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Biomedical subjects

B B Gosink

Publications and source records attributed to B B Gosink.

At least 55 records · Page 3Linked to original sources
PubMed1981

How accurate is ultrasonography in detecting hydronephrosis in azotemic patients?

Screening for hydronephrosis continues to be an essential part of the evaluation of patients with azotemia of unknown cause. To determine whether sonography is as reliable as nephrotomography for screening purposes, we carried out a prospective, comparative study. Sixty-two patients were evaluated. Mean serum creatinine was 4.3 mg/dl. Of 116 kidneys, 45 were obstructed according to urographic criteria and 42 of these were correctly called hydronephrotic by sonography. The 3 false negative sonographic studies occurred in 2 patients. All 3 kidneys contained radiopaque calculi visible on the plain abdominal film. Of the 71 nonobstructed kidneys, 5 were mistakenly called hydronephrotic by ultrasound, giving a false positive rate of 7%. We believe it is appropriate to use gray-scale ultrasound as a screening test for urinary obstruction in azotemic patients providing the plain abdominal radiograph shows no calcifications.

Adolescent↗
PubMed1981

Intrahepatic gas: differential diagnosis.

Twelve patients with intrahepatic gas were examined with diagnostic sonography. In nine of the patients, gas was distributed within the intrahepatic biliary ducts, and, in four, distal acoustic shadowing was identified. Three patients, including one who also had biliary tract gas, had gas within the liver parenchyma but outside the biliary tract. One of these patients had a gas-forming abscess, another a recent biopsy, and a third had a necrotic metastasis following intraarterial chemotherapy. A final patient showed an evanescent pattern of gas within the portal venous system. Sonography can identify the presence and distribution of gas within the liver. When biliary tract air is identified, the possibility of biliary tract dilatation, masked by sonographic shadowing, must also be considered. In addition, in the presence of intrahepatic gas, prominent shadowing may cause disruption of the normal hepatic parenchymal pattern and lead to misdiagnosis of parenchymal abnormalities. By coordinating sonographic findings with the clinical history, however, a useful differential diagnosis may be obtained.

Adult↗
PubMed1979

High-resolution ultrasonography of scrotal pathology.

A prototype high-resolution (10-MHz) real-time ultrasonic system was used to study 22 patients who were ultimately proved to have intra- and extratesticular tumors, scrotal fluid collections, and inflammatory processes. In 5 of 6 patients with primary testicular masses, there were areas of decreased echogenicity within the testis when compared with surrounding normal tissue. In general, the method was highly effective in differentiating and characterizing testicular and extratesticular processes.

Abscess↗
PubMed1979

High-resolution real-time ultrasonography of thyroid nodules.

High-resolution real-time ultrasonography was used to evaluate 98 patients with palpable abnormalities of the thyroid and positive isotopic studies. It confirmed 37 of 73 (51%) suspected solitary nodules. Of 25 patients thought to have multinodular goiter, sonography was supportive in 21 (84%). In patients with adenoma or adenomatous nodules, characteristic features included a sonolucent "halo". Colloid nodules tended to be more sonolucent than normal thyroid tissue, whereas Hashimoto thyroiditis was characterized by an enlarged gland and decreased echogenicity.

Adenoma↗
PubMed1979

Accuracy of ultrasonography in diagnosis of hepatocellular disease.

Retrospective evaluations were made of abdominal echograms in 61 patients who underwent liver biopsy within 3 weeks after ultrasound study. Without knowledge of clinical or biopsy data, determinations were made by two independent observers of: (1) liver size, (2) beam penetration, (3) echogenicity, (4) vascularity, (5) ancillary abnormality, and (6) diagnostic impression. Using these parameters, the presence of generalized parenchymal disease was identified in 81% of reviews of patients with cirrhosis. Thus, in patients with known cirrhosis, there was a 19% false negative rate. In normal patients, 76% were correctly called normal by the reviewers. However, in 24% generalized parenchymal disease was suggested (24% false positive). Patients with fatty liver could not be reliably distinguished from patients with cirrhosis, nor could patients with hepatitis be easily separated from those with normal livers. In all of these determinations, the combination of several features provided more diagnostic accuracy than any single echographic finding.

Biopsy↗
PubMed1978

The dilated pancreatic duct: ultrasonic evaluation.

Eight patients with signs and symptoms of obstructive jaundice were evaluated by gray-scale echography. In each, ultrasonic identification of a dilated pancreatic duct was helpful in confirming the diagnosis of an obstructing lesion at the level of the ampulla of Vater. In only 3 could the tumor mass itself be seen on ultrasound. With the recognition of pancreatic duct dilatation, it is no longer essential for a tumor in the region of the ampulla of Vater to be large or contour-deforming before it can be identified by ultrasound.

Dilatation, Pathologic↗
PubMed1978

The inferior vena cava: mass effects.

Gray scale ultrasound evaluation of the inferior vena cava is essential for adequate workup of abdominal tumors. Demonstration of perivascular nodal masses and/or invasion of the inferior vena cava is of prognostic significance and of value in planning the surgical approach. In addition, accurate delineation of the extent of such tumor invasion by ultrasonography may preclude additional study by more invasive diagnostic procedures, such as angiography. Results of ultrasonic examination of six patients are reported; all were shown to have significant mass effects on the inferior vena cava.

Abdominal Neoplasms↗
PubMed1977

Oscillation of left ventricular structures in aortic regurgitation.

High-frequency diastolic oscillation of the anterior mitral leaflet is a common echocardiographic feature in aortic regurgitation. We have studied a group of 56 patients with aortic regurgitation in whom oscillation of the anterior mitral leaflet was present. Thirty-one of these had similar diastolic oscillation of the posterior leaflet; occasional patients demonstrated oscillation of the interventricular septum or chordae tendineae. The presence of these diastolic oscillations did not correlate with the presence of the Austin-Flint murmur. We conclude that diastolic oscillation of left ventricular structures other than the anterior mitral leaflet can be recorded on echocardiograms of patients with aortic regurgiationmthe mechanism responsible for these oscillations is not known; several possibilities are discussed.

Aortic Valve Insufficiency↗
PubMed1977

Ultrasound in the evaluation of adrenal metastases.

Metastatic involvement of the adrenal glands is a frequent complication of bronchogenic carcinoma, occuring in up to 33% of these patients. Examination of ten patients with adrenal metastases revealed large adrenal masses, occuring bilaterally in five. Five of these patients were examined using the standard bistable technique. These patients demonstrated largely echofree masses with only occasional scattered internal echoes. The remaining five patients were examined with the gray scale technique. With the added resolution afforded by the use of gray scale, the masses in these patients showed a more uniform distribution of echoes. Presence of a margin between the kidney and the mass, and displacement of the kidney inferiorly, posteriorly, and laterally is used to differentiated between upper pole renal masses and those of adrenal origin. Autopsy confirmation was obtained in six of the patients.

Adrenal Gland Neoplasms↗
PubMed1977

Gray scale patterns of pelvic disease in the male.

Pelvic fluid collections, solid masses, extrinsic or intrinsic vesicular masses, and abnormal distension of the bladder due to obstruction can be demonstrated by sonic scanning. Accurate diagnosis is based on the recognition of certain sonographic patterns, in addition to the clinical history and physical findings. These patterns include: (a) internal echo pattern, (b) external contour of the mass, (c) location within the pelvis, and (d) relationship to other pelvic structures.

Abscess↗
PubMed1977

Gray scale echographic patterns of hepatic metastatic disease.

Abnormal gray scale hepatic echograms in 76 patients with known or suspected metastatic disease were reviewed. A varied echographic pattern was found, with the gray scale appearances falling into three identifiable categories (dense, lucent, and bulls-eye) and a fourth group difficult to characterize. Prior chemotherapy seemed to have little consistent effect on echographic patterns. A pattern of dense lesions was associated in a large percentage of cases with adenocarcinoma. Carcinoma of the colon commonly produced this appearance. The remaining echographic patterns showed little correlation with specific primary sites or cell types.

Adenocarcinoma↗
PubMed1976

The significance of mitral valve prolapse in middle-aged and elderly men.

The clinical, roentgenographic, phonocardiographic, ECG, and echocardiographic data were evaluated in 40 consecutive middle-aged and elderly male patients with echocardiographically detectable systolic prolapse of mitral valve leaflets. Prolapse was present during more than half of systole in 31 patients and was holosystolic in six patients. In most instances, both leaflets prolapsed during systole. The closing velocity and excursion of the anterior leaflet were frequently increased particularly in association with evidence of mitral insufficiency. A majority of the patients had cardiac symptomatology. Moreover, roentgenographic and/or ECG evidence of cardiac enlargement or hypertrophy was evident in 45 percent of patients with mitral valve prolapse.

Aged↗
PubMed1976

Gray scale ultrasonic cholecystography: a comparison with conventional radiographic techniques.

A prospective study was designed to assess the accuracy of gray scale ultrasonography in the evaluation of cholelithiasis. A series of 111 patients with nonvisualization on first-day oral cholecystography underwent ultrasonic cholecystography, and the results were compared with subsequent second-day visualitzation or surgical findings. In 75 cases sufficient data were present to assess the accuracy of the method. Ultrasound correctly diagnosed 68 (91%) of these cases with regard to gallstones. Only 6 gallbladders could not be visualized ultrasonically and all subsequently proved to have gallstones. It is concluded that improved ultrasonic technique is of considerable value in investigating the nonvisualized gallbladder. Valuable information conderning other upper abdominal pathology was often discovered.

Cholecystography↗
PubMed1976

Growth rates of small abdominal aortic aneurysms.

A policy of utilizing B-mode ultrasound scan measurements of abdominal aortic aneurysms to help determine operability in poor-risk patients with small asymptomatic aneurysms has been pursued for the past 6 years. Indications for surgery in such patients have included enlargement to 6 cm. in any transverse diameter, the development of symptoms, or evidence of leak or rupture. In addition, patients treated nonoperatively have been followed by serial B-mode echo scans, permitting the accumulation of aneurysm growth rate data. Such data indicate that small aneurysms grow an average of 0.4 cm. per year, but that dramatic increases in aneurysm size may occur unexpectedly in asymptomatic patients. These data appear to have value in both individual decision making and as a baseline for weighting the various risk factors in the poor-risk patient with a small asymptomatic abdominal aortic aneurysm.

Aged↗