PubMed Health⌕ Search

Biomedical subjects

D H Stephens

Publications and source records attributed to D H Stephens.

At least 19 recordsLinked to original sources
PubMed1978

Chenotherapy for gallstone dissolution. I. Efficacy and safety.

Clinical experience with chenodeoxycholic acid therapy for dissolving gallstones is reported, with particular attention to determinants of response. Of 12 patients receiving 15 mg/kg/day or more, ten responded (83%); only 15 of 40 patients (38%) receiving less than 15 mg/kg/day responded. Large solitary stones and stones in gallbladders that visualized poorly after oral cholecystography had a lower response rate. Radiopaque stones did not respond in 18 patients. Five of ten patients with stones in the common bile duct responded. Small, dose-related elevations in SGOT were the only biochemical abnormality observed. Liver biopsy specimens showed no notable abnormality. Diarrhea was an infrequent problem. Stones recurred in three of 15 patients during six to 48 months of observation without treatment. Chenodeoxycholic acid, when given in adequate dosage, continues to appear promising as medical therapy for asymptomatic radiolucent gallstones in radiologically visualizing gallbladders.

Chenodeoxycholic Acid↗
PubMed1978

Comparison of whole lung tomography and computed tomography for detecting pulmonary nodules.

Detecting pulmonary metastasis is important when planning surgical therapy, radiotherapy, or chemotherapy in patients with known malignancy. A series of 91 patients was studied by both whole lung tomography and computed tomography (CT) of the lungs. More pulmonary nodules were detected with CT than with whole lung tomography in 32 (35%) of the patients. Of the 91 patients in the study, 31 had resection of some or all of the pulmonary nodules. In 27 patients, the nodules were primary or metastatic malignant lesions. Bilateral pulmonary nodules were detected with CT in 13 patients when whole lung tomography had demonstrated nodules in only one lung. CT has replaced whole lung tomography as the method preferred by the authors for detecting pulmonary nodules in selected patients at risk to develop pulmonary metastasis.

Adolescent↗
PubMed1978

Roentgenographic simulation of colonic cancer by benign masses in Crohn's colitis.

Crohn's colitis has recently been shown to predispose the patient to cancer of the colon. Unfortunately, many of the manifestations of colonic malignancy, such as polypoid intraluminal masses and strictures, can be simulated roentgenographically by Crohn's colitis. We present five patients in whom this diagnostic difficulty arose. As established by total or subtotal colectomy, none proved to have malignancy; instead, pronounced transmural inflammation and, in two cases, multiple large pseudopolyps were found to account for the roentgenographically indeterminate lesions. These findings exemplify the difficulty in roentgenographic diagnosis of colonic mass lesions in patients with Chrohn's colitis.

Adult↗
PubMed1977

Body computed tomography: a clinically important and efficacious radiologic procedure.

In the institutions represented by the authors, more than 7,500 body CT examinations have been performed. Body CT has been found to be particularly useful in solving specific problems, especially when other diagnostic procedures yield confusiing results. Radiologists and their collegues, and not governmental agencies and insurance companies, should define the experimental, research and clinical usefulness of computed tomography.

Humans↗
PubMed1977

Computed tomography in the evaluation of patients with suspected carcinoma of the pancreas.

The authors assess the efficacy of CT of the pancreas in a series of 151 patients with suspected pancreatic carcinoma. CT diagnoses were divided into four categories based on the original interpretation: "mass" or carcinoma (53 scans); normal pancreas (68 scans); normal pancreas, but another pathologic process was discovered on the CT scan (20 scans); and unsatisfactory or indeterminate examinations (10 scans). In more than 50% of the erroneous diagnoses of pancreatic carcinoma, the mass lesion seen on CT was found at surgery or angiography to be adjacent to, not arising from, the pancreas. False-positive interpretation can be avoided by improved equipment and technique and the accumulation of interpreter experience.

Adenocarcinoma↗
PubMed1977

Computed tomography of the liver.

The diagnostic value of computed tomography (CT) of the liver depends on proper conduct of the examination, knowledgeable interpretation of findings, and an appreciation of the capabilities and limitations of the method. This report documents 10 months of experience with abdominal CT in more than 600 liver examinations using a system fast enough to eliminate respiratory motion. This experience supplied data on the CT appearance of the normal liver and its variations and of various hepatic abnormalities, on the conduct of the examination, including the appropriate of contrast material, and on some of the problems that reduce the technical quality of the examination. CT was highly accurate, but not infallible, in detecting and defining space-occupying lesions and in detecting fatty infiltration; it was less helpful in detecting diffuse hepatic disease. In bile duct obstruction, CT displayed not only the dilated ducts but often the obstructing lesion.

Biliary Tract Diseases↗
PubMed1977

Retrospective comparison of radionuclide scans and computed tomography of the liver and pancreas.

Computed tomography (CT) and radionuclide examinations of the liver and pancreas in 50 patients were compared retrospectively to evaluate their value as diagnostic tests. CT was superior to 75Se-selenomethionine in evaluating pancreatic disease. Both 99mTc-sulfur colloid scans and CT scans were sensitive detectors of liver masses; however, there were more false positive 99mTc-sulfur colloid scans (16% compared to 4%). CT was superior in detecting biliary obstruction and ascites, in assessing diseases that involved the liver extrinsically, and in evaluating the status of adjacent organs. 99mTc-sulfur colloid scans were more sensitive in detection of diffuse non-neoplastic liver diseases (cirrhosis, hepatitis, and cholangitis). Simultaneous interpretation of CT and radionuclide scans was often more helpful than independent interpretation, and the two techniques are therefore complementary.

Gallium Radioisotopes↗
PubMed1977

Diagnosis and evaluation of retroperitoneal tumors by computed tomography.

Nineteen patients with primary and recurrent retroperitoneal tumors were examined by computed tomography. Correlation between CT and subsequent operative findings was remarkably accurate. CT provided clinically useful information regarding the presence, size, extent, and composition of the tumors and also their effect on adjacent structures. CT is recommended for any patient suspected to have a primary or recurrent retroperitoneal tumor.

Adolescent↗
PubMed1977

Computed tomography of the retroperitoneal space.

Computed body tomography is an easily accomplished method that precisely displays the normal and pathologic anatomy of the retroperitoneal space. Suspected retroperitoneal disorders, which are often clinically confusing or obscure, can now be detected or excluded with remarkable accuracy. Few innovations in radiology have more effectively fulfilled such a conspicuous need.

Abscess↗
PubMed1976

Tomography of the gallbladder in oral cholecystography.

Tomography was used to supplement 327 oral cholecystograms in which the findings, including nonvisualized gallbladder, were inconclusive. In 136 cases, operative and tomographic findings were correlated. In 286 cases (87%), tomography provided conclusive diagnostic information. A diagnosis was possible in 108 of 111 cases in which the gallbladder had been visualized on conventional films and in 179 of 216 cases in which the gallbladder had not been visualized. Tomography of the gallbladder is an easily accomplished procedure that usually adds enough information to the inconclusive cholecystogram to permit accurate diagnosis and eliminate the need for reexamination.

Adult↗