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Biomedical subjects

J Bar-Ziv

Publications and source records attributed to J Bar-Ziv.

At least 37 records · Page 2Linked to original sources
PubMed1998

Compression of the esophagus by the spine and the aorta in untreated scoliosis.

An adult patient with severe scoliosis secondary to familial dysautonomia developed dysphagia and recurrent aspirations. Various imaging studies showed a mechanical obstruction of the esophagus due to compression between the spine and the aorta. The patient underwent a gastrostomy and fundoplication, with a significant decrease in symptoms. The case demonstrates one of the possible long-term consequences of untreated scoliosis.

Adult↗
PubMed1998

Trigeminal neuropathy: improved imaging with a dental computed tomography software program.

PURPOSE: This study evaluated the use of images obtained by a dental computed tomography (CT) software program in the diagnosis and treatment of trigeminal neuropathy associated with jaw abnormality. PATIENTS AND METHODS: Twelve patients with jaw abnormality associated with trigeminal neuropathy as the presenting symptom were studied by plain film radiography (PFR) and by a dental CT software program (DS) that displays multiple panoramic and cross-sectional views of the mandible and maxilla. The two modalities were compared for delineation of the integrity of mandibular foramen, mandibular canal, mental foramen, incisive foramen, and incisive canal. Also, displacement of the neurovascular bundle was evaluated and scored. RESULTS: The DS was superior to PFR in showing the bony integrity of the foramina and canals in the jaws, as well as the degree of displacement of the neurovascular bundle. CONCLUSION: DS should be the study of choice for evaluating trigeminal neuropathy associated with abnormalities of the jaws.

Adult↗
PubMed1998

Surgical management of temporomandibular joint ankylosis type III by retaining the displaced condyle and disc.

PURPOSE: This article proposes a hypothesis regarding the value of saving the fractured condyle and disc in their displaced position in ankylosis type III for optimal temporomandibular joint (TMJ) function and growth, and describes four cases treated in this manner. PATIENTS AND METHODS: Four patients (three females and one male, 9 to 48 years old) with TMJ ankylosis type III of 3 to 8 years' duration, a maximal mouth opening of 15 to 19 mm, and severely limited lateral and protrusive movements were treated. The ankylosed sites were resected, leaving the displaced condyle and disc in their medial position. RESULTS: Fifteen to 60 months after surgery, the patients had a maximal mouth opening of 44 to 50 mm, as well as better contralateral and protrusive movements. In addition, two young patients (9 and 11 years old) showed an improved facial symmetry. CONCLUSIONS: Treatment of patients with type III TMJ ankylosis should involve retention rather than removal of the displaced condyle and disc. The condyle and disc are left untouched in their precarious medial position so as to provide normal function and growth.

Adult↗
PubMed1998

Characteristics of bone formation following marsupialization of jaw cysts.

OBJECTIVES: To assess bone regeneration following marsupialization of jaw cysts. METHODS: CT with multiplanar reconstruction (MPR) was performed on 23 patients with cysts of the jaws pre-operatively and 3-4 months after marsupialization. The two images were compared for the three-dimensional outline of the cyst, the distance between the cyst and adjacent structures (vital teeth, maxillary sinus, nasal cavity and mandibular canal) and the integrity of the cortex and mandibular canal. The characteristics of the new bone formation were also determined. RESULTS: The outline of the cyst was changed and partially reduced. The distance between cyst wall and adjacent structures was increased. There was remodelling of the cortex and mandibular canal. The new bone formed in the periphery of the cyst showed either a ground glass appearance or radial bone spicules. CONCLUSION: CT with MPR is useful for evaluation of morphological changes and bone formation following marsupialization of jaw cysts. CT with MPR is the technique of choice for the maxilla and the entire body of the mandible and coronal CT for cysts in mandibular angle and ascending ramus. Cysts can be enucleated safely as early as 3 months after marsupialization.

Adult↗
PubMed1998

'Epiphyseal dysgenesis' in Laurence-Moon-Biedl-Bardet syndrome.

Ten patients with Laurence-Moon-Biedl-Bardet syndrome were investigated. They all belonged to one large family within which several intermarriages had taken place. We found that, apart from the already described abnormalities, these patients suffered from dysgenesis of the following epiphyses: vertebrae, proximal femur, proximal tibia, capitellum, tarsal navicular, and the distal epiphysis of the first metatarsal. The degree of polydactyly, a prominent feature of this syndrome, varied from patient to patient, ranging from a wide fifth metatarsal or metacarpal to a complete sixth digit. As in other epiphyseal dysgenesis, a pseudoepiphysis of the distal first metacarpal was present. One patient (the eldest) was tetraparetic due to severe spinal stenosis.

Adolescent↗
PubMed1998

Somatostatin-receptor scintigraphy in the management of gastroenteropancreatic tumors.

OBJECTIVE: This study evaluates the diagnostic and therapeutic implications of somatostatin-receptor scintigraphy in the management of patients with proven or high clinical suspicion of gastroenteropancreatic endocrine tumors. METHODS: Forty-one patients were studied by planar and tomographic imaging at 4 h and 24 h after 111In-pentetreotide injection. Scintigraphic findings were compared with computed tomography, and in several patients also with ultrasound, angiography, biopsy, and/or surgery, when performed. RESULTS: Among 23 patients with carcinoid tumor, three of nine primary tumors were initially identified by scintigraphy. Unsuspected mesenteric metastases found on scintigraphy in three patients led to octreotide treatment. Scintigraphic detection of multiple metastases in a patient with thyroid metastasis of bronchial carcinoid spared her an unnecessary total thyroidectomy. Among 18 patients with 19 islet-cell tumors, scintigraphy detected three of five insulinomas, whereas computed tomography identified only one. Receptor positivity in an islet-cell tumor (vipoma?) with no metastases on the scan led to surgical removal of the primary tumor. Receptor-positive metastases of gastrinoma (two of three patients), glucagonoma (two of three patients), and parathyroid hormone-related peptide-producing tumor (one patient) led to octreotide treatment. Nonvisualization of metastases of a glucovipoma led to chemotherapy. CONCLUSIONS: Somatostatin-receptor scintigraphy contributes to the management of patients with gastroenteropancreatic tumors in the following ways: 1) localization of a primary occult tumor, allowing surgical removal; 2) staging of the disease for optimal therapy-surgical excision or systemic treatment; and 3) identification of receptor status of the metastases for octreotide treatment or chemotherapy.

Adenoma, Islet Cell↗
PubMed1997

[CT-guided core needle biopsy of abdominal, pelvic and retroperitoneal masses].

CT-guided core needle biopsy of abdominal, pelvic and retroperitoneal masses is accurate and safe and can be performed on an outpatient basis. Between 1987 and 1995, 809 patients (age range 1-87 years) underwent 851 biopsies (minimal lesion diameter 1 cm). Cutting needles were always used, facilitating both cytological and histological diagnosis while minimizing risk of complications. A positive result (malignant, inflammatory or infectious) was obtained in 69% of the 809 and a negative result (normal tissue) in 17.4%, while in 13.6%, material for diagnosis was insufficient. Biopsy was repeated in 42 of them in whom radiological or clinical suspicion of malignancy was high. In 24 (60%) a positive result was obtained after the second biopsy. Significant complications occurred in 7 (0.8%). 1 hemo-rrhaged following liver biopsy and required blood transfusion. Pancreatitis occurred in 6 (2.6%) following pancreatic biopsy. An intraabdominal fluid collection in 1 necessitated percutaneous drainage. There was no mortality following the procedure and no documented case of needle-tract seeding of tumor. All outpatients were discharged within 3 hours of completion of the biopsy, without ill effects.

Abdominal Neoplasms↗
PubMed1997

CT appearances of involvement of the peritoneum, mesentery and omentum in Wilms' tumor.

BACKGROUND: Peritoneal involvement by Wilms' tumor indicates stage III disease. CT is the single preferred modality in determining the extent and staging of Wilms' tumor; however, the CT appearances of Wilms' tumor involvement of the peritoneum have not been specifically addressed in the literature. OBJECTIVE: The objective of this study was to demonstrate the CT manifestations when there is involvement of the peritoneum, mesentery and/or omentum in Wilms' tumor. MATERIALS AND METHODS: Four cases of Wilms' tumor form the basis of this report. They were examined on Elscint CT scanners. RESULTS: Masses ("dropped metastases") in the pelvis were present in all four patients. Three patients had masses in the mesentery of the small bowel and sigmoid colon. Infiltration of the greater omentum was identified in two patients as a mantle of tumor separating bowel from the anterior abdominal wall. Ascites was present in two patients. In one patient broad-based solid masses of varying sizes were noted on the parietal and on the visceral surfaces of the peritoneum, and in a different patient a discrete mass was noted in the lesser omentum. CONCLUSION: The peritoneal spaces, recesses, ligaments and folds are invisible unless invaded by disease which is well demonstrated on CT.

Child↗
PubMed1997

Fracture of the occipital condyles and associated craniocervical ligament injury: incidence, CT imaging and implications.

Thin section contiguous axial computer tomography (CT) was used to demonstrate fractures of the occipital condyle and craniocervical ligament injury. During a 12-month period, 55 consecutive patients who had sustained high energy blunt trauma to the head or upper cervical region were examined (38 male and 17 female, age range 3-80 years, median 24 years). If occipital condyle fracture was suspected clinically, CT was performed from C2 to the foramen magnum with two dimensional sagittal, coronal, and curvilinear reconstructions and employing bone and soft tissue windows. Occipital condyle fractures were classified according to Anderson and Montesano types 1, 2 or 3. Injury to the internal craniocervical ligaments was described. Nine of 55 patients had occipital condyle fractures (16.4%). Injury of the alar ligaments was demonstrated in four and tectorial membrane injury in two patients. Three of the nine patients had associated fractures of cervical vertebrae. Five of nine patients had a normal Glasgow coma scale on admission (55%) and in two patients the occupital condyle fracture was the only significant injury. Plain cervical radiographs were non-diagnostic. Two patients had significant pain and limited motion of the craniocervicum several months following injury. In conclusion, CT should be performed where there is a high clinical suspicion of occipital condyle fracture, that is based mainly on the mechanism of injury.

Adolescent↗
PubMed1997

Computed tomography in the emergency department.

A study was conducted to determine parameters indicating the current use of computed tomography (CT) in the emergency department (ED). Computerized data regarding patients seen in the ED between 1/1/92 and 9/30/95 were retrieved. A rate of 36/1,000 patients underwent CT in the ED (ED CT). Of patients eventually hospitalized, 6.04% had ED CT, whereas 2.81% of the discharged patients had undergone ED CT (P < .001). The most common region examined by ED CT was the head (55.38%), followed by the abdomen (14.19%), pelvis (11.96%), spine (11.46%), and chest (5.57%). The hospitalization rates for patients undergoing head and spine ED CT were 35.99% and 36.84%, respectively. The hospitalization rates for patients undergoing abdomen, pelvis, and chest ED CT were 50.76%, 51.46%, and 55.61%, respectively. The mean number of patients undergoing ED CT increased according to age with a positive linear correlation. Head CT was most common in the very young and the very old. Some parameters about the use of ED CT were identified. The information obtained will allow comparison of practice between EDs in different medical centers and will be useful to hospital administrators, health planners, and clinicians. This retrospective analysis is to be followed by more comprehensive prospective studies involving different EDs in various sections of the country.

Abdominal Injuries↗
PubMed1997

Teeth in the maxillary sinus--imaging and management.

PURPOSE: To evaluate the images obtained by CT in diagnosis and treatment plan of teeth in the maxillary sinus. METHODS: Twelve patients with teeth in the maxillary sinus were studied by plain film radiography (PFR) and by CT with a dental software programme, which displays multiple panoramic and cross-sectional views of the mandible and maxilla. The three-dimensional morphology of the tooth, its inclination, proximity to the sinus wall, surgical planning and prediction of prognosis and complications were estimated on both PFR and on CT scans and scored. RESULTS: The radiographical features interpreted from PFR were fair or poorly diagnosed whereas CT provided excellent features. The surgical approach of choice was based on CT interpretation. CONCLUSION: CT is useful for diagnosis and treatment planning of teeth in the maxillary antrum.

Adult↗
PubMed1997

Effect of axial plane deviation on cross-sectional height in reformatted computed tomography of the mandible.

OBJECTIVE: To assess the effect of angular deviation on the measured height of the mandible in reformatted cross-sectional CT scans. METHODS: Reformatted cross-sectional CT scans were obtained from three dried mandibles, at three angulations, in a special holding and positioning device for perpendicular measurements. The radiographic lengths of 321 measurements were compared with the actual bone length. RESULTS: The mean difference between actual bone length and image length, with transaxial planes parallel to the lower border, was 0% (s.d. 3.6). Deviations of 10 degrees and 20 degrees from the lower border of the mandible resulted in a mean error of 1% (s.d. 4.5) and 2.8% (s.d. 8.0) respectively. When the angulation between the deviated transaxial plane and the lower border was greater than 10 degrees, the maximum error was about +/- 30%. CONCLUSION: The use of different transaxial planes along the mandible may result, in a small proportion of cases, in discrepancies in height when measured from the cross-sectional images obtained. This may lead to incorrect interpretation of the depth of bone available for implants.

Dental Implantation, Endosseous↗
PubMed1997

Liver hemangioma. A perioperative Tc-99m RBC SPECT correlation.

Scintigraphic diagnosis of a liver hemangioma may be difficult when its size approaches the spatial resolution of a gamma camera, and it may not be visualized on a Tc-99m tin-colloid liver SPECT study. The contribution of Tc-99m labeled RBC scintigraphy is shown in a patient with a liver hemangioma discovered during laparoscopic cholecystectomy for chronic cholecystitis. Despite negative CT, US, and Tc-99m tin-colloid SPECT of the liver, Tc-99m labeled RBC SPECT disclosed a focus of increased activity consistent with the hemangioma.

Colloids↗
PubMed1996

Hereditary deficiency of vitamin K-dependent coagulation factors with skeletal abnormalities.

We describe a female infant who presented with severe intracranial bleeding and was found to have a hereditary deficiency of vitamin K-dependent coagulation factors. She also had mild stippling of the left femoral epiphysis and shortness of the distal phalanges of the fingers. We studied the possible relationship between these abnormalities and a peroxisomal defect and followed their responses to treatment with vitamin K. The level of vitamin K-dependent clotting factors returned to near-normal following treatment with pharmacological doses of vitamin K, but there was no effect on the skeletal abnormalities.

Blood Coagulation Disorders↗