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Biomedical subjects

J G Rabinowitz

Publications and source records attributed to J G Rabinowitz.

At least 37 records · Page 2Linked to original sources

Preoperative chest radiography: value as a baseline examination for comparison.

An important use of the preoperative chest radiograph is as a baseline for comparison when complications occur after surgery. Many authors have commented on the value of preoperative chest radiography as a screening examination, but no statistics have been presented regarding its impact on postoperative management. In 369 consecutive general surgical patients, the need for a baseline chest radiograph was evaluated. In 65 patients undergoing chest radiography postoperatively, a preoperative baseline was essential in making an accurate interpretation in 33 (51%). The value of preoperative chest radiography proved to be twofold. Some minimal abnormalities on postoperative radiographs were demonstrated to be clearly new, necessitating treatment or further evaluation. Second, significant abnormalities detected on postoperative radiographs that may have otherwise been subjected to expensive evaluation were often shown to have been present preoperatively. In approximately 9% of patients the preoperative chest radiograph had a significant impact on postoperative management.

Adult↗

Cystic adult medulloblastomas.

The computed tomography scans of four patients who had a medulloblastoma are reviewed. In all the cases, atypical findings were present--specifically, cystic or lucent areas within the tumor. The importance of this uncommon finding associated with adult medulloblastoma is discussed.

Adolescent↗

Intradecidual sign: a US criterion of early intrauterine pregnancy.

The uterine cavity appears on sonograms as a linear echo, which is usually visible during early pregnancy and remains straight until the eighth to ninth week of gestation. The early gestational sac is not enveloped by two layers of decidua, as suggested by descriptions of the double decidual sac sign; the sac (or echogenic area of early implantation) is actually located within a markedly thickened decidua on one side of the uterine cavity. The combination of these two sonographic characteristics is called the "intradecidual sign." An early implantation of 25 days gestational age can be detected by the presence of the intradecidual sign, which is sooner than a gestational sac can be seen. The implantation site can also be located by means of the intradecidual sign. In a study of 36 patients with early intrauterine pregnancy and five with ectopic pregnancy, the intradecidual sign was more sensitive (91.7% vs. 63.9%) and specific (100% vs. 60%) than the double decidual sac sign in the detection of early intrauterine pregnancy.

Female↗

Floating gallstones in bile without added contrast material.

Floating gallstones can occur without the administration of contrast material to increase the specific gravity of bile. This was observed in three patients in 17 months. After a long fast, a large stone was noticed to float because of the high specific gravity of inspissated bile. This stone sank after the patient resumed food intake. In another patient, some stones floated while others sank due to their difference in specific gravity. Sonographic demonstration of a floating stone, however, requires certain strict criteria.

Bile↗

Chondrosarcoma of the spine: an unusual radiographic presentation.

Chondrosarcoma is a primary malignant tumor arising rarely in the axial skeleton. It usually presents as a destructive lesion with diffuse mottled calcification. We report three patients with chondrosarcoma of the spine. Each patient was evaluated by conventional radiographic technique, computed tomography, and myelography. All of them show radiographically a purely destructive process of the body and in one case the body and lamina. This pattern remains to be documented in the radiologic literature.

Adult↗

Ultrasonography and CT of abdominal and inguinal hernias.

Forty-two patients with various abdominal wall hernias and five patients with inguinal hernias were studied with ultrasonography. Thirteen patients were studied by CT. Although hernias are usually apparent on physical examination, difficulty in diagnosis may be encountered in some patients. Ultrasonography and CT are not only capable of diagnosing hernia in such instances, they are also helpful in the clinical management of the patients by demonstrating the precise location and extent of the muscular defect. However, the hernia may simulate a mass or cyst in the ultrasonograph and CT scan and one should carefully demonstrate intraperitoneal communication through a muscular defect or a herniated bowl loop within the hernia in order to avoid misdiagnosis. Pseudohernias due to localized thinning or thickening of the rectus muscle were also observed in five patients.

Diagnosis, Differential↗

Pulmonary complications of AIDS: radiologic features.

Fifty-two patients with pulmonary complications of acquired immunodeficiency syndrome (AIDS) were studied over a 3-year period. The vast majority of the patients were homosexual; however, a significant number were intravenous drug abusers. Thirteen different organisms were noted, of which Pneumocystis carinii was by far the most common. Five patients had neoplasia. Most patients had initial abnormal chest films; however, eight patients subsequently shown to have Pneumocystis carinii pneumonia had normal chest films. A significant overlap in chest radiographic findings was noted among patients with different or multiple organisms. Lung biopsy should be an early consideration for all patients with a clinical history consistent with the pulmonary complications of AIDS. Repeat biopsy is also indicated to ascertain the progression of radiographic findings. Unfortunately, even with documentation of the nature of the pulmonary process, treatment often is ineffective. Of the 52 patients, 41 had died by the time this report was completed.

Acquired Immunodeficiency Syndrome↗

Symposium on Nonpulmonary Aspects in Chest Radiology. The pulmonary ligament.

The pulmonary ligament forms an important attachment of the lower lobe to the mediastinum and therefore influences the ultimate configuration of pneumothorax, lower-lobe atelectasis, and mediastinal pleural effusions. Since the ligament consists of a double pleural sheath, under certain circumstances fluid, air, and so on can collect within it, producing a lesion of triangular configuration. The latter must be differentiated from an air cyst or atelectasis.

Asthma↗

Granulomatous enterocolitis: findings by ultrasonography and computed tomography.

Granulomatous enterocolitis was evaluated in 51 patients by ultrasonography, and in 14 of those patients also by computed tomography (CT). The features of granulomatous enterocolitis include abscesses in various locations and bowel loops that are matted and inflamed, dilated due to obstruction, or have thickened walls. Although the diagnostic findings of ultrasound and CT examinations are not as specific as those of barium-enhanced radiographic examinations, they are helpful in the clinical management of patients. Serial ultrasound examinations are ideal to demonstrate progression or regression of the inflamed bowel-loops and abscesses. Real-time scanning is important in the differentiation of fluid-filled or matted and inflamed bowel-loops from abscesses. However, manual scanning is usually better for the delineation of the abdominal wall and complicated retroperitoneal abscesses.

Abscess↗

Ultrasonography of the extremities and pelvic girdle and correlation with computed tomography.

Ultrasonography was performed on 54 patients with lesions of the extremities and pelvic girdle. Computed tomography (CT) was employed in 8 patients. Focal space-occupying lesions such as tumors, abscesses, hematomas, aneurysms, and popliteal cysts (dissecting or otherwise) were delineated by ultrasound and their extent defined. Differentiation from diffuse changes such as lymphedema, cellulitis, or phlebitis and diagnosis of aneurysms were possible. Popliteal cysts were usually quite characteristic, while correlation with the clinical features suggested the correct diagnosis in the case of the other lesions. CT correlated well with ultrasound, except for one tumor of the forearm which was not shown by CT.

Abscess↗

A comparative study of mesothelioma and asbestosis using computed tomography and conventional chest radiography.

A comparative study using computed tomography and conventional posteroanterior radiography was performed on 27 patients with mesothelioma and 13 patients with advanced asbestosis. The major pathologic features of both asbestosis and mesothelioma were well demonstrated by both modalities; computed tomography demonstrated the findings more frequently and in greater detail. No distinguishing features could be established based on configuration and size of the lesion. Many pleural plaques associated with advanced asbestosis were large and irregular and resembled those associated with mesothelioma. However, nodular involvement of the pleural fissures, pleural effusion, and ipsilateral volume loss with a fixed mediastinum were features predominating in mesothelioma. Growth determination of the plaques associated with asbestosis may be of minimal value since such plaques also undergo growth due to active inflammatory changes.

Asbestosis↗

Ultrasonography and computed tomography of inflammatory abdominal wall lesions.

Twenty-four patients with inflammatory lesions of the abdominal wall were examined by ultrasonography. Nine of these patients underwent computed tomographic (CT) scanning as well. Both ultrasonography and CT clearly delineated the exact location and extent of abdominal wall abscesses. Abscesses were easily differentiated from cellulitis or phlegmon with ultrasound. The peritoneal line was more clearly delineated on ultrasonograms than on CT scans; abscesses were also more distinct on the ultrasonograms because of their low echogenicity compared with the surrounding structures. Gas bubbles, fat density with specific low attenuation values, and underlying inflamed bowel loops in obese patients with Crohn's disease were better delineated by CT.

Abdominal Muscles↗

Case report. Aneurysm of the ductus arteriosus in an adult.

Aneurysm of the ductus arteriosus is unusual in the adult. Computed tomography (CT) may be critical in making a preoperative diagnosis. The value of CT in the diagnosis of this entity, as well as its likely pathogenesis, is discussed.

Aged↗