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Biomedical subjects

M I Shaff

Publications and source records attributed to M I Shaff.

47 records · Page 3Linked to original sources

Percutaneous embolization for the management of hepatic artery aneurysms.

The significant mortality and morbidity of hepatic artery aneurysms indicate the need for new approaches to therapy. Seven cases of intrahepatic aneurysms diagnosed by percutaneous arteriography over a 7-yr period are discussed. Three patients were treated surgically and 4 by percutaneous embolization. The latter method appears to enjoy certain advantages and it may prove to be the treatment of choice for this often fatal condition.

Adolescent↗

An accelerated diagnostic approach to surgical jaundice.

A clear distinction between obstructive and hepatocellular jaundice is difficult in many patients. Biochemical and clinical findings may cause confusion and result in long delays in diagnosis and treatment. Ultrasonography is a major advance in the positive identification of patients with dilated intrahepatic ducts, whether or not the gall bladder is dilated. Isotopic imaging also may be useful in identifying obstructive jaundice. If percutaneous transhepatic cholangiography (PTC) is performed soon after, the site and nature of the obstruction will become evident. Another advance is the introduction of a sheathless narrow needle for PTC. This reduces the possibility of complications and has the advantage of being able to puncture a normal, undilated biliary tree in as many as 60% of cases, ruling out an obstructive cause. The use of these newer radiological investigations will appreciably shorten the period between the onset of jaundice and the ascertainment of its cause.

Cholangiography↗

An evaluation of the radiological signs of fetal death.

Radiological investigation is warranted in the antenatal patient only if the findings are likely to influence future management. The major radiological signs of fetal death are gas in the fetus, overlapping of the cranial bones and Deuel's halo sign. Gas patterns in the portal and umbilical vessels are unique and pathognomonic. Deuel's halo sign would be found more commonly if the correct radiographic view was employed. Spalding's sign is of no value before 20 weeks or if the fetal head is subjected to pressure. Hyperflexion of the fetus more often indicates intra-uterine growth retardation than death in utero.

Female↗

Relationship of renal hemodynamic and functional changes following intravascular contrast to the renin-angiotensin system and renal prostacyclin in the dog.

Deterioration in renal function has been observed after the use of intravascular contrast media. In an attempt to identify factors responsible for this phenomenon, meglumine iothalamate (Conray 60), in a dosage range of 2.5-3.3 ml/kg, was injected as a bolus into the aorta of dogs. Serial measurements were made of parameters of renal function as well as of changes in aortic and renal venous levels of angiotensin II, renin activity, and 6-keto-PGF1 alpha, the stable metabolite of prostacyclin. The major findings were (1) an initial, brief increase followed by approximately a 20% sustained decrease in renal blood flow and creatinine clearance, (2) no significant changes in angiotensin II and renin levels, and (3) a significant decline in the renal secretory rate of 6-keto-PGF1 alpha. These observations suggest that the suppression of prostacyclin, rather than the activation of the renin-angiotensin system, may contribute to the renal function changes attending the use of intravascular contrast media.

6-Ketoprostaglandin F1 alpha↗

MR imaging of the adrenals: correlation with computed tomography.

The purpose of this study was to evaluate the role of magnetic resonance (MR) imaging in adrenal disease based on correlative imaging with CT. Fifty lesions in 36 patients with a variety of adrenal diseases were evaluated, at 0.5 T using spin echo (SE) multislice short repetition time (TR) and SE multislice multiecho long TR sequences. It is concluded that MR is capable of identifying most adrenal abnormalities previously detected by CT. The results suggest that MR has a greater specificity for mass lesions and might be useful to differentiate nonfunctioning adenomas from functioning adenomas, metastasis, pheochromocytomas, cysts, and intraadrenal hemorrhage. Magnetic resonance imaging also has the potential to detect aldosteronomas by increased signal intensity in addition to contour distortion using long TR/echo time sequences. The ability to perform multiplanar imaging and the presence of superior contrast as compared with CT are useful for the assessment of origin and extension of large lesions and the detection of pheochromocytomas in complex cases. Considering MR's limitations, we believe that at present its major role in evaluation of adrenal disease should be complementary to CT.

Adenoma↗

Benign hemangioendothelioma involving posterior mediastinum: CT findings.

We report a case of benign hemangioendothelioma of infancy extending from the deep soft tissues of the neck to involve the entire longitudinal extent of the right posterior mediastinum. The CT findings that aid in the differential diagnosis of this and other posterior mediastinal masses are discussed.

Diagnosis, Differential↗