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Biomedical subjects

D Merine

Publications and source records attributed to D Merine.

At least 19 recordsLinked to original sources
PubMed1991

Hyperplasia of Brunner glands: the spectrum of its radiographic manifestations.

Radiographic features of the duodenal mucosa were analyzed in a series of 26 patients in whom the diagnosis of Brunner gland hyperplasis (BGH) had been established by endoscopic biopsies. The observed mucosal patterns could be classified into five categories: (1) focal BGH causing a solitary submucosal adenoma or a cluster of sessile polyps in the otherwise smooth duodenal bulb surface (five cases); (2) diffuse BGH manifested by a myriad of small and uniform mucosal elevations (six cases); (3) multifocal BGH producing large and well-demarcated polygonal masses (six cases); (4) BGH with concomitant acute and/or chronic duodenitis showing marked thickening and nodularity of duodenal folds (four cases); or (5) BGH with predominant erosive duodenitis, leading to ulcerations (five cases). These radiographic findings showed a good correlation with the endoscopic and histopathologic manifestations of BGH and the frequently coexistent duodenitis.

Adenoma↗
PubMed1991

Angiographic localization of spinal cord blood supply and its relationship to postoperative paraplegia.

Forty-seven patients underwent selective catheterization of middle and lower thoracic intercostal and upper lumbar arteries to define the origin of the artery of Adamkiewicz. One patient had significant atheroembolism, and a second had transient lower extremity paresthesias. No other complications occurred. The origin was found in 26 (55%), and 21 patients underwent thoracoabdominal aneurysm repair with this knowledge. When the critical lumbar or intercostal artery could be included as part of a long proximal or distal anastomosis, all 12 patients could be included as part of a long proximal or distal anastomosis, all 12 patients survived, and one was paralyzed. However, if the aneurysm repair mandated a midgraft anastomosis to intercostal arteries critical to spinal cord perfusion, seven of nine patients either died or were paralyzed (p less than 0.05). In the group of 19 patients operated on in whom spinal cord blood supply was not identified three patients had a technically unsuccessful operation; two died, and one was paralyzed. Twelve of 16 patients who had an adequate, but unsuccessful attempt at localization were treated by intercostal "neglect" and survived. Late paresis developed in two patients, but they are walking now. One of the patients who died had multiple systems failure and awakened paraplegic. She had a patent, enlarged, thoracic radicular artery at T-5 which probably supplied to spinal cord and which was missed angiographically. Paralysis was associated with aneurysm extent (group 2 and III B, dissections vs group 1 & 3, p less than 0.05). Selective intercostal angiography requires further refinement, but it is safe and offers the promise of understanding the mechanisms and risks of spinal cord complications after repair of extensive thoracoabdominal aneurysms.

Adult↗
PubMed1990

Detection of hepatocellular carcinoma: comparison of CT during arterial portography with CT after intraarterial injection of iodized oil.

Fourteen patients with hepatocellular carcinoma (HCC) were examined with computed tomography (CT) during arterial portography (CTAP) and with CT after intraarterial injection of iodized oil. The detectability of main lesions and associated daughter nodules or intrahepatic metastases was assessed. Hepatic resection was subsequently performed in all 14 patients. The results of the imaging studies were compared with the surgical and pathologic findings by means of a lesion-by-lesion analysis. A total of 34 masses were identified in the resected specimens: 18 main tumor masses and 16 intrahepatic metastases. For CTAP, the detection rate of main tumors was 94%; for iodized-oil CT, 82%. However, the daughter-nodule detection rates for both techniques were poor-only 38% detected for CTAP and 50% for iodized-oil CT. Although these two techniques remain important preoperative imaging methods in patients with HCC, the results of this study suggest that small daughter nodules (less than 5 mm in diameter) may go undetected with both techniques.

Aged↗
PubMed1989

Bronchioalveolar carcinoma: emphasis on localized lesions.

Although well defined pathologically, alveolar cell carcinoma can be difficult to diagnose because of its many clinical presentations. In a retrospective study of 45 cases, we reviewed the radiologic, pathologic, and clinical features of this neoplasm. Forty-one patients had a single peripheral mass that measured between 8 mm and 7 cm. Three patients had multiple nodules, and one had diffuse involvement of the right lung. Other prominent radiologic features included air bronchograms in eight cases, a "tail sign" in ten cases, and universal absence of calcifications. Pathologic examination showed an associated scar in 12 patients. There was a relatively high frequency (16%) of metachronous malignancies, including two osteosarcomas, three basal cell carcinomas, and one case each of chronic lymphocytic leukemia and thymoma. All but one of the associated tumors were diagnosed six months to two years before the diagnosis of alveolar cell carcinoma.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1989

Sonographic observations in a patient with typhlitis.

The sonographic findings in a patient with typhlitis are presented. Sonography showed a solid mass with a "target" sign in the right lower quadrant, continuous with the ascending colon. In addition to suggesting the diagnosis, sonography was helpful in the follow-up examination of the patient because it was able to assess the gradual decrease in the thickness of the bowel wall and ultimate resolution of the inflammatory process.

Anemia, Aplastic↗
PubMed1989

CT of the small bowel and mesentery.

The detection and definition of small bowel pathology is a frequent clinical and radiologic problem. Although contrast radiography and enteroclysis are the primary means of evaluating the small bowel, computed tomography (CT) has become increasingly important as a complementary examination. Initial diagnoses proffered by barium studies may be further characterized by CT and this additional information may have significant impact on patient management.

Humans↗
PubMed1988

Mediastinal adenopathy and endobronchial involvement in metastatic renal cell carcinoma.

Mediastinal adenopathy and endobronchial metastases are sometimes the only radiological manifestation of metastatic disease from extrathoracic neoplasms. We report on four patients in whom hilar and paratracheal adenopathy (n = 3) and endobrochial involvement (n = 1) were the only intrathoracic manifestations of metastatic renal cell carcinoma. Three of the patients had nephrectomies 9 months to 4 years before the appearance of intrathoracic disease; another patient presented with medastinal disease as the initial manifestation of renal cell carcinoma. If a patient with a history of renal cell carcinoma develops pulmonary hilar adenopathy, metastatic disease should be suspected and appropriate diagnostic measures should be taken.

Bronchial Neoplasms↗
PubMed1987

Enteroenteric intussusception: CT findings in nine patients.

The CT scans in nine proven cases of enteroenteric intussusception were analyzed. Three different CT patterns were observed: a target lesion (n = 5), a reniform mass (n = 2), and a sausage-shaped mass with alternating layers of low and high attenuation (n = 2). Small-bowel series were available within 2-4 days of CT in eight patients and were positive in five. Surgical proof of intussusception was available in seven of the nine patients. Resected small-bowel specimens from patients with the reniform configuration revealed focal ischemic changes. Other objective parameters of ischemia such as acidosis and hyperamylasemia were also present in the two patients with reniform masses. Such changes were not evident in the other patients. This suggests that intussusceptions with reniform configurations warrant more urgent surgical attention. The varying patterns of intussusception on CT should be recognized so that appropriate management can be initiated.

Adult↗
PubMedDate not supplied

CT myelography and MR imaging of acute transverse myelitis.

Two patients with acute transverse myelitis were evaluated by both CT myelography and magnetic resonance. Computed tomographic myelography showed fusiform cord enlargement involving several levels; one patient had a subtotal block in the thoracic spine. Magnetic resonance displayed similar findings of cord enlargement. The demonstration of cord swelling in acute transverse myelitis is an uncommon radiologic manifestation of the disease.

Acute Disease↗
PubMedDate not supplied

Pseudomembranous colitis: CT evaluation.

The CT findings in five patients with pseudomembranous colitis are presented. The findings consisted of varying degrees of bowel wall and haustral fold thickening. Ascites was noted in three patients. Clinically and radiologically, pseudomembranous colitis can be confused with other inflammatory disorders of the gastrointestinal tract. Although the CT findings were not pathognomonic, they were highly suggestive of pseudomembranous colitis when combined with the clinical information.

Adult↗
PubMedDate not supplied

CT detection of sacral osteomyelitis associated with pelvic abscesses.

In three patients the diagnosis of sacral osteomyelitis was made when CT demonstrated intraosseous (two) and intraforaminal (one) gas. Two of the three patients also had radionuclide bone scans, one of which was unremarkable. In the other case, radionuclide scintigraphy greatly underestimated the extent of the disease process when compared with CT. All three patients had contiguous pelvic abscesses as a cause of the osteomyelitis. Although there was a high clinical suspicion for an intraabdominal process, the diagnosis of superimposed osteomyelitis of the sacrum was unsuspected. The detection of intraosseous gas is a pathognomonic, albeit uncommon, manifestation of osteomyelitis. Although the radionuclide bone scan is the method of choice for detecting osteomyelitis, CT should be used as a complementary study in certain patients.

Abscess↗
PubMedDate not supplied

Spontaneous hepatic hemorrhage: clinical and CT findings.

The clinical records and radiologic findings in six patients with spontaneous (nontraumatic) intrahepatic and subcapsular hemorrhage were reviewed. Four patients had underlying liver lesions (hepatocellular carcinoma and metastasis from B-cell lymphoma in one patient each and hepatic adenoma in two other patients). One patient had intrahepatic hemorrhage associated with hepatic necrosis secondary to organophosphate toxicity. The specific etiology of hemorrhage in the remaining patient proved elusive despite an exhaustive search. Hepatic hemorrhage was diagnosed and followed by CT (six cases), sonography (two cases), and celiac arteriography (three cases). Computed tomography was useful in defining the extent of the hematoma and showing density changes related to the age of the hematoma.

Adolescent↗