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Biomedical subjects

K D Hopper

Publications and source records attributed to K D Hopper.

At least 109 records · Page 6Linked to original sources
PubMed1989

Image-directed percutaneous biopsies with a biopsy gun.

Core tissue for histologic study is believed by many pathologists to be more diagnostic than material from needle aspiration. Recently, a biopsy "gun" has been introduced, which simplifies core biopsies. With this device, 182 biopsies of multiple anatomic sites were performed with ultrasonic, computed tomographic, and fluoroscopic guidance and 18-gauge needles. High-quality histopathologic specimens were obtained in 177 of the biopsies, and diagnostic target tissue was obtained in 167. Only three significant complications occurred: one bleeding complication that required transfusion and two cases of pneumothorax that necessitated placement of chest tubes. The biopsy gun eliminated the disjointed movements of conventional "skinny" needle biopsies, and none of the samples demonstrated significant "crush" artifact or obscuring blood, problems that are commonly associated with manual biopsy techniques. Patient discomfort was decreased with this system compared with that of manual biopsies, and the total procedure time was reduced. Because of these distinct advantages, the authors now use the biopsy gun exclusively for all percutaneous biopsies and recommend that other institutions consider the use of this biopsy method.

Adult↗
PubMed1989

The retrorenal spleen. Implications for percutaneous left renal invasive procedures.

An uncommon but potentially disastrous situation for invasive percutaneous renal procedures is the presence of the spleen behind the upper left kidney. We have termed this anatomic variant "retrorenal spleen." In a computed tomographic (CT) review of 73 patients aged 16 to 86, we found a frequency of retrorenal spleen of 21.1% in the supine and 15.4% in the prone patient. In most individuals with this variant, the spleen was behind the lateral fifth and the superior fourth of the left kidney. The majority (80.0%) of these patients were age 50 or over. However, in only 7.6% would the posterior splenic position pose a risk to posterolateral percutaneous approaches of less than 30 degrees into the upper left collecting system. No patient had retrorenal spleen at the mid-hilar level in either the supine or prone position. Posterolateral approaches up to 40 degrees into the renal hilus are 100% safe from intervening spleen.

Adolescent↗
PubMed1988

Hepatic inversion with an epigastric gallbladder.

Inversion of the liver and anomalous positions of the gallbladder are both rare. We report a patient with an anterior suprahepatic midline gallbladder associated with hepatic inversion. This association of these two rare anomalies has not, to our knowledge, been previously reported.

Cholecystography↗
PubMed1988

Vicarious excretion of water-soluble contrast media into the gallbladder in patients with normal serum creatinine.

Ten patients with normal serum creatinine and no evidence of acute cholecystitis were found to have vicarious excretion of water-soluble contrast media into the gallbladder 20 minutes to 72 hours after injection. Eight of the ten had unilateral renal pathology. Two patients, however, had bilaterally normal kidneys. The patients had been injected with either diatrizoate, iothalamate, or iodamide. The mechanisms and pathophysiology of vicarious contrast excretion are discussed. The vicarious excretion of intravascular contrast in the gallbladder does not in itself indicate renal or hepatobiliary disease. Although commonly associated with unilateral renal pathology, vicarious gallbladder excretion of urographic contrast may be a normal variant in some patients.

Adolescent↗
PubMed1988

Hodgkin disease: clinical utility of CT in initial staging and treatment.

One hundred seven consecutive new cases of Hodgkin disease were evaluated with chest radiography and computed tomography (CT) for initial staging. The data were evaluated with regard to five popular treatment protocols for Hodgkin disease. Thoracic CT scans were normal in 30 of 31 patients who had normal radiographs. In the remaining 76 patients, CT demonstrated 194 new sites of disease and disproved 25 suspected sites of disease. The use of CT scans changed the staging of disease in 20 patients, 16 of whom had extranodal extension. The effect of using CT findings on treatment depended on whether radiation therapy was used, and, if so, which treatment protocol was followed. The use of CT findings would have changed the treatment in 6.5%-62.7% of new cases of Hodgkin disease. The authors recommend that CT scans be obtained in all patients with Hodgkin disease, especially those with abnormal chest radiographs.

Adult↗
PubMed1987

The variable anteroposterior position of the retroperitoneal colon to the kidneys.

Five hundred supine abdominal CT scans were reviewed retrospectively to determine the variation of colonic position about each kidney. The anteroposterior position of the retroperitoneal colon was evaluated for different age groups and sexes at the level of the upper-, mid-, and lower-renal poles. The ascending/descending colon generally assumed a more posterior position about the lower poles and left kidney vs. the upper poles and right kidney. There were few significant differences between the sexes and among different age groups with two exceptions. In middle-aged and older women, the descending colon lay more lateral to the left lower kidney than in their male counterparts. Second, although the colon was located behind the kidney (retrorenal colon), in a nearly equal number of men and women, most patients with this colonic position were 60 years of age or older and had it about their lower renal poles. The overall frequency of retrorenal colon in the supine patient was 1.9%.

Adolescent↗
PubMed1987

The retrorenal colon in the supine and prone patient.

Ninety patients underwent computed tomographic scanning in both the supine and prone positions to show the orientation of the retroperitoneal colon about the kidneys and allow evaluation of changes in colonic position and contents. The data were compared with data on 500 patients scanned only when supine. Particular attention was given to bowel found posterior to the kidneys (retrorenal colon): its frequency of occurrence on 500 scans of supine patients was 1.9%, but 10.0% in the 90 prone patients. Because most invasive renal procedures would not intersect with retrorenal colon located behind the lateral one-third of the kidney, the data were reevaluated after deletion of these patients, giving a frequency in prone patients of 4.7%. This was found exclusively at the level of the lower renal poles, and the involved colon was extensively distended with gas. Attention should be given at fluoroscopy to detect this unusual, posteriorly positioned, air-filled colon before any invasive renal procedure.

Adult↗
PubMed1985

Poland-Möbius syndrome: evaluation by computerized tomography.

The Poland-Möbius syndrome is the combination of two rare congenital disorders and has been reported previously in only 13 patients. We report two additional cases with an evaluation of the findings and possible pathogenesis, and discuss the role of computerized tomography in evaluating the brain, pons, orbits, and facial nerve.

Abducens Nerve↗