Biomedical subjects
Publications and source records attributed to J R Bernstein.
A case of choledochocele, a cystic dilatation of the common bile duct, is reported and relevant aspects of the literature are reviewed. This case is significant for the patient's presentation with jaundice and for the preoperative demonstration and diagnosis by percutaneous transhepatic cholangiogram.
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A case of cavernous hemangioma of the liver resembling a metastatic deposit is reported in a patient with renal cell carcinoma. The clinical and angiographic features that distinguish hepatic hemangiomas from metastatic renal cell carcinoma are discussed. The importance of this distinction in patient management is emphasized.
The occurrence of localized large clusters of colonic pseudopolyps in 4 patients is described. The underlying disease was chronic ulcerative colitis in 2 cases and granulomatous colitis in 2 others. Each lesion presented as a bulky polypoid mass causing partial or total occlusion of the transverse segment or splenic flexure of the colon. The radiographic and pathologic features of this rare entity are illustrated, and the previously reported 10 cases are briefly reviewed.
A case of nodular panniculitis (Weber-Christian disease) with breast involvement is presented. Xeromammography demonstrated unusual calcifications in the nodules.
A case of idiopathic retroperitoneal fibrosis is reported with a description of the gray scale ultrasound findings. The mass was indistinguishable in appearance from many other retroperitoneal processes, such as lymphoma, fibrosarcoma, and liposarcoma. In this case the mass had a well-defined anterior border, and the posterior border with the vena cava and aorta was difficult to demonstrate. The sound transmission properties of the mass were similar to those of normal soft tissue structures. The mass, which showed no echoes at moderate gain levels, produced weak echoes at high gain levels. By marking the projection of the tumor as seen by ultrasound on the skin and then obtaining an x ray with a lead wire on these marks, a comparison of ultrasound with other studies is possible. This also helps in demonstrating the location and extent of the mass. Ultrasound is suggested as a useful noninvasive technique for following the progress of retroperitoneal fibrosis.
Screening mammography can detect early, nonpalpable breast cancer, resulting in improved long-term survival and cure rates. However, greater compliance with screening guidelines has increased the number of mammographic abnormalities found. Since 75% of the surgical biopsies performed for nonpalpable lesions are benign, less expensive and invasive methods of diagnosis are evolving to reduce the cost of screening mammography programs and the number of women undergoing surgery for benign mammographic findings. Stereotactic needle core biopsy allows minimally invasive sampling of most breast lesions and generates tissue cores for histologic evaluation. A specific pathologic diagnosis, as well as determination of invasiveness, can be achieved for mass lesions. Microcalcification can also be sampled to diagnose in situ cancer, although the use of core biopsy for noncomedo intraductal cancer is still evolving. The procedure demands meticulous technique to assure accurate needle placement, and careful correlation of biopsy results and patient follow-up is mandatory. Accuracy relative to surgical biopsy of nonpalpable lesions has been excellent in published series. The role of this procedure in patients with low, intermediate, and high suspicion mammographic lesions is discussed.
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Following the oral administration of [14C]quinelorane, a potent and highly specific dopamine (D2) agonist, to rats, mice, and monkeys, the compound was well absorbed, with 50% or more of the radioactivity appearing in the urine within 24 hr. Dogs were pretreated with 22 consecutive daily doses of quinelorane by the oral route (in order to induce tachyphylaxis to the emetic effect) before receiving an iv dose of [14C]quinelorane; just over 80% of the radioactivity was excreted into the urine. A tissue-distribution study in rats receiving a single oral dose of 0.1 mg/kg [14C]quinelorane indicated a widespread distribution of radioactivity, with levels being notably low in the blood and plasma and high in the salivary gland, adrenals, pancreas, and spleen; levels were highest in the stomach and kidneys. The Tmax of radiocarbon in the 22 tissues varied between 0.5 and 6 hr, with some tissues showing a plateau of radioactivity between these time-points. After 8 hr, levels of radioactivity were clearly decreasing, and by 48 hr, background levels were attained. Following the oral and iv administration of quinelorane to rats, the systemic bioavailability was calculated to be 16% and the volume of distribution was found to approximate that of total extracellular water, i.e. approximately 300 ml/kg. Since absorption was satisfactory and the tissue distribution study indicated widespread radioactivity, the low bioavailability may be due to first-pass metabolism. Rats excreted marginally more of the N-despropyl metabolite than unchanged drug into the urine, and dogs excreted principally unchanged quinelorane into their urine, followed by the N-despropyl metabolite.(ABSTRACT TRUNCATED AT 250 WORDS)