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Biomedical subjects

J W Reeders

Publications and source records attributed to J W Reeders.

At least 19 recordsLinked to original sources
PubMed1992

Perirectal lymph nodes in rectal cancer: in vitro correlation of sonographic parameters and histopathologic findings.

Preoperative staging of lymph nodes in patients with rectal cancer is essential for selecting the most appropriate therapy. To determine the discriminating value of all ultrasound parameters described in the literature, the authors obtained high-frequency sonograms of 43 lymph nodes in 21 resected rectal specimens, thereby simulating the in vivo situation. Univariate analysis revealed that inhomogeneity (P less than .0005), short axis diameter (P less than .005), and hilar reflection (P less than .01) were helpful in differentiating between metastatically involved and noninvolved lymph nodes. A prognostic trend was seen for long-axis diameter (P = .05), roundness index (P = .09), and echogenicity (P = .05). With stepwise logistic regression analysis, inhomogeneity and hilar reflection were selected as being independently discriminative. Inhomogeneity is a parameter with a high specificity; hilar reflection is particularly sensitive. No clear differentiation could be made, however, in a sizable proportion of lymph nodes (60%). The prospective use of especially these significant parameters in vivo is recommended to determine their ultimate value in preoperative staging.

Humans↗
PubMed1992

Benign fibrosing disease at the hepatic confluence mimicking Klatskin tumors.

BACKGROUND: Hilar obstructions remain a challenge with regard to diagnosis and treatment. METHODS: In the period from 1984 to 1990, 82 patients underwent resective surgery under the presumptive diagnosis of hilar cholangiocarcinoma (Klatskin tumor). The diagnosis was based on the combined appearances on direct cholangiography and ultrasonography in all cases, with the use of various other imaging modalities in some cases. RESULTS: The perioperative findings from an experienced surgical team were usually thought to be compatible with bile duct carcinoma. However, histologic examination of the resected specimens revealed benign fibrosing or localized sclerosing lesions in 11 patients (13.4%). CONCLUSIONS: The current state of diagnostic imaging fails as yet to discriminate reliably between benign and malignant hilar lesions. Whereas the immediate therapeutic consequences may be equal (resection followed by hepaticojejunostomy), the late consequences differ in a major way because benign disease has a much better prognosis. In the presence of suspicious hilar obstruction, operable lesions should not be treated by "palliative" intubational techniques and radiation therapy without a firm diagnosis of malignancy. However, overtreatment (extended liver resection, vascular reconstruction, and liver transplantation) should be avoided as well when a benign lesion has not been ruled out.

Adenoma, Bile Duct↗
PubMed1992

Pressure and X-ray recording of reflux into the thoracic stomach.

Anastomotic leakage, pulmonary aspiration and reflux-esophagitis might be induced or aggravated by the increased duodenogastric reflux observed in the thoracic stomach. In this study, the effect of respiration on the reflux-promoting pressure gradient in the intrathoracally located stomach was assessed. In nine patients pressure recording was done in the duodenum and the abdominal and thoracic part of the stomach. Intrapleural pressure was determined by recording mouth pressure during inspiratory occlusion. In addition, the course of injected contrast was examined fluoroscopically. The mean end-expiratory pressure gradient in the thoracic part of the stomach was 0.8 cm H2O, increasing up to 6.0 cm H2O and 21.3 cm H2O during normal and forced inspiration, respectively. Fluoroscopic examination showed reflux of contrast that coincided with the downward movement of the diaphragm. From this study, we conclude that reflux into the thoracic stomach is promoted by intraluminal pressure fluctuations induced by voluntary breathing. Performing a pyloroplasty or -myotomy after intrathoracic esophagogastrostomy destroys the integrity of the pyloric sphincter as a barrier to reflux, thus promoting duodenogastric reflux.

Duodenogastric Reflux↗
PubMed1991

Transrectal US in the diagnosis of localized colitis cystica profunda.

Colitis cystica profunda (CCP) mimicks rectal carcinoma, which makes distinguishing this benign lesion from the more common rectal neoplasm clinically and pathologically difficult. When transrectal ultrasound (US) was used in this case, three features of CCP were seen. There were multiple lesions, which did not penetrate beyond the submucosa. A large cystic component was seen, with a layer of uniform thickness in two of the three lesions. Non-solid contents and a lack of infiltration can be visualized at transrectal US, which helps diagnose CCP.

Colitis↗
PubMed1989

Resectional surgical procedures for carcinoma of the head of the pancreas.

Of a total series of 103 patients with preoperatively diagnosed carcinoma of the head of the pancreas (including ampullary carcinoma, carcinoma of the distal part of the common bile duct and pancreatic duct and acinar cell carcinoma), 78 underwent pancreatic resection. The remaining 25 had palliative surgical treatment, either a gastric or biliary bypass, and are not included in the present study. Three of the 78 patients who underwent pancreatic resection died, and ten patients required early reoperation. Predictive criteria could be formulated for the prognosis and outcome of the patients with carcinoma of the head of the pancreas. The most reliable index for survival time of the patients proved to be the radicality of the resection, which was directly related to the differentiation of the primary tumor. Forty-three of 48 patients who underwent radical resection are alive, with a survival time ranging from three to 49 months. Eleven of 23 patients who underwent palliative resection are alive, with a survival time ranging from two to 29 months. Of 44 patients with well or moderately differentiated adenocarcinoma who underwent radical resection, 38 are alive, with a survival time ranging from six to 41 months (mean of 29 months).

Adenocarcinoma↗
PubMed1988

Urinary tract malakoplakia with extension into the retroperitoneum with secondary gastrointestinal involvement.

A rare case of malakoplakia of the urinary tract with diffuse retroperitoneal extension is presented. Sonographically guided cytologic puncture revealed the pathologic diagnosis. The splenic flexure of the colon and the stomach appeared to be secondarily involved in the inflammatory retroperitoneal tumor. The relative role of the various imaging modalities in defining retroperitoneal extension of the disease is illustrated, with a special reference to computed tomography and endosonography. After antimicrobial treatment and left nephrectomy, partial regression of the retroperitoneal mass was documented.

Adult↗
PubMed1987

Pancreatitis associated with congenital duodenal duplication cyst in an adult.

A case is reported of an adult patient with a history of relapsing pancreatitis. A soft duodenal submucosal lump was found by endoscopic retrograde cholangio-pancreaticography (ERCP). Endoscopic ultrasonography (endo-US) showed an anechoic lesion covered with normal duodenal wall structure. Histology of the surgically resected cyst confirmed the diagnosis. Since surgery no further attacks of pancreatitis have occurred.

Adult↗
PubMed1983

[Roentgenology of cancer of the gastric stump].

The carcinoma of the stomach stump is a late complication after partial resection of the stomach and gastroenterostomy. The risk for carcinoma increases with the interval, but in older people the interval is shorter. 12 patients with carcinoma of the stomach stump are discussed. The average interval from the primary operation of the stomach until the carcinoma was 23.8 years. With x-ray examination the diagnosis was correct in 11 patients, in 1 patient the examination was interpreted falsely.

Female↗
PubMed1983

Corpus cavernosography.

The cavernous spaces of the penis can be demonstrated by injecting 20 cm3 contrast agent (Urografin 60%) dorsolaterally behind the gland penis. By injecting the contrast agent into one corpus cavernosum, both corpora become visible by X-ray. Pathologic conditions (trauma, Peyronie's disease, priapism, malignancy, etc.) cause typical changes in the cavernous spaces and blood drainage. The literature has been reviewed.

Diatrizoate Meglumine↗
PubMed1982

Ischaemic colitis associated with carcinoma of the colon.

In a retrospective study of one hundred and seventy patients with ischaemic colitis, we found eight patients with partially obstructive carcinoma of the colon located distally, seven located in the sigmoid and one in the splenic flexure. The frequency of this association (1-4.7% in the literature and 5.3% in our series) requires careful examination by radiologist and surgeon. The radiologist should be alert to the association of ischaemic damage proximal to an obstructive colorectal cancer. The surgeon must examine any colonic segment removed for carcinoma in order to exclude an ischaemic process in the area of the anastomosis and prevent leakage at the anastomosis or stricture formation.

Aged↗