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Biomedical subjects

L Needleman

Publications and source records attributed to L Needleman.

98 records · Page 6Linked to original sources
PubMed1986

Sonography of diffuse benign liver disease: accuracy of pattern recognition and grading.

Sonograms of 110 patients were compared to recently performed liver biopsies for evaluation of the accuracy of sonography in predicting the type (pattern) of pathology and its grade of severity (mild, moderate, or severe) in a wide variety of diffuse liver processes. There are two distinct, abnormal sonographic patterns: the fatty-fibrotic pattern seen primarily with cirrhosis, chronic hepatitis, and/or fatty infiltration, and the centrilobular pattern seen primarily with acute hepatitis. Sonography was 88% accurate in assigning the correct pattern to the corresponding pathology (sensitivity 89%, specificity 86%, p less than 0.001). The degree of accuracy was dependent on the grade of pathologic severity, with mild disease offering the greatest difficulty; moderate and severe diseases were accurately detected and placed in the correct pattern in all cases. Sonographic grading of the severity of disease was far less precise (63% overall). This study showed that sonography can distinguish between two abnormal sonographic patterns of diffuse benign liver disease as well as between normal and abnormal patterns.

Biopsy↗
PubMedDate not supplied

Doppler evaluation of the renal transplant.

Well-established roles for Doppler ultrasound assessment of renal transplants include postoperative evaluation for vascular occlusion and detection of renal artery stenosis. Doppler studies can often differentiate rejecting transplants from those that normally function. While very high Doppler indices are specific for rejection, waveforms in acute tubular necrosis may be abnormal. Mild cases of rejection may have normal waveforms. Further investigation is needed to determine the role of Doppler methods in graft dysfunction and to establish methods to improve their specificity.

Blood Flow Velocity↗
PubMedDate not supplied

Role of selective arteriography in the diagnosis of a ruptured middle colic artery aneurysm.

A case of a ruptured middle colic artery is reported. The diagnosis was initially overlooked and eventually made by selective arteriography. Aneurysms of visceral arteries are rare and rupture of them even more infrequent. Awareness of this potentially fatal and treatable entity should enable early detection by selective visceral arteriography. The roles of embolization and surgery in the management of visceral aneurysms are discussed.

Aged↗
PubMedDate not supplied

CT-pathologic correlation of axillary lymph nodes in breast carcinoma.

A prospective study was performed to determine whether thoracic CT yielded useful information regarding the status of axillary lymph nodes (LNs) in patients with breast cancer. Thirty-five consecutive patients with clinically suspected stage II or III breast carcinomas were scanned preoperatively from the supraclavicular regions to the lung bases. Axillary LNs measuring greater than or equal to 1 cm were considered abnormal. The lymph nodes were classified according to their relationship to the pectoralis muscle. Extracapsular lymph node extension was diagnosed when there was irregularity and spiculation of the lymph node margin with surrounding fatty infiltration. Correlation with axillary dissection was obtained in 20 patients, giving a positive predictive value for axillary metastases of 89% with 50% sensitivity, 75% specificity, and 20% negative predictive value. CT was also able to detect the level of axillary involvement accurately when the lymph nodes were enlarged and to evaluate extracapsular LN extension. Although superior to physical examination, CT was not an accurate predictor of axillary LN involvement, primarily because of its low negative predictive value.

Adult↗