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Biomedical subjects

L H Berman

Publications and source records attributed to L H Berman.

At least 19 recordsLinked to original sources
PubMed2000

The use of ultrasound-guided cutting-needle biopsy in paediatric neck masses.

OBJECTIVE: Neck masses are common in children. Although there is a low incidence of therapeutically significant pathology, biopsy is occasionally required for evaluation. Open biopsy or fine needle aspiration may be used to obtain tissue. Open biopsy provides material suitable for histological analysis but requires general anaesthesia. Cytological material obtained by fine needle aspiration is often inconclusive. A core of histological material may also be obtained by percutaneous cutting-needle biopsy, a recognised procedure at other anatomical sites, usually performed under local anaesthesia. MATERIALS AND METHODS: There are few accounts using cutting needles in adult neck masses and no previous paediatric series. We present our experience of ultrasound-guided core biopsies of neck masses in 15 children ranging in age from three months to 16 years. RESULTS: Thirteen biopsies were easily performed without sedation as an outpatient procedure under topical and injected local anaesthetic. In all fifteen cases the procedure was well tolerated and a tissue successfully obtained. CONCLUSION: Ultrasound guided cutting needle biopsies of head and neck masses of children can be performed under local anaesthesia in the majority of cases.

Adolescent↗
PubMed2000

Management of neck lumps--a triage model.

We report our experience in the out-patient triage of 100 patients presenting with a lump in the neck. The out-patient visit consisted of a general history and examination, assessment of the upper air and food passages and, where indicated, ultrasound and core needle biopsy of the lump. Other investigations were performed as appropriate. One hundred neck lump patients were seen in a 9 month period. Ninety-six of these lumps were diagnosed on an out-patient basis, only four requiring admission for formal excision biopsy. Among the diagnoses were eleven lymphomas, nine parotid neoplasms, nine lymph node metastases, five thyroglossal cysts, and four branchial cysts. Almost half the patients seen had either a reactive lymphadenopathy, or no abnormality. The establishment of a tissue diagnosis on an out-patient basis allowed appropriate referrals to be made and management plans to be formulated. The theoretical risk of seeding of malignant cells in the needle tract is acknowledged and discussed.

Adolescent↗
PubMed1999

Scrotal trauma: a cause of testicular atrophy.

Scrotal trauma is often mentioned as a cause of testicular atrophy yet there have been few studies documenting the effect of scrotal trauma on testicular size months or years following injury. We performed clinical and sonographic examinations in 10 patients who had suffered blunt scrotal trauma. A significant reduction in volume of the injured testis was observed in 5/10 cases at follow-up sonography. In two cases the affected testis was heterogeneous and colour flow Doppler examination showed reduced flow. In three cases the testis was homogeneous but reduced in volume and in the remaining five cases the affected testis appeared normal. We conclude that testicular atrophy is a sequel of scrotal trauma and occurred in 50% of patients in this study.

Adolescent↗
PubMed1999

Subclavian and internal jugular veins at Doppler US: abnormal cardiac pulsatility and respiratory phasicity as a predictor of complete central occlusion.

In 21 consecutive patients, the authors analyzed changes in venous Doppler waveforms of damped or diminished cardiac pulsatility and respiratory phasicity. Each patient was suspected of having upper limb venous thrombosis, but thrombus was not visible at gray-scale ultrasonography (US) in the subclavian and brachiocephalic veins. US findings were compared with phlebographic findings. The results show that US can be used to establish the presence or absence of thrombosis in the distal portion of the brachiocephalic or subclavian veins, which are inaccessible to direct insonation.

Adult↗
PubMed1998

Duplicated superficial femoral veins: a source of error in the sonographic investigation of deep vein thrombosis.

PURPOSE: To determine whether the number of false-negative ultrasound (US) findings of thrombosis is larger when a duplicated femoropopliteal venous system is present. MATERIALS AND METHODS: A retrospective review was performed of 381 venograms obtained after initial US findings were considered negative for thigh or popliteal thrombosis in patients in whom deep vein thrombosis was suspected Venograms were evaluated for the presence of thrombosis and the presence and configuration of duplicated superficial femoral veins. RESULTS: Multiple superficial femoral veins were present on 177 (46%) of the 381 venograms; 149 (84%) were duplex systems. False-negative US findings occurred in four (2%) of 204 patients with single femoral veins and in 10 (6%) of 177 patients with duplicated femoral veins (P = .056, not statistically significant). CONCLUSION: The frequency of missed proximal thrombosis at sonography appears to be increased when duplicated superficial femoral veins are present. Data from clinical and imaging studies are insufficient to support the adoption of a totally noninvasive imaging strategy.

Congenital Abnormalities↗
PubMed1997

Bayesian registration of models using finite element eigenmodes.

This paper is concerned with registering three-dimensional wire-frame organ models. This involves finding correspondences between points on the models of two different examples of the same organ. Such registration is widely used in the processing of medical data; for example in segmentation, or to superimpose functional information on a more detailed structural map. The algorithm described in this paper is based on matching the modes of deformation of organ shapes. Modes with lower spatial frequency characterise large scale organ features whereas small scale variations determine the high frequency modes. First, the organ sizes are normalised using a generalised version of the centroid size metric. The axes of the fundamental frequency modes are then aligned to provide initial rigid-body registration. The registration is refined by matching increasingly high frequency modes using the 'Highest confidence first' algorithm. The matches are evaluated using a Bayesian combination of local prior and likelihood functions. The prior is derived from the Gompertz metric of biological growth and ensures that physically impossible matches are not accepted. The likelihood function is a measure of the similarity between local modal deformation components. The registration algorithm has been applied by the authors in the analysis of three dimensional ultrasound data. Results are presented showing the registration of two liver models derived from 3D ultrasound.

Algorithms↗
PubMed1997

Endodontics in the '90s: old dogma and new tricks ... can we be re-taught?

Endodontics has gone through many changes in the past several years. Electronic apex locators and surgical microscopes have taken a lot of the guess work out of doing root canal. Digital radiograpy has expanded our diagnostic abilities. Ultrasonic intrumentation and the advent of new filing systems have increased the efficacy of canal cleaning. There have also been some major refinements in how we can now obturate canals. Apicoectomies can now be performed with refined ultrasonic root end preparations, and we have increased our ability to better seal root ends with new filling materials. The result is that endodontic procedures can now be performed more expediently and with a more predictable outcome. This article is written from the perspective of a full-time practicing endodontist, and describes the various changes occurring within the specialty of endodontics.

Endodontics↗
PubMed1997

Mismanaged care.

Explore the source record for details and available documents.

Health Maintenance Organizations↗
PubMed1996

Vascularity of the neonatal femoral head: in vivo demonstration with power Doppler US.

PURPOSE: To detect the intrinsic blood supply of the unossified neonatal femoral head in vivo by using power Doppler ultrasound (US) and to ascertain whether a reduction in blood flow could be demonstrated with hip abduction. MATERIALS AND METHODS: One hip of 13 neonates was examined with power Doppler sonography. After vessels within the femoral head were identified, the thigh was slowly abducted and the angle at which flow became undetectable was recorded. Spectral Doppler tracings were obtained in all subjects. RESULTS: Intrinsic blood flow of the femoral head was demonstrated in all subjects. Flow became undetectable during hip abduction in 11 of 13 neonates and reappeared during adduction. The angle at which flow became undetectable varied from 60 degrees to 85 degrees. Spectral Doppler signals demonstrated a mixed arterial and venous trace. CONCLUSION: Power Doppler US provides a simple real-time assessment of the femoral head blood supply. This may prove helpful in identifying neonates at risk of avascular necrosis, a complication of treatment of hip dysplasia with abduction hip restraints.

Femur Head↗