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H M Goldstein

Publications and source records attributed to H M Goldstein.

At least 19 recordsLinked to original sources
PubMed2001

Stereotactic breast biopsy of nonpalpable lesions: determinants of ductal carcinoma in situ underestimation rates.

PURPOSE: To measure the effect of biopsy device, probe size, mammographic lesion type, lesion size, and number of samples obtained per lesion on the ductal carcinoma in situ (DCIS) underestimation rate. MATERIALS AND METHODS: Nonpalpable breast lesions at 16 institutions received a histologic diagnosis of DCIS after 14-gauge automated large-core biopsy in 373 lesions and after 14- or 11-gauge directional vacuum-assisted biopsy in 953 lesions. The presence of histopathologic invasive carcinoma was noted at subsequent surgical biopsy. RESULTS: By performing the chi(2) test, independent significant DCIS underestimation rates by biopsy device were 20.4% (76 of 373) of lesions diagnosed at large-core biopsy and 11.2% (107 of 953) of lesions diagnosed at vacuum-assisted biopsy (P <.001); by lesion type, 24.3% (35 of 144) of masses and 12.5% (148 of 1,182) of microcalcifications (P <.001); and by number of specimens per lesion, 17.5% (88 of 502) with 10 or fewer specimens and 11.5% (92 of 799) with greater than 10 (P <.02). DCIS underestimations increased with lesion size. CONCLUSION: DCIS underestimations were 1.9 times more frequent with masses than with calcifications, 1.8 times more frequent with large-core biopsy than with vacuum-assisted biopsy, and 1.5 times more frequent with 10 or fewer specimens per lesion than with more than 10 specimens per lesion.

Axilla↗
PubMed1987

Medication-induced esophagitis: diagnosis by double-contrast esophagography.

Although medication-induced esophagitis is recognized more frequently nowadays, reports of associated radiographic findings are limited. Nine cases of esophagitis associated with various medications were evaluated by using double-contrast esophagography. The usual features were several discrete focal ulcerations localized to a short segment of the proximal half of the esophagus. In seven of the cases, the offending medication was an antibiotic. Symptoms resolved in about 4 days after medication was discontinued. Finding characteristic radiologic abnormalities in the appropriate clinical setting may obviate endoscopy.

Adolescent↗
PubMed1985

Pancreatic phlegmon. Clinical features and course.

The clinical course of 19 patients with pancreatic phlegmon, as diagnosed by computed tomography (CT) and clinical criteria, was assessed retrospectively and compared to that of eight patients with pancreatic abscess diagnosed either at surgery or with percutaneous aspiration. Controls consisted of 55 patients with uncomplicated acute pancreatitis without CT scans and 11 patients with acute pancreatitis in whom CT scans were negative or only consistent with acute pancreatitis (no phlegmon). The age, sex, and presumed etiology of the pancreatitis were not significantly different in the four groups. Patients with phlegmon had a higher incidence of severe pancreatitis as defined by Ranson's criteria, presence of an abdominal mass, as well as a longer duration of fever, abdominal pain and leukocytosis than controls without CT scans. With the exception of a palpable abdominal mass and fever lasting over five days, the results were similar when comparing the phlegmon group and controls with CT scans, although the severity of the disease and prolonged abdominal pain tended to be increased in the former patients. There was no statistically significant difference in clinical or laboratory criteria between the phlegmon and abscess groups, although the latter group had longer hospital stays and periods with no oral intake (npo). Management of patients with phlegmon tended to include TPN, longer npo periods, antibiotics, and longer hospital stay than in controls without CT scans. Controls with CT scans were managed similarly to the phlegmon group because of prolonged amylase elevation and abdominal pain. Percutaneous aspiration was successful in differentiating abscess from phlegmon in five of six cases. Major complications were rare in the phlegmon group and spontaneous resolution was the rule. Pancreatic phlegmon is a distinct clinical/radiologic entity which may be very difficult to differentiate clinically from pancreatic abscess. Early percutaneous thin-needle aspiration of the inflammatory mass (under CT guidance) seems to be the diagnostic procedure of choice. Management is nonsurgical unless complications arise. The role of TPN and antibiotics is unknown, and controlled studies of these therapeutic approaches in pancreatic phlegmon are needed.

Abscess↗
PubMed1985

Renal and perirenal infection: the role of computerized tomography.

Predisposing factors, onset of symptoms to diagnosis interval, computerized tomography findings and the impact of computerized tomography on the outcome were studied retrospectively in 24 patients with renal or perirenal infections. The most common predisposing factors were diabetes mellitus and urinary tract calculi. The mean interval from the onset of symptoms to diagnosis was 6.8 days. The most common computerized tomography findings were thickening of Gerota's fascia, renal enlargement, focal decreased renal attenuation, perirenal fluid and focal gas. Four patients died despite early diagnosis and appropriate therapy. Computerized tomography aided in the diagnosis, assessment of the extent of disease, treatment and followup. Computerized tomography is the most direct method to evaluate patients with suspected renal or perirenal infection, although mortality may not be altered significantly.

Abscess↗
PubMed1985

The normal mucosal surface pattern of the duodenal bulb: radiologic-histologic correlation.

Similar to the stomach and colon, the duodenum also demonstrates a fine mucosal relief pattern on double-contrast radiographic examination. Two patterns may be identified--fine reticular and "small dot." In order to investigate the origin of these patterns, duodenal bulb specimens were obtained at autopsy, and macroscopic and microscopic features were correlated with radiographic patterns. Findings indicate that the surface patterns identified radiographically on cadaveric specimens and in live patient subjects are due to villi and the collections of barium within the intervening sulci. Knowledge of this normal pattern will prevent misdiagnoses, especially when inflammatory disease of the duodenum is being considered.

Duodenum↗
PubMed1984

Diverticulitis of the right colon.

Diverticulitis of the right colon is a relatively uncommon disease that usually mimics acute appendicitis. Most patients are operated on early, and a barium enema is not commonly obtained. Five cases with barium studies are presented. In four of the five cases an intramural mass effect and evidence of involvement of the colonic wall were present. Diverticula of the right colon were found in all five patients. If the diagnosis is made without surgery, medical therapy is usually successful.

Acute Disease↗
PubMed1984

Fixed transverse folds in the esophagus: a sign of reflux esophagitis.

Scarring from reflux esophagitis is usually manifested by circumferential stricture formation. This article reports 17 cases in which double-contrast esophagography demonstrated fixed transverse folds in the esophagus, presumably secondary to longitudinal scarring from reflux esophagitis. In all cases, pooling of contrast material between the folds produced a series of horizontal, relatively parallel collections of barium in a "stepladder" arrangement. This appearance should be distinguished from linear ulcerations, tertiary esophageal contractions, and the delicate transverse striations that are occasionally observed as a transient phenomenon on the double-contrast examination.

Cicatrix↗
PubMed1982

Evaluation of 12 colon-cleansing regimens with single-contrast barium enema.

In a study of patient preparation for barium enemas, 1,435 patients were examined at six different institutions with 12 different preparation protocols. There were 2,870 films evaluated a total of 7,839 times by seven different radiologists who were blind to both the institution and the preparations used. The statistical design, randomization, and analysis of the data obtained was performed by one of the authors, a statistician, and the following conclusions were made: Dulcolax (bisacodyl) plus 2 L tapwater enema is better than all the other protocols in all parts of the colon for both genders and all ages. Dulcolax or castor oil or X-Prep, each with 2 L water enema, are logically similar and better than the other protocols. Water enema only or castor oil only are the least effective protocols.

Barium Sulfate↗
PubMed1979

Abdominal pansonography in the evaluation of renal cancer.

Abdominal pansonography was performed in 34 patients after solid renal tumors were diagnosed. Included were evaluation of the inferior vena cava (IVC), the liver, and the retroperitoneal area. Additional findings including hepatic metastases, IVC extension of tumor, and retroperitoneal nodal masses were discovered in 14 patients. The role of pansonography as a noninvasive adjunctive diagnostic tool for more complete staging and treatment planning of renal cancer is discussed.

Adenocarcinoma↗
PubMed1979

Comparison of scintigraphy, sonography, and computed tomography in the evaluation of hepatic neoplasms.

A comparison of scintigraphy, ultrasonography, and computed tomography (CT) in 94 proven patients with clinically suspected liver disease is reported. CT proved to be the most accurate in detecting masses and assessing the complete extent of intrahepatic disease. The most reliable combination was CT and scintigraphy. The specific advantages and disadvantages of each method are discussed. The diagnostic scheme followed in the imaging evaluation of an hepatic mass in our clinical practice is discussed.

False Negative Reactions↗
PubMed1978

Radiologic demonstration of multiple foci of malignancy in the esophagus.

Three patients, each with two synchronous esophageal carcinomas demonstrated radiologically, are presented. The importance of complete esophageal evaluation in patients with one obvious tumor of the esophagus is emphasized. Assessment of the full extent of disease in such cases directly affects treatment planning.

Aged↗