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E J Adam

Publications and source records attributed to E J Adam.

At least 37 records · Page 2Linked to original sources
PubMed1993

Subtle diagnostic markers of orbital floor blow-out fracture on coronal CT scan.

The sagittal plane, computerized tomography (CT) scan has been proposed as the most important radiological view in the diagnosis of orbital floor blow-out fractures. This view however is impractical and unnecessary. Direct, coronal plane CT scan with careful attention paid to the shape of the inferior rectus muscle and antral roof will successfully diagnose this traumatic condition, as in our reported case in which no other radiological abnormalities were present.

Adult↗
PubMed1993

Cranial computed tomography of elderly patients: an evaluation of its use in acute neurological presentations.

We assessed the use of cranial computed tomography (CT) in elderly patients with acute neurological deficit and its influence on patient management. Clinical notes from 100 consecutive CT referrals from geriatric admissions presenting with acute neurological deficit were reviewed and categorized according to clinical presentation. CT results and subsequent therapy were recorded. Twenty of the patients had treatable lesions (in 6 out of 14 patients with signs atypical of stroke and 7 out of 19 patients with acute confusion). These two groups contained 68% of all treatable lesions found. Forty-four scans yielded no new diagnostic information; these included all scans for transient ischaemic attacks and for progression of stroke. The remaining scans yielded information regarding pathology but did not alter patient management. CT is a valuable first-line investigation in elderly patients presenting with signs atypical of stroke and unexplained confusion but may be less useful in patients with other presentations.

Acute Disease↗
PubMed1993

Sonography of the thymus in healthy children: frequency of visualization, size, and appearance.

OBJECTIVE: The purpose of this study was to determine the frequency of visualization, the size, and the sonographic appearance of the normal thymus on sonograms of children 2-8 years old. SUBJECTS AND METHODS: Fifty children without symptoms referable to the thymus were scanned through the suprasternal notch and parasternal windows with a Diasonics DRF 100 scanner and a 7.5-MHz probe. The anteroposterior and longitudinal dimensions of the thymus were measured and the echogenicity of the thymus was subjectively assessed and compared with the liver and thyroid gland. No change was made in the time-gain compensation or overall gain settings. RESULTS: The thymus was completely visualized and measured in 47 (94%) of the 50 patients. The mean anteroposterior and longitudinal measurements were 1.4 and 2.5 cm, respectively, for the right lobe and 1.4 and 2.9 cm, respectively, for the left lobe. On longitudinal sonograms, the right lobe tended to have an inverted teardrop shape whereas the left lobe was either triangular or sickle shaped. The mean absolute dimensions of the thymus changed little with age, although the number of children in each age group was small. The internal echogenicity of the thymus most closely resembled that of the liver. CONCLUSION: The thymus is clearly and easily visualized on sonograms in the majority of children 2-8 years old, a much later age than reported previously.

Child↗
PubMed1992

Spectrin redistributes to the cytosol and is phosphorylated during mitosis in cultured cells.

Dramatic changes in morphology and extensive reorganization of membrane-associated actin filaments take place during mitosis in cultured cells, including rounding up; appearance of numerous actin filament-containing microvilli and filopodia on the cell surface; and disassembly of intercellular and cell-substratum adhesions. We have examined the distribution and solubility of the membrane-associated actin-binding protein, spectrin, during interphase and mitosis in cultured CHO and HeLa cells. Immunofluorescence staining of substrate-attached, well-spread interphase CHO cells reveals that spectrin is predominantly associated with both the dorsal and ventral plasma membranes and is also concentrated at the lateral margins of cells at regions of cell-cell contacts. In mitotic cells, staining for spectrin is predominantly in the cytoplasm with only faint staining at the plasma membrane on the cell body, and no discernible staining on the membranes of the microvilli and filopodia (retraction fibers) which protrude from the cell body. Biochemical analysis of spectrin solubility in Triton X-100 extracts indicates that only 10-15% of the spectrin is soluble in interphase CHO or HeLa cells growing attached to tissue culture plastic. In contrast, 60% of the spectrin is soluble in mitotic CHO and HeLa cells isolated by mechanical "shake-off" from nocodazole-arrested synchronized cultures, which represents a four- to sixfold increase in the proportion of soluble spectrin. This increase in soluble spectrin may be partly due to cell rounding and detachment during mitosis, since the amount of soluble spectrin in CHO or HeLa interphase cells detached from the culture dish by trypsin-EDTA or by growth in spinner culture is 30-38%. Furthermore, mitotic cells isolated from synchronized spinner cultures of HeLa S3 cells have only 2.5 times as much soluble spectrin (60%) as do synchronous interphase cells from these spinner cultures (25%). The beta subunit of spectrin is phosphorylated exclusively on serine residues both in interphase and mitosis. Comparison of steady-state phosphorylation levels of spectrin in mitotic and interphase cells demonstrates that solubilization of spectrin in mitosis is correlated with a modest increase in the level of phosphorylation of the spectrin beta subunit in CHO and HeLa cells (a 40% and 70% increase, respectively). Two-dimensional phosphopeptide mapping of CHO cell spectrin indicates that this is due to mitosis-specific phosphorylation of beta-spectrin at several new sites. This is independent of cell rounding and dissociation from other cells and the substratum, since no changes in spectrin phosphorylation take place when cells are detached from culture dishes with trypsin-EDTA.(ABSTRACT TRUNCATED AT 400 WORDS)

Amino Acids↗
PubMed1992

Ultrasonographic assessment of the extent of hepatic steatosis in severe malnutrition.

Ultrasonographic, blinded assessment was made of the extent of hepatic steatosis in 55 children with severe malnutrition: undernutrition (n = 6), marasmus (n = 18), marasmickwashiorkor (n = 17), and kwashiorkor (n = 14). The children were examined on admission, in early recovery (considered as baseline), and again at discharge. Eleven healthy control children and eight of the previously malnourished children were studied as comparison groups. Both oedematous and non-oedematous malnourished children had significantly more steatosis than the comparison groups at each time. Children with oedematous malnutrition had significantly greater steatosis than non-oedematous children at admission. Half of the non-oedematous malnourished children had appreciable hepatic steatosis at both admission and at baseline. Hepatic fat was only slowly mobilised. The rate constant was 1.4 +/- 0.3%/day. One quarter of the children did not change steatosis grades during the period they were in hospital. There was no overall correlation between the extent of steatosis and liver size. Hepatic steatosis in childhood malnutrition is not confined to oedematous children: it is frequently present in marasmic and undernourished children. Its extent is not necessarily related to the degree of hepatomegaly and accumulated lipid is only slowly mobilised.

Child, Preschool↗
PubMed1992

Gantry angulation in brain CT: dosage implications, effect on posterior fossa artifacts, and current international practice.

The aim of this study was first to determine the effect of use of different scan planes at computed tomography (CT) of the brain on lens radiation dose and on severity of posterior fossa artifact. Twenty patients requiring nonenhanced and contrast material-enhanced brain CT scanning were selected. Each was scanned with two different beam angulations, one passing through the eyes and one avoiding them, and the resulting radiation doses were measured. Angling of the beam to avoid the orbit reduced the dose by 87%, while the severity of posterior fossa artifacts was not significantly different. Second, the implications of these results was assessed by means of an international questionnaire survey of current scanning technique. Only 32% of the respondents routinely avoided the eye during brain CT. No single scan plane was accepted by the respondents as being superior in terms of minimizing posterior fossa artifact. The authors conclude that the potential exists for a reduction in lens dose after reappraisal of radiologic practice in brain CT.

Brain↗
PubMed1991

Intra-abdominal sepsis: the role of radiology.

A wide range of imaging tools is available for the investigation of abdominal sepsis. Plain films and barium studies alone are generally regarded as inadequate and most patients will require ultrasound, CT or nuclear medicine studies to locate the source of sepsis. The choice of imaging modality depends on several factors, most important of which are the clinical condition of the patient and the presence or absence of localizing signs and symptoms. Ultrasound has the advantage of being portable and is therefore probably the best initial imaging method for the critically ill patient. It should also be the first investigation in patients with signs and symptoms localizing to the right upper quadrant, renal areas, subphrenic spaces or pelvis. Transvaginal ultrasound is particularly useful in examining the pelvis. CT is the imaging modality of choice for the pancreas and retroperitoneum and in patients who are poor candidates for ultrasound or in whom visualization on ultrasound is inadequate. In patients with PUO or evidence of sepsis without localizing signs or symptoms, nuclear medicine studies in the form of 67Ga citrate or labelled white cell scans are useful to localize the septic focus, although in most cases CT or ultrasound will subsequently be required for detailed anatomical definition. Imaging techniques have an increasingly important role to play in the treatment of sepsis, and guided aspiration and drainage may be performed with a high degree of accuracy under ultrasound or CT guidance, eliminating the need for surgical intervention in many individuals.

Abdomen↗
PubMed1989

Total abdominal and pelvic ultrasound: incidental findings and a comparison between outpatient and general practice referrals in 1000 cases.

Ultrasound examination is a rapid and non-invasive method of examining the abdomen. Opinions differ as to whether the entire abdomen and pelvis should be examined in all cases or whether examination can be confined to the region of suspected pathology. The aim of this study was to evaluate the diagnostic yield of total abdominal and pelvic ultrasound examination in patients referred for primary diagnostic ultrasound and with particular reference to specific symptoms. The results of 1000 examinations were analysed. In 25% of patients, a significant abnormality was found and almost one-third of these were incidental findings. The incidence of abnormalities was not significantly different between patients referred via their general practitioners and those referred via the hospital outpatients department. We recommend total abdominal and pelvic examination in all cases regardless of the presenting symptoms.

Abdomen↗
PubMed1986

The value of oblique scans in the ultrasonic examination of the abdominal aorta.

A method of scanning the abdominal aorta using oblique scan plans is described. In 150 patients attending for abdominal ultrasound scans these additional views resulted in an increased visualisation of the aorta and allowed the origin of both renal arteries to be demonstrated in 79% of patients; the right renal artery alone was demonstrated in 92% of patients.

Adolescent↗
PubMed1985

Racial variations in normal ureteric course.

Three hundred consecutive normal intravenous urograms were studied. The position of the ureter relative to the vertebral pedicles was assessed at different levels in patients from different racial groups. Medial placement of the ureter (where it overlay or was medial to a pedicle) was considerably commoner in black patients of African origin than in white Northern Europeans. In both races it occurred more frequently in males and in the young, and it was more common on the right side than on the left. The recognition of this normal variant, particularly in the black patient, is important in the interpretation of intravenous urograms.

Adult↗
PubMed1984

Evaluation of the role of computed tomography in radiotherapy treatment planning.

The role of computed tomography (CT) in radiotherapy treatment planning was assessed in a series of 231 patients in whom treatment was planned with radical intent. For each patient, a treatment plan was produced by the best conventional techniques in use at the Middlesex Hospital. Each patient then underwent a CT scan in which the treatment conditions were closely simulated. As a result of the CT scan images, alteration was made to the planned treatment in 47% of 198 assessable patients. Large differences were seen in the usefulness of CT treatment planning for tumours in different sites, with the greatest contribution made to treatment of tumours of the sinuses and nasopharynx and of the bladder. Although its unit cost is high, computed tomography can be a very useful tool in radiotherapy treatment planning and can contribute uniquely to improved patient management for adequately selected patients.

Bronchial Neoplasms↗
PubMed1983

The value of parotid sialography.

One hundred consecutive parotid sialograms were reviewed to assess the clinical usefulness of the technique. In 54 per cent of patients significant information was provided by the sialogram, and in 22 per cent the diagnosis was made on sialographic appearances alone or the findings altered subsequent management. The highest proportion of useful investigations was found in those presenting with bilateral parotid swelling. No significant information was obtained in patients with an isolated lump in the parotid region.

Dilatation, Pathologic↗