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Biomedical subjects

E Colon

Publications and source records attributed to E Colon.

At least 19 recordsLinked to original sources
PubMed1999

MR imaging of flexor digitorum accessorius longus.

OBJECTIVE: The flexor digitorum accessorius longus muscle (FDAL), an anomalous muscle about the ankle, has recently been implicated in tarsal tunnel syndrome. The purpose of this study is to document the prevalence of the FDAL, its MR appearance and its relation to the neurovascular bundle in the tarsal tunnel. DESIGN AND PATIENTS: The prevalence of the FDAL was determined from 100 ankle MR examinations in asymptomatic individuals. The appearance of the FDAL was summarized from 20 examples of FDAL: six gathered from the asymptomatic group and 14 acquired from a group of randomly collected cases of patients with ankle complaints. RESULTS: The prevalence of the FDAL was 6%, calculated from the group of 100 asymptomatic individuals. Possessing a dominant fleshy component in the tarsal tunnel, the FDAL accompanies the posterior neurovascular bundle as it descends the ankle. CONCLUSION: The FDAL is encountered in 6% of asymptomatic individuals. Its prominent fleshy component in the tarsal tunnel and its close proximity to the posterior tibial neurovascular bundle readily differentiate the FDAL from other medial anomalous muscles on MR imaging.

Adolescent↗
PubMed1998

Perineal seeding of prostate cancer as the only evidence of clinical recurrence 14 years after needle biopsy and radical prostatectomy: molecular correlation.

Perineal needle tract seeding of prostate cancer is an unusual complication of perineal prostate biopsy. We report a case with the longest known interval from biopsy to perineal recurrence--14 years. The prostate-specific antigen did not become detectable until 12 years after biopsy and no other metastases were apparent, suggesting that the patient's perineal disease was an isolated recurrence. Immunohistochemical staining of the perineal recurrence and the original biopsy and prostate for the p53 tumor suppressor gene and bcl-2 oncogene proteins revealed rare/absent p53 expression but marked increased bcl-2 expression. This unusual molecular pedigree may help to explain this rare clinical scenario.

Aged↗
PubMed1997

MR features of longitudinal tears of the peroneus brevis tendon.

OBJECTIVE: Our objective is to describe the characteristic MR imaging features of longitudinal tears of the peroneus brevis tendon and to describe pathologic conditions and normal variants that are associated with these tears which may require surgical intervention at the time of primary tendon repair. MATERIALS AND METHODS: We retrospectively reviewed 10 MR images of asymptomatic volunteers and 31 MR images of 27 patients with evidence of longitudinal splits of the peroneus brevis tendon. Seven of these cases were surgically proven. In addition, we assessed five pathologic conditions and normal variants: lateral collateral ligamentous tears; injuries to the superior peroneal retinaculum; low-lying muscle belly of the peroneus brevis tendon; peroneus quartus muscle; and convex, flat, or irregular retromalleolar groove. RESULTS: In the patient's group, we saw longitudinal splits as clefts and an irregularity of the contour of the peroneus brevis tendon with (71%) and without (29%) signal changes on proton density-weighted and T2-weighted MR imaging sequences. Divisions of the split tendon assumed a characteristic C-shaped configuration that partly enveloped the peroneus longus tendon. Fifteen cases revealed other pathologic conditions and normal variants known to be associated with or to predispose to tears of the peroneus brevis tendon. These include ankle ligamentous tears (n = 3); abnormal superior peroneal retinaculum (n = 4); low-lying muscle belly of the peroneus brevis tendon (n = 1); peroneus quartus muscle (n = 2); and convex, flat, or irregular retromalleolar groove (n = 15). MR imaging revealed tears in all patients with surgical proof (n = 7). CONCLUSION: MR imaging is a useful technique for revealing longitudinal tears of the peroneus brevis tendon as well as showing anatomic and pathologic factors associated with or predisposed to tears.

Adult↗
PubMed1997

Alterations in the distal extension of the musculus peroneus brevis with foot movement.

OBJECTIVE: A low-lying belly of the musculus peroneus brevis (presence of muscle tissue within the fibular groove) is said to be a risk factor for rupture or dislocation of the peroneal tendons. However, alterations in foot position may affect the position of the musculotendinous junction. The purpose of this study was to evaluate the normal position of the musculotendinous junction of the musculus peroneus brevis in full dorsiflexion and plantar flexion. MATERIALS AND METHODS: The ankles of 12 adult asymptomatic volunteers were imaged in full dorsiflexion and plantar flexion. The number of scans between the fibular groove and the first scan imaging the muscle belly of the musculus peroneus brevis was documented in each patient in full dorsiflexion and plantar flexion. RESULTS: Distal extension of muscle belly into or beyond the fibular groove was present in 11 subjects in dorsiflexion and in seven subjects in plantar flexion. CONCLUSION: Extension of the muscle belly of musculus peroneus brevis into and distal to the fibular groove is part of the normal excursion of the muscle during foot motion. Care should be taken not to misdiagnose this normal finding as a pathologic condition when interpreting MR studies of the ankle.

Adult↗
PubMed1997

The peroneocalcaneus internus muscle: MR imaging features.

OBJECTIVE: The peroneocalcaneus internus muscle is a rare muscle of the posterior calf that to our knowledge has not been reported in the radiology literature. The purpose of our study was to describe the normal anatomy and MR characteristics of this muscle in eight patients in whom the muscle was identified. CONCLUSION: The peroneocalcaneus internus muscle is a rare muscle that originates from the inner aspect of the distal fibula, descends within the tarsal tunnel, and inserts on a small tubercle in the calcaneus, just distal to the sustentaculum tali. The muscle may displace the flexor hallucis longus muscle medially and thus indirectly encroach on the neurovascular bundle.

Adolescent↗
PubMed1996

Painful legs and moving toes associates with tarsal tunnel syndrome and accessory soleus muscle.

Painful legs, moving toes is a rare syndrome characterized by leg pain and uncontrolled toe movements. We present a 35-year-old man with a 1-year history of unilateral knee, calf, and medial ankle pain with spontaneous movements of second through fifth toes. Electrodiagnostic studies showed an absent lateral plantar nerve response consistent with a tarsal tunnel entrapment neuropathy. Cine magnetic resonance imaging revealed a large accessory soleus muscle compressing the flexor hallucis longus in the tarsal tunnel of the affected extremity. Lidocaine block of the tibial nerve at the popliteal fossa did not stop these movements, but blockade of the medial and lateral plantar nerves distal to the medial malleolus stopped them temporarily. Treatment with foot orthotics and cessation of running activity decreased the symptoms. We conclude that painful leg and moving toes in this patient resulted from a compression neuropathy at the tarsal tunnel possibly caused by a large adjacent accessory soleus muscle.

Adult↗
PubMed1995

IGF-I alters energy expenditure and protein metabolism during parenteral feeding in rats.

In this study, 20 micrograms.kg.-1.h-1 of recombinant human insulin-like growth factor I (IGF-I) was infused into normal healthy rats to examine the effects of IGF-I on glucose, protein, and energy metabolism in either overnight-fasting or parenteral-feeding states. The fed state was maintained by continuous intravenous feeding of a complete diet containing 838 kJ.kg-1.d-1, 2 g N.kg-1.d-1, and no fat. At each nutritional state, one-half of the animals received IGF-I infusion while the other half received saline as control. [14C-1]leucine and [3H-6]glucose were used to determine the effects of IGF-I on protein and glucose kinetics during fed and fasting states. The results showed that 1) infusion of IGF-I at this amount did not alter plasma glucose appearance and only marginally decreased plasma glucose concentrations in both nutritional states; 2) during fasting, IGF-I did not show anabolic effects on protein metabolism either at the whole-body level or in individual tissues. However, during feeding, IGF-I significantly stimulated exogenous nitrogen utilization by the whole body; and 3) IGF-I reduced the thermogenic effect of feeding. The results suggest that parenteral feeding may be an important variable in the response of protein anabolism to IGF-I in vivo.

Animals↗
PubMed1995

Differential effects of interleukin-1 receptor antagonist in cytokine- and endotoxin-treated rats.

Previous studies have demonstrated that the administration of the cytokines, interleukin-1 (IL-1) and tumor necrosis factor (TNF)(20 micrograms/kg) to rats in a fasting state can produce many and perhaps most of the metabolic alterations found in patients with sepsis and injury. The purposes of the present study were 1) to define the metabolic effects of IL-1 and TNF during a fed state provided by continuous intravenous feeding for 20 h and 2) to characterize the unique effects of IL-1 among the overall response to cytokines by using IL-1 receptor antagonist (IL-1RA; 5 mg/kg). The effects were also explored during the endotoxemic condition induced by infusion of 200 micrograms/kg of endotoxin into rats. The results showed that during feeding IL-1 is responsible for the increase in glucose flux and plasma insulin, the development of insulin resistance, and plasma zinc depression during condition mimicking sepsis and injury, similar to effects observed in the fasting state. The changes in energy expenditure have a more complex mechanism. The results also suggested that certain host responses to cytokines or endotoxin, particularly related to protein metabolism, differed between the fed and fasting states. These data may have a special clinical relevance for the insulin-resistant state that develops during severe infection, since using IL-1RA in conjunction with nutritional therapy may offer additional advantages in the treatment of these severe metabolic disorders.

Animals↗
PubMed1994

Retroperitoneal imaging with third and fourth generation computed axial tomography in clinical stage I nonseminomatous germ cell tumors.

OBJECTIVES: To examine the accuracy rate of abdominal staging using third and fourth generation computed tomography (CT) scanning in clinical Stage I testicular nonseminoma patients. METHODS: Between January 1985 and August 1993, 57 patients presented to our center with clinical Stage I testicular nonseminoma. Retroperitoneal computed tomographic staging studies were interpreted to be normal preoperatively in the entire group. In addition, tumor marker values were normal or returned to normal postorchiectomy within the appropriate half-life intervals. All patients were subjected to radical or modified retroperitoneal lymph node dissection (19% and 72%, respectively). Original abdominal CT scans (preretroperitoneal lymph node dissection) were available for blinded retrospective re-review in 16 cases (7 pathologic Stage II, 9 pathologic Stage I). RESULTS: Nineteen of 57 (33%) patients were upstaged at surgery including 6 patients (11%) who demonstrated II B volume disease. Third and fourth generation CT scanning of the retroperitoneum yielded a 66% accuracy rate in this population. Six out of 7 pathologic Stage II pre-lymph node dissection abdominal CT scans that were available for blinded re-review revealed nonpathologic nodes by size criteria in the primary landing zone for the corresponding original tumor. CONCLUSIONS: Our data suggests that for clinical Stage I nonseminoma in the 1985 to 1993 era, undue reliance was placed on a less than ideal staging test. The 33% false-negative rate reported showed no improvement over earlier reports and reaffirms concern for relying solely on third or fourth generation CT imaging of the retroperitoneum in the staging of clinical Stage I nonseminomatous germ cell tumor (NSGCT) patients. The presence of any number of lymph nodes in the expected primary landing zone, regardless of size, should raise serious suspicion for occult nodal disease.

False Negative Reactions↗
PubMed1994

Efficacy of radiographic chest imaging in patients with testicular cancer.

OBJECTIVE: To determine the efficacy of computed tomography of the chest (CTC) and plain radiograph (CXR) in the initial staging process of testicular germ cell tumors. METHODS: The medical records of 362 patients with testicular germ cell tumor treated at our center between January 1980 and August 1993 were reviewed with particular attention to initial chest screening studies. Two hundred one patients had both CXR and CTC, 24 CXR alone, and 20 CTC alone during initial staging. One hundred seventeen patients were excluded from analyses because of undergoing whole lung tomography (92), unknown staging (19), or inadequate follow-up (6). Analysis included findings based on abdominal staging results using computed tomography of the abdomen (CTA). RESULTS: Of the 201 patients who had both CTC and CXR, 117 (58.2%) had nonseminomas (NSGCT) and 84 (41.8%) had seminomas (SEM). Among the patients with NSGCT, 21 (17.9%) had chest metastasis, 16 (76.2%) of which were detected by CXR. The 5 that were missed on CXR had significant retroperitoneal disease documented by CTA and the knowledge of chest metastases potentially altered therapy in 2 patients. Only 2 of 84 (2.4%) patients with SEM had metastatic chest disease and both were identified by CXR. False-positive CTC following negative CXR resulted in costly and sometimes invasive additional procedures in 10 patients with NSGCT and 6 with SEM. None of the CXR-only patients had adverse consequences from the solitary study (at least 1 year follow-up). The CTC-only patients could have undergone CXR only and had similar outcome. CONCLUSIONS: CXR alone is preferable for initial chest staging in all patients with SEM and in patients with NSGCT with negative findings on CTA. CTC remains of slight benefit for patients with clinical Stage II and greater NSGCT and to evaluate further suspicious CXR findings in any patient, although it appears not to be necessary in patients who have clinical Stage I disease determined by CTA. These findings have important cost-saving implications.

False Negative Reactions↗
PubMed1994

Perirenal liposarcoma containing extramedullary hematopoiesis associated with renal cell carcinoma.

We present the first reported case of a perirenal well-differentiated liposarcoma containing extramedullary hematopoiesis associated with an ipsilateral T2N0M0 renal cell carcinoma. This patient, a seventy-one-year-old white male, had no known hematologic disorder and on preoperative evaluation had similar radiographic findings identified within the contralateral perirenal space. Pathologic evaluation after radical nephrectomy reported the perirenal mass to consist only of myelolipomatous change, however, further review identified liposarcoma.

Aged↗
PubMed1994

The effect of informed consent on the level of anxiety in patients given i.v. contrast material.

OBJECTIVE: A common reason given for not obtaining informed consent before the use of IV contrast material is that the anxiety created by informing patients of potential reactions will increase the possibility of their occurring. However, the idea that this is possible is debatable, and no study of this subject has used a standardized anxiety index. Accordingly, using the State-Trait Anxiety Inventory, we assessed the anxiety level among patients about to have an IV contrast procedure and measured the effect of informing them of the risks associated with the use of contrast material. SUBJECTS AND METHODS: Approximately 2050 adult outpatients at three separate medical centers were solicited for participation in this study. Each of the 1251 patients who volunteered to participate was placed into one of six groups. The majority were patients who were awaiting the injection of either ionic or nonionic contrast material and who were or were not informed of the risks associated with the use of IV contrast material. The last two groups were generally healthy outpatients reporting for routine X-rays who were not awaiting IV contrast administration but who were informed of the risks associated with the use of ionic and nonionic contrast material. Each patient informed of the risks was asked to read a standardized consent form, and all patients completed a standardized anxiety index. RESULTS: Patients who were informed of the risks associated with IV contrast material did not have measurably increased anxiety, and they did not have an increased prevalence of adverse reactions. Indeed, the only patients who had statistically significant increased anxiety compared with the other groups were among those awaiting the injection of ionic contrast material who were not informed of the risks (p = .04). The majority (51-78%) of patients in all six groups had measurable elevated anxiety scores. CONCLUSION: We conclude that it is not justified to fail to obtain informed consent in order to avoid anxiety-induced adverse reactions to IV contrast material. The majority of patients awaiting injection of IV contrast material have measurable increased anxiety levels regardless of whether they are informed of its risks.

Anxiety↗
PubMed1993

Effect of fish oil on glucose metabolism in the interleukin-1 alpha-treated rat.

Fish oil has been demonstrated to ameliorate many of the responses to infection. This study was conducted to determine whether fish oil feeding could modify the alterations of glucose metabolism induced by interleukin-1 alpha (IL-1 alpha) infusion in the rat. Male Sprague-Dawley rats were pair-fed for 5 weeks on two experimental diets in which the source of fat was either fish oil or soybean oil and provided 20% of calories; the diets were isonitrogenous and isocaloric. After 5 weeks of feeding, rats from both diet regimens were further divided into two subgroups to receive a 3-hour infusion of either 0.1% albumin in saline or 0.1% albumin in saline containing IL-1 alpha. A total of 20 micrograms/kg IL-1 alpha was administered, and half the dose of IL-1 alpha was given as a bolus and the remaining portion (10 micrograms/kg) was continuously infused into the jugular vein. During the last 2 hours of IL-1 alpha infusion, a primed constant infusion of D-(6-3H)glucose and D-(U-14C)glucose was combined to determine the effects of IL-1 alpha and diet on glucose kinetics. Plasma levels of glucose and insulin, energy expenditure, and respiratory quotient were also measured. IL-1 alpha significantly increased concentrations of plasma insulin and the percentage of glucose carbon recycling, confirming previous findings. Concentrations of glucose and insulin with IL-1 alpha treatment were significantly higher in soybean oil- fed animals compared with fish oil-fed animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1993

Prevalence and duration of postoperative pneumoperitoneum: sensitivity of CT vs left lateral decubitus radiography.

OBJECTIVE: The purpose of this study was to evaluate the prevalence, location, and duration of pneumoperitoneum in postoperative patients and to compare the sensitivities of CT and left lateral decubitus radiography in the detection of postoperative pneumoperitoneum. SUBJECTS AND METHODS: Twenty-seven CT scans and 27 abdominal radiographs with the patient in the left lateral decubitus position were obtained prospectively in 17 patients after uncomplicated abdominal surgery. Fifteen patients were examined 3 days after surgery and 12 were examined 6 days after surgery. The studies were evaluated in a blinded fashion for the presence, location, and volume of free air. The presence of air on the radiographs and the presence and quantity of air on the CT scans were correlated with each subject's surgical procedure, age, sex, and body habitus. RESULTS: Pneumoperitoneum was seen on 13 (87%) of 15 CT scans and eight (53%) of 15 radiographs obtained 3 days after surgery and on six (50%) of 12 CT scans and one (8%) of 12 radiographs obtained 6 days after surgery. The calculated volume of free air seen on the CT scans ranged from 0.3 to 5.8 ml. Sixty-two percent of collections by volume were located in the midline/parahepatic space, 22% in the pelvis, and 16% in the mesentery. Radiographs showed pneumoperitoneum in only nine (47%) of 19 examinations in which the corresponding CT scans showed free air. Findings on radiographs were false-negative in seven (87%) of eight obese patients in whom pneumoperitoneum was detected on CT scans. CONCLUSION: The prevalence of pneumoperitoneum in the postoperative period based on CT findings is greater than that previously reported. Small amounts of pneumoperitoneum frequently collect along the anterior abdominal wall in two preferential spaces, the pararectus and midrectus recesses. The results of this study show that CT is significantly more sensitive than plain radiography for detecting small amounts of free intraperitoneal air in postoperative patients. Radiography is particularly insensitive for imaging obese and heavy patients.

Adult↗
PubMed1993

Protein S deficiency: imaging findings.

Protein S deficiency is an autosomal-dominant inherited disorder of coagulation associated with spontaneous and recurrent venous thrombosis. Approximately 5% of patients with deep venous thrombosis of the lower extremities who are less than 45 years old have a deficiency of protein S. Patients frequently have spontaneous and recurrent deep venous thrombosis and pulmonary embolism during young adulthood. Thrombosis occurs less commonly in the splanchnic and cerebral veins. Arterial thrombosis is rare but is seen in the cerebral circulation. Radiologists should include protein S deficiency in the differential diagnosis of unexplained thrombosis in young patients. This pictorial essay illustrates the range of imaging findings encountered in patients with this disorder.

Adult↗
PubMed1990

A method for delivery of precise doses of smoked cocaine-base to humans.

Despite increasing smoked cocaine-base use, there have been relatively few parametric studies in this area. The major reason for the limited number of studies is the lack of a simple procedure for the administration of precise doses of smoked cocaine-base to human volunteers. This paper describes a new method that allows for the delivery of precise doses of smoked cocaine-base. A complete description of the method and the precision of the administration procedure are presented. Furthermore, a study is described which was undertaken to determine: 1) the reproducibility of peak blood cocaine levels when the same dose of cocaine was given on two separate occasions; and 2) the dose-related effects on smoking topography, biochemical, physiological and subjective measures. Subjects (N = 5) were administered three doses of cocaine-base (10, 20 and 40 mg). Four subjects were given repeated doses of cocaine-base. Subjects were blind to the dose and in most cases randomly assigned to different doses. The results showed: 1) a significant correlation of peak whole blood cocaine concentrations among similar doses within subjects (r = .99); 2) no significant effects of dose on smoking topography; and 3) significant dose effects for whole blood cocaine concentrations, heart rate and systolic blood pressure.

Adult↗