Biomedical subjects

A Sherrick

Publications and source records attributed to A Sherrick.

3 recordsLinked to original sources

PubMed2000

Lung nodule enhancement at CT: multicenter study.

PURPOSE: To test the hypothesis that absence of statistically significant lung nodule enhancement (< or =15 HU) at computed tomography (CT) is strongly predictive of benignity. MATERIALS AND METHODS: Five hundred fifty lung nodules were studied. Of these, 356 met all entrance criteria and had a diagnosis. On nonenhanced, thin-section CT scans, the nodules were solid, 5-40 mm in diameter, relatively spherical, homogeneous, and without calcification or fat. All patients were examined with 3-mm-collimation CT before and after intravenous injection of contrast material. CT scans through the nodule were obtained at 1, 2, 3, and 4 minutes after the onset of injection. Peak net nodule enhancement and time-attenuation curves were analyzed. Seven centers participated. RESULTS: The prevalence of malignancy was 48% (171 of 356 nodules). Malignant neoplasms enhanced (median, 38.1 HU; range, 14.0-165.3 HU) significantly more than granulomas and benign neoplasms (median, 10.0 HU; range, -20.0 to 96.0 HU; P < .001). With 15 HU as the threshold, the sensitivity was 98% (167 of 171 malignant nodules), the specificity was 58% (107 of 185 benign nodules), and the accuracy was 77% (274 of 356 nodules). CONCLUSION: Absence of significant lung nodule enhancement (< or = 15 HU) at CT is strongly predictive of benignity.

Adult↗

PubMed1998

Intermittent antegrade tepid versus cold blood cardioplegia in elective myocardial revascularization.

BACKGROUND: The ideal temperature for blood cardioplegia administration remains controversial. METHODS: Fifty-two patients who required elective myocardial revascularization were prospectively randomized to receive intermittent antegrade tepid (29 degrees C; group T, 25 patients) or cold (4 degrees C; group C, 27 patients) blood cardioplegia. RESULTS: The two cohorts were similar with respect to all preoperative and intraoperative variables. The mean septal temperature was higher in group T (T, 29.6 degrees +/- 1.1 degrees C versus 17.5 degrees +/- 3.0 degrees C; p < 0.0001). After reperfusion, group T exhibited significantly greater lactate and acid release despite similar levels of oxygen extraction (p < 0.05). The creatine kinase-MB isoenzyme release was significantly lower in group T (764 +/- 89 versus 1,120 +/- 141 U x h/L; p < 0.04). Hearts protected with tepid cardioplegia demonstrated significantly increased ejection fraction with volume loading, improvement in left ventricular function at 12 hours, and decreased need for postoperative inotropic support (p < 0.05). The frequency of ventricular defibrillation after cross-clamp removal was lower in this cohort (p < 0.05). There were no hospital deaths, and both groups had similar postoperative courses. CONCLUSIONS: Intermittent antegrade tepid blood cardioplegia is a safe and efficacious method of myocardial protection and demonstrates advantages when compared with cold blood cardioplegia in elective myocardial revascularization.

Aged↗

PubMed1998

Accuracy of high-resolution CT in diagnosing lung diseases.

OBJECTIVE: The purpose of our study was to determine if high-resolution CT facilitates the diagnoses of three diseases that cause cystic air spaces in the lungs: pulmonary eosinophilic granuloma, pulmonary lymphangiomyomatosis, and emphysema. MATERIALS AND METHODS: Retrospective review of high-resolution CT findings in patients with pathologically proven pulmonary eosinophilic granuloma (n = 10), pulmonary lymphangiomyomatosis (n = 9), and emphysema (n = 10) and five control patients without cystic air spaces was conducted by two thoracic radiologists unaware of the pathologic diagnosis. After reviewing the scans, the radiologists made a diagnosis and indicated their level of confidence in the diagnosis on a three-point scale. RESULTS: High-resolution CT allowed the two radiologists to be confident of the diagnosis of pulmonary eosinophilic granuloma in 84% of CT scans, lymphangiomyomatosis in 79%, and emphysema in 95%. When confident, the observers were correct in 100% of the cases. Agreement between observers was good for confident diagnoses based on high-resolution CT scans of pulmonary eosinophilic granuloma (kappa = .77), lymphangiomyomatosis (kappa = .88), and emphysema (kappa = 1). Distribution of cystic changes differed on high-resolution CT scans for lymphangiomyomatosis and pulmonary eosinophilic granuloma. No consistent distribution pattern was observed for emphysema. Lack of a perceptible cyst wall was unique to cases of emphysema. All patients with lymphangiomyomatosis lacked nodules in the intervening lung parenchyma, whereas most patients with pulmonary eosinophilic granuloma had parenchymal nodules. CONCLUSION: High-resolution CT can help radiologists reliably diagnose pulmonary eosinophilic granuloma, lymphangiomyomatosis, and emphysema.

Adult↗