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Biomedical subjects

J O Kaplan

Publications and source records attributed to J O Kaplan.

10 recordsLinked to original sources
PubMed1989

Developing an interventional radiology practice in a community hospital: the interventional radiologist as an equal partner in patient care.

Development of an interventional radiology practice or section depends first on the commitment and ability of the interventionalist but is also contingent on an appropriate environment. Moreover, the interventionalist must attempt to change long-standing concepts and referral patterns with aggressive dissemination of information. He or she must be an advocate of the procedures offered, as well as their benefits to the patient and the health care system. One must actively include outpatient visits and admissions as part of services offered. Allies in this effort include primary care physicians, internists, hospital administration, and third-party payers. In addition, organized radiology can now offer some assistance through the Society of Cardiovascular and Interventional Radiology and the American College of Radiology. All of these factors will contribute significantly to the success of interventional radiology in both teaching and community hospital settings.

Hospital Departments↗
PubMed1989

Blue toe syndrome: treatment with percutaneous atherectomy.

"Blue toe syndrome" refers to digital ischemia of the foot in the presence of palpable or Doppler audible pedal pulses. This clinical syndrome is caused by microembolization to small vessels from a proximal source. The use of percutaneous transluminal atherectomy is described in the treatment of embologenic superficial femoral artery lesions in seven patients. All seven had prompt healing of the ischemic toes, and none required surgical revascularization or amputation. One patient developed a recurrent stenosis at the atherectomy site and had a second episode of digital ischemia, which was treated by means of atherectomy with a larger device. Histologic study of atherectomy specimens suggests that emboli arise from adherent fibrinoplatelet aggregates or thrombus and less often from cholesterol-rich atheromatous plaque. Although either percutaneous transluminal angioplasty or atherectomy can be used to treat the underlying stenosis, percutaneous atherectomy offers the advantage of nonsurgical removal of embologenic material and provides material for histologic study. Percutaneous atherectomy is an effective method of treating embologenic superficial femoral stenoses in patients with ipsilateral blue toe syndrome.

Adult↗
PubMed1989

MR imaging of intracranial carotid occlusion.

The MR scans of seven patients with intracranial carotid occlusion (five proved, two presumed) were reviewed to evaluate the MR signal characteristics seen in this disorder. Five patients had clinical signs of cerebral infarction. Of the remaining two patients, one was asymptomatic and the other had a long-standing occlusion and headaches. We correlated the MR findings with cerebral angiography in five patients and with CT scans in six patients. All occluded vessels demonstrated MR signal predominantly isointense to brain on proton-density- T1- and T2-weighted images. Since there is an absence of flow, the MR signal is based on the intrinsic properties of the arterial thrombus and possibly on the chronicity of the occlusion. The pathogenesis and histopathology of intravascular thrombus differ significantly from extravascular hematoma, which accounts for the differences in their MR signal characteristics. The demonstration of occluded intracranial vessels may solidify the diagnosis of stroke in cases in which clinical and/or CT findings are equivocal. In patients presenting with infarction, an occluded carotid artery by MR may obviate the need for angiography; however, the demonstration of a patent carotid in conjunction with infarction suggests the possibility of an embolus, which may require angiography. We believe that MR is a valuable adjunct to CT in evaluating patients with cerebrovascular infarction.

Adult↗
PubMed1980

Improved technique for cervical metrizamide myelography.

Introduction of metrizamide into the lumbar subarachnoid space with the patient in a prone 15-20 degree head-down position improves delivery of contrast material for cervical myelography. Excellent visualization of the spinal cord and nerve roots has resulted using this technique.

Humans↗
PubMed1980

The occult tethered conus syndrome in the adult.

Twelve adults presented with tethered conus syndrome which had gone undiagnosed throughout childhood. Seven patients had had surgery directed toward the presenting symptoms or cutaneous abnormalities because the true underlying pathology was not appreciated. Although plain radiographs of the lumbosacral spine were abnormal, it was myelography that established the diagnosis. Computed tomography was performed in 4 cases and optimally showed the point of tethering, the nature and extent of the tethering masses, and the course of the intradural bands.

Adult↗
PubMed1980

Mediastinal adenopathy in myeloma.

Radiographic detection of intrathoracic lymphadenopathy in multiple myleoma is uncommon, but may occur late in the course of the disease. Rarely, it may present a diagnostic problem and needle aspiration biopsy may be necessary for definitive diagnosis.

Diagnosis, Differential↗
PubMed1979

Mediastinal pancreatic pseudocyst.

The extension of a pancreatic pseudocyst into the mediastinum is a difficult clinical and radiographic diagnosis. The chest roentgenogram reveals a retrocardiac mass in a patient with nonspecific upper abdominal and chest complaints. Usually there is a preceding history of alcoholism or pancreatitis. The upper gastrointestinal series often demonstrates typical displacement of the distal esophagus anteriorly and to the left. The value of computed tomography is illustrated. Correct preoperative diagnosis is important for proper surgical treatment, since a mediastinal pseudocyst is best managed without thoracotomy.

Adult↗