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C Tuchmann

Publications and source records attributed to C Tuchmann.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Potential role of duplex Doppler sonography in acute renal colic.

PURPOSE: We assessed the value of renal duplex Doppler sonography in diagnosing obstruction in patients with acute renal colic. METHODS: We compared the results of renal duplex Doppler sonography with those of intravenous urography (IVU) in 65 patients presenting with symptoms of renal colic. The Doppler spectral waveforms were used to calculate the resistance index (RI). The difference between the mean RIs (delta RI) in the 2 kidneys was calculated for each patient. The sensitivity, specificity, and accuracy of delta RI for the diagnosis of obstruction were calculated with several discriminatory thresholds. RESULTS: All patients had an obstruction on IVU. When a high delta RI threshold for obstruction (delta RI > or = 0.1) was applied, the sensitivity and specificity of duplex Doppler sonography were 10% and 80%, respectively. When the delta RI threshold was decreased, the sensitivity increased but the specificity decreased, and both remained quite low. Twelve patients had a lower mean RI in the obstructed kidney than in the normal contralateral kidney. Among 14 patients without pyelocaliceal dilatation, the sensitivity of duplex Doppler sonography was 70% with a delta RI threshold of 0.03. CONCLUSIONS: Duplex Doppler sonography is not sensitive enough to diagnose obstruction in patients with acute renal colic.

Acute Disease↗
PubMedDate not supplied

Duplex Doppler sonography of the flaccid penis: potential role in the evaluation of impotence.

PURPOSE: Duplex Doppler sonography of the cavernosal arteries of the penis with intracavernous injection (ICI) of vasoactive agents has been widely used to evaluate arterial insufficiency in impotence. Our goal was to assess the potential value of peak systolic velocity (PSV) measurements on the flaccid penis in the diagnosis of arteriogenic impotence. METHODS: Forty-four men underwent duplex Doppler sonography with PSV measurements before and after ICI of prostaglandin E(1). Three different cutoff values for lowest normal PSV before injection-5 cm/second, 10 cm/second, and 15 cm/second-were tested. RESULTS: Thirteen patients had arteriogenic insufficiency based on post-ICI duplex sonography and clinical response. Results for our different cutoff PSV values of 5 cm/second, 10 cm/second, and 15 cm/second in diagnosing arteriogenic impotence were, respectively: sensitivity 29%, 96%, and 100%; specificity 100%, 92%, and 23%; negative predictive value 80%, 92%, and 100%; positive predictive value 100%, 81%, and 41%; and overall accuracy 79%, 93%, and 44%. In the flaccid state, there was a significant difference in mean PSV between the "normal" group (12.6 +/- 0.9 cm/second) and the arteriogenic impotence group (7.7 +/- 1.1 cm/second). Twenty-nine patients with a bilateral PSV of 10 cm/second or less before ICI had a normal clinical response. CONCLUSIONS: A cutoff PSV value of 10 cm/second in the flaccid state had the best accuracy in predicting arterial insufficiency. Duplex Doppler sonography is proposed as the initial test to evaluate the penile arterial supply and to determine whether patients are good candidates for therapy with ICI.

Adult↗
PubMedDate not supplied

Appendiceal stump abscess.

Recurrence of traditionally treated appendicitis is rarely reported but known to surgeons and is probably underestimated. We described a case, illustrated by CT, of stump abscess 2 years after laparoscopic appendectomy. Sonography and CT are helpful in detecting pericecal changes, but diagnosis is confirmed by laparotomy.

Abdominal Abscess↗