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Biomedical subjects

R L Bree

Publications and source records attributed to R L Bree.

At least 109 records · Page 6Linked to original sources
PubMed1976

Medial deviation of the ureters secondary to psoas muscle hypertrophy.

Bilateral medial deviation of mid and distal portions of the ureters can occur as a normal finding in patients with psoas muscle hypertrophy. Two groups of patients are presented, both composed of young, healthy males. In 13 patients, the distance between the ureters at the narrowest point averaged 3.7 cm. Psoas muscle hypertrophy was evident radiographically and confirmed by ultrasound. In 20 patients with normal psoas muscles, the average minimum distance between the ureters was 7.1 cm. The importance of this observation is to avoid overdiagnosis of retroperitoneal disease in this group of young, muscular men. The differential diagnosis and severe examples of this normal variant are presented.

Adult↗
PubMed1976

Transcatheter occlusion of abdominal tumors.

Radiological and clinical experience with transcatheter intravascular occlusion of abdominal and pelvic tumors in 55 patients is presented. Major indications include control of hemorrhage, palliation of local tumor symptoms, and preoperative management of facilitate surgery. Methods of occlusion included embolization (clot, subcutaneous tissue, and Gelfoam), introduction of a stainless steel coil into larger vessels, and balloon catheters. Hemorrhage was controlled in 8 of 12 patients with bleeding gastrointestinal and pelvic tumors. Experience in 36 patients with hypernephroma is discussed. Initial observations are presented, including occlusion of the hepatic artery for dearterialization of primary and secondary neoplasms and of the splenic artery for hypersplenism.

Abdominal Neoplasms↗
PubMed1976

Therapeutic vascular occlusion utilizing steel coil technique: clinical applications.

The stainless steel coil has been utilized for permanent intravascular occlusion of the proximal portion of the renal, hepatic, splenic, and internal iliac vessels. This therapeutic approach has been successful in the management of renal arteriovenous fistulas, renal carcinomas, neoplasms of the liver, giant cell tumors of the sacrum, and in hypersplenism. The techniques involved and clinical uses are discussed.

Adult↗
PubMed1976

Transcatheter embolization of the internal iliac artery in the management of neoplasms of the pelvis.

Six patients with neoplasms of the pelvis were treated with embolization of the internal iliac artery. The technique was used for the control of hemorrhage and pain and for preoperative devascularization. No complications or serious side-effects occurred. Embolization of the internal iliac artery often provides a therapeutic alternative, when a surgical procedure is not feasible.

Adult↗
PubMed1975

Selective arterial embolization for control of massive upper gastrointestinal bleeding.

Massive upper gastrointestinal bleeding was controlled in 11 of 15 patients by the use of selective injected arterial emboli. Embolization is most successful in the treatment of patients with demonstrated arterial bleeding sites at angiography. This group of patients generally has ulcers and it is this group in whom vasopressin infusion has the lowest success rate. At the same time we were successful in controlling only 1 of 4 patients who were bleeding from diffuse hemorrhagic gastritis, those patients in whom vasopressin infusion is very successfu, We, therefore, now embolize only patients in whom arterial bleeding sites are demonstrated at angiography or in whom vasopressin infusion has failed to control the bleeding from hemorrhagic gastritis. Our experience also indicates that short acting occlusive agents, such as autogenous blood clot mixed with aminocaproic acid, are as successful in controlling bleeding as the more permanent types of embolic material.

Adult↗
PubMedDate not supplied

Further observations on the usefulness of the sonographic Murphy sign in the evaluation of suspected acute cholecystitis.

A positive sonographic Murphy sign, the presence of maximal tenderness elicited over a sonographically localized gallbladder, has been reported to be a helpful adjunctive finding in patients with proven acute cholecystitis who are evaluated with ultrasonography. We evaluated 200 patients with right upper quadrant pain, thought to be acute cholecystitis. Results of ultrasound examinations and subsequent follow-up were tabulated. The sensitivity of the sonographic Murphy sign in acute cholecystitis was 86% with a specificity of 35%, positive predictive value of 43%, and negative predictive value of 82%. The sensitivity of the sonographic findings, including stones, gallbladder wall edema, and pericholecystic fluid collections, was 93%, a specificity of 53%. The combination of the Murphy sign accompanied by gallstones yielded a specificity of 77%. The large number of false positives, and only moderate improvement in specificity when accompanied by gallstones, makes this sign unreliable in separating acute from chronic cholecystitis.

Abdominal Pain↗
PubMedDate not supplied

Hepatic focal nodular hyperplasia: MR imaging at 1.0 and 1.5 T.

Ten cases of hepatic focal nodular hyperplasia (FNH) were studied with magnetic resonance (MR) imaging. Proof of diagnosis was by needle biopsy or follow-up of as long as 5 years. Both short TR/TE and long TR/TE images were obtained. The most common finding was isointensity of the lesion relative to liver parenchyma with all pulse sequences. A central scar was seen in only one patient and was hyperintense on long TR/TE images. Slight hyperintensity of the lesion on short TR/TE and long TR/TE images was seen in two cases. Textural heterogeneity was present in only one of these. The most common presentation in our series was a visually isointense lesion relative to liver on short TR/TE images and an isointense or slightly hyperintense lesion on long TR/TE images. A review of the literature and the present findings suggest that FNH has a variable appearance on MR images.

Humans↗
PubMedDate not supplied

Abdominal fine needle aspiration biopsies with CT and ultrasound guidance: techniques, results and clinical implications.

Experience with fine needle aspiration biopsy (FNAB) of solid intraabdominal masses with computed tomography and ultrasound guidance in 117 patients at a large community hospital is described. An overall accuracy of 86%, sensitivity of 86%, and specificity of 93% was obtained. FNAB was found to be safe and accurate and obviated the need for surgery in nearly 50% of patients. Further experience is required to assess the value of FNAB in solid renal masses and in abdominal lymphoma.

Abdominal Neoplasms↗
PubMedDate not supplied

Computed tomography of renal oncocytomas.

A retrospective analysis of 5 renal oncocytomas studied with CT was performed. Oncocytomas appeared as rounded hypodense solid masses with sharp margination from the normal renal parenchyma. They showed uniform homogeneous enhancement on CT scans performed after drip infusion of urographic contrast. One oncocytoma studied with dynamic CT scanning demonstrated a stellate (spoke-wheel) pattern of enhancement. No evidence of involvement of adjacent renal parenchyma, perinephric fat, renal veins or regional lymph nodes was present at CT and the findings were confirmed at surgery. Although the differential diagnosis between renal oncocytoma and hypernephroma may not be possible, preoperative awareness of a potentially benign lesion may guide the surgeon to attempt renal preserving surgery instead of the customary nephrectomy.

Adenoma↗
PubMedDate not supplied

CT detection of skeletal muscle metastases.

The CT appearance of skeletal muscle metastases, proven by biopsy, is presented in a series of 11 patients. Primary sites of neoplasm included chest, head and neck, breast, esophagus, uterus, ovary, prostate, and lymph nodes. Computed tomographic guided biopsies were performed in seven patients and four patients underwent open biopsy. The CT findings consisted primarily of muscle enlargement with the masses containing low density and loss of normal fat and vascular planes. Invasion of adjacent bony structures

Esophageal Neoplasms↗
PubMedDate not supplied

Large infiltrating renal transitional cell carcinomas: CT and ultrasound features.

A series of nine patients with large infiltrating renal transitional cell carcinomas is presented. These large tumors are rare but important in the differential diagnosis of renal masses. The average tumor size was 8.5 cm. In six patients the tumor involved almost the entire kidney. Seven masses were centrally located but two were peripheral. With CT the masses exhibited low attenuation relative to the normal or opposite renal parenchyma. Four masses exhibited necrosis. Lymphadenopathy, venous invasion, calcification, and spontaneous hemorrhage were all seen in this series. The major differential diagnostic possibility was renal cell carcinoma but lymphoma and metastatic disease were included. The diagnosis was confirmed in six patients by fine needle aspiration biopsy because of the presence of metastatic disease or the possibility of lymphoma. In the remaining three patients the diagnosis was made at surgery. The recognition that a large infiltrating renal mass may represent a transitional cell neoplasm is important in the eventual surgical management, and accurate preoperative diagnosis is stressed.

Biopsy, Needle↗