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Biomedical subjects

S F Quinn

Publications and source records attributed to S F Quinn.

At least 91 records · Page 5Linked to original sources
PubMed1985

Characteristic sonographic signs of hepatic fatty infiltration.

Hepatic fatty infiltration sonographically appears as an area of increased echogenicity. When focal areas of fat are present in otherwise normal liver parenchyma, the fatty area may be masslike in appearance, leading to further imaging evaluation and sometimes even biopsy. This article discusses seven patients with focal fatty infiltration, who had sonographic signs that were highly suggestive of the fatty nature of the masses. These signs included angulated, geometric margins between normal and fatty tissue and interdigitating margins with slender fingers of normal or fatty tissue. These signs may be useful in diagnosing masslike areas of focal fatty infiltration and distinguishing these sonographically from other hepatic mass lesions.

Aged↗
PubMed1984

Bull's-eye lesions: a new gastrointestinal presentation of mastocytosis.

Systemic mastocytosis is a rare disorder that infrequently affects the GI tract. Bowel involvement in mastocytosis is characterized by thickened folds and small mucosal nodules, and there is an increased incidence of peptic ulcer disease and malabsorption. This paper describes a new case of mastocytosis that presented radiographically as 1.0-1.5 cm gastric and duodenal nodules. Some of the duodenal nodules were bull's-eye lesions with central collections of barium. Mastocytosis, along with primary neoplasms, aberrant pancreas, eosinophilic granuloma, and metastases should be included in the differential for bull's-eye lesions of the GI tract.

Adult↗
PubMed1984

The diagnostic significance of posttraumatic sphenoid sinus effusions: correlation with head computed tomography.

In review of 1544 patients with both head computed tomography (CT) examinations and skull radiographs, 150 patients were found to have a history of acute head trauma. Twenty-nine of these patients had sphenoid sinus effusions. Ninety-three percent (27/29) of those cases had abnormal CT examinations, as compared with 48% (58/121) of cases without sphenoid effusions. Of the patients with sphenoid effusions, 31% (9/29) had intracerebral hematomas, 24% (7/29) had extracerebral hematomas, 13% (4/29) had pneumocephalus, and 13% (4/29) had cerebral edema. We conclude that the presence of posttraumatic sphenoid sinus effusion on the skull radiograph is a sensitive sign for intracranial damage and serves as an emergent indication for head CT.

Brain Edema↗
PubMed1984

Osteopetrosis with calcifying tendinitis.

Osteopetrosis is a hereditary disease caused by cellular dysfunction. Calcifying tendinitis is a sequela of stress mediated by multinucleated cells in the tendon fibers. Our patient had both osteopetrosis and calcifying tendinitis. A related cellular dysfunction may predispose individuals with osteopetrosis to calcifying tendinitis.

Adult↗
PubMed1983

Spinal lipoma presenting as a mediastinal mass: diagnosis by CT.

Spinal lipomas account for less than 1% of all spinal tumors. Prior to the advent of computed tomography, the preoperative diagnosis could only be suggested on the basis of nonspecific clinical and radiographic findings. We report a case of an unusual spinal lipoma that presented as a mediastinal mass. The low attenuation values of the tumor allowed a preoperative diagnosis. Computed tomography with metrizamide should serve as the first diagnostic procedure for evaluation of spinal lipomas.

Cervical Vertebrae↗
PubMed1983

Posttraumatic osteolysis of the clavicle.

Posttraumatic osteolysis of the distal clavicle should be considered when continued pain follows trauma. The osteolysis and accompanying symptoms can be partially alleviated by immobilization of the shoulder joint. The pathology is poorly understood, but synovial hyperplasia appears to play an integral part in the resorptive process.

Accidents, Traffic↗
PubMed1983

Respiratory failure due to metoclopramide.

Metoclopramide is a promising drug used not infrequently by practicing physicians. Its dystonic reactions are uncommon in the general population but are not infrequent in children. These reactions can be serious, and appropriate understanding of their manifestations and treatment can be lifesaving.

Adult↗
PubMedDate not supplied

MR imaging of patellar retinacular ligament injuries.

Seventeen patients with patellar retinacular ligament injuries were evaluated with magnetic resonance (MR) imaging. MR findings were correlated with clinical, surgical, and arthroscopic findings. The injuries involved the medial retinacular ligament in 16 of 17 patients and the medial and lateral retinacular ligament in one patient. Nine of 17 patients showed MR evidence of a patellar dislocation. In these patients, a triad of findings that included focal impaction injuries involving the lateral femoral condyle, osteochondral injuries of the medial patellar facet, and injuries of the medial retinacular ligament were seen. Seven of the nine patients with patellar dislocation injuries had frank osteochondral injuries. The injured retinaculum had an indistinct, irregular appearance associated with edema and hemorrhage. The patellar dislocations were clinically unsuspected in the initial evaluation of eight of these nine patients. In eight of 17 patients, the mechanism of injury was a patellar tendon tear (n = 1) or valgus hyperextension (n = 7). In the seven patients with hyperextension injuries, three had associated meniscal and cruciate ligament tears. MR imaging can help define patellar retinacular and associated osteochondral injuries, which may be clinically useful information.

Adolescent↗
PubMedDate not supplied

Evaluation of loose bodies in the elbow with MR imaging.

The evaluation of loose bodies in the elbow is usually done by means of clinical examination, radiography, and postarthrographic computed tomography (CT). The authors review their experience with magnetic resonance (MR) imaging in place of post-arthrographic CT for the evaluation of loose bodies in the elbow. The prospective interpretation of MR studies of the elbow in 20 patients was compared with arthroscopic findings. All elbows were imaged in multiple planes with thin sections, surface coils, and combinations of T1, T2, and proton-density weighting. The sensitivity for showing loose bodies with MR imaging was 100%, and the specificity was 67%. Because this was a nonblinded study, the results are biased and caution must be used when extrapolating these results to the general population. In this limited experience, MR imaging has reliably shown loose bodies in the elbow, and in the authors' institutions has replaced postarthrographic CT for that purpose.

Adolescent↗
PubMedDate not supplied

MR imaging of silicone breast implants: evaluation of prospective and retrospective interpretations and interobserver agreement.

MR imaging was used to evaluate the integrity of silicone breast implants in 54 women with 108 implants. MR images were interpreted by relatively inexperienced readers who tried to reproduce the experiences reported in the literature. The study examines the interobserver agreement using different diagnostic signs and the influence of experience on interpretation errors. Prospective and retrospective interpretations were compared with surgical findings at the time of explanation. Diagnostic indicators, including the linguine sign, the inverted tear drop sign, the C sign, water droplets mixed with silicone, and extracapsular globules of silicone, were evaluated for diagnostic efficacy and interobserver agreement. The prospective sensitivity and specificity were 87% and 78%, respectively. With the retrospective interpretations, the sensitivity and specificity increased to 93% and 92%, respectively. Most of the prospective false-positive interpretations were due to misinterpreting radial folds as signs of implant rupture. Six implants interpreted retrospectively as false positives had gross amounts of silicone around the implants at surgery but there were no obvious rents in the implant shells. There was fair to excellent interobserver agreement with the individual diagnostic signs except for extracapsular globules of silicone. All of the signs had specificities of greater than 90%. The sensitivities of the individual signs were less than the overall retrospective sensitivity. With experience, the sensitivity improved from 87% to 93% and the specificity improved from 78% to 92%. This study helps substantiate the use of diagnostic signs used by other authors to detect silicone loss from breast implants by MR imaging; however, questions remain as to the clinical role of MR imaging in evaluating implants for silicone loss.

Adult↗
PubMedDate not supplied

Evaluation of the iliac arteries: comparison of two-dimensional time of flight magnetic resonance angiography with cardiac compensated fast gradient recalled echo and contrast-enhanced three-dimensional time of flight magnetic resonance angiography.

We compared dynamic contrast-enhanced three-dimensional time of flight (3DTOF) magnetic resonance angiography (MRA) with two-dimensional time of flight (2DTOF) MRA with cardiac compensated fast gradient recalled echo (C-MON) and conventional angiography (CA) when it was available. C-MON re-orders the normal data acquisition to minimize ghosting artifacts generated by pulsatile flow. The initial phase of the study involved optimization of parameters and comparison C-MON with no C = MON in eight patients and volunteers. The final phase of the study involved 53 patients who were imaged with contrast-enhanced 3DTOF MRA and 2DTOF MRA with C-MON. Thirty of these patients also had CA. In the initial phase, 2DTOF MRA with C-MON was found to be equal (n = 3) or superior (n = 5) to 2DTOF without C-MON. In the final phase, the agreement among all imaging modalities varied from substantial to almost perfect (Cohen's kappa = .6-.83). The lowest agreement was using 2DTOF to evaluate the external iliac segments. The among suggested treatments varied from substantial to almost perfect for all imaging modalities (Cohen's kappa = .73-93). The diagnostic efficacies of 2DTOF with C-MON and contrast-enhanced 3DTOF were high overall, with the lowest value being a specificity of 63% for one reader in the evaluation of an external iliac segment using 2DTOF. In summary, 2DTOF with C-MON helped to eliminate artifacts due to pulsatility in the iliac arterial segments. In our experience, both dynamic contrast-enhanced 3DTOF MRA and 2DTOF MRA with C-MON performed well in the evaluation of the iliac arteries. Both studies have high interobeserver agreement and high diagnostic efficacy. Contrast-enhanced 3DTOF MRA should be reserved for situations in which the iliac vessels are extremely tortuous or occluded or the external iliac segments are poorly seen.

Adult↗
PubMedDate not supplied

Transluminally placed endovascular grafts for venous lesions in patients on hemodialysis.

This report summarizes a feasibility study of transluminally placed endovascular grafts (TPEG) using pre-expanded polytetrafluoroethylene (PTFE) to treat venous abnormalities in patients on hemodialysis. Seventeen patients with peripheral (n = 11) or central (n = 6) venous lesions were treated with TPEG devices. Covered Gianturco stents were used for the peripheral lesions and covered Palmaz stents were used for central lesions. Venous abnormalities included vascular rupture after balloon angioplasty or surgical thrombectomy (n = 4), stenosis associated with an aneurysm (n = 2) and occlusive disease and central stenoses not responsive to balloon angioplasty (n = 11). The mean primary patency period was 37 days. The mean secondary patency period was 215 days. At 60, 180, and 360 days the primary and secondary patency rates were 40%, 32%, and 32%, and 70%, 55%, and 39%, respectively. Follow-up studies have shown various outcomes of the implanted TPEG devices, which have included stenoses within the TPEG (n = 2), stenoses central to the TPEG (n = 1), stenoses peripheral to the TPEG (n = 3), acute thrombosis extending to the TPEG without a stenosis (n = 1), graft abandoned with patent TPEG (n = 6), and TPEG patent within primary patency period at last follow-up (n = 4). The TPEG devices, made with pre-expanded PTFE, appear safe in the short term, do not prevent progressive dialysis access site failure, and need to be compared to PTA and endovascular stenting in a randomized prospective trial.

Blood Vessel Prosthesis↗
PubMedDate not supplied

MRI of inflammatory synovial processes.

MRI was used to evaluate inflammatory synovial processes in 53 patients over a 4-year period. Multiple disease processes were imaged, including: rheumatoid arthritis [n = 12], osteochondromatosis [n = 6], bursal abnormalities [n = 17], ganglion cyst [n = 1], meniscal cyst [n = 5], hemophilia [n = 1], and septic arthritis [n = 11]. The soft tissue contrast resolution of MRI and its multiplanar capability makes it particularly suitable for evaluating masslike or fluid inflammatory processes for diagnostic purposes, to determine extent of disease, and in some cases, to determine the composition of the inflammatory processes.

Humans↗
PubMedDate not supplied

Thyroid biopsies: fine-needle aspiration biopsy versus spring-activated core biopsy needle in 102 patients.

PURPOSE: Use of the single-action spring-activated core biopsy needle was compared with the fine needle aspiration biopsy (FNAB) technique in ultrasound (US)-guided thyroid biopsies. PATIENTS AND METHODS: Results in 102 patients who underwent sonographically guided thyroid biopsies with both fine needles and core biopsy needles were prospectively evaluated. Results from the 21-gauge FNAB (n = 102) were compared with results from 18-gauge (n = 1), 19-gauge (n = 2), 20-gauge (n = 43), or 21-gauge (n = 56) single-action spring-activated core biopsy needles. RESULTS: If the suggestive and diagnostic results were combined, the diagnostic accuracy for the core biopsy needle was 90.2% (92 of 102) and was 80.3% (82 of 102) for FNAB (P = .048). The diagnostic accuracy for the combination of both needles was 97.1% (99 of 102). The complication rate was 0.98% (n = 1). This complication was a minor soft-tissue infection successfully treated with orally administered antibiotics. CONCLUSION: In summary, sonographically guided biopsies of the thyroid performed with single-action core biopsy needles are safe and effective. The results with use of these needles are better than the results of FNAB, but the best results are obtained when both needles are used in the same patient.

Adult↗
PubMedDate not supplied

Percutaneous transluminal angioplasty versus endovascular stent placement in the treatment of venous stenoses in patients undergoing hemodialysis: intermediate results.

PURPOSE: This report describes intermediate findings from an ongoing prospective randomized trial comparing the results of percutaneous transluminal angioplasty (PTA) with results of endovascular stent placement in patients undergoing hemodialysis. PATIENTS AND METHODS: Among 87 consecutive patients with venous stenoses or occlusions, 47 (54%) were treated with PTA alone and 40 (46%) were treated with PTA and stent placement. RESULTS: For peripheral sites, the primary patency rates for PTA at 60, 180, and 360 days were 55%, 31%, and 10%, respectively, and for stents were 36%, 27%, and 11%, respectively (P = .6528). The secondary patency rates for PTA at 60, 180, and 360 days were 94%, 80%, and 71%, respectively, and for stents were 73%, 64%, and 64%, respectively (P = .1677). For central sites, the primary patency rates for PTA at 60, 180, and 360 days were 81%, 23%, and 12%, respectively, and for stents were 67%, 11%, and 11%, respectively (P = .4595). The secondary patency rates for PTA were 100% at each interval, and for stents were 100%, 89%, and 78%, respectively (P = .5408). CONCLUSION: Intermediate results suggest that, overall, there is no difference in the patency rates for peripheral venous stenoses in dialysis patients treated with PTA or PTA and endovascular stent placement. At this time, the numbers of patients are too small to conclude if certain sites such as larger central veins will respond better to one treatment or the other.

Adult↗
PubMedDate not supplied

The role of percutaneous needle biopsies in the original diagnosis of lymphoma: a prospective evaluation.

PURPOSE: A prospective evaluation to determine if percutaneous needle biopsy yields enough tissue to establish the diagnosis of lymphoma and initiate therapy. PATIENTS AND METHODS: Lymphoma was diagnosed in 43 patients for the first time. Patients underwent either a core needle biopsy (n = 41) or an aspiration-type needle biopsy (n = 2) performed with imaging guidance. Immunochemical studies were performed on specimens from 39 of 43 patients (91%); flow cytometry was performed formed on specimens from 10 patients (23%). Patient progress was followed to see if biopsy results were used as a basis for treatment or if additional material was obtained with an open surgical procedure. RESULTS: On the basis of treatment decisions, needle biopsy results were sufficient for a diagnosis to be made in 36 of 43 patients (84%). In seven patients (16%), needle biopsy specimens were considered nondiagnostic, suspicious for lymphoma, or insufficient. None of the 43 patients responded to therapy in a manner that suggested the diagnosis of lymphoma to be incorrect. CONCLUSION: Image-guided needle biopsy should be the first procedure performed in the diagnosis of lymphoma, except in easily accessible superficial neck, inguinal, and axillary nodal sites.

Abdominal Neoplasms↗
PubMedDate not supplied

Local delivery of heparin with balloon angioplasty: results of a prospective randomized trial.

PURPOSE: To evaluate the effectiveness of local delivery of heparin via hydrogel-coated balloons in the treatment of vascular stenoses associated with hemodialysis access. MATERIALS AND METHODS: This was a randomized, prospective trial comparing treatment with hydrogel-coated balloon catheters delivered with heparin coating (n = 33) and without (n = 26). All patients were undergoing hemodialysis, and all stenoses involved the venous anastomosis of a dialysis graft or a native vein. The heparin-treated balloons were soaked in concentrated heparin and delivered in a protected manner to help prevent washout of heparin. RESULTS: The mean primary patencies were 143 days with heparin treatment and 214 days without heparin (P = .174). The mean assisted primary patencies were 165 days with heparin and 194 days without (P = .315). The mean secondary patencies were 351 days with heparin and 384 without (P = .81). CONCLUSION: In this population with this technique, the treatment outcome of venous outflow stenosis in patients with dialysis grafts is not improved with local delivery of heparin.

Angioplasty, Balloon↗