent correlation with the ultrasound measurement. Following exercise, vascular responses and fluid transfers caused an increase in volume of the compartment contents, which is reflected in compartment widening. Because the compartment contents are usually contained by a complete but only moderately compliant wall, intracompartmental pressure will normally rise, and symptoms of a compartment syndrome will result. Diagnosis of exertional compartment syndrome in the leg has usually been made at clinical examination. Measurement of compartment width increase is intended to complement intracompartmental pressure and aid in differentiating the diagnosis of exertional compartment syndrome from shin splints, stress fracture, and tendonitis. Additionally, muscle atrophy, hypertrophy and growth can be recorded by the ultrasound technique.

Adult↗
PubMed1981

Ultrasonic determination of hepatomegaly.

Retrospective evaluation of abdominal ultrasound examinations were made in 36 patients who came to autopsy within 1 month after the ultrasound study. Without knowledge of clinical or autopsy data, two observers made independent determinations of the midhepatic line measurement of the liver on the ultrasound study using supine and left lateral decubitus longitudinal scans. Autopsy determination of hepatomegaly was made using hepatic weight, patient's total body weight, and patient age correlated with pertinent clinical history. Results of the autopsy/ultrasound correlation demonstrated that those livers measuring 13.0 cm or less in the midhepatic line (both supine and left lateral decubitus positions) were normal in 93% of the cases. Similarly, it was demonstrated that when the liver measured 15.5 cm or greater, it was enlarged in 75% of the cases. Used together, these two criteria result in an 87% accuracy rate in determining the presence or absence of hepatomegaly. Approximately 25% of the cases in our study fell into the borderline category of 13.0-15.5 cm.

Age Factors↗