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Biomedical subjects

M D Rifkin

Publications and source records attributed to M D Rifkin.

At least 109 records · Page 6Linked to original sources
PubMed1986

Prostatic evaluation by transrectal endosonography: detection of carcinoma.

Transrectal endosonography is one of the most sensitive techniques to evaluate prostatic disease and is far more accurate than conventional sonography. A retrospective review of sonographic characteristics of the prostate was made in an attempt to define the ability of the technique to distinguish benign from malignant disease. Analysis included evaluation of the capsule (smoothness, regularity, and/or invasion), abnormal foci (echogenicity, margination, brightness, thickness, and symmetry), and presence of acoustic shadowing and/or enhancement from the abnormal foci. Evaluation of 443 pathologically proved cases (the majority being large lesions) showed that differentiation between benign and large and/or invasive malignant disease may be suggested by results of transrectal endosonography. However, there is still great overlap of the sonographic appearances.

Humans↗
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↗
PubMed1986

Sonoendoscopic evaluation of extraesophageal and extragastric abnormalities: a review.

A conventional fiberoptic gastroscope was modified to incorporate a 9-MHz transducer 7 cm from the tip. Conventional fiberoptic gastroscopy could be performed simultaneously with sonoendoscopic evaluation of the esophagus and gastric, extraesophageal, and extragastric areas. The instrument was utilized to evaluate intra- and extra-luminal abnormalities of the mediastinum and upper abdomen. This paper presents our data on extraluminal disease. Small hepatic and pancreatic tumors were identified, occasionally with more accuracy than conventional imaging studies. Additionally, mediastinal tumors, gastrointestinal tumors, and cardiac abnormalities were also clearly demonstrated.

Endoscopy↗
PubMed1986

Endorectal sonographic prospective staging of rectal cancer.

Endorectal sonography was used to evaluate and prospectively stage rectal cancers in 59 patients. All patients were studied without knowledge of findings of other diagnostic studies, including sigmoidoscopic, computed tomographic (CT), and digital rectal examinations. Sonographic interpretation was established blindly and compared with CT and with pathological staging after surgery for the rectal cancer. Results demonstrate that endorectal sonography is more accurate in detecting the site of rectal cancer and in defining perirectal fat infiltration and perirectal lymph node involvement as compared with CT. The experience suggests endorectal sonography is a useful adjunct in the diagnosis and prospective staging of rectal cancer.

Adult↗
PubMed1986

Intraoperative abdominal ultrasonography: initial experience with a dedicated high-resolution operative transducer.

A dedicated 8-MHz intraoperative scanning probe was used in 42 patients who underwent exploratory abdominal surgery. A variety of pathologic processes involving the liver, pancreas, bowel, and biliary and genitourinary systems were evaluated. Sonographic studies were evaluated to determine if they added new information (20 patients, 47.6 per cent), confirmed known information (20 patients, 47.6 per cent), or provided false information (two patients, 4.8 per cent). Preliminary experience with a specially developed transducer suggests that its design avoids many of the difficulties encountered with other transducers employed for this technique. Intraoperative sonography has, in many instances, the potential to simplify surgery, shorten operating time, and modify the type of surgical procedure performed.

Abdomen↗
PubMed1985

Driller wrist (vibratory arthropathy).

Driller wrist is an occupational disease with pathophysiologic changes resulting from recurrent use of vibratory tools. The entity includes the clinical finding of Raynaud phenomena with or without associated bone changes in the wrist. Osseous involvement is usually mild and is associated with cystic changes of the carpals and occasionally other structures. Two cases are reported, one with typical cystic abnormalities and the other with more severe disease which progressed to joint instability.

Humans↗
PubMed1985

Ultrasound detection of focal bacterial nephritis (lobar nephronia) and its evolution into a renal abscess.

A case of acute focal bacterial nephritis (lobar nephronia) which evolved into a renal abscess is reported. This case is unusual for 2 reasons: the focal nephritis was isoechoic (not previously reported), and it progressed to an abscess despite antibiotic therapy. Ultrasound initially detected the focal nephritis and later confirmed its progression to an abscess. Successful treatment was obtained with sonographically guided percutaneous catheter drainage in conjunction with systemic antibiotics.

Abscess↗
PubMed1985

Outpatient therapy of intra-abdominal abscesses following early discharge from the hospital.

Although percutaneous aspiration and drainage of abdominal abscesses will frequently avert an open surgical procedure, patients remain hospitalized during drainage. The authors treated 9 patients for abscesses using percutaneous drainage catheters and sent them home with the catheter in place. All had an uneventful recovery. An average of $12,050 was saved in each case. The authors suggest that outpatient drainage of abdominal abscesses is significantly less expensive than inpatient treatment, yet does not jeopardize patient care.

Abdomen↗
PubMed1985

Ultrasound examination of the hand.

Twenty-five surgically confirmed soft-tissue lesions of the hand were examined prospectively by real-time ultrasound. Use of sonography enabled a reliable diagnosis of the cystic or solid nature of soft-tissue lesions, an accurate estimation of the volume, and precise three-dimensional localization of the abnormality. Sonography also facilitated the location of foreign bodies. Assessment of anatomic relationships of these lesions to tendons and surrounding structures by real-time sonography during palpation, flexion, and/or extension also aided in the surgical approach.

Adolescent↗
PubMed1985

Transrectal US as an adjunct in the diagnosis of rectal and extrarectal tumors.

Transrectal ultrasound (US; also called endosonography) was used to evaluate known or suspected rectal and perirectal masses. Thirty-one patients were examined with commercially available endosonographic probes. Those who obtained and interpreted the sonograms had no knowledge of other diagnostic studies, which included digital rectal and sigmoidoscopic examinations, conventional US, and computed tomography (CT). All but one patient underwent surgical exploration for diagnoses that included rectal cancers, perirectal abscesses, presacral endometriosis, intramural dermoid of the rectum, and intramural venous angioma. Transrectal US was able to image all masses situated within 12 cm of the anus. Malignant infiltration of perirectal fat and perirectal node involvement were detected at least as accurately with US as with CT, suggesting that this technique is a cost-effective, reliable adjunct for staging rectal cancers.

Abscess↗
PubMed1985

Transrectal prostatic ultrasonography: comparison of linear array and radial scanners.

Transrectal ultrasound probes can image the prostate only in a single plane. A retrospective study was undertaken to evaluate the capabilities and differences of longitudinal and transversely oriented images obtained from transrectal sonographic examinations. The patients were studied by both modalities using commercially available machines. Comparisons of the images demonstrated that the transverse image yielded more information about the lateral margins of the prostate; the longitudinal image showed the apex and base more clearly; prostatic calculi, which can be confused with other pathologic processes, were more accurately identified by the longitudinal scanners; and both techniques adequately demonstrated the abnormality, particularly cancer, although some lesions were seen better on either one or the other orientation. Either scanner can be used for a satisfactory study, but both methods may have to be utilized to conduct a thorough evaluation of the prostate and surrounding structures.

Calculi↗
PubMed1985

Diagnostic capabilities of high-resolution scrotal ultrasonography: prospective evaluation.

The use of scrotal ultrasonography has been advanced with the development of high-resolution real-time equipment. A group of 284 consecutive patients referred for scrotal examination was studied ultrasonically and followed over a three-year period. Abnormal scrotal contents were accurately detected in 98.5 per cent of cases. Separation of testicular from extratesticular pathology was 99 per cent accurate. While all malignant testicular lesions could be identified, there were examples which could not be differentiated from benign lesions prior to surgical exploration and biopsy. However, there are many examples where the ultrasound results can change clinical management of the patient.

Abscess↗
PubMed1985

Ultrasonography of the lower genitourinary tract.

As techniques and equipment become even more sophisticated, the use of diagnostic ultra-sound should expand. More accurate diagnoses, simplification of invasive techniques, and increased benefit of therapeutic techniques can be expected.

Cystitis↗
PubMed1984

Real-time ultrasonography of the spinal cord: intraoperative and postoperative imaging.

Fourteen subjects with spinal cord pathology were studied with 10 MHz linear array or 5 MHz mechanical sector ultrasound scanners. Twelve patients were studied intraoperatively. The examinations were rapid, aiding the surgeon at the time of exploration. Sonography defined cysts, outlined the extent of neoplasia and aided in the localization of bone fragments. Guidance for placement of syringo -subarachnoid shunts reduced the amount of surgical manipulation. Four patients were examined postoperatively through laminectomy defects, three confirming adequate position and function of shunts and in one case demonstrating tumor recurrence.

Humans↗
PubMed1984

Ainhum--an unusual presentation involving the second toe in a white male.

Ainhum (dactolysis spontanea) is most frequently seen involving the fifth toes of black men. An atypical case involving the second toes bilaterally in a white male is presented. The differential diagnosis, radiological findings and pathological appearance of this rare entity are discussed.

Ainhum↗
PubMed1984

Neonatal colonic atresia: ultrasound findings.

High resolution real-time ultrasound examination of the abdomen was performed in a neonate with abdominal distention. Dilated distal small bowel and a complex mass in the course of the ascending colon were noted. Ultrasound correctly suggested the diagnosis of mid-colonic atresia with a patent ascending colon twelve hours prior to the radiographic demonstration of gas in the obstructed right colon. The sonogram was also able to accurately exclude the presence of ascites or a renal or hepatic mass as the cause for abdominal distention.

Colon↗