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J W Charboneau

Publications and source records attributed to J W Charboneau.

90 records · Page 5Linked to original sources
PubMed1984

High-resolution parathyroid ultrasonography in familial benign hypercalcemia (familial hypocalciuric hypercalcemia).

Familial benign hypercalcemia, or familial hypocalciuric hypercalcemia (FHH), is frequently confused with primary hyperparathyroidism, but the consistent failure of subtotal parathyroidectomy to normalize serum calcium levels in FHH makes accurate distinction from familial hyperparathyroidism imperative. Because ultrasonography frequently demonstrates enlargement of the parathyroid glands in hyperparathyroidism, we examined 14 hypercalcemic adults (who had not undergone operation) from seven kindreds with FHH by using a high-resolution real-time scanner. We compared our results with those from 156 patients (who had undergone scanning preoperatively) with surgically confirmed hyperparathyroidism. Enlargement of the parathyroid glands was detected ultrasonographically in 137 of 156 (88%) of the total group of patients with hyperparathyroidism and in 17 of 24 patients (71%) with hyperparathyroidism who had hypercalcemia (serum calcium, 10.6 to 11.0 mg/dl) comparable to that of the FHH group (mean value, 10.7 mg/dl). In contrast, the single possible parathyroid lesion seen in the FHH group was substantially smaller (4 mm) than the smallest (7 mm, 75 mg) abnormal gland reliably detected by ultrasonography in the group with hyperparathyroidism and was conceivably normal in size. Patients with FHH have a dramatic absence of ultrasonographic parathyroid enlargement. High-resolution parathyroid ultrasonography may be of ancillary diagnostic benefit in patients with familial hypercalcemia.

Adult↗
PubMed1984

Renal oncocytoma: sonographic analysis of 14 cases.

The sonographic features of 15 histologically confirmed renal oncocytomas in 14 patients are presented. Lesions were evaluated for homogeneity, echogenicity, margination, venous invasion, and nodal enlargement. Nine were less than 5.5 cm in diameter, homogeneous, and well circumscribed. Three lesions were greater than 8 cm in diameter, contained areas of central necrosis or calcification, and were nonspecific for renal oncocytoma. One of these lesions (12 cm) contained a central scar. Two masses were slightly inhomogeneous and, at best, moderately circumscribed. In no case were metastatic nodes or venous invasion present. Since about 6% of renal cell carcinomas may have this appearance, the homogeneous, well marginated renal mass that is isoechoic with cortex and less than 5.5 cm in diameter is as likely to represent renal cell carcinoma as it is an oncocytoma. Although only present in one of the cases, the central fibrotic scar in a larger mass has been described in oncocytoma and may be the most specific feature. Preoperative investigation with fine-needle aspiration biopsy for cytology may be indicated in an attempt to avoid radical nephrectomy in selected patients.

Adenoma↗
PubMed1984

Ultrasonography and computed tomography in focal fatty liver. Report of two cases with special emphasis on changing appearances over time.

The features of focal fatty infiltration of the liver are described in 2 patients. In 1 patient, hepatic malignancy was initially suspected, and the true nature of the lesion was not appreciated until months later. The nondiagnostic features on ultrasonography and the characteristic features on computed tomography are described. Additional diagnostic information was obtained by guided liver biopsy and from repeat computed tomography months later, when partial or total resolution of the lesions was observed.

Adult↗
PubMed1983

Spectrum of sonographic findings in 125 renal masses other than benign simple cyst.

The sonographic findings of 125 renal masses that did not meet the sonographic criteria of benign simple cyst were retrospectively reviewed and correlated with the pathologic diagnosis. Of the 125 masses, 102 were renal cell carcinoma. These carcinomas, two of nine angiomyolipomas, and the 14 other renal masses of various histologic types exhibited a broad spectrum of sonographic findings. Seven of nine angiomyolipomas and the one multiloculated cystic nephroma had a rather characteristic sonographic appearance. With the knowledge of this spectrum of sonographic findings and strict attention to scanning techniques and sonographic criteria, the radiologist should be able to define the characteristics of a variety of renal masses and suggest the correct diagnosis. It should be possible to make the diagnosis of angiomyolipoma confidently if the characteristic sonographic and computed tomographic appearance of these tumors can be demonstrated. In some cases, the correct histologic diagnosis of a renal mass can be made only with biopsy or surgery.

Adenocarcinoma↗
PubMed1983

High-resolution ultrasonographic and pathologic abnormalities of germ cell tumors in patients with clinically normal testes.

Germ cell tumors that manifest as extragonadal masses in patients with testes that are normal to palpation are an unusual clinical finding. The possibility of the existence of an occult testicular primary tumor has prompted investigation of noninvasive techniques to examine the testes. The records of patients who had undergone high-resolution real-time ultrasonography of the testes were matched to those of patients who had presented with newly diagnosed germ cell tumors from January 1981 through October 1982. Six patients were identified, and their case records are reviewed. Ultrasonographic and pathologic findings are discussed. High-resolution ultrasonography seems to be an important adjuvant test in the assessment of patients with germ cell tumors who present with extragonadal disease.

Adult↗
PubMed1983

High-resolution ultrasound-guided percutaneous needle biopsy and intraoperative ultrasonography of a cervical parathyroid adenoma in a patient with persistent hyperparathyroidism.

We present a case of persistent hyperparathyroidism in which high-resolution real-time ultrasonography was used to perform a percutaneous needle biopsy of a parathyroid tumor. Additionally, intraoperative ultrasonography was valuable in the precise localization of the tumor and thereby reduced the need for extensive surgical reexploration.

Adenoma↗
PubMed1982

Small-part ultrasonography in primary hyperparathyroidism: initial experience.

Small-part, real-time ultrasonography using a high-resolution real-time ultrasound scanner was evaluated in 100 consecutive patients undergoing cervical exploration for primary hyperparathyroidism. The radiologic accuracy was 76%. This accuracy was related directly to the weight of the resected gland(s). The surgical success rate with ultrasonography was 96%, whereas the rate without ultrasonography was 97%. Operating time was not appreciably decreased. The exact role of this new modality in the management of primary hyperparathyroidism is as yet unclear.

Adenoma↗
PubMed1982

High-resolution parathyroid sonography.

A total of 165 consecutive patients with suspected primary hyperparthyroidism was scanned preoperatively using high-resolution real-time sonography. The sensitivity of the procedure was 69% and the specificity 94% in the localization of individually enlarged parathyroid glands. In the subgroup of 21 patients undergoing reoperation in the neck, the sensitivity and specificity were 80% and 92%, respectively. In patients with a single parathyroid adenoma, there was a close but not linear correlation between sonographic diagnostic accuracy and the size of the adenoma, which in turn was directly related to the serum calcium and immunoreactive parathyroid hormone levels. High-resolution sonography has become the procedure of choice in our institution for the preoperative localization of enlarged parathyroid glands in the neck.

Adenoma↗
PubMed1980

Jejunogastric intussusception.

Jejunogastric intussusception is a rare complication after gastric surgery. Only 16 documented cases have been reported at the Mayo Clinic, Rochester, Minn, during the past 72 years. Jejunogastric intussusception is a difficult condition to diagnose clinically. Essentially all patients have epigastric pain. Patients with intussusception generally have had retrocolic gastrojejunostomy without gastric resection. Intussusception of the efferent limb of jejunum is the most frequent type. Surgery is indicated for all patients with the acute type, whereas the chronic type may or may not require operative intervention, depending on the severity of the symptoms. Confirming the diagnosis at operation is occasionally difficult because of spontaneous reduction. Symptoms may recur after operation, but documented recurrence is rare.

Adult↗
PubMedDate not supplied

Treatment of neuroendocrine cancer metastatic to the liver: the role of ablative techniques.

Carcinoid tumors and islet cell neoplasms are neuroendocrine neoplasms with indolent patterns of growth and association with bizarre hormone syndromes. These tumors behave in a relatively protracted and predictable manner, which allows for multiple therapeutic options. Even in the presence of hepatic metastases, the standard of treatment for neuroendocrine malignancy is surgery, either with curative intent or for tumor cytoreduction, i.e., resection of 90% or more of the tumor volume. Image-guided ablation, as either an adjunct to surgery or a primary treatment modality, can be used to treat neuroendocrine cancer metastatic to the liver. Image-guided ablative techniques, including radiofrequency ablation, alcohol injection, and cryoablation, can be used in selected patients to debulk hepatic tumors and improve patient symptoms. Although long-term follow-up data are not available, the surgical literature indicates that significant ablative debulking may improve patient survival. In this review, we discuss metastatic neuroendocrine disease and its treatment options, especially image-guided ablative techniques.

Catheter Ablation↗
PubMedDate not supplied

Renal vein and inferior vena cava tumor thrombus in renal cell carcinoma: CT, US, MRI and venacavography.

Renal cell carcinoma has a propensity to extend as tumor thrombus into the renal vein and inferior vena cava (IVC). The preoperative assessment for the presence and extent of renal vein and IVC tumor thrombus is important for planning appropriate surgical resection. Imaging procedures [CT, ultrasound (US), MR, venacavography] were correlated with surgical findings and pathology in 431 consecutive patients who had a radical nephrectomy for renal cell carcinoma. Ninety-nine (23%) patients had tumor thrombus extending at least into the main renal vein. Of these, 29 had tumor thrombus extending within the IVC. Patients were classified into two groups based on the surgical extent of tumor thrombus. Group A patients had no tumor thrombus or had tumor thrombus only in the renal vein proximal to the site of surgical ligation. Group B patients had tumor thrombus that extended to or beyond the distal renal vein at the site of surgical ligation. Forty-one patients had Group B tumor thrombus. Group B tumor thrombus was not seen in a renal cell carcinoma that was smaller than 4.5 cm. The sensitivity of CT for detecting Group B tumor thrombus was 79% and that of US was 68%. However, a much higher percentage of US examinations were technically indeterminate. In the patients who had either MR or venacavography, both imaging procedures were 100% sensitive for detecting group B tumor thrombus. Magnetic resonance imaging and venacavography appear to be the most sensitive means of identifying tumor thrombus.

Adult↗
PubMedDate not supplied

Comparison of tissue harmonic imaging with conventional US in abdominal disease.

Harmonic waves are generated from nonlinear distortion of an acoustic signal as an ultrasound wave insonates tissues in the body. These beams are integer multiples of a fundamental transmitted frequency. Potential advantages of harmonic imaging include improved axial resolution due to higher frequencies and better lateral resolution due to narrower beams. Decreased noise from side lobes improves signal-to-noise ratios and reduces artifacts. Deleterious effects of the body wall are also reduced. The authors prospectively studied ultrasonographic (US) findings in 100 adult patients with 202 abdominal lesions by comparing harmonic US images with conventional US images. The results were subjected to statistical analysis. Harmonic imaging was superior to conventional US in regard to lesion visibility and diagnostic confidence. Harmonic imaging was particularly useful for depicting cystic lesions and those containing echogenic tissues such as fat, calcium, or air. In patients with a body mass index of 30 or more, harmonic imaging was clearly better for lesion visibility and confidence of diagnosis. The authors recommend routine use of harmonic imaging for abdominal US studies in all adult patients.

Abdomen↗
PubMedDate not supplied

The presence of somatostatin receptors in malignant neuroendocrine tumor tissue predicts responsiveness to octreotide.

In 77 percent of patients suffering from a malignant carcinoid syndrome, administration of the somatostatin analog, octreotide (SMS 201-995, Sandostatin) induced clinical improvement coupled with a decrease in 24-hour urinary 5-hydroxyindole acetic acid (5-HIAA). This finding prompted an evaluation to determine the correlation between the presence of somatostatin receptors in tumor tissue and the response to octreotide in patients with advanced, metastatic, neuroendocrine tumors. In tissues of 31 tumors (20 carcinoid, eight islet-cell carcinoma, three medullary thyroid carcinomas), the presence of somatostatin receptors was analyzed by binding of the somatostatin analog 125I-Tyr3-SMS 201-995 and autoradiography. Receptors were detected in 16 of 20 samples of carcinoid tissues; all but one patient with receptor-positive tumors improved clinically after treatment with octreotide, and the urine 5-HIAA level was reduced a median of 63 percent (range, 39-94 percent) compared to values before treatment. Of the receptor-negative carcinoid patients, only one showed clinical improvement, which was minimal, and there was a negligible reduction in 5-HIAA after octreotide therapy. All eight patients with metastatic islet-cell carcinomas were positive for somatostatin receptors. Symptomatic improvement and a > 50 percent decrease in the level of at least one of the pathologically elevated marker hormones was seen in all eight. None of the three patients with medullary carcinoma of the thyroid had a decrease in calcitonin, and all three were initially somatostatin receptor-negative. We conclude that the presence of somatostatin receptors in malignant neuroendocrine tumor tissue appears to correlate with the response to octreotide therapy. Analysis of somatostatin receptors in malignant neuroendocrine carcinoma tissue should be included in future prospective clinical trials of this synthetic peptide.

Amino Acid Sequence↗