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Biomedical subjects

J T Cuttino

Publications and source records attributed to J T Cuttino.

At least 19 recordsLinked to original sources
PubMed1992

Post-ligation dilatation of the fallopian tube.

RATIONALE AND OBJECTIVES: Dilatation of fallopian tube remnants after ligation has been described but never systematically studied in post-ligation hysterosalpingograms (HSGs). This study describes the frequency and appearance of proximal tubal remnant dilatation as seen on HSGs in women with a history of bilateral tubal ligation (BTL). METHODS: A retrospective review of medical records and a subjective and objective evaluation of dilatation seen on HSGs included 68 consecutive women seen for pre-reanastomosis HSG. RESULTS: Among the 68 women, 44 (67%) had objectively measured dilatation on one or both tubes. Dilatation was present in both short and long tubal remnants. There were no measurable differences between women with and without presence of dilatation. Neither length nor dilatation of tubal remnant was associated with pregnancy outcome. CONCLUSIONS: Dilatation of the tubal remnant after bilateral tubal ligation is a common finding on HSG and can be accurately identified from the HSG by radiologists. Dilatation is not strictly related to length, and in our small sample with follow-up, was not associated with pregnancy outcome.

Adolescent↗
PubMed1989

Microradiographic demonstration of human intrarenal microlymphatic pathways.

Renal lymphatics play a prominent role in physiological and pathologic states. However, intrarenal microlymphatic morphology has not been well established in humans. We have developed microangiographic techniques for studying microlymphatic morphology. Lymphatics were identified by location, presence of valves, and histologic characteristics in 4 patients (3 presented here and 1 reported previously), all of whom had congestive cardiac states. The renal lymphatics begin in the cortical interstitium near glomeruli and run adjacent to afferent arterioles and interlobular arteries. They drain into arcuate and interlobar vessels and then into hilar lymphatics. They also originate in and drain the medullary structures in the area of the vasa recta. Our study details the microlymphatic morphology in humans and confirms the similarity of human lymphatics to those studied extensively in pigs and dogs.

Adult↗
PubMed1989

Streptococcal antigen-induced dislocation and dysplasia of the hip in newborn rats. Radiologic and histologic evaluation of a model of congenital dislocation of the hip.

Dislocation of the hip developed in 62% of newborn rats with streptococcal antigen-induced synovitis. Age at the time of the induction of synovitis is critical since dislocation is not observed in older rats. Synovitis with distention and laxity of the joint capsule is most likely responsible for the hip dislocation. Although congenital dislocation of the hip in children is not mediated by an inflammatory process, the current model of dislocation of the hip in rats is similar in being critically age-dependent, and associated with ligamentous laxity. Our model may be helpful in studying this important clinical entity.

Age Factors↗
PubMed1988

Urothelial microvascular response to chronic renal inflammatory disease.

Renal pelvocaliceal mucosal opacification has been observed clinically in patients with inflammatory disease. We studied the microvascular changes that might be responsible for this finding using barium injection and microradiographic studies of 20 human kidneys excised due to infection. There were six patients with staghorn calculi and chronic pyelonephritis, four with pyohydronephrosis, eight with acute and chronic pyelonephritis, and two with xanthogranulomatous pyelonephritis. The microangiograms correlated with severity of inflammation. In mild cases, slight vessel hypertrophy involved the terminal arterioles and arteries supplying the urothelium. In severe cases, there was marked neovascularity with feeding vessel hypertrophy and mucosal thickening. Our studies demonstrate that abnormal pelvocaliceal vascularity is responsible for the findings seen on urography and angiography of inflammatory disease.

Angiography↗
PubMed1988

Needle localization biopsy of occult lesions of the breast. Experience in 199 cases.

From January 1980 through June 1986, 199 percutaneous needle localizations for clinically occult breast lesions were performed at North Carolina Memorial Hospital. A retrospective analysis of the medical records, mammograms, operative notes, and pathology reports was undertaken to evaluate the success of this procedure. In our series, biopsy was prompted by abnormal calcifications in 27.1% of lesions, occult masses in 37.2%, and by a combination of occult masses and microcalcification in 35.7%. Overall, we had a yield of positive biopsies for cancer of 16.3%, with the yield improving from 12.3% in the earlier years of our study, to 18.7% in the latter years. Of the cancer cases detected, 89.7% were stage I. The localization procedure was successful in 95.9% of the cases. Analysis of our eight failures, along with a review of the literature, shows the major reasons for failure to be incomplete removal of areas with multiple calcifications, dislodgement of the needle, and problems resulting from lack of communication between the radiologist and surgeon. We conclude that the failure rate is low, the yield good, and needle localization a worthwhile procedure for localizing nonpalpable occult lesions.

Adult↗
PubMed1988

Computerized data base of teaching conference cases.

Conferences consisting of case presentation with discussion are a major tool in radiology resident teaching. We used a computerized data base to study the case mix at our teaching conference. At daily conferences from July 1984 to March 1985 each case was recorded as to patient name, identification number, date, type of conference, case presented, modality used, organ study, and diagnosis. Data were entered on a 256K IBM PC with two 360K disk drives running dBase II (Ashton-Tate). Use of a computer to store the information offered the advantage of rapid analysis of the data by type of study or region of interest. Initial use of the system has confirmed its utility in the areas of teaching file generation, monitoring of conference content, and as an aid in modifying the case content to represent more evenly the spectrum of disease found in a given organ or an organ system.

Humans↗
PubMed1987

Molding of the uterus following intrauterine contraceptive device removal: documentation by hysterosalpingography.

Intrauterine contraceptive devices (IUDs) distort the uterine cavity. We report 2 cases of endometrial molding demonstrated by hysterosalpingography (HSG) following removal of an IUD. Other processes may cause filling defects in the uterine cavity including inflammatory synechiae (Asherman's syndrome), tuberculosis, endometrial hyperplasia, and polyps. Whenever filling defects are seen, the history of IUD usage should be determined.

Adult↗
PubMed1987

Resident performance evaluation.

The authors have developed a resident evaluation system that minimizes inefficiencies and achieves the aims of evaluation. Individual resident performance is evaluated on each monthly rotation by those who have had significant contact with him as determined by the resident. Residents are rated as "below," "adequate," or "above" for these performance categories: (1) overall performance, (2) basic knowledge, (3) organizational skills, (4) communication skills, (5) interpersonal relationships, and (6) other areas and comments. The results are shared with the resident in a feedback session and recommendations made. These evaluations are summarized and discussed with the resident by the program director at the end of each year. This system has proved to be an efficient use of attending radiologist's and program director's time. The format has been accepted readily by all participants. The system has been helpful in identifying problem areas in resident performance and in curriculum and has resulted in prompt corrective action.

Employee Performance Appraisal↗
PubMed1987

The evaluation of gross hematuria in anticoagulated patients: efficacy of i.v. urography and cystoscopy.

To determine the efficacy of investigating gross hematuria in anticoagulated patients, records were reviewed of 24 patients who had gross hematuria while being treated with warfarin for various thromboembolic disorders. All had IV urography, and half had cystoscopy. Sources of bleeding were found in seven (29%) of 24 patients by IV urography and in five (42%) of 12 patients by cystoscopy. Abnormalities considered responsible for bleeding included renal stones (four), transitional cell carcinoma (one), calcified renal mass (one), lymphoma (one), bladder tumors (two), hemorrhagic cystitis (two), and a bleeding prostate tumor (one). Additionally, an enlarged prostate was the only abnormal finding in five patients. If an enlarged prostate is considered a source of bleeding, the workup that included both IV urography and cystoscopy identified a cause of bleeding in 17 (71%) of 24 patients. The results suggest that IV urography and cystography are warranted in patients who take anticoagulants and who have gross hematuria.

Adult↗
PubMed1986

Bladder mucosal tears during voiding cystourethrography in chronic renal failure.

We report 6 patients with chronic renal failure who developed contrast intravasation/extravasation during voiding cystourethrography. Two patients underwent cystoscopy and were noted to have diffuse mucosal tears, but had normal-appearing bladder mucosa on follow-up inspection. None of the patients experienced symptoms or clinical sequelae. Pathophysiological changes in the chronically unused bladder which predispose it to mucosal injury are considered.

Adolescent↗
PubMed1986

A uniform acceptance date for resident recruitment.

Residency recruitment in diagnostic radiology remains a challenge. We recommend a unified policy of recruitment, to be agreed upon and adhered to by all residency training program directors. We endorse the action discussed at the 1985 Residency Training Program Symposium in Nashville to institute a Resident Match and strongly urge all program directors to participate. With more qualified candidates and a shrinking number of positions, it is the only rational solution to this dilemma.

Education, Medical, Graduate↗
PubMed1986

Screen-film mammography versus xeromammography in the detection of breast cancer.

There are two common methods of obtaining high-quality screening mammography: screen-film mammography (more simply, mammography) using a dedicated unit, and xeromammography. We studied the accuracy of the two techniques in detecting breast cancer by a retrospective study, analysing accuracy of interpretation in cases where both mammography and xeromammography were performed. Seventy-six patients were considered with 86 biopsies and mammograms resulting in detection of 32 cancers and 54 benign lesions. There was no difference in accuracy of interpretation between mammography and xeromammography. The sensitivities were: mammography 0.91, xeromammography 0.88. The specificities were: mammography 0.63, xeromammography 0.75. We conclude that both modalities are comparable in detecting cancer when optimal technique and experienced personnel are used.

Adult↗
PubMed1985

Salpingitis isthmica nodosa: radiologic and clinical correlates.

Salpingitis isthmica nodosa (SIN) is thought to be an inflammatory condition of the fallopian tubes and is strongly associated with infertility and an increased risk of ectopic pregnancy. The diagnosis is best made radiographically at hysterosalpingography (HSG), where the characteristic finding consists of multiple nodular diverticular spaces in close approximation to the true tubal lumen. We reviewed 1,194 HSGs performed over a five year period and identified 45 patients who had SIN (4%). There was a high rate of primary infertility (37.5%) and ectopic pregnancy (9.4%). Of 70 involved tubes, 62 (89%) had evidence of associated inflammation on historic, radiologic, surgical, or histologic grounds. We conclude that SIN is a disorder most likely acquired during the fertile years, and that the lesion is either a direct consequence of infection or that--once present--it predisposes the patient to subsequent infections.

Adult↗
PubMed1985

Renal medullary lymphatics: microradiographic, light, and electron microscopic studies in pigs.

Although renal cortical lymphatics have been extensively studied, the existence of renal medullary lymphatics has not been well documented. We studied renal microlymphatics in pig kidneys by retrograde ureteral injection of barium-sulfate-gelatin-saline mixture. Lymphatics filled as a result of forniceal rupture and interstitial extravasation. Microradiographs were correlated with histology and electron microscopy. We traced renal microlymphatic vessels from the arcuate level not only into the cortex but also into the pyramidal region, and therefore concluded that medullary lymphatics existed.

Animals↗