PubMed Health⌕ Search

Biomedical subjects

H Nath

Publications and source records attributed to H Nath.

At least 19 recordsLinked to original sources
PubMed1998

Needle-track metastasis after transthoracic needle biopsy.

Metastasis along the needle track (NTM) after a transthoracic needle biopsy (TNB) is considered a very rare complication. A survey of the membership of the Society of Thoracic Radiology and a review of the English-language literature were conducted to assess the incidence of this complication and its predisposing factors and natural history. A questionnaire was sent to all radiology departments in the United States and Canada that had a senior member of the Society of Thoracic Radiology. The total number of TNB between 1978 and 1993 and occurrences of NTM were elicited. If an NTM was encountered, information on the size of the nodule, proximity to the pleura, histology, size of the biopsy needle, and the interval between biopsy and NTM and outcome of the patient was elicited. The incidence of NTM was estimated using binomial proportions. Results of the literature survey were tabulated to provide similar information. One hundred sixty-five questionnaires were mailed and 75 responses were received. Approximately 68,346 TNB were reported. Five departments reported a total of eight NTM, resulting in an incidence of 0.012%. The average interval between TNB and NTM was 2.6 months. There were no predictable risk factors. The outcome was known in only 11 patients; 4 patients died by the time of reporting (2 after 14 months and 1 each after 6 and 9 months). From the results of this survey, the incidence of NTM after TNB is approximately 0.012%. This small risk is random and unavoidable.

Biopsy, Needle↗
PubMed1998

Can chest CT decrease the use of preoperative bronchoscopy in the evaluation of suspected bronchogenic carcinoma?

BACKGROUND: Fiberoptic bronchoscopy (FOB) is frequently used to diagnose and stage bronchogenic carcinoma (BC). However, the value of FOB in diagnosis/staging BC presenting as a pulmonary nodule or mass (PNM) is controversial. Since chest CT is usually obtained in these patients, it may be used in patient selection for preoperative FOB. OBJECTIVE: Evaluation of the role of chest CT in determining the predictive value of FOB in diagnosing/staging a PNM, by comparing the results of CT and bronchoscopy. DESIGN: Retrospective review of chest CTs and medical records. PATIENTS: Consecutive patients with BC between 1992 and 1994 who had diagnostic FOB and CT in our institution, but without radiographic evidence of (1) pulmonary atelectasis, (2) endobronchial tumor or narrowing of the central airways, and (3) the PNM abutting the central airways. RESULTS: Sixty-four patients met the selection criteria. The size of the PNM ranged from 1.5 to 10 cm; the size was < or = 4 cm in 62 patients. FOB provided a diagnosis in 22 patients. Bronchoscopy detected endobronchial lesions in 11 patients (17%); 3 had lesions in more than one lobe. In three patients, the PNM was <3 cm. The radiographically undetected endobronchial tumor increased the tumor stage in only two patients. The "CT bronchus" sign had a positive and negative predictive value of 75% and 68%, respectively. CONCLUSIONS: (1) In this study, CT failed to detect endobronchial tumor in 11 of 64 patients (17%). Because of the implications of a new staging system, more studies are necessary before abandoning staging FOB. (2) The CT bronchus sign has a very high positive and negative predictive value in the use of diagnostic FOB and should be used to guide the method of biopsy of a PNM.

Bronchoscopes↗
PubMed1996

Validation of thermography in the diagnosis of reflex sympathetic dystrophy.

OBJECTIVES: To examine the validity of several thermogram-derived indices of autonomic functioning in the diagnosis of reflex sympathetic dystrophy (RSD). DESIGN: A series of chronic pain patients were classified diagnostically based on thermogram results using discriminant function analysis, and validity measures (e.g., sensitivity, specificity) were used to determine the accuracy of computerized thermographic pixel analysis in discriminating RSD from other pathology. SETTING: The study was conducted at the Rush Pain Center, a multidisciplinary outpatient pain clinic. PATIENTS: A series of 46 chronic pain patients referred for suspected sympathetically mediated pain. INTERVENTIONS: All patients underwent computerized thermographic examination under a baseline condition after acclimating to a climate-controlled room, immediately after a cold challenge was applied to the contralateral uninvolved extremity (4 degrees C for 90 s) and 20 min after the cold challenge. OUTCOME MEASURES: Temperature during the three experimental periods, degree of temperature asymmetry between affected and nonaffected limbs during the three periods, response to cold challenge, and recovery following cold challenge were measured. RESULTS: Temperature asymmetry accurately discriminated between RSD and non-RSD patients, with the most accurate asymmetry measures obtained at baseline. Responses to cold challenge and actual temperature values did not discriminate between RSD and non-RSD pain patients. CONCLUSIONS: Thermography can be a useful component of RSD diagnosis. In situations where sensitivity and specificity are equally important, an asymmetry cutoff of 0.6 degree C appears optimal. If specificity (i.e., accurately ruling out non-RSD cases) is more important, a cutoff of 0.8 degree C or 1.0 degree C may be considered as well.

Adult↗
PubMed1994

Anomalous origin of posterior descending artery from left anterior descending artery with unusual intraseptal course.

The posterior descending artery (PDA) arises from the right coronary artery (RCA) in approximately 85% of people; only in from 10 to 15% does it arise from the circumflex artery. We report an unusual case of origin of the PDA from a branch of the left anterior descending artery (LAD). The PDA passed through the interventricular septum before it reached the posterior interventricular groove.

Adult↗
PubMed1992

Usefulness and limitations of transesophageal echocardiography in the assessment of proximal coronary artery stenosis.

To assess the usefulness of transesophageal echocardiography in the evaluation of proximal coronary artery stenosis, 111 consecutive patients (mean age 61 years) who had intraoperative transesophageal echocardiography and coronary angiography within 1 week of surgery were studied. Transesophageal echocardiography visualized the entire length of the left main artery (0.2 to 2.2 cm, mean 0.93), 0.2 to 2.2 cm of the proximal left anterior descending artery and 0.1 to 3.4 cm of the proximal left circumflex artery in 103 patients (93%) and 0.1 to 4.6 cm of the proximal right coronary artery in 55 patients (49%). In the coronary artery segments visualized by echocardiography and compared with the corresponding angiographic segments, transesophageal echocardiography correctly identified 23 (96%) of 24 left main stenoses, 11 (78%) of 14 stenoses involving the left anterior descending artery, 6 (75%) of 8 left circumflex stenoses and all 7 stenoses (100%) of the right coronary artery. In all seven patients with ostial stenosis (left main artery in five and right coronary artery in two), the condition was correctly diagnosed by this technique. The sensitivity and specificity of transesophageal echocardiography in the overall evaluation of proximal coronary artery stenosis as customarily defined by angiography were 96% and 99% for the left main artery, 48% and 99% for the left anterior descending artery, 67% and 100% for the left circumflex artery and 37% and 100% for the right coronary artery, respectively. The distance of the stenotic lesion from the origin of the vessel by transesophageal echocardiography also correlated well with that measured by angiography (r = 0.63 to 0.99).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Intrapulmonary teratoma: a case report and review of the literature.

Intrapulmonary teratomas are rare; only 30 cases have been reported in the world literature. These tumors are thought to originate from the third pharyngeal pouch. They occur equally in men and women and usually are diagnosed in the second to fourth decade of life. They are more often benign than malignant, although malignant lesions may have a favorable postoperative prognosis and benign lesions may exhibit high morbidity and mortality because of their size and location. These tumors present radiographically as lobulated masses that may contain calcification or peripheral collections of air. They most often occur in the upper lobes. The computed tomographic findings of intrapulmonary teratoma are less well known but have been described in two cases. An additional case is presented with a review of the literature and a tabular summary of the characteristics of this unusual entity.

Adult↗
PubMed1991

The influence of balloon inflation duration on the acute angiographic result of percutaneous transluminal coronary angioplasty.

This study was performed to evaluate the importance of the duration of balloon inflation during PTCA, by comparing two common inflation durations. Patients were randomized to a 30-second inflation protocol (group I, 83 procedures, 109 lesions), or a 60-second protocol (group II, 83 procedures, 115 lesions). There were no differences in baseline characteristics between the two groups, and no subsequent differences in mean inflation number (3.4 +/- 1.6 vs 3.1 +/- 1.6), residual stenosis (34% +/- 17% vs 33% +/- 16%), presence of dissection (29% vs 34%), or clinical success (89% vs 84%), group I versus group II, respectively. The 30-second inflations caused significantly less chest pain score (147 +/- 239 vs 399 +/- 516, P less than 0.001), and ST segment alteration (75 +/- 94 seconds vs 136 +/- 163, P less than 0.05). These results indicate that 60-second inflations do not produce a superior result to 30-second inflations. Furthermore, shorter inflations are much better tolerated.

Aged↗
PubMed1990

Anomalous origin of bronchial arteries: potential pitfall of embolotherapy for hemoptysis.

Bronchial artery embolization was performed in two patients with anomalous origins of the bronchial artery. In one patient, the anomalous bronchial artery originated from the convex surface of the aortic arch between the origins of the brachiocephalic and left carotid arteries, while in the other, it originated from the internal mammary artery. Anomalous bronchial arteries represent a potential pitfall during bronchial artery embolization. Radiologists involved in embolotherapy for hemoptysis should therefore be alerted to the possible presence of anomalous bronchial arteries, especially when significant bronchial artery supply to areas of abnormal pulmonary parenchyma is not demonstrated at a catheter search or aortography of the descending aorta. In these instances, arch aortography should be performed to identify anomalous origins of the bronchial arteries or other nonbronchial systemic collateral vessels.

Adult↗