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Biomedical subjects

R H Cohan

Publications and source records attributed to R H Cohan.

At least 91 records · Page 5Linked to original sources
PubMed1986

CT evaluation of retroperitoneal hemorrhage associated with femoral arteriography.

CT was used to assess retroperitoneal hemorrhagic complications temporally related to femoral artery catheterization in eight patients. In six patients with retroperitoneal hemorrhage caused by an angiographic complication, CT showed a high-density soft-tissue mass originating at the inguinal vessels and extending into the ipsilateral retroperitoneal spaces. In the other two patients, CT not only excluded significant bleeding from the catheterized vessel but determined an alternative diagnosis (hematoma secondary to anticoagulation and pneumatosis intestinalis due to ischemic bowel). CT findings prompted surgery in three patients.

Adolescent↗
PubMed1985

Computed tomography of epithelial neoplasms of the anal canal.

Twenty-five patients with squamous-cell or cloacogenic carcinomas of the rectum were evaluated by computed tomography (CT). Seven patients were studied before and 19 after treatment. CT provided excellent definition of tumor extent, including local spread, lymph node involvement, and distant metastases. In one of seven pretherapy studies, CT findings significantly altered patient management. Tumor recurrence was correctly identified in 14 of 19 patients having posttherapy scans, although CT-guided biopsy was required to confirm the presence of malignancy in three cases. Four scans were false positive. Extensive soft-tissue stranding in the ischiorectal fossa and/or perirectal fat associated with a large focal mass occurred in all patients with local tumor recurrence. Stranding was also seen in all patients treated with radiation. CT is an excellent method for preliminary evaluation and follow-up of patients with anal epithelial neoplasms, facilitating rapid and effective management.

Adult↗
PubMed1984

CT assistance for fluoroscopically guided transthoracic needle aspiration biopsy.

Five cases are presented that illustrate the utility of obtaining limited CT prior to fluoroscopically guided biopsy in patients who have lung or mediastinal lesions that cannot be adequately localized by chest radiography. Each case describes a unique setting in which the CT images facilitate accurate and safe biopsy needle placement. The rare requirement for biopsy using CT alone, which can be considerably more time consuming, is emphasized.

Adult↗
PubMed1984

Computed tomography of renal oncocytoma.

Six patients with small solid renal tumors were evaluated by computed tomography (CT). Two patients had renal oncocytomas, three had small renal cell adenocarcinomas, and one had separate foci of each of these tumors in the same kidney. We describe several features that may alert the clinician to the possible presence of oncocytoma. We found, however, that unless the dense central scar that can be seen in larger oncocytomas is visualized on CT (as was the case in one of our patients), differentiation between oncocytomas and renal cell carcinomas by CT is not possible.

Adenocarcinoma↗
PubMed1977

Flunisolide aerosol in the treatment of perennial allergic rhinitis.

A double-blind, crossover study was performed with a new topical aerosol steroid, flunisolide, administered every 12 hours over a period of eight weeks to 36 adult patients with perennial allergic rhinitis. During the treatment period the majority of patients had significant relief of symptoms as compared with the placebo period. Most prominent improvement occurred with the symptoms of nasal stuffiness, sneezing, rhinorrhea and the number of times patients had to blow their noses. Best results were obtained in patients with higher degrees of atopy. Side effects were minimal and limited to nasal irritation in some patients. Criteria for optimal patient selection are discussed and an explanation for the lack of systemic effects of aerosolized use of the newer corticosteroids is given.

Adolescent↗
PubMed1976

Treatment of perennial allergic rhinitis with cromolyn sodium. Double-blind study on 34 adult patients.

A double-blind crossover study was performed on 34 adult patients with perennial allergic rhinitis, using an aqueous solution of 4% cromolyn sodium or a placebo substance six times daily over a 4-wk period with daily documentation of both symptoms and use of symptomatic medications. All patients had markedly positive skin test reactions to at least one antigen. Chemistry screens and IgE serum levels were determined. Significant reductions occurred in the symptom-scores for runny nose, stuffy nose, sneezing, and nose blowing while patients were on cromolyn treatment (p less than 0.005). Likewise, while on treatment, there was a significant reduction in the consumption of antihistamines. In an attempt to differentiate between good and poor cromolyn responders by clinical and laboratory parameters, we found that (1) patients with high IgE levels responded better than those with low IgE levels, (2) patients with markedly positive skin test reactions to epidermoids and to foods responded better than those with pollen allergy, and (3) females appeared to have a significantly better drug response than males. Age did not play a role in drug response, nor did drug sequence (placebo-active or active-placebo).

Adolescent↗
PubMed1976

Papular urticaria.

Explore the source record for details and available documents.

Antipruritics↗
PubMed1976

Minocycline therapy in acne vulgaris.

A double-blind, random distribution study showed that a lower than recommended dose of minocycline--50 mg twice daily--was as effective as a dose of 250 mg twice daily of tetracycline for treatment of acne vulgaris in comparable patient groups, and that minocycline produced no vestibular side effects at the lower dosage. Like tetracycline, minocycline did not produce the phototoxicity associated with demeclocycline or the life-threatening colitis associated with clindamycin. Patients in this study did not develop a resistance either to minocycline or to tetracycline. Studies of the use of minocycline in patients who have developed tetracycline resistance and long-range studies of patients on the new lower dose of minocycline are now underway.

Acne Vulgaris↗
PubMedDate not supplied

Unknown ESUR cases 2004.

The authors present 14 cases from the film interpretation session of the 11th annual meeting of the European Society of Urogenital Radiology presented in September, 2004. The cases demonstrate the imaging findings, differential diagnoses, and clinical relevance of a wide variety of genitourinary tract diseases. The cases include examples of benign and malignant urinary tract neoplasms, inflammatory processes, vascular diseases, traumatic injuries, and congenital anomalies.

Adolescent↗
PubMedDate not supplied

Non-seminomatous testicular tumors: effect of lesion side on CT detection of lymph node metastasis.

Abdominal CT examinations of 40 patients with non-seminomatous testicular tumors were reviewed with previous knowledge of the side of the testicular primary. Metastatic nodes, between 1.5 cm and 2.0 cm in diameter were overlooked more frequently in patients with right than in those with left testicular primaries, because mildly enlarged aorto-caval or para-caval nodes (which are the most frequent site of metastasis from a right testicular lesion) were more difficult to detect than enlarged left para-aortic lymph nodes. Efforts to delineate the aorto-caval region on CT examinations of patients with right-sided lesions must be increased in order to reduce a surprisingly high false negative rate.

Adolescent↗
PubMedDate not supplied

Biliary cytodiagnosis. Bile sampling for cytology.

The records of 121 patients who presented for PTC and biliary drainage within a five-year period were reviewed. Fifty-eight bile samples had been obtained from 38 of these patients for cytologic analysis. Malignancy was detected in 14 of 32 patients with carcinoma (sensitivity 44%). Repeat sampling was positive in four of nine patients whose initial specimen contained no tumor cells. Bile duct carcinoma, pancreatic carcinoma, and metastatic disease were all detected. An approach to biliary cytodiagnosis is offered that, it is hoped, will further minimize future false negative results.

Bile↗
PubMedDate not supplied

Computed tomography of masses in periportal/hepatoduodenal ligament.

The CT findings in 70 patients with masses in or adjacent to the porta hepatis/hepatoduodenal ligament were analyzed. Underlying disease processes included metastatic disease (44 cases), lymphoma/leukemia (10 cases), biliary carcinoma (seven cases), hepatoma (four cases), benign disease (three cases), and gallbladder carcinoma (two cases). Location of the mass was confirmed in 62 patients and showed six patterns: four along the hepatoduodenal ligament or within the porta hepatis; another within the liver impinging on the hepatoduodenal ligament/porta hepatis; the sixth, an intraductal mass. Of the masses along the hepatoduodenal ligament or within the porta hepatis the four patterns were well defined nodular masses caused by discrete nodes; matted masses due to confluent adenopathy; mixed, well defined and confluent masses in various locations along the hepatoduodenal ligament; infiltrating, enhancing soft tissue densities obscuring the portal vein margins. No disease specific pattern was seen; nonetheless, knowledge of these patterns is very helpful in detection of masses in this region.

Adult↗
PubMedDate not supplied

CT findings in xanthogranulomatous pyelonephritis with coexistent renocolic fistula.

A case of diffuse xanthogranulomatous pyelonephritis of the kidney with an associated renocolic fistula is reported. Computed tomography demonstrated typical findings with an enlarged poorly functioning kidney with multiple near-water-density masses replacing the renal parenchyma surrounding a central staghorn calculus. A mottled gas collection within the renal parenchyma was secondary to a renocolic fistula rather than a pyogenic abscess.

Abscess↗
PubMedDate not supplied

Computed tomography of primary retroperitoneal malignancies.

The CT examinations and medical records of 33 patients with primary retroperitoneal malignancies were reviewed. Computed tomography findings were then compared with those from scans performed on 122 patients with non-Hodgkin lymphoma who presented during the same time interval. Primary retroperitoneal neoplasms had three distinct CT appearances. Twenty-one patients (64%) had large soft tissue masses. Seven patients (21%) had masses with fatty density components, and five patients (15%) had tumors that were primarily of water attenuation. With the exception of those liposarcomas that contained recognizable fat, CT could not distinguish among the different cell types. Seventeen patients with non-Hodgkin lymphoma had large dominant retroperitoneal soft tissue masses that resembled primary retroperitoneal malignancies. In most cases, however, CT was able to differentiate these tumor masses from primary retroperitoneal tumors. Although 19 of 20 sarcomas of soft tissue attenuation were heterogeneous, only six of the 17 lymphomas presenting as dominant masses had such an appearance. Computed tomography is extremely helpful in initially evaluating patients with primary retroperitoneal tumors and in assisting the surgeon in planning his or her approach by accurately defining tumor extent.

Adolescent↗
PubMedDate not supplied

Computed tomography of renal lymphoma.

The CT studies of 29 patients with renal or perirenal lymphoma were retrospectively reviewed. Four patterns of disease were identified. Seventeen of 29 patients (59%) had bilateral renal masses. Only seven of these patients had associated enlarged retroperitoneal lymph nodes. Eight patients (28%) had single renal or perirenal lesions adjacent to or contiguous with bulky retroperitoneal lymphadenopathy. Three patients had infiltration of the perirenal space without significant renal parenchymal involvement, and one patient had a solitary renal mass. No patients in this series had diffuse involvement of the kidney without a focal mass. Renal involvement with lymphoma should be considered in any patient who develops multiple homogeneous solid renal or perirenal masses, even in the absence of other retroperitoneal disease.

Female↗
PubMedDate not supplied

CT of fundoplication.

To determine the CT findings postfundoplication, we retrospectively compared CT in 22 postfundoplication patients with CT in 22 patients with unrepaired hiatal hernias and gastroesophageal (GE) junction abnormalities and 24 patients with gastric or esophageal carcinoma involving the GE junction. Seventeen of the 22 postfundoplication patients had undergone a Nissen procedure. Of the 22 patients, 11 had esophageal dilatation, 14 had GE junction masses, 4 had esophageal wall thickening, 7 had surgical clips, and none had hepatic metastases or upper abdominal lymphadenopathy. Statistically, on CT, postfundoplication patients are more likely to have a GE junction mass (p = 0.023) and least likely to have wall thickening (p = 0.021). Nonetheless, because the findings occur frequently in each group, they are not diagnostic in the individual patient. However, 11 of 12 post-Nissen masses had the unique finding of an oval or linear central fat density within the mass. This finding was absent in the other postfundoplication masses and in those patients with repaired hiatal hernia or tumor. We conclude that pseudomasses occur on CT postfundoplication and can be indistinguishable from hiatal hernias and GE junction neoplasms unless a central fat density is present.

Adult↗