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Biomedical subjects

G Pierce

Publications and source records attributed to G Pierce.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Situs revisited: imaging of the heterotaxy syndrome.

Situs anomalies present a diagnostic challenge to radiologists because of the overlapping spectrum of findings commonly seen in asplenia and polysplenia. In a series of 21 patients with a diagnosis of heterotaxy syndrome, all 11 asplenic patients and seven of 10 polysplenic patients had congenital heart disease. Although there was a variety of complex congenital heart disease, the most common type in both patient groups was a common atrioventricular canal. In both groups, the laterality of the aorta and stomach was quite variable, but intestinal malrotation was a constant feature. In 11 asplenic patients, the most frequent findings were a bridging liver (10 cases), absent spleen (10 cases), and left-sided inferior vena cava (nine cases). Only seven of these patients had an aorta ipsilateral to the inferior vena cava, contrary to previous thought that this finding was specific for asplenia. In the 10 polysplenic patients, bridging livers were less frequent (five cases), single (six cases) or multiple (four cases) spleens were seen, and azygous continuation with interruption of the inferior vena cava was usually present (eight cases). Although not pathognomonic of polysplenia, inferior vena cava interruption with azygous or hemiazygous continuation is the most common anatomic finding of this condition. Although the terms asplenia and polysplenia are helpful in suggesting the typical anatomy, both syndromes encompass an overlapping spectrum that needs to be described individually and may best be called heterotaxy syndrome.

Abnormalities, Multiple↗
PubMedDate not supplied

Clinical experience with pleuroscopy utilizing the bronchofiberscope.

The gas sterilized bronchofiberscope has been utilized as a pleuroscope for visual exploration of the pleural space and forceps biopsy of abnormal lesions in 16 patients with undiagnosed pleural disease. The instrument was inserted through a small (1-2 cm) incision. Aspiration of pleural fluid and instillation or aspiration of air to produce a controlled pneumothorax are easily accomplished through the instrument's suction channel. In eight patients with undiagnosed pleural effusion, biopsy of visualized nodules established the diagnosis of carcinoma. Three patients with bronchogenic carcinoma and pleural effusion had no pleural metastases at pleuroscopy which was confirmed in two patients who had thoracotomy and lung resection. Parenchymal subpleural nodules of metastatic carcinoma were confirmed by pleuroscopic biopsy in one patient. Biopsy via the pleuroscope was unsuccessful in two patients, one with pleural fibrosis, probably related to asbestosis, and one with mesothelioma. Both required open surgical biopsy of the pleura. There has been minimal patient discomfort and no serious complications.

Adenocarcinoma↗
PubMedDate not supplied

The effects of tissue velocity changes on acoustical interfaces.

Three case reports illustrate the changes in a distal acoustic interface after transmission of an ultrasonic beam through a tissue containing two different tissue velocities. The "break" created in the distal interface should be recognized and should not be interpreted as representing a pathologic change.

Aged↗