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Biomedical subjects

B Kaufman

Publications and source records attributed to B Kaufman.

197 records · Page 11Linked to original sources
PubMedDate not supplied

Femoral artery pseudoaneurysm: Doppler sonographic features predictive for spontaneous thrombosis.

PURPOSE: The objective of this prospective study was to evaluate whether Doppler imaging characteristics can be used to predict spontaneous thrombosis of femoral artery pseudoaneurysms (PAs). METHODS: Eleven post-cardiac catheterization PAs were monitored with color Doppler sonography. Total volume of the lesion, volume filled with free-flowing blood, length and width of the neck of the PA, and its anatomic position were evaluated. RESULTS: All of the PAs in our series underwent spontaneous thrombosis. PAs with necks 0.9 cm or longer underwent spontaneous thrombosis in 9.8 days on average, while PAs with necks shorter than 0.9 cm required an average of 52 days to thrombose. CONCLUSIONS: PAs with longer neck lengths are more likely to thrombose in a shorter period than are those with shorter necks. It may thus be worthwhile to await spontaneous resolution when the aneurysmal neck length is 0.9 cm or more.

Aneurysm, False↗
PubMedDate not supplied

Anesthetic care of a patient with an intracranial hemorrhage after thrombolytic therapy.

Thrombolytic therapy is being used with increasing frequency to treat acute myocardial infarction (MI). It is important for both the general and cardiac anesthesiologist to understand the effects of thrombolysis on hemostasis and myocardial function, since these patients can present for emergent surgery in the cardiac or general operating theater. The authors report a case of a patient who developed an intracranial hemorrhage following thrombolytic therapy that required emergency surgical intervention.

Anesthesia, Intravenous↗
PubMedDate not supplied

Absent right precordial R waves are associated with reduced left ventricular function and poor prognosis in patients with aortic stenosis.

Right precordial Q waves can be present in patients with aortic stenosis as well as in those with anterior myocardial infarction. In order to evaluate the relationship of right precordial Q waves to left ventricular function and prognosis in patients with aortic stenosis, we studied 49 such patients with no history of myocardial infarction, by means of ECG, clinical history and echocardiography. 15 (31%) patients had Q waves in both V1 and V2 and 34 (69%) did not. There were no differences in age (77+/-9.0 years vs. 78+/-9.7), follow-up time (15+/-9.0 months vs. 18+/-10), gender (female:male 8:7 vs. 15:19), aortic valve gradient on Doppler (70.0+/-20 mmHg vs. 71+/-20) and left ventricular mass (360+/-118 g vs. 320+/-80) between the two groups (all P=NS). Left ventricular shortening fraction (22+/-9.0% vs. 28+/-8.5, P<0.05), ejection fraction (51+/-15% vs. 62+/-12, P<0.01) and circumferential fibre shortening (0.8+/-0.3 circ/s vs. 1.0+/-0.3, P<0.0s) were all significantly reduced in patients with right precordial Q waves compared to those without. During a mean follow-up of 1.5 years, 9 out of 15 (60%) patients with right precordial Q waves died compared with only 5 out of 34 (15%) patients with a normal QRS pattern died (P<0.01). In summary, a right precordial QS ECG pattern is present in nearly 1/3 patients with aortic stenosis and is associated with impaired left ventricular systolic function and adverse prognosis.

Aged↗
PubMedDate not supplied

MR imaging of pediatric cerebral abnormalities.

One hundred sixteen magnetic resonance (MR) imaging studies from 105 pediatric patients with a variety of cerebral abnormalities were reviewed to determine the diagnostic efficacy of MR in the pediatric population. All subjects tolerated the MR procedure well, although sedation was necessary for younger children. Compared with CT, MR proved to be advantageous in detection and characterization of the pathology in 23 of 105 patients, especially when the abnormality was located along the base of the brain and midline, or when it involved primarily the white matter. Intracranial calcification was the one abnormality not detected with MR although dense calcifications could be seen as areas of low signal intensity. Some characteristics of various pathological entities were compared in an attempt to differentiate among abnormalities in the same anatomical location: craniopharyngioma from optic chiasm and hypothalamic glioma, cystic glioma from arachnoid cyst, and chronic subdural hematoma from subdural hygroma. The lack of ionizing radiation in MR is of particular interest in pediatric neuroradiology since radiation is of special concern in the young age group.

Adolescent↗
PubMedDate not supplied

MR imaging of brain stem gliomas.

Magnetic resonance (MR) and CT examinations of 26 patients with the established or clinically suspected diagnosis of brain stem glioma were reviewed. Eleven tumors were seen on both MR and CT. The entire extent of the abnormality was better outlined on MR, although CT was more advantageous in demonstrating cystic components and calcium deposition. Magnetic resonance and CT depicted focal intratumoral hemorrhage equally. Magnetic resonance was found to be particularly suitable to follow up the progression or regression of the disease. Of particular interest were two patients with evidence of aqueductal obstruction but normal CT appearance of the midbrain; the causative abnormality, believed to be a glioma, was clearly shown by MR imaging. In nine patients the normal appearance was helpful to exclude the possibility of a brain stem glioma. Thus far, results have shown 100% sensitivity (true positive ratio) and specificity (true negative ratio) with MR in the evaluation of brain stem gliomas. It is concluded that MR imaging should be the examination of choice and could be the definitive screening procedure in patients with suspected brain stem glioma.

Adolescent↗
PubMedDate not supplied

The endorectal pull-through procedure in children and young adults: a follow-up study.

At our institution, proctocolectomy with rectal mucosectomy and ileoanal anastomosis with endorectal pull-through is now the procedure of choice for young patients with chronic ulcerative colitis and familial polyposis. We have followed up 66 patients (37 male and 29 female, with a median age of 16 years) for at least 6 months after closure of the temporary ileostomy. The patients were seen regularly in follow-up or were sent a comprehensive questionnaire to assess their condition. Twenty-two patients had the construction of a J-pouch, and 44 had a straight ileo-anal pull-through. Stool frequency, day (median 4 to 7 stools) and night (median 1 to 3 stools), was similar in the two groups. Voluntary continence was excellent in both groups during waking hours. Occasional night-time incontinence in small volumes, mild perianal itching, and minimal bleeding from irritation were similar in both groups. Most of the patients could distinguish gas from stool. When medication was used, bulk agents were usually chosen, with a nonspecific antidiarrheal agent taken occasionally. A few patients with the straight ileo-anal pull-through expressed some dissatisfaction early during the follow-up period; however, all but two patients expressed satisfaction later. Of the 66 patients, 41 had at least one complication during the postoperative period; however, in 26 the complications were minor. The more severe complications included small bowel obstruction (11 patients requiring surgical decompression), infection (one patient requiring surgery), and transient neuropathy (three patients).

Adenomatous Polyposis Coli↗
PubMedDate not supplied

A sensitive noninvasive analysis of Pt in external tissues. Followup of Pt deposition following cisplatin treatment.

Noninvasive analysis of heavy elements in external tissues by diagnostic-x-ray spectrometry (DXS) is presented. Pt can be detected accurately with sensitivity below 1 microgram/g wet weight of tissue. In the present paper the possibility to monitor Pt accumulation and clearance in the external tissues of cancer patients treated with cisplatin [Cis-diamminedichloroplatinum (II)-cDDP] chemotherapy is reported. The DXS method is based on x-ray fluorescence analysis. Heavy elements in the small skin area of interest are analyzed by their excitation with a monochromatic soft x-ray beam of 14.6 KeV. Spectral L lines of heavy metals such as Pt are detected with minimum interference by other elements in the tissues. Skin Pt levels up to about 6 micrograms/g were observed following several courses of cDDP treatment. The Pt seemed to be homogeneously distributed in different skin areas with similar levels in the dermis and epidermis. The rate of clearance of Pt from the skin (50% in about 30 days) was slower by three orders of magnitude than its clearance from plasma. Further studies may use DXS to establish the accurate kinetics of Pt deposition and clearance in tissues of cDDP treated patients, as well as the exact relation between tissue Pt levels and the development of the drug related late complications.

Biophysical Phenomena↗
PubMedDate not supplied

Bilateral Nothnagel syndrome. Clinical and roentgenological observations.

The clinical features of a patient with bilateral oculomotor palsy, ataxia, disturbance of memory, and hypokinesia are described. Pneumography and CT scanning showed dilation of the posterior portion of the third ventricle, indicating involvement of the postero-medial thalamic structures. The relation of this finding to the patient's amnesia and hypokinesia is briefly discussed. It is concluded that the patient suffered an infarction within the region served by penetrating branches which arise from the cephalad end of the basilar artery, probably including the mesencephalic artery.

Amnesia↗
PubMedDate not supplied

Acute NMR changes during MCA occlusion: a preliminary study in primates.

Advancements in computer science and magnet design have resulted in the recent development of high resolution NMR imaging systems. Using our primate model we evaluated the ability of NMR scanning to detect early changes following middle cerebral artery (MCA) occlusion. Serial NMR scans documented progressive changes secondary to edema and swelling beginning ninety minutes after MCA occlusion. NMR was also able to readily demonstrate the area of cerebral infarct 10 days after a six hour episode of MCA occlusion. Soft tissue contrast and image resolution were superb. Correlation with pathologic sections was excellent.

Animals↗
PubMedDate not supplied

Demonstration of diastematomyelia and associated abnormalities with MR imaging.

Three patients were studied with a 0.3 T superconducting magnet to assess the role of magnetic resonance (MR) imaging in the recognition and evaluation of diastematomyelia and associated abnormalities. Comparison was made with other imaging techniques, including metrizamide computed tomographic (CT) myelography. With MR imaging, the divided spinal cord was well imaged in its entire craniocaudal extent, comparable to CT myelography. The bony septum, when it contained a marrow cavity, was also seen well. In two patients, dural ectasia and low position of the spinal cord with and without associated lipoma were clearly imaged. MR imaging demonstrated associated syringohydromyelia in one patient that was not detected by other radiologic studies. This preliminary experience with MR imaging of diastematomyelia suggests that once the bony details of the abnormality are defined, MR imaging can delineate the presence and extent of the divided spinal cord as well as its associated abnormalities adequately, obviating other studies.

Adolescent↗
PubMedDate not supplied

Doctors and rugby union football: a research and development project.

For several decades, unconfirmed rumours have suggested that prowess at rugby can help in securing a place at certain medical schools. It is a fact that most medical schools can field at least one team of rugby players with their attendants. After qualification, however, active participation in the game (of rugby) rapidly drops away and there is no suggestion that playing rugby confers any advantage in passing the MRCP or other postgraduate medical qualifications. This paper addresses the association of doctors with rugby.

Football↗