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Biomedical subjects

H L Neiman

Publications and source records attributed to H L Neiman.

At least 73 records · Page 4Linked to original sources

The radiologic significance of the left pulmonary ligament. Experience with 26 patients.

Pathologic processes confined to or by the left pulmonary ligament present a confusing radiographic appearance. Such processes may simulate pleural scarring, parenchymal scarring, or even left lower lobe collapse. Radiologic awareness of this structure is limited because in the normal state, it is not visualized on either posteroanterior or lateral chest x-ray films. The absence of secondary signs of left lower lobe collapse, together with a process which may extend above the level of the left hilum, is valuable in confirming that such a triangular density seen behind the left cardiac border is disease in or confined by the pulmonary ligament, rather than left lower lobe collapse.

Adult↗

Ultrasonographic evaluation of pericholecystic abscesses.

Pericholecystic abscess formation is a serious complication of cholecystitis that develops after gallbladder perforation and is usually associated with acute inflammatory signs and symptoms. Ultrasonographic findings in three surgically proven cases of pericholecystic abscess are reported. The findings ranged from a well defined band of low-level echoes around the gallbladder to multiple, poorly defined hypoechoic masses surrounding an irregular, indistinct gallbladder outline. The former situation correlated with a well encapsulated pericholecystic inflammatory process, while the latter was associated with extensive abscess formation resulting from gallbladder rupture. Cholelithiasis was identified in two of the three cases. Ultrasound for preoperative detection of pericholecystic abscess is discussed.

Abscess↗

Ureterolymphatic backflow.

A case is reported of apparent radiologic demonstration of a communication between a completely obstructed distal ureter and its draining lymphatics in a patient with invasive bladder tumor involving the ureteral orifice.

Aged↗

The spectrum of radiologic findings in allergic bronchopulmonary aspergillosis.

Early diagnosis of allergic bronchopulmonary aspergillosis (ABPA) is important. Initiation of corticosteroid therapy in ABPA is essential to prevent progressive destruction of lung parenchyma. The earliest radiographic manifestations of the disease may be present only on bronchograms. In addition to the classic radiographic findings (infiltrate, massive homogeneous consolidation, tram-line shadow, parallel line shadow, ring shadow, toothpaste shadow, glove-finger shadow), perihilar infiltrates simulating adenopathy (pseudohilar adenopathy) and air fluid levels were frequently demonstrated.

Adolescent↗

Computed tomography in the detection of retroperitoneal hemorrhage after translumbar aortography.

Direct imaging of retroperitoneal hemorrhage following translumbar aortography was performed using computed tomography. Seven patients were scanned over the area of aortic entry immediately after undergoing angiographic examination. In five cases, there was definite evidence of periaortic hematoma, most commonly seen as a discrete soft tissue density with absorption coefficients between +20 and +35 EMI units. Other signs of retroperitoneal bleeding were less consistently present (e.g., loss of aortic contour, aortic displacement, and thickening of diaphragmatic crura). The clinical implications of detecting significant hemorrhage following translumbar aortography are also discussed.

Aortography↗

Dose reduction in mammography.

The Min-R system is more than a satisfactory substitute for xerography. At equal distances, the images obtained are equivalent. Radiation exposure was 25 per cent of xerography, a significant reduction in exposure. By using a long cone and improving geometry, superior images were obtained in 4 per cent of 400 comparison patients. If mammography is to be used as an early detection device in patients with carcinoma of the breast, modalities with lower exposure requirements must be used. Min-R, a new film screen system, fulfills the requirement of reduced patient exposure without loss of diagnostic accuracy.

Female↗

Bladder fistula.

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Colonic Neoplasms↗

Chiba needle percutaneous transhepatic cholangiography.

Percutaneous transhepatic cholangiography with the Chiba University needle has been utilized in 30 patients. The ducts were successfully demonstrated in all 21 patients with obstructive jaundice. Sixty-seven percent of normal or stenosed ducts were visualized. No serious complications occurred and emergency post-procedural laparotomy was unnecessary. Our results reflect other reports. Percutaneous transhepatic cholangiography is an efficacious method of evaluating the hepatobiliary system.

Adult↗

Urological complications of regional enteritis.

Urological complications of regional enteritis occur frequently and may be clinically unsuspected. Radiographic findings include nephrolithiasis, characteristic stricture of the ureter, panvesiculitis, and enterovesical fistual. Less specific findings include renal amyloidosis and retroperitoneal abscesses. Mucosla nodularity of the bladder dome, even without gastrointestinal symptoms, should raise the possibility of regional enteritis. On the other hand, occult ureteral stenosis in patients with known regional enteritis may be present. For this reason, it is recommended that routine and periodic excretory urograms be a central part of the evaluation of the patient with regional enteritis.

Adolescent↗

Accuracy of biliary duct ultrasound: comparison with cholangiography.

Thirty patients were studied by diagnostic ultrasound and percutaneous transhepatic or surgical cholangiography to evaluate diagnostic accuracy in differentiating obstructive from nonobstructive hepatobiliary disease. Correct recognition of biliary duct caliber was accomplished by ultrasound in 86% of cases, and was most accurate (89%) in patients with dilated intrahepatic biliary radicals. Diagnostic ultrasound is sufficiently accurate to be a useful screening tool for determining the caliber of the biliary duct system and, on this basis, obstructive from nonobstructive hepatobiliary disease.

Biliary Tract Diseases↗

Ultrasound of the parotid gland.

Five cases of parotid gland masses were studied by ultrasound. Only retention cysts and true cysts of the parotid gland appear sonolucent at low and high gain settings. Benign and malignant tumor present as solid masses except for the Warthin's tumor which is sonolucent at lower gain settings but has a lattice of internal echoes at higher gain settings.

Adenolymphoma↗

Priscoline-augmented hepatic angiography.

Tolazoline hydrochloride (Priscoline) is a useful adjunct to hepatic angiography in the evaluation of space-occupying lesions. It was of definite value in 8 of 26 studies, either in facillitating the diagnosis or in evaluating the extent of disease. The mechanism of enhanced visualization is presumably related to its vasodilatory effect on the small blood vessels of the liver. Priscoline deserves further evaluation in the following situations: (a) a negative hepatic angiogram in the face of positive clinical findings or radionuclide images; (b) suspicious but not definitive findings on conventional hepatic angiography; and (c) assessment of the full extent of disease.

Adult↗

Eosinophilic gastritis. Radiologic-pathologic correlation (RPC) from the Armed Forces Institute of Pathology (AFIP).

Eosinophilic gastroenteritis may involve the gastrointestinal tract locally ofr diffusely. When localized to the stomach, the preferred terminology is "eosinophilic gastritis". Pathologically, this entity is characterized by a high eosinophil count (which closely follows the symptomatology) and diffuse infiltration of the antral wall by eosinophils. Typical roentgenographic manifestations include gastric antral rigidity, thickened folds, and mucosal nodules. The differential diagnosis is discussed. Correct diagnosis is vital because of the benign nature of the disease and good response to conservative therapy.

Adult↗

Coarctation of the aorta. Roentgenographic assessment after operative correction.

Persistent abnormalities in the cardiac silhouette and aortic arch are frequent in the late follow-up of patients operated upon for coarctation of the aorta. These abnormalities for the most part can be correlated with age at operation, the presence of a coexistent uncorrected congenital anomaly, or a persistent hemodynamic defect. This group of patients requires continuing clinical and roentgenologic assessment, as these abnormalities are frequently the hallmarks of additional significant cardiovascular disease despite correction of the primary congenital defect.

Adolescent↗