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Biomedical subjects

E Buonocore

Publications and source records attributed to E Buonocore.

At least 55 records · Page 3Linked to original sources
PubMed1982

Digital subtraction angiography for postoperative evaluation of renal arterial reconstruction.

Digital subtraction angiography after peripheral intravenous injection of contrast material is a new method to evaluate the cardiovascular system. Digital subtraction angiography was obtained postoperatively in 21 patients undergoing renal revascularization for treatment of hypertension and/or preservation of renal function. Digital subtraction angiography provided excellent visualization of the reconstructed renal arterial supply in all cases. The advantages and limitations of this technique in the evaluation of patients with renovascular disorders are discussed.

Aged↗
PubMed1982

The use of percutaneous transluminal angioplasty for renal artery stenosis in patients with generalized atherosclerosis.

From April 1979 to March 1981 percutaneous transluminal angioplasty was attempted in 27 patients with atherosclerotic renal artery stenosis. In 13 patients percutaneous transluminal angioplasty was considered successful with a decrease in blood pressure and/or improvement in renal function. Dilation of the stenosed renal artery was not technically possible in 4 patients and was unsuccessful in 10. Eight patients required surgical intervention after percutaneous transluminal angioplasty, including 4 electric operations and 4 done on an emergency basis. In our series 5 patients sustained intimal tears of the renal artery during percutaneous transluminal angioplasty with intramural dissection and/or thrombosis. Continued multidisciplinary evaluation of percutaneous transluminal angioplasty in the treatment of renal artery stenosis is recommended.

Adult↗
PubMed1981

Detection of tricuspid regurgitation and estimation of central venous pressure by two-dimensional contrast echocardiography of the right superior hepatic vein.

Two-dimensional echocardiography (2DE) was utilized to visualize the right superior hepatic vein (RSHV) for detection of tricuspid regurgitation (TR) and estimation of central venous pressure (CVP). Patients were divided into two groups. Eighteen patients were placed in group I on the basis of typical clinical features of TR (five patients) or 2DE contrast evidence of TR (13 patients). Group II included 55 patients without TR. Maximal transverse dimension of RSHV of at least 1.8 cm (range 1.8 to 3.8 cm, mean 2.4 cm) identified all patients in group I (100% sensitivity). One patient in Group II had RSHV width of 2.1 cm (96% specificity). Predictive value was 95%. RSHV width ranged from 0.4 to 2.1 cm (mean 1.3 cm) in group II. Mean values for group I and II were significantly different (p less than 0.001). Linear regression analysis was utilized to compare CVP and maximal RSHV width in 42 patients (15 group I and 27 group II). The slope of the line was significantly different from zero (p less than 0.005); the correlation coefficient was 0.70. In patients with maximal RSHV width greater than 1.5 cm, the predictive value for elevated CVP (greater than 6 mm Hg) was 87% with 69% sensitivity and 78% specificity. In 13 group II patients with technically satisfactory 2DE but no distinctly visible RSHV, CVP ranged from 4 to 12 mm Hg with four elevated values (greater than 6 mm Hg). Predictive value of normal CVP in absence of visible RSHV was 69%. This study suggests that determination of maximal RSHV width is useful in detection of TR and may be helpful in estimation of CVP.

Central Venous Pressure↗
PubMed1981

The role of computerized tomography in renal transplant patients.

We evaluated 53 patients with computerized tomography after renal transplantation. The diagnostic value of computerized tomography scanning was primarily in differentiating between patients with acute rejection and those with obstructive uropathy, urinary fistula or significant perinephric fluid collections. Computerized tomography guidance also may be helpful in performing anterograde pyelography or percutaneous allograft biopsy. The computerized tomography scan provides an effective, non-invasive, complementary method of evaluating post-transplant dysfunction.

Graft Rejection↗
PubMed1981

Digital subtraction angiography of the abdominal aorta and renal arteries. Comparison with conventional aortography.

Digital subtraction angiography (DSA) was used to study the cardiovascular system in more than 400 patients and was specifically compared with conventional angiography of the aorta and renal arteries in 30 patients. For the renal arteries, the overall accuracy of DSA was 71% (50/70). Excluding 11 cases of inadequate visualization of the renal arteries on DSA, the sensitivity of the new technique was 93% (55/59) and the specificity 91.5% (54/59). Aortic disease, including intravascular clots and occlusions, was faithfully delineated by DSA.

Angiography↗
PubMed1981

Imaging capability of an experimental digital subtraction angiography unit.

We evaluated an experimental digital subtraction unit in terms of field uniformity, linearity of signal response to x-radiation, response of the log amplifier, and imaging capability as measured with the Rose phantom. For comparison, conventional film subtraction phantom measurements were made. Our results indicate that this unit exhibits greater sensitivity to contrast media than conventional film subtraction units.

Angiography↗
PubMed1981

Two-dimensional echocardiographic assessment of electrocardiographic criteria for right atrial enlargement.

Right atrial (RA) size was determined with two-dimensional echocardiography using the apical four-chamber view in 45 adult patients with various echocardiographic criteria for RA enlargement and in 25 normal controls. RA size varied from 11.4-24.0 cm2 (mean 16.1 cm2) in controls. RA enlargement (greater than or equal to 25 cm2) was found in only two of 11 patients with P pulmonale (predictive value [PV] = 18%) and one of five with prominent positive P-wave forces in lead V1 (PV = 20%). However, RA enlargement ws found in eight of eight patients with a qR pattern in lead V1 in the absence of clinical indications of coronary artery disease (PV = 100%). RA enlargement was also found in 13 of 28 patients with a total QRS amplitude in lead V1 of 6 mm or less and a threefold or greater ratio of total QRS amplitude in lead V2 relative to that in V1(V2/V1 greater than or equal to 3) (PV = 48%). A V2/V1 ratio of 4 or more detected 11 of 13 patients with RA enlargement, with six false-positive diagnoses (sensitivity = 85%, specificity = 60%, PV = 65%). The combination of total QRS amplitude in V1 of 4 mm or less, together with a V2/V1 ratio of 5 or more, detected six of 11 with RA enlargement, with one false-positive diagnosis (sensitivity = 46%, specificity = 93%, PV = 86%). We conclude that ECG criteria for RA enlargement that primarily use increased P-wave amplitude have a limited PV. The qR pattern in lead V1 appears to be extremely accurate in detecting RA enlargement. ECG criteria in leads V1 and V2 using decreased amplitude in leads V1 and a V2/V1 greater than or equal to 3 are of some value in detecting RA enlargement.

Adult↗
PubMed1981

Steerable real-time sonographically guided needle biopsy.

A method for dynamic real-time ultrasonic guidance for percutaneous needle biopsy has been successful in obtaining cytologic and histologic specimens from abdominal masses. The system depends on a real-time ultrasonic transducer that has been rigidly attached to a laterally placed steerable needle holder. Using simple trigonometric functions, a chart has been derived that gives the exact angulation and needle length to produce quick, reliable, guided needle placements. Examples of successful renal, hepatobiliary, and retroperitoneal biopsies are presented. Advantages of this technique include speed, accuracy, low cost, three-dimensional format, and the omission of contrast media and radiation.

Adrenal Gland Neoplasms↗
PubMed1981

Recurrent acute pancreatitis and intussusception complicating an intraluminal duodenal diverticulum.

A patient is presented who exhibited recurrent episodes of acute pancreatitis as well as intermittent intussusception. It is felt that both of these abnormalities are due to an intraluminal duodenal diverticulum. The developmental theories of the intraluminal duodenal diverticulum are discussed. Early recognition of intraluminal duodenal diverticulum is aided by the awareness of its existence and the characteristic appearance on upper gastrointestinal barium examination. Surgery is curative.

Acute Disease↗
PubMed1981

Prolapsed left atrium behind the left ventricular posterior wall: two dimensional echocardiographic and angiographic features.

Left atrial enlargement can usually be detected accurately using M mode echocardiography. However, in the presence of heart disease, asymmetric enlargement may lead to inaccurate assessment of left atrial size and shape. Pericardial effusion can usually be diagnosed on the basis of characteristic M mode echocardiographic findings. However, false positive patterns sometimes occur with the use of this single dimensional technique. Three patients with a greatly enlarged left atrium are described whose M mode echocardiogram suggested significant posterior pericardial fluid accumulation. In each patient, two dimensional echocardiography detected portions of a huge left atrium that prolapsed behind the left ventricular posterior wall and mimicked an isolated posterior pericardial effusion. In one case a right anterior oblique left ventricular cineangiogram suggested the presence of a ventricular septal defect or a false aneurysm of the left ventricle due to the prolapsed left atrium. Because two dimensional echocardiography can provide accurate spatial orientation with visualization of intracardiac structures in relation to one another in real time, it can identify the presence of left atrial prolapse and play an important role in the differential diagnosis of isolated echo-free spaces behind the left ventricle detected with M mode echocardiography.

Aged↗
PubMed1980

Digital subtraction angiography of the human cardiovascular system.

Initial clinical application of a system for digital subtraction angiography (DSA) to the human cardiovascular system in 88 patients is reported. The equipment consisted of a specially designed computer system integrated with a fluoroscopic and radiographic apparatus for digitization, manipulation, and display of data. After intravenous injection of contrast material, adequate visualization of the heart and carotid, thoracic, abdominal, and femoral arteries was obtained with sufficient quality to obviate conventional angiography in many clinical settings. In this mode, nonselective opacification is obtained. However, DSA was also used to extend the capability of selective angiography. The availability of quantitative information permitted the determination of rates of transit of contrast material in various organs which may give insights of their physiologic performance.

Aneurysm↗
PubMed1979

Positron-emission computed tomography of the pancreas: a preliminary study.

Twenty-seven patients with suspected pancreatic disease were examined with emission computed tomography (ECT) with 11C-labeled amino acids. Of 24 patients with known clinical outcome, there were 1 false positive and 2 false negative results. One finding of interest was the increased concentration of radiopharmaceutical that accurately delineated the presence and extent of 4 pancreatic carcinomas and 1 lymphoma. In the normal subjects ECT reliably identified the pancreas. Disadvantages of ECT include the need for a cyclotron and high-quality hot chemistry laboratory, and the relatively long scanning time. The advantage of ECT is that it offers a unique opportunity to image biologic activity of the pancreas.

Carbon Radioisotopes↗
PubMed1979

Differentiation of retroperitoneal tumor using positron emission computed tomography.

Positron emission computed tomography (ECT) with 11C-DL-tryptophan and 11C-aminocyclobutanecarboxylic acid (11C-ACBC) has produced some promising results in patients with retroperitoneal masses. This brief report gives an example of one patient in whom a retroperitoneal mass could not be differentiated from the pancreas by transmission computed tomography but was suspected to be of pancreatic origin based on arteriographic findings. The ECT scans with 11C-DL-tryptophan showed a normal pancreas, whereas the tumor localizing agent 11C-ACBC concentrated in a tumor surrounding the tail and body of the pancreas. This approach with dual radiopharmaceuticals for the differentiation of metabolically active neoplasms and normal tissues warrants further investigation.

Aged↗