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Biomedical subjects

G Aviram

Publications and source records attributed to G Aviram.

10 recordsLinked to original sources
PubMed2005

Transthoracic needle biopsy of lung masses: a survey of techniques.

AIM: In order to assess the range and everyday use of the various techniques for percutaneous transthoracic needle biopsy of lung masses in the USA and Canada, we surveyed thoracic radiologists in academic and community practice on their standard approach to the procedure. MATERIALS AND METHODS: The 300 questionnaires that were mailed to members of the Society of Thoracic Radiology throughout the USA and Canada contained specific questions on their approach to a transthoracic needle biopsy of a routine case of a 3cm lung mass located in the right lower lobe 1cm from the pleural surface. RESULTS: A total of 140 (47%) members responded. Of the 139 responders who performed lung biopsies, 103 (74%) were located at a teaching centre affiliated to a university or medical school, and 36 (26%) were community-based radiologists. In total 97 (70%) replied that they would perform the procedure under CT guidance, 31 (22%) under either CT or fluoroscopy guidance, and 11 (8%) only under fluoroscopy. Fine-needle aspiration was the procedure of choice for the given case by 101 (73%) responders, whereas 20 (14%) preferred doing core biopsy, and 18 (13%) chose both techniques. On-site cytology confirmation for obtaining diagnostic material was available to 101 (73%) responders. Before performing the procedure, 107 (77%) verified coagulation tests whereas 32 (23%) did not. Follow-up imaging for pneumothorax assessment was not routinely performed by 15 (11%) responders. CONCLUSION: The majority of radiologists performed percutaneous transthoracic needle biopsy of a lung mass under CT guidance, by fine-needle aspiration, using repeated pleural puncture technique, and with a cytologist on site. A significant minority did not obtain coagulation screening before the procedure, and a small minority did not routinely assess for pneumothorax by late chest radiography.

Biopsy, Fine-Needle↗
PubMed2002

Atrial thrombosis as a late complication of cardiac surgery computed tomography appearance.

We present two cases of large atrial thrombi diagnosed many years after cardiac surgery. In both cases, CT showed homogeneous non-enhancing masses. In one case the mass was immediately adjacent to an area of surgical repair; neither thrombus was in the atrial appendage, a more common location for thrombosis. The combination of appropriate clinical history and CT appearance should permit recognition of delayed postoperative intracardiac thrombosis.

Cardiac Surgical Procedures↗
PubMed2001

Metachronous primary carcinomas of the lung in an HIV-infected patient.

Studies have suggested that human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients have an increased risk of developing primary lung cancer, with a poor prognosis. We report a 59-year-old HIV-seropositive man who developed two metachronous primary bronchogenic carcinomas with different histologic features. The initial tumor was cured after early diagnosis and resection, with subsequent development of a contralateral tumor 6 years later. The case emphasizes that early diagnosis and treatment of lung cancer in HIV/AIDS patients should be sought as they may improve their short-term prognosis. However, because of their immunocompromised state, extended survival is still limited by a higher likelihood of developing subsequent malignancies.

Carcinoma, Bronchogenic↗
PubMed2001

Cavitary lung disease in AIDS: etiologies and correlation with immune status.

To investigate the etiology and differential features of cavitary lung disease in patients with acquired immune deficiency syndrome (AIDS), chest computed tomography (CT) records from a 2-year period were reviewed to identify all human immunodeficiency virus (HIV)-positive patients with cavitary lung disease. Medical records were reviewed for the documentation of specific causes of lung cavitation and the CD4 count at the time of imaging. Of 25 HIV-positive patients with cavitary lung disease, 20 had specific diagnoses. Infection was the etiology in all the cases. Polymicrobial infection was found in 17 patients (85%) and unimicrobial in 3 (15%). Seventeen patients (85%) had bacterial organisms, 10 of whom had other pathogens as well. Mycobacteria were isolated in 8 patients (40%), fungi in 3 (15%), cytomegalovirus (CMV) in 3 (15%), and Pneumocystis carinii pneumonia (PCP) in 1 (5%). Mediastinal or hilar lymphadenopathy and additional noncavitary ill-defined nodular opacities were found more frequently in patients with mycobacterial pathogens. Mean CD4 count in patients with cavitary disease because of bacterial pathogens alone was significantly higher than in patients with nonbacterial pathogens (alone or combined with bacterial pathogens) (203 vs. 42, p < 0.05). Four patients expired during the diagnostic hospital admission; 2 of them had pulmonary cavitary disease associated with Nocardia asteroides. Cavitary lung disease in patients with AIDS undergoing chest CT should be assumed infectious and is generally polymicrobial.

AIDS-Related Opportunistic Infections↗
PubMed2001

Computed tomography to assess pulmonary injury associated with concurrent chemo-radiotherapy for inoperable non-small cell lung cancer.

OBJECTIVE: To characterize serial computed tomography (CT) findings of pulmonary injury after a uniform regimen of concurrent chemo-radiotherapy in inoperable non-small cell lung cancer, and to compare the radiation-induced lung toxicity with other concurrent chemo-radiation regimens. METHODS: Twenty-four patients with advanced non-small cell lung cancer received 2 induction cycles of cisplatin and vinblastine, followed by 2 further cycles of cisplatin and vinblastine, concurrent with 60 Gy radiation at 2 Gy per fraction. Radiation-induced lung injury in the acute and chronic phases was assessed by serial CT scans and compared with preradiation baseline scans. Acute radiation pneumonitis was evaluated using the Common Toxicity Criteria, and chronic radiation fibrosis was graded according to the European Organisation for Research and Treatment of Cancer--Radiation Therapy Oncology Group Scale. RESULTS: Seventeen (81%) patients had characteristic CT findings of radiation-induced pulmonary damage, which were confined to the radiation ports. Although patchy nonhomogeneous and air-space opacities characterized acute radiation pneumonitis, and homogeneous opacities with loss of volume were typical for chronic fibrosis, ground-glass opacities were found frequently in both phases. Acute radiation pneumonitis grade 1 was seen in 29% and grade 2 in 9.5%. Chronic radiation fibrosis grades 1, 2 and 3 were found in 14%, 33% and 19% of the patients respectively. Median survival time was 13 months. CONCLUSION: CT enables detailed evaluation of radiation-induced pulmonary injury after concurrent chemo-radiation for inoperable non-small cell lung cancer. Although survival time with the present regimen is comparable to other concurrent chemo-radiation regimens, a high incidence of radiation injury was found, though the severity was not life threatening.

Adult↗
PubMed1998

Duodenal ulcer patients exhibit a greater skin response to histamine.

BACKGROUND: Histamine is considered a major mediator in the process of gastric acid secretion. When acid peptic activity overpowers the mucosal defense mechanism, peptic ulceration may develop. Is the hyperreactivity of patients with duodenal ulcer to histamine also expressed in the skin? OBJECTIVE: The aim of the present study was to assess the reactivity of patients with duodenal ulcer to histamine as reflected in the skin, by comparing the erythema and the cutaneous blood flow response to histamine in duodenal ulcer patients and healthy controls. METHODS: Twenty volunteers participated in the study: 10 duodenal ulcer patients and 10 age and gender matched healthy controls. Histamine was topically administered to the back and to the volar side of the forearm, and the induced response was quantified by spectrophotometry and laser Doppler flowmetry (LDF). The extent of the response and time parameters were compared. RESULTS: The maximum response, as measured by LDF, was greater in the peptic ulcer patients (P < 0.05) compared to healthy controls. Aging was accompanied by decreased responsiveness in both groups. CONCLUSION: The results suggest that some peptic ulcer patients exhibit a greater cutaneous response to topical application of histamine than healthy controls. As the methods used are non-invasive, simple and rapid, they might be useful in preclinical ulcer diagnosis and detection of patients at risk.

Administration, Topical↗
PubMed1997

Corrosive gastritis: sonographic findings in the acute phase and follow-up.

This paper reports our experience with transabdominal ultrasound in both the acute phase and follow-up in a patient with corrosive gastritis. The case presented demonstrates that serial sonography can localise the injury, demonstrate its depth and reveal the presence of peristalsis, thereby reducing the radiation exposure resulting from barium studies.

Acute Disease↗
PubMed1994

Histamine effect on human cutaneous blood flow: regional variations.

Different reactivities of small blood vessels to the histamine released by exogenous and endogenous substances may play a role in the regional variations of the elicited cutaneous response. To study the regional dependence of cutaneous blood flow in response to histamine, the compound was administered intradermally (prick introduction), thereby bypassing the spatially dependent penetration process. The induced response was quantified with cutaneous blood flow measurements utilizing laser Doppler flowmetry. Extent of response and time parameters were compared. Three anatomical sites, the back, volar side of the forearm, and ankle, were studied on 20 volunteers (10 men and 10 women, age 24-34). For comparison, topical administration was also performed. Significant differences in the measured responses at the three sites were observed: the increase of the cutaneous blood flow on the back was greater than the forearm (p < 0.01 prick test, p < 0.05 topical application), and that of both sites was greater than the ankle (p < 0.01 prick test, p < 0.05 topical application). There were no significant differences among the different sites in time parameters and no gender variations. As expected, the time required to reach maximum response was shorter for the intradermal method as compared to the topical application on the back (p < 0.001) and forearm (p < 0.05). On the other hand, the time required to decrease to 50% of maximum response was not different for the intradermal and topical methods of histamine application. These blood vessel response observations may provide initial insight into inherent functional differences influencing cutaneous manifestations of endogenous and exogenous diseases.

Administration, Topical↗