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Biomedical subjects

E M James

Publications and source records attributed to E M James.

69 records · Page 4Linked to original sources

High-resolution parathyroid sonography.

A total of 165 consecutive patients with suspected primary hyperparthyroidism was scanned preoperatively using high-resolution real-time sonography. The sensitivity of the procedure was 69% and the specificity 94% in the localization of individually enlarged parathyroid glands. In the subgroup of 21 patients undergoing reoperation in the neck, the sensitivity and specificity were 80% and 92%, respectively. In patients with a single parathyroid adenoma, there was a close but not linear correlation between sonographic diagnostic accuracy and the size of the adenoma, which in turn was directly related to the serum calcium and immunoreactive parathyroid hormone levels. High-resolution sonography has become the procedure of choice in our institution for the preoperative localization of enlarged parathyroid glands in the neck.

Adenoma↗

Human endoscopic ultrasonography.

Conventional transcutaneous ultrasound examinations are often compromised by intervening pulmonary or bowel gas and have limited resolution. Ultrasonic probes of frequencies greater than 5 MHz, which enhance resolution, cannot be used successfully on the skin surface, because they do not penetrate deeply enough to view intraabdominal organs in most adults. To overcome these problems, we tested an ultrasonic endoscope which had a 10-MHz, 64-element linear assay, generated real-time images at resolutions of less than 1 mm, and was an integral part of a 35-mm-long and 13-mm-wide endoscopic rigid tip. Thirty-two studies were performed in 15 healthy subjects, 4 patients with pancreatic cancer and 6 patients with chronic pancreatitis, and 1 patient each with a gastric ulcer and a suspected pancreatic abscess. We demonstrated that this procedure is safe, provides high resolution real-time ultrasound visualization of the heart, aorta, spleen, pancreas, liver, gallbladder, kidneys, and gastrointestinal mucosa and can detect moderate-sized pancreatic tumors and hepatic metastases less than 1 cm in diameter. Because endoscopic visualization of gastrointestinal mucosa and ultrasound examination of extraluminal organs can be obtained during a single procedure, rapid differentiation among mucosal and intramural disease of the hollow gut and disease of extraluminal organs should be possible with this diagnostic technique.

Digestive System↗

Sequential liver imaging in the hypereosinophilic syndrome: discordant images with scintigraphy, ultrasound, and computed tomography.

Sequential liver scintigrams in a patient with hypereosinophilic syndrome were used to demonstrate liver involvement initially and then to show progression of hepatic disease followed by gradual normalization on treatment. Computed tomography and ultrasound images of the liver were normal; thus, tissue density differences and sonar interfaces were apparently not sufficiently large for detection of tissue infiltrates, whereas abnormalities in Kupffer cell function resulted in abnormal scintigram images. A pattern of changing and vanishing filling defects on the scintigram while computed tomography and ultrasound images were normal was observed in the hypereosinophilic syndrome.

Eosinophilia↗

Chronic ulcerative colitis and colon cancer: can radiographic appearance predict survival patterns?

Twenty-four patients with chronic ulcerative colitis and colon carcinoma who underwent barium enema examination prior to the diagnosis of cancer were studied in an attempt to correlate the radiographic appearance of the tumors with their biologic behavior, as well as to assess the accuracy of the barium enema in detection. Of the radiographically detected tumors, 65% displayed an annular infiltrative appearance, with the prime radiographic manifestation being relative nondistensibility of the involved segment. The remaining tumors had various appearances more typical of noncolitic colon cancer. Patients with infiltrative lesions had a much poorer prognosis than those with noninfiltrative lesions. Of 33 gross tumors described pathologically and/or surgically, only 70% were correctly detected by barium enema. It is suggested that periodic barium enema examinations are an unreliable means of following patients with ulcerative colitis if malignant degeneration is to be detected at an early and curative stage. Prophylactic proctocolectomy may be the best therapeutic approach.

Adult↗

The fine structure of dense lysosomes isolated from rat spleen.

A dense fraction from rat spleen was shown to consist of membrane bound organelles of varying shape and size which were packed with electron dense particles with the appearance of ferritin. Electron microscope microanalysis confirmed that iron was present in the organelles and the amount correlated with the density as noted in transmission electron microscopy. The organelles also stained, positively for acid phosphatase and, therefore, confirmed the biochemical findings that dense lysosomes (L30) had been isolated. The role lysosomes play in the degradation of red blood cells, and as possible sites of iron storage, are briefly discussed.

Animals↗