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Biomedical subjects

E Levine

Publications and source records attributed to E Levine.

At least 145 records · Page 8Linked to original sources
PubMed1984

Scintigraphic evaluation of giant cell tumor of bone.

Technetium-99m methylene diphosphonate bone scans were performed in 21 patients with giant cell tumors of bone. All tumors showed increased radiophosphate uptake, often more intense at the tumor periphery than in its center. However, radionuclide bone scanning often overestimated intraosseous tumor extent as a result of increased tracer uptake beyond true osseous tumor limits. In addition, it failed to detect soft-tissue tumor extension in nine patients. Therefore, scintigraphy is less useful than either computed or conventional tomography in planning surgical margins of giant cell tumors. Gallium-67 citrate scans obtained in seven patients showed slight uptake in four tumors and no uptake in three. Radiogallium imaging is thus of limited use in evaluation of suspected giant cell tumors of bone.

Adolescent↗
PubMed1984

DRGs: a recent refinement to an old method.

In this review of disease classification schemes, the authors argue that the recently promulgated diagnosis related groups (DRGs) method of reimbursing Medicare patient care is the culmination of a tradition with antecedents going back thousands of years. They describe the historical development of disease classification schemes, beginning with ancient pathological descriptions corresponding to modern disease classification, attempts in the seventeenth and eighteenth centuries to gather statistical information on mortality to better understand the causes of death, and the activity leading to the development of the International Classification of Diseases, on which the DRG methodology is based. The authors then review 20th-century attempts to estimate nursing requirements by relating disease classification schemes to patient care needs.

Costs and Cost Analysis↗
PubMed1984

Computed tomography of sacral and perisacral lesions.

The sacrum and perisacral soft tissues are not readily amenable to investigation by conventional radiological techniques. Computed tomography (CT) has provided an excellent imaging modality for the evaluation of these areas. This article describes the normal CT anatomy of the sacrum, the CT technique for evaluating the sacrum and perisacral soft tissues and the contribution of CT to the assessment of the many disorders that may involve the sacrum. Conditions discussed include osseous tumors of the sacrum, spinal dysraphism, cauda equina tumors and cysts, lesions arising primarily in the presacral space and sacral trauma. The use of CT scanning of the sacrum following intrathecal administration of Metrizamide is described.

Adolescent↗
PubMed1984

Newer developments of extra-anatomic bypass.

We have analyzed our eight year experience with more than 200 instances of extra-anatomic bypass and have made certain observations. Extra-anatomic bypass provides an acceptable alternative to extensive direct intra-abdominal and intrathoracic vascular reconstructive procedures. This is particularly true in high risk patients and in the presence of infection. While axillobifemoral bypass is widely known and used, other types of extra-anatomic bypass are emphasized. These are axillary-axillary, axillopopliteal, axillotibial and axillofemoral bypass under local anesthesia. Technical factors, such as the type of graft, the course of the bypass and ancillary techniques to improve the long term patency, are also discussed herein.

Anesthesia, Local↗
PubMed1983

Incidence of misdiagnosed and unsuspected choroidal melanomas. A 50-year experience.

The eye pathology files at Ohio State University, Columbus, were examined for a 50-year period to determine the percentage of misdiagnosis of uveal melanomas in three separate time periods (1931 through 1959, 1960 through 1969, and 1970 through 1981) and the percentage of unsuspected melanomas during these same periods. Of 395 eyes enucleated for choroidal melanoma, 369 had clear media. Histologic examination of these eyes showed that 13 (3.5%) did not contain a melanoma. The incidence of misdiagnosis decreased from 10.9% in 1931 through 1959 to 1.7% in 1960 through 1981. Of 411 choroidal melanomas present on histologic examination, 37 (9%) were unsuspected. All had opaque media. This percentage, when categorized by the aforementioned periods, decreased from 19.6% to 13.3% to 2.4%, respectively. These results confirm the reliability of indirect ophthalmoscopy, widely used since the 1960s, in the diagnosis of melanoma in the presence of clear media and the reliability of ultrasonography, used since 1970, in the diagnosis of melanoma in eyes with opaque media.

Choroid Neoplasms↗
PubMed1983

Ewing tumor of rib: radiologic findings and computed tomography contribution.

The ribs are frequent sites of primary Ewing tumor accounting for about 10-12% of all cases. The lesions may be predominantly lytic or sclerotic or show a combination of bone destruction and secondary reactive changes. In some patients bony changes are subtle and are obscured initially by frequently associated large extrapleural masses or pleural fluid. These patients may present clinically with findings secondary to compression of mediastinal structures by the soft tissue masses. Computed tomography (CT) is of great value in the diagnosis of such difficult cases and better demonstrates the tumor extent and relationships than other available imaging modalities. CT is also of considerable help in determining the optimal time for en bloc tumor resection. Many tumors are initially considered non-resectable due to extensive involvement of the lung, the mediastinum, or the diaphragm. CT accurately documents tumor regression during preoperative courses of chemotherapy.

Adult↗
PubMed1983

Dynamic computed tomography scanning of benign bone lesions: preliminary results.

The majority of benign bone lesions can be evaluated adequately using conventional radiologic techniques. However, it is not always possible to differentiate reliably between different types of benign bone lesions on the basis of plain film appearances alone. Dynamic computed tomography (CT) scanning provides a means for further characterizing such lesions by assessing their degree of vascularity. Thus, it may help in distinguishing an osteoid osteoma, which has a hypervascular nidus, from a Brodie's abscess, which is avascular. Dynamic CT scanning may also help in the differentiation between a fluid-containing simple bone cyst, which is avascular, and other solid or semi-solid benign bone lesions which show varying degrees of vascularity. However, because of the additional irradiation involved, dynamic CT scanning should be reserved for evaluation of selected patients with benign bone lesions in whom the plain film findings are not definitive and in whom the CT findings may have a significant influence on management.

Adolescent↗
PubMed1983

Diagnosis and management of asymptomatic renal cell carcinomas in von Hippel-Lindau syndrome.

Renal cell carcinomas occurred in 6 of 17 subjects with the von Hippel-Lindau syndrome (HLS). In 4 patients, the tumors were discovered by abdominal computed tomography (CT) during a prospective study. Abdominal CT is recommended as a safe and accurate method for screening patients with HLS for renal cell carcinoma. Renal cell carcinoma in HLS tends to be multifocal and bilateral. Because of this, it is recommended that the tumors be treated by surgical enucleation rather than by more extensive surgical procedures which might ultimately lead to the need for dialysis.

Adenocarcinoma↗
PubMed1983

Computed tomography of renal oncocytoma.

Renal oncocytoma is a relatively rare tumor that has an excellent prognosis and usually may be treated adequately by local resection. Preoperative differentiation from renal cell carcinoma, which requires radical nephrectomy, is thus of importance. The computed tomographic (CT) and pathologic features of three incidentally-detected renal oncocytomas were compared with those of six renal cell carcinomas of comparable size. Renal cell carcinoma appears on CT as a solid mass that generally has an indistinct interface with normal renal parenchyma, a lobulated contour, and a nonhomogeneous pattern of contrast enhancement. These features correlate with the pathologic findings of an irregular tumor margin and the frequent presence of tumor hemorrhage and necrosis. Oncocytoma, on the other hand, generally has a distinct margin, a smooth contour, and a homogeneous appearance on contrast-enhanced CT scans. These findings correlate with a smooth tumor margin and absence of tumor hemorrhage and necrosis on pathologic examination. These features are not pathognomonic of oncocytoma, as angiographic evidence suggests that renal cell carcinoma may show both distinct margination and a homogeneous blush in 6% of cases. However, their demonstration by CT should alert radiologists and surgeons to the possibility that a renal mass may be an oncocytoma. Such a presumptive diagnosis then can lead to a surgical approach that allows for renal-conserving surgery.

Adenocarcinoma↗
PubMed1982

Computed tomography of sacral and presacral lesions.

Forty-two patients with various sacral and presacral lesions were examined by computed tomography (CT). CT was sensitive in detecting intraosseous neoplasms and presacral soft tissue masses and in seven cases identified lesions not visible on plain films. The total extent of each lesion was readily determined using CT. However, CT is diagnostically nonspecific and differentiation between primary and secondary tumors of the sacrum in generally not possible from the CT appearance alone. CT is also of considerable use in the evaluation of several non-neoplastic conditions of the sacrum, including spinal dysraphism, anterior and internal meningocele and trauma.

Adolescent↗
PubMed1982

Computed tomography in the evaluation of metastatic adenocarcinoma from an unknown primary site. A retrospective study.

Abdominal computed tomography (CT) and other studies were evaluated retrospectively in 46 patients with metastatic adenocarcinoma or undifferentiated carcinoma in whom the primary tumor site was not evident from the history, physical examination, or chest radiograph. The primary site was ultimately located in 21 patients (45.7%). CT of the abdomen in particular detected it in 16 patients (34.8%) and demonstrated additional and often unsuspected metastatic disease in 65%. CT proved superior to sonography in both diagnosis and assessment of the extent of disease and had a significantly higher diagnostic yield than contrast studies of the urinary and gastrointestinal tracts. abdominal CT is recommended as the initial modality in patients with metastatic adenocarcinoma of unknown primary origin. If the abdominal scan is negative, it should be followed by pelvic sonography or CT, particularly in women. Contrast studies should be limited to patients with specific organic dysfunction.

Abdominal Neoplasms↗
PubMed1982

Computed tomography in the preoperative evaluation of masses arising in or near the joints of the extremities.

Knowledge of the precise anatomical relationship of a mass lesion to a joint is helpful in the preoperative planning of surgery. We have evaluated this relationship in 23 patients with a variety of benign and malignant lesions related to the knee and other major joints. In 15 patients, the lesion-joint relationship was assessed by routine computed tomographic (CT) scans followed within 24 hours by arthrography. In nine of these 15 patients, CT demonstrated that the lesion either was remote from the joint or clearly invaded it, and arthrography could have been avoided in these patients. In six patients, the CT findings were indeterminate and further evaluation by arthrography was indicated. CT scans limited to the joint area and obtained immediately after arthrography were available in 14 patients. In general, postarthrography CT did not add significant information to that provided by prearthrography CT scans or by arthrography. However, it may be helpful in occasional cases in which arthrography is not definitive.

Adolescent↗
PubMed1982

The cost of managing digital diagnostic images.

A study of the cost of recording and archiving digitally formatted diagnostic images is presented for an academic radiology department serving a 614-bed university hospital and a large outpatient population. The radiological examinations include computed tomography, nuclear medicine, ultrasound, and digital radiography. The archiving management strategies studied include the combined use of computer magnetic tapes, computer disc storage, and multiformat video film recordings. The estimated cost per patient for the archiving of digital diagnostic images is presented.

Archives↗
PubMed1982

CT screening of the abdomen in von Hippel-Lindau disease.

Patients with von Hippel-Lindau disease often develop asymptomatic abdominal manifestations including renal cysts and carcinomas, pheochromocytomas, and pancreatic tumors and cysts. Early detection of renal carcinoma and pheochromocytoma is particularly important. Accordingly, periodic abdominal screening of affected individuals and at-risk family members is necessary. Abdominal computed tomography (CT) was performed in 31 subjects from three families. Fifteen had asymptomatic abdominal manifestations of von Hippel-Lindau disease including renal cysts in 13, renal carcinoma in four, pancreatic cysts in five, and pheochromocytomas in two. CT constitutes an excellent noninvasive screening technique for patients with possible abdominal involvement by von Hippel-Lindau disease.

Adenocarcinoma↗
PubMed1982

A peripheralized digital image management system: prospectus.

The number of diagnostic radiology examinations being performed on digitally formatted imaging equipment is continually increasing. However, most digital data are recorded as analogue images and the films stored in a central file. The dynamic range of raw digital data is lost. Currently, the space and cost requirements for storage of all digital data have discouraged most users from attempting it. This article presents the concepts and describes the requirements and initial fabrication of a system that will capture and retain all digital data using a network of peripheralized image acquisition, display, and storage devices. Any piece of digitally formatted equipment can be interfaced into the system. A real-time computer capability provides that any digital examination can be reviewed at any display station for up to 10 days.

Computers↗