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Biomedical subjects

R Rothberg

Publications and source records attributed to R Rothberg.

13 recordsLinked to original sources

The parathyroid adenoma: an imaging/surgical perspective.

The clinical picture of hyperparathyroidism has changed since the implementation of routine serum calcium testing, resulting in more asymptomatic patients undergoing early surgical exploration. Although operative complications (e.g., recurrent laryngeal nerve paralysis, hypocalcemia, etc.) are not prevalent, the risk can be minimized by minimizing tissue dissection. For this reason, we feel that preoperative tumor localization is of great importance. We report our imaging results of parathyroid adenomas, utilizing ultrasonography, technetium-thallium subtraction scanning, digital subtraction angiography and magnetic resonance imaging. We also present an imaging protocol which, we have found, maximizes preoperative identification of these tumors.

Adenoma

Transmission of human immunodeficiency virus from parents to only one dizygotic twin.

The acquired immunodeficiency syndrome-related complex was identified in a mother and one of her nonidentical twins. Generalized lymphadenopathy was first noted in the infant at age 17 months, and that of the mother was incidentally discovered 6 months later. The father, who had had homosexual contacts before the conception of the twins, appeared to be in good health. No one in the family had constitutional symptoms or showed signs of opportunistic infection. Both parents and the patient had hypergammaglobulinemia, low T-helper-to-suppressor-cell ratio, and positive serum antibody to human immunodeficiency virus. Attempts to isolate the virus from all family members were unsuccessful. The twin brother was in good health with a normal immunologic profile and negative antibody to human immunodeficiency virus.

AIDS-Related Complex

Thyroid cartilage imaging with diagnostic ultrasound. Correlative studies.

In 1976, Noyek observed that the thyroid cartilage framework of the larynx could be imaged by diagnostic ultrasound; the image appeared uniquely independent of the presence or absence of calcification. It was suggested that ultrasound, with its simple, nonroentgenographic, noninvasive features, might permit screening detection of thyroid cartilage destruction. It might, therefore, give direction to better computed tomographic (CT) imaging, and, specifically, more effectively identify T4 laryngeal cancer. Since that time, with improving generations of ultrasound transducers, more than 130 clinically correlated laryngeal ultrasound examinations have been recorded. Thirty CT, ultrasound, and pathologically correlated advanced cases of laryngeal carcinoma were critically evaluated by the Departments of Otolaryngology and Radiology at Mount Sinai Hospital, Toronto. Our diagnostic imaging approach has resulted in remarkably improved thyroid cartilage imaging by CT when "directed" by preliminary ultrasound.

Carcinoma

Sonographic guidance of thyroid needle biopsy.

We describe a new technique for sonographically guided needle biopsy of the thyroid using high-resolution real-time ultrasound. It proved to be highly effective for obtaining diagnostic samples from thyroid nodules in 13 of 14 patients who otherwise could not have a diagnostic thyroid aspiration because their nodules were in difficult locations or were not palpable. We believe that sonographic guidance will be important to those physicians employing thyroid needle biopsy.

Biopsy, Needle

Diagnostic ultrasound imaging of parotid disease--a contemporary clinical perspective.

Diagnostic ultrasound provides fast, simple screening soft tissue information for evaluation of both parotid glands on the same single image display. This information augments the findings on history and physical examination and directs further radiologic studies if indicated. This manuscript attempts to establish the role for diagnostic ultrasound in the evaluation of patients with diffuse and focal parotid disease. It also attempts to establish a more definitive role for diagnostic ultrasound in relation to other diagnostic imaging modalities.

Cysts

Thyroid tumor imaging.

Clinical assessment of a patient with a focal or diffuse thyroid tumor is but the first step in diagnostic evaluation. The diagnostic imaging process augments information obtained by the inspecting eye and the palpating hand; it allows the qualification (for example, cystic v solid) and the quantification (for example, size, extension, and assessment of physiologic function) of the thyroid tumor mass. This diagnostic input allows the establishment of a more realistic provisional diagnosis and directs a rational treatment approach to the patient. This presentation reviews the major imaging modalities available for thyroid tumor evaluation: diagnostic ultrasound, radionuclide scans, and conventional radiology and computed tomography. The applications of these various modalities and their critical potentials and limitations are placed in a contemporary clinical setting. It is hoped that an increasing familiarity with these imaging modalities will give better direction to the specialist in otolaryngology--head and neck surgery and greater surgical benefit to his or her patients.

Adenocarcinoma

Some biochemical indices of nutrition in treated cystic fibrosis patients.

Postprandial levels of copper, ceruloplasmin, iron, total iron binding capacity, cholesterol, vitamin A, carotene, folic acid, vitamin C, albumin, and total globulins in plasma, of 25-OH-vitamin D in serum, and of glutathione reductase activity, an index of riboflavin status, in erythrocytes were determined in a group of 18 juvenile cystic fibrosis patients receiving specialized outpatient care with attention to diet, vitamin supplementation, and pancreatic enzyme replacement. Bone mineralization was assessed by radiographic and photon beam technique. In the plasma of cystic fibrosis patients, levels were elevated for copper, ceruloplasmin, total globins, and total proteins and were depressed for iron, vitamin D, vitamin A, carotene, and albumin. Cortical thickness was diminished in the patients, but bone density was not. For patients with cystic fibrosis, a relation was established between forced vital capacity and certain biochemical indices in plasma. As forced vital capacity decreased, plasma levels increased for copper, total globulins and total proteins and decreased for albumin.

Adolescent

Zinc status and vitamin A transport in cystic fibrosis.

Zinc status and the retinol transport system were examined in 18 retinol supplemented cystic fibrosis (CF) patients and 40 age-matched controls. Plasma vitamin A was significantly lower in the CF group as compared to the controls and correlated positively with plasma retinol-binding protein (RBP) in both the CF and control groups. Plasma zinc of the CF group was not significantly lower than controls whereas hair zinc was. Plasma zinc was positively correlated with plasma RBP, vitamin A, and albumin in the CF group but not in the controls. Plasma concentrations of vitamin A, RBP, albumin, and zinc decreased with age in the CF group but not in the controls. The data support previous suggestions that low plasma vitamin A levels in CF are due to defects in the retinol transport system. The zinc status of the CF groups as a whole was judged to be low-normal however a subgroup of CF patients were in the marginal to deficient category. This subgroup also had lower levels of plasma vitamin A and RBP. The data suggest that zinc may be a contributing factor in the low plasma vitamin A/RBP levels of CF patients with marginal or deficient zinc status.

Adolescent