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Biomedical subjects

N O Whitley

Publications and source records attributed to N O Whitley.

53 records · Page 3Linked to original sources
PubMed1983

Computed tomography in invasive carcinoma of the cervix: an appraisal.

The clinical staging, computed tomographic scans, and surgical findings in 42 patients with cervical carcinoma were compared prospectively to determine the accuracy and clinical utility of computed tomography in demonstrating extent of disease and involvement of paraaortic lymph nodes. Computed tomography was of limited value in stage IB and IIB tumors, but was comparable in accuracy to clinical examination in the assessment of IIB disease. Computed tomography was of value in radiation therapy and may detect unsuspected bony metastases (stage IVB). Retroperitoneal adenopathy can be detected by computed tomography with an overall accuracy of 83% and a specificity of 86%. Computed tomography is an important adjunct in determining tumor extent in more advanced disease (stages IIIB and IVB) and in detecting paraaortic adenopathy.

Female↗
PubMed1982

An evaluation of the computed tomographic scanner for the staging of carcinoma of the cervix.

Twenty patients with invasive carcinoma of the cervix (FIGO stages IB-IV) were staged by routine pelvic examination, intravenous urography, chemistry studies, and barium enema. All patients received a CT scan of the abdomen and pelvis followed by pelvic examination under anesthesia (EUA). CT agreed with EUA staging in 13 of 20 patients (65%). All patients had surgical para-aortic lymph node sampling. The sensitivity of CT for para-aortic lymph node involvement was 67% and the specificity was 92%. CT scanning is equal to other clinical staging procedures for carcinoma of the cervix. It offers the advantages of being noninvasive and visualizing tumor for the construction of radiation portals. CT is useful in the detection of para-aortic lymphadenopathy; however, the presence of normal sized or enlarged nodes makes pathologic examination, either by needle aspiration or surgery, necessary.

Female↗
PubMed1982

Volume determinations in computed tomography.

Modern computed tomographic (CT) scanners allow reasonably high-resolution cross-sectional visualization of most viscera and masses. To determine the accuracy of CT volume estimation, CT volumes of inanimate objects, cadaver kidneys and spleens, and in vivo balloons were performed. Regions of interest were outlined by a hand-operated cursor, and the computer program calculated the cross-sectional area in square millimeters and in pixels. A second computer program used Simpson's rule to calculate the volume from these multiple cross-sectional area. Calculated CT volumes were within +/-10% of directly measured volumes. Tumor masses being treated by chemotherapy were followed up clinically and by CT. Volume changes determined by CT are believed to be equal to and frequently more sensitive than clinical examination. From our experimental CT and clinical experiences, accuracy can be affected by (1) respiratory movement; (2) rapid changes in in vivo blood volume; (3) low CT number-gradient at the objects' periphery; (4) observer error in cursor tracing of the desired structure; and (5) mathematical errors inherent in Simpson's rule. We conclude that CT can estimate volumes of CT definable masses and can be useful in following tumor response to therapy.

Female↗
PubMed1982

Value of multi-planar CT images in interactive dosimetry planning of intracavitary therapy.

A method of intracavitary treatment planning and dosimetry analysis which uses multi-planar reconstructed computerized tomography (CT) images is presented. The aim of the method is to improve ability to precisely locate clinical reference points, to fully define pertinent anatomic structures and to provide dose distributions and their relationship to these structures in multiple planes. Our approach is based on interactive treatment planning and point dose display on sagittal and coronal reconstructed CT images as well as the usual transaxial image. The advantages of clinical evaluation of isodoses directly on multi-planar CT images are assessed. These include precise anatomic and dose relationships between the cervix and paracervical structures, the bladder, rectum and pelvic node-bearing sites. Problems of image magnification, blurred images and inadequate resolution attendant to orthogonal radiographs, which are the basis of current techniques, are minimal. Analysis and results of the method and a comparison with the technique of orthogonal radiographs are presented for a demonstration case.

Adenocarcinoma↗
PubMed1982

CT patterns of mesenteric disease.

To evaluate the patterns of mesenteric disease as visualized by computed tomography (CT), we reviewed the scans of 370 patients whose primary diagnoses coincided with diseases known from the pathology literature to have frequent mesenteric involvement. Diagnoses included selected malignancies, inflammatory diseases, and traumatic injuries. Four general patterns of involvement of the mesentery were recognized: (a) rounded masses, (b) "cake-like" masses, (c) ill-defined masses, and (d) stellate mesentery. Of the malignancies reviewed, mesenteric involvement as visualized by CT occurred most commonly with ovarian carcinoma (20/52) and non-Hodgkin's lymphoma (41/134). The incidences of CT evidence of involvement of the mesentery with other common malignancies were carcinoma of the colon (8/68), carcinoma of the pancreas (5/21), and leukemia (5/19). Certain benign and malignant lesions of the mesentery do demonstrate unique CT patterns of involvement. Examples of the individual patterns in common and unusual disease states are illustrated.

Colonic Neoplasms↗
PubMed1982

Computed tomographic evaluation of carcinoma of the cervix.

To assess the accuracy of computed tomography (CT) in staging advanced carcinoma of the cervix, 18 staging evaluations were performed in 16 patients with locally advanced (FIGO Stage IB-IVA) cervical carcinoma. CT staging results were compared with the results of clinical staging and postoperative staging. CT was accurate in 12/18 (66%) cases, clinical staging was accurate in 10/18 (55%) cases, and clinical staging with cystoscopy was accurate in 14/18 (78%) cases. CT staging failed to detect microscopic pelvic sidewall involvement and bladder involvement when there was no contrast material in the bladder. In the detection of para-aortic lymph node involvement by tumor, there were 12 true-negative, 4 true-positive, 1 false-positive, and 1 false-negative study (sensitivity = 80%, specificity = 92%). It is concluded that CT is equal in accuracy to other clinical staging techniques and offers the advantage of visualizing the tumor, which allows for more accurate determination of radiation portals.

Carcinoma↗
PubMed1982

CT of peritoneal mesothelioma: analysis of eight cases.

In order to define the computed tomographic appearance of mesothelioma, eight patients with histologically proven peritoneal mesotheliomas had computed tomography (CT) performed during the course of their disease. CT findings for all cases were analyzed for evidence of tumor involvement in the peritoneum, mesentery, liver, bone, lymph nodes, and lower pleural space, and for ascitic and pleural fluid. CT findings included evidence of peritoneal involvement (7/8 patients, 88%), ascites (6/8, 75%), mesenteric involvement (6/8, 75%), pleural involvement (4/7, 57%), bone destruction (2/8, 25%), peritoneal mass (1/8, 12%), and retroperitoneal lymph node involvement (1/8, 12%). On the basis of diffuse mesenteric and peritoneal involvement and high incidence of ascites, CT may suggest the diagnosis of peritoneal mesothelioma; however, it may be difficult to differentiate from carcinomatosis, gastrointestinal malignancies, ovarian carcinomas, and, rarely, lymphomas. It is important to suggest the diagnosis of peritoneal mesothelioma because special stains and electron microscopy are necessary for pathologic diagnosis. Experience suggests that CT may be useful in suggesting the diagnosis and biopsy site, and after response to therapy of peritoneal mesothelioma.

Adult↗
PubMed1982

Liver injury and complications in the postoperative trauma patient: CT evaluation.

Twenty-eight patients with surgically documented and classified hepatic injury were studied by computed tomography (CT) in the postoperative period. CT demonstrated no abnormalities in 12 of these patients, most of whom had sustained simple lacerations of the liver. Of the 16 patients with abnormal scans, perihepatic fluid collections were present in six, five of whom had simple lacerations at surgery. The other 10 patients had CT evidence of parenchymal abnormalities, and all of these had sustained major hepatic injuries. CT is useful in depicting the postoperative anatomy, and in many cases demonstrates the nature and extent of damage; the likelihood of finding an abnormality varies with the severity of the injury, even though repair has been attempted. The frequent problem of postoperative sepsis is also amenable to CT evaluation, but the changes demonstrated are often nonspecific and the possibility of residual hepatic injury has to be considered. Finally, CT can document healing of parenchymal injury.

Abscess↗
PubMed1981

Computed tomography for localization of parathyroid adenomas.

Fourteen consecutive patients with the clinical diagnosis of primary hyperparathyroidism had computed tomography (CT) preoperatively to evaluate the use of CT in localizing parathyroid adenomas. The patients were scanned from above the level of the thyroid cartilage to the bifurcation of the trachea. Computed tomography correctly identified, prospectively, the site of the adenoma in 7 of 14 patients, including one adenoma that was ectopic in location. Nine of these patients also had barium esophagrams, and this study was accurate in only three of the nine. Our study suggests that CT may be beneficial in the preoperative localization of parathyroid adenomas, particularly those in ectopic locations.

Adenoma↗
PubMed1979

Progression of medial fibroplasia of the renal artery and the development of renovascular hypertension.

A 33-year-old normotensive white women was rejected as a kidney donor because arteriography disclosed medial fibroplasia of the right renal artery. 44 months later she became hypertensive and arteriography revealed progression of the lesion. When renal venous renin assay demonstrated lateralization, a saphenous vein aortico-distal right renal arterial bypass graft was done; her blood pressure has been normal for more than 2 years since. Such patients should not donate kidneys because the course of renal arterial dysplastic lesions cannot be predicted.

Adult↗
PubMed1977

Malakoplakia of kidney simulating renal neoplasm.

In a nine-year-old girl with renal hypertension and a urinary infection, angiographic studies of the left kidney suggested an intrarenal pheochromocytoma. After nephrectomy, the kidney was found to contain only a cystic lesion characterized by multiple small, friable excrescences. Under the light microscope these appeared to be formed by granulovacuolated macrophages. Electron microscopy showed intracytoplasmic inclusion identified as Michaelis-Gutmann bodies in various stages of formation. Images suggestive of degraded bacteria were also observed within phagolysosomes.

Child↗
PubMedDate not supplied

Obstructive pulmonary disease in rheumatoid arthritis.

Twenty-six of 43 patients (60.5%) with classic rheumatoid arthritis (RA) participating in a controlled, prospective study were found to have maximal midexpiratory flow rates (MMEFs) suggestive of obstructive pulmonary disease. Cigarette smokers with RA had significantly lower MMEFs than either nonsmokers with RA or smokers with degenerative joint disease. There was an increased prevalence of the Pi phenotype MS among the RA patients. Interstitial fibrosis, tobacco smoking, and protease inhibitor deficiencies were all significant factors in producing airway obstruction in patients with RA.

Adult↗
PubMedDate not supplied

CT diagnosis of acalculous cholecystitis.

Acalculous cholecystitis is an uncommon but potentially fatal complication of prolonged critical illness. Both clinical and biochemical parameters lack sufficient sensitivity and specificity to confidently make the diagnosis preoperatively. Over a 2 year period we have evaluated 16 patients with suspected acute acalculous cholecystitis by CT. Based on CT findings, a positive diagnosis of acalculous cholecystitis was made in seven of these patients and confirmed pathologically in six. Criteria used in reaching the CT diagnosis and potential advantages of CT over other imaging modalities in this clinical context are considered.

Adolescent↗