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Biomedical subjects

J V Kaude

Publications and source records attributed to J V Kaude.

At least 19 recordsLinked to original sources
PubMed1992

Renal peripelvic lymphatic cysts (lymphangiomas) associated with generalized lymphangiomatosis.

Renal peripelvic lymphatic cysts (lymphangiomas) are usually seen as an isolated finding. They appear as multiple mass lesions with low attenuation on computed tomography (CT), and show no contrast enhancement. We present a case of renal peripelvic lymphatic cysts associated with generalized lymphangiomatosis, and examined with magnetic resonance imaging (MRI), CT, and lymphangiography. Multiplanar MRI demonstrated the extent of disease, including retroperitoneal lesions. The lesions had low-signal intensity on T1-weighted and high-signal intensity on T2-weighted images. The diagnosis of generalized lymphangiomatosis was verified by renal sinus cyst puncture, lymphangiography, and tissue biopsy.

Female↗
PubMed1992

Screening test for detection of metallic foreign objects in the orbit before magnetic resonance imaging.

RATIONALE AND OBJECTIVES: A study was designed to determine whether plain films, used as a screening modality for magnetic resonance imaging (MRI), could reliably detect intraorbital metallic foreign objects. METHODS: In the first experiment, 20 metal particles were placed in five human cadaver orbits. Routine orbital plain film series and computed tomography (CT) were obtained, randomized, and interpreted blinded by three experienced radiologists. RESULTS: The threshold size of particle detection for CT (0.07 mm3) was lower than for plain films (0.12 mm3). Placing metal particles in artificial and true vitreous demonstrated that all particles moved under a magnetic field at 1.5 T. When human globes were exposed to industrial tools (grinder, bandsaw, air hose, etc.), no metal objects penetrated the sclera. CONCLUSIONS: Plain films can be used as a low-cost, low-radiation screening procedure for high-risk patients with occupations involving metal work. CT should be used for patients with a history of eye trauma from other causes.

Costs and Cost Analysis↗
PubMed1992

Multiple criteria in sonographic diagnosis of prostatic carcinoma allows identification of all glands harboring clinically significant tumor: an in vitro study with histopathologic correlation.

Fresh whole prostate glands were examined systematically in a water bath to look for four sonographic criteria for prostatic carcinoma: well-circumscribed hypoechoic regions, external asymmetry of the gland, increase in anterior-posterior diameter ratio, and irregularity of the prostatic capsule. Whole mount sections were examined to correlate the histopathologic and sonographic findings. Using hypoechogenicity alone, 26 of 43 glands harboring tumor were identified correctly. Using all four criteria, 40 of 43 glands harboring tumor were identified, a statistically significant improvement in sensitivity (P less than 0.05). Specificity of both methods was similar (P greater than 0.1). The three tumors that were missed measured 0.5 x 0.5 x 0.5 cm, 0.5 x 0.5 x 0.5 cm, and 0.3 x 0.4 x 0.9 cm, and were found at autopsy in patients who died of causes unrelated to the prostate. The authors conclude that systematic examination of the gland with attention to multiple criteria for abnormality can improve case finding in prostatic adenocarcinoma.

Adenocarcinoma↗
PubMed1991

Antiperistaltic and isoperistaltic intussusception associated with abnormal motility after Roux-en-Y gastric bypass: a case report.

Antiperistaltic and recurrent intussusceptions are extremely rare in the adult. We report a patient with both. The patient developed an antiperistaltic intussusception distal to her Roux enteroenterostomy years after a Roux-en-Y gastric bypass for morbid obesity. The diagnosis was made preoperatively with gastrointestinal contrast radiography and ultrasonography. At surgery, the intussusception was reduced, and 12 inches of nonviable bowel was resected, with a functional end-to-end anastomosis. An isoperistaltic intussusception occurred in the early postoperative period just distal to the anastomosis. Manometric evaluation of the Roux limb after the second operation showed altered gastrointestinal motility, consisting of orad-propagated and aboard-propagated migrating motor complexes, minimal phase 2 activity, and lack of conversion to the fed pattern with a liquid meal. Although manometry was not performed before the development of the intussusception, our findings are consistent with the hypothesis that altered intestinal motility may contribute to the development of intussusception.

Adult↗
PubMed1991

Peritoneal mesothelioma. Radiologic appearances correlated with histology.

Previous imaging reports of peritoneal mesothelioma have described a variety of radiologic appearances, but have not included its pathologic classification. We retrospectively reviewed 10 cases of peritoneal mesothelioma representing the following histologic categories: 7 epithelial, 2 sarcomatoid, and one biphasic. By imaging, epithelial mesotheliomas demonstrated diffuse thickening of the peritoneum and mesentery and/or multiple small nodules. The sarcomatoid-type appeared as a mass and the biphasic-type had radiologic and gross pathologic features of both sarcomatoid and epithelial types. We conclude that peritoneal mesothelioma presents with a wide spectrum of radiographic appearances and should therefore be included in the differential diagnoses of diffuse as well as localized peritoneal processes.

Humans↗
PubMed1990

[The pulsatile flow index (PFI) in the diagnosis of dysfunctional kidney transplants].

In 61 patients (167 examinations) the pulsatile flow index (PFI) was used to diagnose the cause of renal transplant dysfunction. The results were correlated with histology and clinical course and outcome, angiography or quantitative radionuclide renography. Renal transplant rejection was diagnosed by PFI with a sensitivity of 85%. The specificity was 81% and the diagnostic accuracy 83%. The positive predictive value was found to be 76%, whereas the negative predictive value was 89%. In presence of acute tubular necrosis (ATN) the PFI was normal in 89% of examinations and therefore distinguishable from acute rejection.

Adolescent↗
PubMed1989

Pulsatile flow index for qualitative measurements of blood flow with duplex ultrasound. An experimental study.

We determined the accuracy of Doppler blood flow measurements in an experimental investigation using a tissue-simulating phantom, pulsatile flow pumps and heparinized blood. A new index for qualitative assessment of blood flow, the pulsed flow index (PFI) is described. The PFI takes advantage of the area under the flow velocity curve between the true zero line and the diastolic baseline. Under conditions of continuous flow, the PFI ranged from 0.82 to 0.94 (mean value 0.90). The PFI was found to be relatively independent of the transducer/vessel angle (+/- 8%) and the inter/intra-operator variation was small (+/- 7.5%, or +/- 7%, respectively).

Blood Flow Velocity↗
PubMed1988

Extracorporeal shock-wave lithotripsy: prevalence of renal stones 3-21 months after treatment.

One hundred and four (70%) of the first 148 patients who underwent extracorporeal shock-wave lithotripsy (ESWL) at the University of Florida were evaluated for persistent or recurrent renal stone disease. Radiographs obtained 3-21 months after treatment showed that 53 (50%) of 106 treated kidneys were free of stones. In 48 of the 53 kidneys that contained stones, the stones were residual fragments dating from the period immediately after ESWL. New stones had developed in only five kidneys. The 50% incidence of stone-free kidneys 3-21 months after ESWL is less than the 65-90% rate reported by other institutions in the United States and Europe. After stone removal by ESWL, new stone formation occurs at a rate of 5%, which is much lower than the expected recurrence rate of 37-50%.

Follow-Up Studies↗
PubMed1988

Extracorporeal shock-wave lithotripsy: long-term complications.

Of 148 patients who had extracorporeal shock-wave lithotripsy (ESWL) for renal lithiasis in 1984, 21 (14%) returned after 17-21 months for renal function tests (21 patients) and blood pressure determination (20 patients). Quantitative radionuclide renography showed a statistically significant (p = .048) decrease in the percentage of effective renal plasma flow (ERPF) to the treated kidney. Two of these patients had developed hypertension requiring treatment but became normotensive when given medication. In the other patients there was a statistically significant increase in both systolic (p = .0002) and diastolic (p = .015) blood pressures. Information about blood pressure was also obtained from an additional 71 (48%) of the 148 patients; of the total 91 patients (61%) in whom blood pressures were obtained, seven (8%) had developed sufficiently severe hypertension to require treatment beginning within 21 months after ESWL. Side effects of ESWL for renal lithiasis include hemorrhage, edema, and acute tubular necrosis of the kidney. This form of renal trauma is associated with an immediate decrease in renal function of the treated kidney, and this decrease may be permanent. ESWL is also associated with the onset of hypertension, which may occur immediately or be delayed by several weeks or months. Although the pathogenesis remains unknown, hypertension is an important complication of ESWL in about 8% of patients.

Adult↗
PubMed1987

Sonographic evaluation of the kidney following extracorporeal shock wave lithotripsy.

We investigated the value of real-time sonography for determination of pelvicaliceal dilatation 24-48 h after extracorporeal shock wave lithotripsy (ESWL) in 369 patients (419 treated kidneys). A varying degree of hydronephrosis was present in 121/419 (29%) kidneys. Fragmented stones post-ESWL were demonstrable in 346/419 kidneys (82%), but were missed by ultrasound in three kidneys (less than 1%). In four kidneys (1%), stone fragments which were shown to be present by ultrasound were not detectable on radiographs. In 25/419 kidneys (6%), evidence of renal trauma caused by ESWL was demonstrated by ultrasound. The most important incidental finding was a small renal cell carcinoma of the contralateral (untreated) kidney.

Diagnosis, Differential↗