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Biomedical subjects

J Halls

Publications and source records attributed to J Halls.

At least 19 recordsLinked to original sources
PubMed1991

Radionuclide ventriculography in severely underweight anorexia nervosa patients before and during refeeding therapy.

Congestive heart failure is a well-recognized complication of refeeding therapy in underweight patients with anorexia nervosa but there are few data describing cardiac function during the critical refeeding period. This prospective study examined left ventricular function with conventional electrocardiographic-gated radionuclide ventriculography (RVG) in severely underweight anorexia nervosa patients both before and during refeeding therapy. Eight patients underwent rest and exercise RVG at admission and after regaining approximately 5% to 10% of their ideal body weight. With the admission study serving as a control, the left ventricular ejection fraction and regional wall motion analysis were analyzed before and after refeeding and weight gain. Resting left ventricular ejection fractions were not significantly different between the first and second RVGs (64 +/- 11% vs. 62 +/- 8%, respectively; P greater than .05). Likewise, the left ventricular ejection fraction with maximal exercise did not significantly differ when comparing the first or the second RVG (74 +/- 10% vs. 72 +/- 8%, P greater than .05). During the baseline RVG, the left ventricular ejection fraction increased from 64 +/- 11% (rest) to 74 +/- 10% (maximal exercise) (P less than .001). During the second RVG, the ejection fraction increased from 62 +/- 8% (rest) to 72 +/- 8% (maximal exercise) (P = .003). However, the left ventricular exercise ejection fraction in the second RVG in one patient increased only by one absolute percentage point. Four of the eight patients had regional wall motion abnormalities detected during resting and/or exercise RVG. Abnormal cardiac function occurs in asymptomatic patients with anorexia nervosa undergoing refeeding therapy.

Adolescent↗
PubMed1991

Color Doppler sonography in hepatocellular carcinoma.

Sixteen patients with hepatocellular carcinoma (HCC) were assessed with color Doppler sonography (CDS) for flow compared to normal hepatic parenchyma. Nine showed moderate increased flow, and two revealed marked increased flow. In most instances, the increased flow was peripheral. Color Doppler was also useful in assessing seven patients with portal vein invasion. In two instances, venous invasion was not detected on preliminary grayscale images. In another patient, hepatic venous invasion was suspected on grayscale images, but was shown to represent extrinsic compression only by color Doppler.

Carcinoma, Hepatocellular↗
PubMed1990

Effects of isosorbide dinitrate on the pattern of arterial blood flow in healthy human subjects.

1. Blood velocity measurements have been made in the superficial femoral artery, 10 cm downstream of the common femoral artery bifurcation, in healthy human subjects, using a multi-channel Doppler ultrasound device. 2. In a randomized double-blind protocol, the effects of isosorbide dinitrate were examined during a 2 h period. 3. The changes induced by isosorbide dinitrate include: (i) an increase in the width of the artery and a reduction in brachial arterial blood pressure, implying relaxation of arterial smooth muscle; (ii) an increase in reverse flow and a decrease in time-averaged mean velocity associated with a relatively small decrease of the velocity excursion during the cardiac cycle, implying an increase in flow pulsatility; and (iii) an alteration of the flow pattern both in the core and near the vessel walls.

Adult↗
PubMed1988

Guillain-Barré syndrome: diagnostic criteria, epidemiology, clinical course and prognosis.

Thirty-four patients were identified with Guillain-Barré syndrome (GBS) on review of 266 neuropathy cases admitted to a Copenhagen county hospital from June 1977 to January 1984. The age-adjusted incidence rate of GBS is 2.0 x 10(-5) years-1. The natural history of the disease, antecedent events, symptoms and signs, autonomic dysfunction, sequelae, CSF findings and mortality are described. Six cancer patients with GBS differed significantly from the non-cancer patients in a more protracted disease course and failure to improve. The National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) criteria for the diagnosis of GBS are discussed, and it is concluded that the criteria, although useful in comparative studies, are too restrictive when used in clinical practice.

Aged↗
PubMed1987

Medical treatment of hepatic amebic abscess: rare need for percutaneous drainage.

Although amebic liver abscess can virtually always be successfully treated medically, percutaneous drainage has been advocated recently. In 96 recently treated patients, therapeutic aspiration and percutaneous drainage were rarely needed. Most cases were correctly diagnosed by means of clinical, laboratory, and sonographic findings. Abscesses in only 13 (13.5%) patients were diagnostically aspirated. An abscess in one patient was therapeutically aspirated because the patient was responding slowly to medical therapy. No patient required catheter drainage. The key to successful amebic abscess management is medical therapy. Therapeutic drainage is rarely needed. Successfully treated patients occasionally respond slowly to medical therapy, and successfully treated amebic abscesses may enlarge or become bizarre-appearing on sonograms. This should not prompt therapeutic drainage. Diagnostic aspiration is appropriate when amebic and pyogenic abscesses are indistinguishable using clinical and imaging findings. Rare indications for therapeutic aspiration or drainage include pyogenic superinfection and large, juxtacardiac abscesses (potential intrapericardial rupture).

Chloroquine↗
PubMed1987

Sonographic features of amebic and pyogenic liver abscesses: a blinded comparison.

We blindly compared the sonographic findings in amebic (112 lesions) and pyogenic (30 lesions) liver abscesses. Two sonographic features were significantly more prevalent in amebic abscesses: the lesions had a round or oval shape and the lesions had an echogenicity that was lower than that of normal liver and were internally homogeneous on high-gain scans. Amebic abscesses were round or oval in 92 instances (82%), while 18 pyogenic abscesses (60%) (p less than .01) had these shapes. Fifty-nine (58%) of 101 amebic abscesses displayed low echogenicity and homogeneous internal echoes with high-gain settings compared with nine (36%) of 25 pyogenic abscesses (p less than .04). Despite these different sonographic patterns, image findings alone were inadequate in distinguishing pyogenic from amebic liver abscesses. However, when the sonographic findings were coupled with clinical and laboratory data, a correct diagnosis was possible in 83 (86%) of 96 patients with amebic abscess. It appears that, although some sonographic features of amebic abscess differ from those of pyogenic abscess, these differences are not sufficient to allow a specific diagnosis on the basis of sonography alone. Sonography can expedite abscess detection and, when coupled with clinical and laboratory data, can aid in differentiating pyogenic from amebic liver abscesses.

Humans↗
PubMed1983

Patterns of resolution in successfully treated hepatic amebic abscess: sonographic evaluation.

Gray-scale sonography has provided a means of following cases of successfully treated hepatic amebic abscess, allowing new insights into the natural history of this entity. In this study the majority of cases (23 of 32) resolved over a variable time period (1.5-23 months, median 7 months) to a normal sonographic hepatic parenchymal pattern. It is important that the transient, persistent abnormality seen after successful treatment not prompt reinstitution of therapy or further diagnostic testing in these patients. A smaller subgroup (six of 32) had sonographically persistent residua that appeared identical to benign simple cysts of the liver. The remaining three lesions showed slightly increased or decreased hepatic echogenicity after treatment.

Follow-Up Studies↗
PubMed1983

Posttraumatic intrahepatic biloma: sonographic diagnosis.

Posttraumatic intrahepatic biliary cysts or bilomas were once thought to be rare. With increased use of sonography and 99mTc-HIDA cholescintigraphy, this entity will probably be detected more often. Preoperative sonographic diagnosis of posttraumatic biloma was made in five patients. A well circumscribed, anechoic hepatic lesion with excellent distal sonic enhancement strongly suggests the diagnosis. Cholescintigraphy especially using delayed scans or percutaneous aspiration, can confirm the diagnosis.

Adult↗
PubMed1982

Prospective evaluation of the sonographic Murphy sign in suspected acute cholecystitis.

The sonographic Murphy sign, the presence of maximal tenderness elicited over a sonographically localized gallbladder, has been considered useful in the evaluation of patients with suspected acute cholecystitis. We prospectively evaluated this sign in 427 consecutive patients referred for evaluation of acute cholecystitis. The overall accuracy of the sonographic Murphy sign in the 219 patients with sufficient confirmation to be included in the statistical analysis was 87.2%. Sensitivity was 63% and specificity was 93.6%. The predictive value of a positive sign was 72.5%, while the predictive value of a negative sign was 90.5%. The sonographic Murphy sign is a useful, albeit imperfect, adjunct in the assessment of patients with suspected acute cholecystitis.

Acute Disease↗
PubMed1982

Sonography in the diagnosis and management of hepatic amebic abscess in children.

Hepatic amebic abscess is a potentially fatal infection which is difficult to diagnose in children. Sonography is an ideal non-invasive imaging tool which can prove invaluable in the diagnosis and management of hepatic amebic abscess. Sonographic findings should suggest the correct diagnosis in most instances. This allows prompt initiation of therapy, forestalling life-threatening complications. Sonography is also an extremely useful non-invasive means of following response to therapy in children with hepatic amebic abscesses.

Child↗
PubMed1982

Sonographic findings in hepatic amebic abscess.

Sonograms of 143 hepatic amebic abscesses in 106 patients were analyzed retrospectively. A strongly suggestive but not pathognomonic pattern was noted in 54 abscesses (37.8%), consisting of (a) lack of significant wall echoes, (b) a round or oval configuration, (c) less echogenicity than the normal parenchyma, with fine, homogeneous low-level echoes throughout at high gain, (d) a location contiguous to the liver capsule, and (e) distal sonic enhancement. Most other hepatic abscesses (53.1%) had all but one or two of these features. Thirteen patients (9%) had bizarre sonographic findings. Peripheral or central areas of increased echogenicity occurred more frequently than previously reported. At normal gain settings, most lesions (53.8%) were predominantly anechoic. The above pattern and trans-diaphragmatic pleural involvement were helpful in the diagnosis.

Humans↗
PubMed1982

Sonography of pyogenic splenic abscess.

Pyogenic splenic abscess is an uncommon lesion associated with high mortality. Diagnosis may be difficult, especially in deep-seated abscesses. Plain radiographs and nuclear medicine techniques may be helpful, but can be insufficiently specific. Sonography, which images morphologic changes, is useful in assessing splenic abscesses. Five of six abscesses had a predominantly anechoic pattern with internal foci of higher echogenicity. In one gas-containing lesion, there were high amplitude echoes throughout the abscess. The abscesses were easily distinguishable from the surrounding homogeneous normal spleen. Sonography, while not definitive, is an effective tool in reaching an early diagnosis of splenic abscess. This allows prompt splenectomy, ameliorating prognosis.

Abscess↗
PubMed1981

Sonographic anatomy of the hepatic artery.

One hundred clinical abdominal sonographic examinations were assessed to determine the frequency with which various parts of the hepatic artery system were imaged. The common, proper, and right hepatic arteries were seen in a large percentage of cases (92%, 75%, and 73%, respectively). Sixty-one consecutive patients with dilated biliary ducts were evaluated to determine the relationship of hepatic artery branches to the biliary tree and portal venous system. Normal and variant hepatic artery anatomy is discussed. Knowledge of the hepatic artery system and its variations is useful in the sonographic assessment of problems involving the gallbladder, liver, pancreas, and portal venous system.

Bile Duct Diseases↗