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Biomedical subjects

H L Neiman

Publications and source records attributed to H L Neiman.

At least 37 records · Page 2Linked to original sources

Percutaneous biliary drainage as an initial therapy in sepsis of the biliary tract.

Percutaneous biliary drainage offers a rapid, low-risk, effective method of decompressing the biliary tract in the patient with cholangitis and sepsis. A definite surgical procedure can be delayed until the patient is stabilized. The procedure provides anatomic detail that can be used to plan surgical treatment. In some patients who do not have surgically correctable lesions, operation can be avoided altogether.

Adult↗

Periportal sinusoidal dilatation associated with pregnancy.

Periportal sinusoidal dilatation is an hepatic vascular lesion previously reported solely as a complication of oral contraceptive therapy. We report a case occurring during pregnancy and describe the angiographic appearance and pathologic findings. Peliosis hepatis is the main consideration in the differential diagnosis--the features distinguishing of these hepatic lesions are presented.

Adult↗

Accessory hemiazygos continuation of left inferior vena cava: CT demonstration.

The first CT description of accessory hemiazygos continuation of a left-sided inferior vena cava is presented. This venous anomaly appears as a mediastinal mass on plain chest films and may simulate an aortic dissection on CT or angiography. Careful attention to the various abnormal vascular pathways will obviate the need for further invasive testing.

Aortic Dissection↗

Differentiation of tumor from syringohydromyelia: intraoperative neurosonography of the spinal cord.

Real-time ultrasonography was useful in differentiating tumor from syringohydromyelia as the cause of cervical cord widening in four patients. Those with syringohydromyelia had a smooth, regular, cystic space located symmetrically in the spinal cord. Tumor appeared as an echogenic, hypoechoic, or cystic expansile lesion that both narrowed the subarachnoid space and obliterated the spinal canal. When intraoperative sonography detects cystic lesions of the spinal cord, careful search for the presence of these signs is necessary to exclude tumor. Intraoperative spinal cord ultrasonography is simple and rapid, and it provides the surgeon with valuable information not readily available previously.

Adult↗

Dynamic CT in the evaluation of physiologic status of renal transplants.

Dynamic computed tomographic scans were performed in 23 patients to evaluate perfusion and function of renal transplants. Using corticomedullary junction and corticoarterial junction attenuation/time curve analysis, we were able to differentiate normal renal transplants from those undergoing rejection. Corticomedullary junction time was used to assess function and was significant in distinguishing normal renal transplants from those with rejection (p less than 0.001). Similarly, corticoarterial junction time was used to assess perfusion and had a significance of p less than 0.05. The study demonstrates the ability of computed tomography to yield excellent physiologic information.

Graft Rejection↗

CT findings in ulcerative, granulomatous, and indeterminate colitis.

Eight patients with ulcerative colitis, three with colitis indeterminate, and 15 patients with Crohn disease were studied by computed tomography (CT) to establish CT criteria for each disorder in hopes of providing a new diagnostic perspective useful in the radiographic evaluation of inflammatory colitis. The CT findings in ulcerative colitis included thickening of the colon wall (mean, 7.8 mm), which was characterized by inhomogeneous attenuation and a "target" appearance of the rectum, and proliferation of perirectal fat. Bowel wall thickening (mean, 13 mm) with homogeneous attenuation, fistula and abscess formation, and mesenteric abnormalities were observed in patients with Crohn colitis. Patients with colitis indeterminate showed colonic changes on CT observed in both disorders. Initial experience suggests that CT can differentiate patients with well established ulcerative and Crohn colitis.

Abscess↗

Ultrasound identification of impalpable testicle tumor.

We describe an ultrasound technique that accurately detected an occult testicular primary in a young man with a large retroperitoneal seminoma. A simple water bath system and commonly available ultrasound equipment are used to provide high resolution scans and excellent patient acceptance.

Adult↗

Computed tomography of tuberculous osteomyelitis of the pubis.

Computed tomographic findings in a case of isolated pubic tuberculous osteomyelitis with an associated tuberculous soft tissue abscess are described. Computed tomographic findings include local bony erosion and destruction, as well as an associated peripherally enhancing soft tissue mass.

Humans↗

Bilateral renal artery thrombotic occlusion: a unique complication following removal of a transthoracic intraaortic balloon.

An intraaortic balloon pump (IABP) was inserted through the ascending aorta during a coronary artery bypass operation. Five days later, after removal of the IABP and ligation of the end-to-side Dacron graft, the patient became acutely anuric. Abdominal aortography demonstrated a large "trapeze-shaped" thrombus which occluded both renal arteries. Following thrombectomy the patient recovered, with eventual return of renal function to the preoperative state.

Aged↗

Urosonography in spinal cord injury patients.

Urosonography, ultrasound of the urinary tract, is a noninvasive imaging method used to evaluate renal masses, renal parenchymal disease, hydronephrosis, bladder volume and calculi. The applicability of ultrasound was studied in 54 spinal cord injury patients by correlating uroradiological examinations with ultrasound. Emphasis was placed on ultrasonic imaging of ureterectasis and vesicoureteral reflux. Ultrasound confirmed all positive radiographic findings of renal and bladder abnormalities (renal calculi, chronic pyelonephritis, trabeculated bladder and bladder calculi), and yielded additional information in 27 per cent of the kidney and 13 per cent of the bladder studies. Ultrasound was used to confirm vesicoureteral reflux in 56 per cent of the patients and ureterectasis in 33 per cent. It is recommended that spinal cord injury patients undergo a baseline excretory urogram followed by periodical ultrasound examinations to detect hydronephrosis, renal parenchymal disease, and renal and bladder calculi, and to measure bladder volume and residual urine. Whenever real-time equipment and experienced ultrasonologists are available ultrasound can be used as an alternate to voiding cystourethrography to detect vesicoureteral reflux.

Adolescent↗

Use of computerized tomography in the evaluation of filling defects of the renal pelvis.

Computerized tomography has been used in the evaluation of 5 patients with radiolucent masses of the collecting system. There were 3 cases of renal calculi. 1 peripelvic cyst and 1 squamous cell carcinoma of the renal pelvis. The results of computerized tomography scanning are correlated with the results of excretory urography and ultrasonographic scanning. The diagnostic advantage of computerized tomography scanning for evaluation of radiolucent masses of the upper collecting system is elucidated.

Adolescent↗

Hemodynamic assessment of transluminal angioplasty for lower extremity ischemia.

Seventy-two patients underwent hemodynamic testing before and after treatment for occlusive disease of their lower extremities. Percutaneous transluminal angioplasty (PTA) was used to treat lesions in 26 iliac segments and produced 23 initially improved ankle or upper thigh indices, two hemodynamic failures, and one technical failure; PTA for 54 femoropopliteal lesions produced initial hemodynamic improvement in 41 cases, three hemodynamic failures, and ten technical failures. Hemodynamic follow-up of the iliac segments showed improvement in 25 (92%) as measured by the systolic pressure index of the ankle; follow-up of the femoropopliteal segments showed continued patency of 41 (65.9%). The authors analyze these hemodynamic data.

Aged↗