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Biomedical subjects

J E Jacobs

Publications and source records attributed to J E Jacobs.

At least 37 records · Page 2Linked to original sources
PubMed1996

Multiphasic renal CT: comparison of renal mass enhancement during the corticomedullary and nephrographic phases.

PURPOSE: To evaluate thin-section computed tomography (CT) performed during the corticomedullary and nephrographic phases of contrast material enhancement in the characterization of renal masses. MATERIALS AND METHODS: A prospective study of 30 patients was undertaken with CT to characterize 31 "indeterminate" renal masses. In all patients, 5-mm-thick, contiguous, high-tube-current (320-340-mA) scans were obtained through the kidneys before (axial mode), during (helical mode, 25-second delay, corticomedullary-phase images), and after (axial mode, 120-second delay, nephrographic-phase images) administration of a 117-second biphasic injection of intravenous contrast material. RESULTS: Eight of 16 neoplasms measured less than 20 HU on CT scans obtained without contrast material enhancement; measurements of two of these corresponded to "cyst attenuation" during the corticomedullary phase. Enhancement of 10 HU or greater was demonstrated in 11 neoplasms during the corticomedullary phase and in all neoplasms in the nephrographic phase. No enhancement was seen in 15 radiologically benign cysts. Both renal neoplasms and normal renal cortex demonstrated significantly greater enhancement in the nephrographic phase compared with that in the corticomedullary phase (P = .0002 and P < .0001, respectively). CONCLUSION: Enhancement of renal neoplasms is time dependent and may not be evident in hypovascular tumors analyzed during the early corticomedullary phase. Reliance on absolute CT attenuation measurements, without use of internal standards as controls, may lead to misdiagnosis of neoplasms as cysts.

Adult↗
PubMed1996

Heterotopic ossification of midline abdominal incisions: CT and MR imaging findings.

OBJECTIVE: Heterotopic ossification of a midline surgical incision in a form of myositis ossificans traumatica in which osseous, cartilaginous, and, occasionally, myelogenous elements develop within an abdominal wound. When large amounts of internal ossification are present, the scar may demonstrate a complex radiologic appearance and potentially may be misinterpreted as a retained foreign body or incisional neoplastic recurrence. This report describes the CT and MR imaging findings of this entity. SUBJECTS AND METHODS: The authors retrospectively reviewed the cross-sectional imaging findings of 11 patients with ossified midline abdominal wounds. All but one of the patients were men, and the median age at diagnosis was 40 years old (range, 20-76 years old). Initial imaging was performed 7 days to 36 months after surgery (mean, 6.7 months). CT and MR imaging scans were reviewed, and lesion size, location, distance from the xiphoid, shape, and stability were assessed. Pathologic proof was obtained in one patient. RESULTS: CT and MR imaging examination in all patients showed ossified surgical scars, with the attenuation or signal intensity of the ossified components equivalent to that of the spine. Intralesional, fat-density components suggestive of marrow were present in two patients. All scars were located in the upper abdomen between the anterior abdominal fascia and the peritoneal surface, at the level of or inferior to the xiphoid process. Scars ranged in length from 0.7 to 13.4 cm (mean, 6.9 cm). Distances from the inferior tip of the xiphoid to the superior aspect of the ossified scar ranged from 0 to 4.9 cm (mean, 2.2 cm). Time from surgery to the initial postoperative demonstration of scar ossification ranged from 11 days to 36 months (mean, 6.8 months). None of the five patients who underwent preoperative CT examinations had abnormalities in the location of subsequent scar ossification. Of the nine patients with multiple postoperative examinations, scar size and appearance remained stable in six. In the remaining three patients, scar size was stable but showed progressive internal ossification. CONCLUSION: Heterotopic ossification within midline abdominal scars can be diagnosed by both CT and MR imaging examination. Recognition of the imaging appearances of such ossification should help prevent diagnostic confusion when attending postoperative patients.

Abdominal Muscles↗
PubMed1996

Strategy for repeat biopsy of patients with prostatic intraepithelial neoplasia detected by prostate needle biopsy.

PURPOSE: We evaluated the strategy for repeat biopsy of patients with prostatic intraepithelial neoplasia without concurrent carcinoma detected on prostate needle biopsy. MATERIALS AND METHODS: Of 1,275 consecutive patients undergoing prostate needle biopsy 61 were identified with prostatic intraepithelial neoplasia but without concurrent prostate carcinoma. Of the 61 patients 53 had undergone repeat biopsy. The medical records, transrectal ultrasound, and operative and pathological reports of these patients were reviewed. RESULTS: Repeat biopsy was done in 53 patients with prostatic intraepithelial neoplasia, yielding carcinoma in 15, prostatic intraepithelial neoplasia without carcinoma in 8 and benign tissue in 30. The yield of carcinoma from repeat biopsy of a prostatic intraepithelial neoplasia site was 8.3% (7 of 84 sites). A total of 18 sites of carcinoma was detected by repeat biopsy of a previous random biopsy site (8), a prostatic intraepithelial neoplasia site only (5), a transrectal ultrasound nodule (3), a palpable nodule and prostatic intraepithelial neoplasia site (1), and a transrectal ultrasound nodule and prostatic intraepithelial neoplasia site (1). Carcinoma was as frequently detected by repeat biopsy of a prostatic intraepithelial neoplasia site (6 patients) as by random repeat biopsy (6 patients). CONCLUSIONS: Repeat prostate needle biopsy of patients with prostatic intraepithelial neoplasia should include random repeat biopsy and repeat biopsy of transrectal ultrasound abnormalities as well as previous sites of prostatic intraepithelial neoplasia.

Adenocarcinoma↗
PubMed1995

Children's perceptions of the risk of sexual abuse.

Research to date has not examined children's perceptions of the risk of sexual abuse, and how those perceptions change following participation in a prevention program. This study assessed children's current perceptions of the risk of sexual abuse, changes in children's perceptions of risk after participation in a sexual abuse prevention program, and age differences in children's beliefs about risk. The findings indicate that children's already high perceptions of the risk of sexual abuse increased after participation in a prevention program, and that their predictions of abuse by strangers increased after the program. However, children's predictions of the likelihood of sexual abuse in specific videotaped scenarios was quite low. Younger children had lower perceptions of risk than older children and their perceptions of the likelihood of abuse in the videotaped scenarios remained lower than the perceptions of older children even after the intervention program. In addition, children perceived differences in the risk-levels of various situations, but the factors they used to discriminate risk were not necessarily related to real risks. The findings are discussed in relation to the larger issue of how children's perceptions of the risk of sexual abuse are related to the goals of prevention programs.

Child↗
PubMed1995

CT of inflammatory disease of the colon.

CT plays an important role in the evaluation of patients with suspected colonic inflammation. High-resolution, thin-section imaging of the gastrointestinal tract allows assessment of both the intraluminal and extraluminal components of colonic disease, thereby enabling radiologists to detect and stage colonic pathology accurately. In addition, CT can be used to guide percutaneous drainage of abscess collections, often obviating the need for surgical intervention. This article describes CT techniques for diagnosing inflammatory diseases of the colon as well as the typical CT appearances.

Appendicitis↗
PubMed1995

Glutaraldehyde colitis: radiologic findings.

PURPOSE: Two percent glutaraldehyde on colonic mucosa may result in a toxic colitis, and the clinical features may mimic those of colonic ischemia. The study was performed to determine the radiologic appearance of glutaraldehyde-induced toxic colitis. MATERIALS AND METHODS: A retrospective review was performed with the clinical and imaging findings in four patients with glutaraldehyde-induced colitis seen during a 6-year period. RESULTS: Patients developed a self-limited syndrome of cramps and abdominal pain, tenesmus, and rectal bleeding within 48 hours of uncomplicated sigmoidoscopy or colonoscopy. Sample cultures excluded enteric pathogens. Computed tomography (CT) demonstrated circumferential thickening of the colonic wall in a left-sided distribution in all patients. Heterogeneous mural enhancement (target-sign appearance) was noted in two patients. Follow-up CT studies confirmed resolution of mural wall thickening with conservative management. CONCLUSION: The clinical and radiologic features of glutaraldehyde-induced toxic colitis may mimic those of colonic ischemia. This complication should be suspected in patients who develop hemorrhagic colitis immediately after undergoing colonoscopy.

Adult↗
PubMed1995

Hepatic enhancement during helical CT: a comparison of moderate rate uniphasic and biphasic contrast injection protocols.

OBJECTIVE: The purpose of this study was to compare the degree and timing of peak hepatic enhancement, optimal scanning intervals, and optimal delay times of moderate-rate uniphasic and biphasic contrast material injection protocols for hepatic helical CT. MATERIALS AND METHODS: One hundred fifty patients were randomized into three injection protocols, receiving 42.3 g iodine (150 ml iothalamate meglumine) delivered using 3 ml/sec uniphasic, 2 ml/sec uniphasic, or biphasic (3 ml/sec [50 ml], 1 ml/sec [100 ml]) technique. Statistically fitted aortic and hepatic enhancement curves were generated from dynamic incremental CT data for each patient. Protocols were compared by maximum hepatic enhancement, and contrast enhancement indices were modeled for a 38-sec helical acquisition. RESULTS: The 3 ml/sec and 2 ml/sec uniphasic protocols produced higher peak hepatic enhancement (64 +/- 15 H and 62 +/- 15 H [mean +/- 1 SD]) than the 3 ml/sec biphasic protocol (52 +/- 10 H; p < .001). Contrast enhancement indices for the 3 ml/sec uniphasic and 2 ml/sec uniphasic protocols (385 +/- 398 H/sec and 397 +/- 412 H/sec) were significantly greater than the index for the 3 ml/sec biphasic protocol (123 +/- 194 H/sec; p < .0001) at a 50-H threshold. Optimal scan delay times were 50 +/- 8, 75 +/- 7, and 119 +/- 8 sec, respectively, for the 3 ml/sec uniphasic, 2 ml/sec uniphasic, and 3 ml/sec biphasic techniques. CONCLUSION: The moderate-rate uniphasic injections studied provided greater hepatic enhancement throughout the helical acquisition without requiring the prohibitively long delay time necessitated by the moderate-rate biphasic injection. These findings differ from prior results that showed that a uniphasic injection may provide comparable levels of hepatic enhancement when compared with a high-flow-rate biphasic injection.

Adult↗
PubMed1994

Pancreatic sparing of focal fatty infiltration.

PURPOSE: To describe typical findings of focal fatty sparing of the pancreas. MATERIALS AND METHODS: Computed tomography, ultrasonography, and/or magnetic resonance imaging were performed in seven patients. RESULTS: In these patients, the area of sparing of fatty change was within the head or uncinate process of the pancreas. CONCLUSION: Differentiating pancreatic fatty sparing from true neoplasm by means of cross-sectional imaging obviates the need for invasive diagnostic studies.

Adipose Tissue↗
PubMed1994

Follow-up of benign hypoechoic peripheral zone lesions of the prostate gland: US characteristics and cancer prevalence.

PURPOSE: To evaluate the role of biopsy-proved benign peripheral zone hypoechoic lesions of the prostate gland, ultrasonographic (US) characteristics at follow-up, prostate-specific antigen (PSA) levels, and digital rectal examination (DRE) in prediction of cancer risk. MATERIALS AND METHODS: Retrospective analysis was performed for 105 consecutive patients with 148 benign hypoechoic lesions discovered at transrectal US (TRUS) and diagnosed with US-guided needle biopsy. At least one repeat TRUS study was performed in each patient. RESULTS: Among the benign lesions, 72% changed at follow-up TRUS, either disappearing or becoming smaller, less hypoechoic, and more vague. Cancer developed in 13% of patients. In 93% of patients in whom cancer developed, the appearance changed in the peripheral zone at follow-up TRUS. In this patient population, the positive predictive value for development of cancer was 16% with a changing TRUS appearance, 19% with an abnormal DRE result, and 27% with an elevated level of PSA; only the latter was statistically significant. CONCLUSION: The PSA value, alone or in combination with a changing TRUS appearance, is the best indicator for development of cancer.

Adult↗
PubMed1994

Stereotactic needle biopsy of nonpalpable breast masses.

One hundred two patients with nonpalpable breast masses that presented as mammographic densities with or without calcification were studied consecutively. Using the Stereotix stereotactic device, fine-needle aspirations were obtained with subsequent hook-wire placement followed by surgical excision. Pathology results were reached separately and then compared to the cytologic diagnoses. For patients with adequate cytologic material, sensitivity was 95% and specificity was 100%. There were six suspicious or equivocal diagnoses: three were determined to be benign, while three were malignant. There was inadequate tissue in 13%. Although this technique had limitations, for patients with adequate cytologic and histologic material the accuracy was excellent.

Biopsy, Needle↗
PubMed1994

Cosmetic periodontal procedures.

This paper reviews the newest advances in and opinions about cosmetic periodontal surgery. It includes a review of basic periodontal anatomy as it relates to restoring ideal health and esthetic gingival and osseous tissues. Treatments for excessive gingival tissue, ridge augmentations, and gingival deficiencies are discussed. These procedures are important in creating the illusion of a natural cosmetic smile in otherwise compromised situations.

Alveolar Ridge Augmentation↗
PubMed1992

The impact of mothers' gender-role stereotypic beliefs on mothers' and children's ability perceptions.

The focus of this study is the relation between mothers' gender stereotypic beliefs, their perceptions of their children's abilities, and their children's self-perceptions in 3 activity domains. Approximately 1,500 mothers and their 11- to 12-year-old children responded to questions about the children's abilities in the math, sports, and social domains. It was predicted that mothers' beliefs about their children would be moderated by their gender stereotypic beliefs about the abilities of female and male people in general. As predicted, path analyses revealed that mothers' gender stereotypic beliefs interact with the sex of their child to influence their perceptions of the child's abilities. Mothers' perceptions, in turn, mediate the influence of past performance on children's self-perceptions in each domain.

Adolescent↗