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Biomedical subjects

N R Dunnick

Publications and source records attributed to N R Dunnick.

At least 181 records · Page 10Linked to original sources
PubMed1982

The role of seminal vesiculography in the evaluation of male infertility.

Although most cases of male infertility are the result of primary testicular abnormalities (either maturation arrest, decreased spermatogenesis, or germinal hypoplasia), obstruction of the genital tract is a well recognized and potentially correctable cause of infertility. Seminal vesiculography is an excellent method of evaluating the male genital tract not only for obstruction but also for other structural lesions that may cause infertility. In 27 patients undergoing vesiculography as part of an evaluation of infertility, obstruction was found in 25%. Three patients (11%) were found to have nonobstructing structural lesions as a possible cause of infertility. Patients with obstructive lesions were found to have significantly lower semen volumes than those with patent outflow tracts. The continued role of seminal vesiculography in the evaluation of male infertility is discussed.

Adult↗
PubMed1982

Failure to ablate the adrenal gland by injection of contrast material.

Five attempts were made in 4 patients to infarct an adrenal gland containing an aldosterone-producing tumor, using vigorous retrograde injections of contrast material into the adrenal vein. Although a modest amount of tumor staining was attained in 3 patients, no clinical or laboratory changes were seen. Contrast extravasation appears to be a transient and benign complication. Adrenal vein thrombosis is probably responsible for the reported adrenal infarctions but can be prevented by systemic anticoagulation. The authors conclude that adrenal venography is a safe procedure whose potential risks are far outweighed by the decreased surgical complications when a functional adrenal tumor is accurately located preoperatively.

Adenoma↗
PubMed1982

Localization of functional adrenal tumors by computed tomography and venous sampling.

Fifty-eight patients with functional lesions of the adrenal gland underwent radiographic evaluation. Twenty-eight patients had primary aldosteronism (Conn syndrome), 20 had Cushing syndrome, and 10 had pheochromocytoma. Computed tomography (CT) correctly identified adrenal tumors in 11 (61%) of 18 patients with aldosteronomas, 6 of 6 patients with benign cortisol-producing adrenal tumors, and 5 (83%) of 6 patients with pheochromocytomas. No false-positive diagnoses were encountered among patients with adrenal adenomas. Bilateral adrenal hyperplasia appeared on CT scans as normal or prominent adrenal glands with a normal configuration; however, CT was not able to exclude the presence of small adenomas. Adrenal venous sampling was correct in each case, and reliably distinguished adrenal tumors from hyperplasia. Recurrent pheochromocytomas were the most difficult to localize on CT due to the surgical changes in the region of the adrenals and the frequent extra-adrenal locations.

Adenoma↗
PubMed1982

Interstitial pulmonary infiltrate following combined therapy for esophageal carcinoma.

Seven patients with squamous cell carcinoma of the esophagus received radiation therapy in twice weekly 400 rad fractions over five weeks followed by esophagectomy. Four of these patients developed severe interstitial pulmonary infiltrates and died of pulmonary insufficiency 18-50 days after surgery. In three of these patients the infiltrates were detected within 24 hours of surgery while the infiltrate was not present until the eighth postoperative day in the fourth patient. Postmortem examination revealed widespread dilatation of interstitial and subpleural lymphatics. It is postulated that the combination of large fraction radiation therapy followed by extensive surgery resulted in lymphatic obstruction.

Aged↗
PubMed1982

Parapelvic cysts: appearance on CT and sonography.

The computed tomographic (CT) and sonographic appearance of 16 patients with parapelvic cysts were retrospectively reviewed. CT revealed a water-density renal hilar mass that did not fill with contrast material after intravenous injection. Sonography demonstrated a cystic renal hilar mass with echogenic walls that did not communicate with the collecting system. The differential diagnosis of renal hilar masses as seen by CT and sonography is discussed.

Adult↗
PubMed1982

Preoperative CT evaluation of adrenal glands in non-small cell bronchogenic carcinoma.

Preoperative chest computed tomographic (CT) scans in 84 patients with biopsy-proved non-small cell bronchogenic carcinoma were reviewed. At least one adrenal gland was visualized in 70 of these. Evidence of a solid adrenal mass was present in 18 (14.5%) glands in 15 (21.4%) patients. Percutaneous needle aspiration under CT guidance confirmed metastatic malignancy in the four patients who were biopsied. Because the documented presence of adrenal metastases in non-small cell lung cancer makes surgical resection or local irradiation inappropriate, it is recommended that both adrenal glands in their entirety be specifically included whenever a staging chest CT examination is performed in patients with such tumors. Percutaneous needle biopsy for pathologic confirmation of the nature of solid adrenal masses discovered in this process is also useful.

Adrenal Gland Neoplasms↗
PubMed1982

Skeletal manifestations in cutaneous T-cell lymphomas.

The clinical course of three patients with cutaneous T-cell lymphoma (CTCL) in whom skeletal disease developed is presented and the literature on skeletal involvement in these disorders is reviewed. Three separate types of skeletal manifestations occurred: (1) osteolytic lesions, (2) osteoblastic lesions, and (3) diffuse osteoporosis. Hypercalcemia was present in two cases. Tumor cells from two patients in short-term culture secreted osteoclast-activating factor(s). Both of these patients had pathologic evidence of osteoclast activation in bone sections. Thus, the tumor cells in certain patients with CTCL may derive from a monoclonal proliferation of a T-cell subset capable of producing humoral bone-resorbing factor(s) similar to those demonstrated in cultures of mitogen- and antigen-activated normal lymphocytes. Since skeletal lesions are unusual, it would follow that other T-cell subsets account for pathologic cell proliferation in most patients with CTCL.

Adult↗
PubMed1982

Use of functional maps in renal scintigraphy to detect segmental arterial lesions.

Renography using a gamma camera, a minicomputer, [123I]orthoiodohippurate ([123I]OIH), and a canine model was employed to evaluate computer-generated maps of regional renal function. Renograms were obtained before and after ligations of the right renal arterial branch in four dogs, with subsequent angiographic and histologic confirmation of the lesions. Postoperative time-activity curves were normal. Washout and persistence index in three of four right kidneys showed regional abnormality. Functional renal mapping may provide a clinical technique for evaluating human renal vascular hypertension.

Animals↗
PubMed1981

Radiographic contribution to diagnosis and treatment of complications from peritoneoscopy.

Peritoneoscopy is a valuable nonsurgical procedure for evaluating patients with malignant disease. Directed biopsies of suspected tumor masses may be obtained, and peritoneoscopy can frequently obviate the need for laparotomy. Although the complication rate is low, the radiologist must be aware of potential problems. Radiologists may participate not only in the diagnosis and localization of these complications but also in their therapy by interventional techniques. The radiographic findings in four patients with complications of peritoneoscopy are presented.

Adult↗
PubMed1981

The role of pancreatic venous sampling in the localization of occult insulinomas.

The palpation and enucleation of occult insulinomas (less than 15 mm) can be a difficult surgical problem even with good arteriographic localization. In the authors' limited experience, confirmation of arteriographic findings by pancreatic venous sampling provided little additional localizing information. However, if arteriography is negative or equivocal, venous sampling can indicate the segment of pancreas to be "blindly" resected if the adenoma is not palpable. Venous sampling may be misleading in polyendocrine syndromes because of the frequency of multiple adenomas and variable hormone production.

Adenoma, Islet Cell↗
PubMed1981

CT of American Burkitt lymphoma.

One hundred abdominal and chest CT scans in 29 patients with American Burkitt lymphoma were reviewed. Abdominal and/or pelvic masses were the most common finding and were detected in 13 (45%) patients. Masses indicating relapse were noted in three (10%) additional patients. Ascites and retroperitoneal involvement were noted in seven and five patients, respectively. Other findings included hepatic lesions, splenomegaly, gastric wall abnormalities, renal enlargement, urate nephropathy, and bony involvement. Pleural effusions and two mediastinal masses were noted on chest scans. CT was found to be a rapid screening procedure and especially useful in delineating the size and intrathoracic extension of abdominal masses, defining deep pelvic diseases, assessing the response to therapy, and defining areas of relapse. Lack of retroperitoneal fat and inadequate opacification of bowel loops were frequent problems that limited the value of CT scans.

Adolescent↗
PubMed1981

Value of CT and lymphography: distinguishing retroperitoneal metastases from nonseminomatous testicular tumors.

Sixty-three consecutive patients with nonseminomatous testicular carcinoma were prospectively examined for paraaortic metastases before undergoing a staging laparotomy with lymphadenectomies or biopsies. Fifty patients had computed tomographic examinations and paraaortic metastases were correctly predicted in 25 of the 38 patients (sensitivity 66%) with paraaortic tumor. In the 56 patients having the study, lymphography was more accurate as 34 of the 44 patients with metastases (sensitivity 77%) were identified. Using inferior vena cavography in 55 patients, only 24 of 41 patients with metastatic tumor (sensitivity 59%) were diagnoses. All three methods had specificities of 100% in those patients who were free of paraaortic metastases. Overall accuracies were 74% for computed tomography, 82% for lymphography, and 69% for inferior vena cava cavography. Although lymphography was the most accurate method for nonbulky tumor, computed tomography was most useful for defining the extent of bulk disease. Inferior vena cavography did not contribute any new information and was responsible for one false-positive result which was explained by computed tomography. A combination of lymphography followed by computed tomography provided the most accurate assessment of paraaortic metastases.

Adolescent↗
PubMed1981

Cardiac metastasis from osteosarcoma.

A case of osteosarcoma metastatic to the heart demonstrated by computed tomography (CT) is reported. Although the prognosis is poor, successful excision of such a metastasis has been reported previously. It is pertinent to examine the heart for metastases by CT, since these patients may be followed by this modality for the development of pulmonary metastases.

Adult↗
PubMed1980

Effective treatment of hormonally-unresponsive metastatic carcinoma of the prostate with adriamycin and cyclophosphamide: methods of documenting tumor response and progression.

Combination chemotherapy with Adriamycin and cyclophosphamide was administered to 22 men with progressive tumor following hormonal treatment for metastatic carcinoma of the prostate. Objective partial response was documented in 7 patients (32%); an additional four (18%) had stable disease for a minimum of four months, and 11 (50%) were non-responders. Patients with partial response had a median survival of 14 months and lived significantly longer than those with no response (median five months); survival of men with stable disease approximated that of partial responders. Serial utilization of multiple staging procedures during chemotherapy demonstrated that although no single test allowed identification of all patients with objective tumor response or progression, improvement in median of five parameters could be documented in responding patients. In patients adequately studied at the time of disease progression, deterioration in a median of six tests was found. Serum acid phosphatase radionuclide bone scan, and plasma carcinoembryonic antigen were the most sensitive procedures which detected both objective tumor response and progression. Toxicity of chemotherapy was acceptable except in patients with prior radiation therapy. Administration of Adriamycin and cyclophosphamide was associated with clinical benefit in half of our patients with hormone-resistant prostatic cancer. Tumor response and progression can best be objectively assessed if several staging procedures are serially employed during treatment.

Aged↗