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Biomedical subjects

R N Berk

Publications and source records attributed to R N Berk.

At least 37 records · Page 2Linked to original sources
PubMed1982

Subjective vs. objective evaluation of gallbladder opacification during oral cholecystography in comparative clinical trials: implications for studies involving visual assessment.

Radiographs and CT images taken during oral cholecystography in dogs were interpreted in an independent, blind fashion by three radiologists on two occasions and visual assessment of gallbladder density compared to the actual CT values. While there was significant intra- and inter-observer variation, the mean scores for the observers' interpretations of both radiographs and prints correlated well with the actual CT values (p less than 0.05). In five out of six comparisons between first and second readings, the observers gave a lower score on the second reading. The considerable variation reflects the problems inherent in subjective evaluation of agents that produce small but measurable differences in radiographic density. Studies involving such subjective data have to be carefully designed in order to obtain meaningful results.

Administration, Oral↗
PubMed1982

Cholecystokinin cholecystography, sonography, and scintigraphy: detection of chronic acalculous cholecystitis.

Because the efficacy of cholecystokinin cholecystography in the detection of chronic acalculous cholecystitis remains in doubt, the procedure is rarely used in clinical practice. However, the ability to observe gallbladder contraction with sonography and 99mTc-para-isopropylacetanilido-iminodiacetic acid cholescintigraphy (PIPIDA) offers a possibility to improve the sensitivity of the test. To determine if the degree of gallbladder contraction after cholecystokinin is the same as measured by the three techniques and if it differs in symptomatic patients compared to the normal population, cholecystokinin cholecystography, cholecystokinin sonography, and cholecystokinin PIPIDA were performed in 10 symptomatic patients and 10 normal volunteers. The mean maximum contraction of the gallbladder during the three studies was 63%, 61%, and 68%, respectively, for the volunteers, and 72%, 63%, and 73%, respectively, for the patients. The mean maximum gallbladder contraction during all three procedures was 64% +/- 26% SD in the volunteers and 74% +/- 17% SD in the patients. The differences were not statistically significant. Although there was good correlation in the degree of maximum gallbladder contraction among cholecystokinin cholecystography, cholecystokinin sonography, and cholecystokinin PIPIDA, marked variation in both the volunteers and the patients makes it unlikely that the degree of contraction as observed by any of these techniques can be used to indicate the presence of chronic acalculous cholecystitis.

Biliary Dyskinesia↗
PubMed1981

Campylobacter colitis: a common infectious form of acute colitis.

A case of acute ulcerating colitis due to Campylobacter fetus is presented. The radiographic and endoscopic findings are indistinguishable from those of idiopathic acute ulcerative colitis. The clinical and bacteriological data relating to Campylobacter are discussed.

Adult↗
PubMed1981

Concentration and excretion of contrast agents during oral cholecystography as measured by computed tomography in dogs.

Nine healthy mongrel dogs were given 2 consecutive doses of 1 of 3 cholecystographic contrast agents (iopanoic acid, sodium ipodate, and sodium tyropanoate), followed by daily computed tomograms (CT) and abdominal radiographs in a randomized crossover study in order to determine: (a) the maximum time for excretion of the contrast material from the gallbladder, (b) the maximum time for elimination of contrast material from the blood, and (c) the correlation between the density of the gallbladder on CT and the actual concentration of iodine in the gallbladder bile. In all 9 animals gallbladder opacification disappeared on CT within 4 days after administration of the contrast material. Plain abdominal radiographs did not show gallbladder opacification after 2 1/2 days. Daily blood iodine measurements showed that all of the contrast material was cleared from the blood within 7 days after administration. In 7 dogs CT imaging of the gallbladder was followed by percutaneous aspiration of bile from the gallbladder using CT guidance. There was a direct linear correlation between the actual concentration of iodine in the bile and the density of the gallbladder on CT (r = 0.925). This suggests that CT measurements can be used to determine the concentration of contrast agents in the gallbladder during oral cholecystography.

Administration, Oral↗
PubMed1981

The radiological diagnosis of gallbladder disease. An imaging symposium.

Changes in the radiological diagnosis of gallbladder disease are occurring at a remarkable rate. In this symposium, several recognized authorities place the various diagnostic modalities and their interrelation in modern perspective. The present and future roles of oral cholecystography and intravenous cholangiography, the radiological diagnosis of chronic acalculous cholecystitis, and the use of ultrasonography and cholescintigraphy are analyzed.

Acute Disease↗
PubMed1980

Cecal hernia into the lesser sac.

Two cases of cecal herniation through the foramen of Winslow into the lesser sac are presented. This unusual and potentially life-threatening form of internal herniation can be diagnosed radiographically on plain abdominal radiographs and barium studies by identifying the cecum lying posterior and medial to the stomach in association with the absence of the cecum in the right lower quadrant of the abdomen. One of the described cases is unique in that the patient was asymptomatic relative to the internal hernia. The other case clearly demonstrates the importance of increased intra-abdominal pressure as a causative factor in foramen of Winslow hernia.

Aged↗
PubMed1980

Radiographic evaluation of spastic colon disease, diverticulosis, and diverticulitis.

Spastic colon disease is a syndrome consisting of abdominal pain and abnormal bowel function associated with thickening of the circular muscle layer of the colon. The condition may be related to changes in intraluminal pressure associated with a lifelong low residue diet. Radiologic features include thickening, crowding, irregularity, and distortion of the interhaustral folds of the sigmoid colon, which in the past have been incorrectly considered to be manifestations of acute diverticulitis. Spastic colon disease leads to diverticulosis which develops because of mucosal herniations through the weakened colonic wall. When a diverticulum perforates, acute diverticulitis ensues. Depending on how the subsequent inflammatory response is contained, a mural abscess, colonic narrowing or obstruction, an intra-abdominal abscess, or a fistula may occur and be demonstrated on barium enema examination.

Barium Sulfate↗
PubMed1980

The effect of diet and fasting on gallbladder opacification during oral cholecystography in dogs as measured by computed tomography.

To determine the influence of diet and fasting on gallbladder opacification during oral cholecystography, 10 dogs were studied in a blind, random fashion, giving single or two consecutive doses of iopanoic acid, sodium tyropanoate, or sodium ipodate while the animals were fasting, on a normal diet, or on a low-fat diet. Gallbladder density was determined by CT to eliminate the bias created by subjective interpretation of radiographs. For maximum, first-dose gallbladder opacification during clinical cholecystography, iopanoic acid should be given with a meal and sodium ipodate while the patient is fasting; diet makes no difference with sodium tyropanoate. For maximum opacification with two consecutive doses, iopanoic acid may be given with a meal or during fasting, while sodium ipodate and sodium tyropanoate should be administered during fasting.

Administration, Oral↗
PubMed1980

Hepatic artery injury during portacaval shunt surgery.

The angiographic and clinical findings are presented in three patients in whom the proper hepatic artery was injured during a portacaval shunt operation. In two of the patients, hepatic artery occlusion, hepatic necrosis, and death occurred within several days. In the third, an elongated, lobular aneurysm, clearly related to the operation, was an incidental finding on a postoperative angiogram. Because of the dependency of the cirrhotic liver on hepatic artery blood flow, hepatic artery occlusion in advanced cirrhotic patients is usually fatal and may be the cause of progressive and rapid onset of the hepatic coma in the postoperative period. The complications should be suspected when the SGOT increases rapidly in the postoperative period and can be confirmed by arteriography.

Adult↗
PubMed1979

Determinants of the rate of intestinal absorption of oral cholecystographic contrast agents in the dog jejunum.

Successful opacification of the gallbladder during oral cholecystography depends on adequate absorption of the contrast agent from the intestine. The present studies were undertaken to define the specific characteristics of the intestinal mucosa and the properties of the various contrast agents which determine their rates of intestinal absorption. The polarity of the compounds was established by determining the ratios of their distribution between bulk solvents (benzene and water). In addition, the maximum aqueous solubility of each compound was determined. Using in vivo cannulated segments of dog jejunum, apparent passive permeability coefficients were measured. From these data, the apparent maximal rate of intestinal absorption was calculated. The six cholecystopaques studied differed markedly in polarity as judged by their varying ratios of distribution between benzene and water. The permeability coefficients varied inversely with the polarity of the compounds. However, the incremental changes in the coefficients were considerably less than the corresponding changes observed in the partition ratios. The rates of absorption of the more polar contrast agents (tyropanoate, iopronic acid, and iocetamic acid) were greater than the less polar compounds (iopanoic acid, sodium ipodate, and calcium ipodate) under the conditions in which the resistance of the unstirred water layer is not rate limiting and where bile acid micelles are not present.

Animals↗
PubMed1978

Ascariasis of the gastrointestinal tract.

The radiographic findings and complications of Ascaris lumbricoides infection of the gastrointestinal tract are presented. Since the clinical symptoms of ascariasis are usually vague or nonspecific, the radiologist may be in a position to play a major role in the proper diagnosis of this disease.

Ascariasis↗
PubMed1978

Unusual fistulae due to colonic diverticulitis.

Examples of diverticulitis of the colon associated with fistulae to the left hip, inferior mesenteric vein, and portal vein resulting in the demonstration of intrahepatic abscesses, the vermiform appendix, and the skin are presented with a review of the literature. A case of a fistula to the epidural space is included.

Colon↗
PubMed1978

The effect of fasting on gallbladder opacification during oral cholecystography: a controlled study in normal volunteers.

The effect of fasting on gallbladder opacification during oral cholecystography was studied in 10 normal volunteers using 2 oral cholecystographic agents, iopanoic acid and sodium tryopanoate. Radiographs made 15 hours after ingestion of the contrast agents revealed good opacification of the gallbladder in all subjects when iopanoic acid was administered with a meal and when sodium tyropanoate was administered in the fasting state; in only 2 subjects when iopanoic acid was given in the fasting state; in 3 when given in the fasting state with ox bile; and in 3 when sodium tyropanoate was given with a meal.

Administration, Oral↗