Biomedical subjects
Z J Rubinstein
Publications and source records attributed to Z J Rubinstein.
Percutaneous removal of intravascular foreign bodies.
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Carcinoma of the gall bladder: a CT diagnosis.
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CT findings in partial eventration of the right diaphragm.
Elevation of the anterior part of the right diaphragm results in the spurious radiological appearance of a mass at the right lung base. Standard chest views are usually sufficient to show the true nature of the "mass." Occasionally, however, a true mass lesion cannot be entirely excluded, and further studies are then required. Two such cases are described and in both the computed tomographic findings clearly showed the anterior part of the liver to be situated under the elevated diaphragm. This elevation of the anterior part of the liver results in tilting of the organ with the posterior part remaining in its normal position below the nonelevated part of the diaphragm. The anterior and posterior parts of the liver are therefore not shown on the same tomographic planes but are found to lie at different levels.
Disseminated intravascular clotting and renal cortical necrosis complicating a snake bite.
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Interventional therapeutic procedures in radiology.
The changing role of diagnostic radiology in modern medicine is reviewed. Special emphasis is placed on the ever-increasing use made of diagnostic procedures for therapeutic purposes. Percutaneous catheter introduction, formerly utilized only for diagnostic vascular procedures, has now been adapted for use in the renal and biliary systems. Treatment may be definitive and may replace surgery. Examples include embolization for the control of internal hemorrhage, removal of retained biliary calculi and intravascular foreign bodies, drainage of a fluid-filled cavity, and dilatation of an area of arterial stenosis. Palliative treatment, as part of the management of malignant tumors, includes intraarterial chemotherapy, preoperative embolization and percutaneous relief of inoperable obstructions of the renal or biliary tracts. Illustrative cases are presented and the indications, techniques and complications of these procedures are discussed.
[Percutaneous angiographic removal of severed catheters and guidewires from the vascular system].
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The value of angiography prior to use of the latissimus dorsi myocutaneous flap.
In 5 patients studied, preoperative angiography showed the thoracodorsal artery to be patent in two--both of them then had successful transfers of latissimus dorsi myocutaneous flaps. Obliteration of this artery was apparent in 3 patients, precluding the operation. We suggest that selective preoperative angiography be performed in all patients in whom a latissimus dorsi myocutaneous flap transfer is being considered, as a patent thoracodorsal artery is essential to the success of this procedure.
[Traumatic aneurysm of the ulnar artery in the palm].
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Conservative management of splenic trauma: angiographic observations.
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Food as a cause of small intestinal obstruction. A report of five cases without previous gastric surgery.
The clinical and roentgenographic findings in five patients with small intestinal obstruction caused by food impaction are presented. None had undergone previous gastric surgery. While the clinical features are those of small intestinal obstruction, an upper gastrointestinal study may demonstrate the exact site and nature of the obstruction.
Crossed renal ectopia: clinical and radiological findings in 22 cases.
The clinical and radiological features of 22 patients with crossed ectopic kidneys are reported, including a case with unusual mobility of an unfused ectopic kidney. In some cases the anomaly was an incidental finding. However, complications were frequent and included seven hydronephrotic and three non-functioning kidneys, two of the latter were found to be obstructed by a calculus. Vesico-ureteral reflux was demonstrated in three of the five children in whom the examination was performed. Anomalous blood supply was present in all patients who underwent renal arteriography or surgery. Skeletal anomalies were present in 11 patients, one of whom had in addition coarctation of the aorta, and another atrial septal defect and anal atresia.
The value of lymphangiography in chyluria: a report of three cases.
The lymphographic findings in three patients suffering from idiopathic chyluria are described. These findings included lymphangiectases and retrograde filling of kidney lymphatics;bilaterally in two and unilaterally in one patient. In the latter patient, the contrast was also seen entering the renal calyces and pelvis before passing to the bladder. The thoracic duct was patent in all three cases. The value of lymphangiography in patients with chyluria is emphasized.
Crossed renal ectopia: angiographic findings in six cases.
Angiographic findings in six patients with crossed renal ectopia are reported. Crossed fused ectopia was present in four cases, and the remaining two had single crossed ectopic kidneys. All kidneys, including the nonectopic ones, had an anomalous blood supply. No constant arterial pattern was discernible, and renal arteries were found to arise from the aorta both above and below the normal level as well as from the iliac arteries. It is suggested that angiography be undertaken in all cases when surgery is contemplated.
Angiographic observations in penetrating duodenal ulceration and their resemblance to primary pancreatic disease.
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Hypotonic duodenography in chronic pancreatitis.
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Percutaneous transluminal aortic angioplasty: early and late results.
Percutaneous transluminal angioplasty of the infrarenal abdominal aorta (13 patients) and its bifurcation (15 patients) was performed in 28 patients with a total of 32 dilatation procedures. The group consisted of 16 female and 12 male patients and initial successful dilatation was achieved in all. Recurrence within 1 month requiring bypass surgery occurred in 1 patient. Three patients were lost to follow-up. Long-term follow-up in the remaining 24 patients ranged from 1 to 9 years with a mean of 4.5 years. During the follow-up period, repeat angioplasty of the original stenosis was performed in 3 patients and another patient underwent dilatation of a new lesion which developed in the aorta. According to clinical and noninvasive studies, these 4 patients, as well as the other 20, have maintained patency of the treated lesions and are symptom free. No immediate complications requiring surgery occurred. We conclude that angioplasty is the initial treatment of choice in focal lesions of the distal abdominal aorta and its bifurcation.
Hepatic computerized tomography in the Dubin-Johnson syndrome: increased liver density as a diagnostic aid.
Computed tomography of the liver was performed in 17 patients with Dubin-Johnson syndrome as well as 50 control patients free of liver disease. Multiple readings of liver attenuation values were made in the patients in these two groups and their values compared. The Dubin-Johnson group had liver attenuation values significantly higher than the control group but considerable overlap between the 2 groups existed. It is concluded that computed tomography may be useful as confirmatory evidence of Dubin-Johnson syndrome.