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L Talner

Publications and source records attributed to L Talner.

5 recordsLinked to original sources

Current experience with computed tomographic cystography and blunt trauma.

We present our experience with computed tomographic (CT) cystography for the diagnosis of bladder rupture in patients with blunt abdominal and pelvic trauma and compare the results of CT cystography to operative exploration. We identified all blunt trauma patients diagnosed with bladder rupture from January 1992 to September 1998. We also reviewed the radiology computerized information system (RIS) for all CT cystograms performed for the evaluation of blunt trauma during the same time period. The medical records and pertinent radiographs of the patients with bladder rupture who underwent CT cystography as part of their admission evaluation were reviewed. Operative findings were compared to radiographic findings. Altogether, 316 patients had CT cystograms as part of an initial evaluation for blunt trauma. Of these patients, 44 had an ultimate diagnosis of bladder rupture; 42 patients had CT cystograms indicating bladder rupture. A total of 28 patients underwent formal bladder exploration; 23 (82%) had operative findings that exactly (i.e., presence and type of rupture) matched the CT cystogram interpretation. The overall sensitivity and specificity of CT cystography for detection of bladder rupture were 95% and 100%, respectively. For intraperitoneal rupture, the sensitivity and specificity were 78% and 99%, respectively. CT cystography provides an expedient evaluation for bladder rupture caused by blunt trauma and has an accuracy comparable to that reported for plain film cystography. We recommend CT cystography over plain film cystography for patients undergoing CT evaluation for other blunt trauma-related injuries.

Adolescent↗

Computerized tomography cystography for the diagnosis of traumatic bladder rupture.

PURPOSE: We present our experience with computerized tomography (CT) cystography for diagnosing bladder rupture in patients with blunt abdominal and pelvic trauma, and compare the results of CT cystography with those of surgical exploration. MATERIALS AND METHODS: We identified all patients with blunt trauma diagnosed with bladder rupture from 1992 to September 1998. We reviewed the radiology computerized information system for all CT cystography performed to evaluate blunt trauma during the same period. We also reviewed the medical records and pertinent radiographic studies of patients with bladder rupture who underwent CT cystography as part of the hospital admission evaluation. Operative and radiographic findings were compared. RESULTS: CT cystography was performed in 316 patients as part of the initial evaluation of blunt trauma. Of the 44 patients with the ultimate diagnosis of bladder rupture CT cystography revealed bladder rupture in 42, while 23 of the 28 (82%) who underwent formal bladder exploration had operative findings that exactly matched the CT cystography interpretation in terms of the presence and type of rupture. In the 316 patients CT cystography detected bladder rupture with an overall sensitivity and specificity of 95% and 100%, respectively. For intraperitoneal rupture sensitivity was 78% and specificity was 99%. CONCLUSIONS: CT cystography provides expedient evaluation of bladder rupture due to blunt trauma and has accuracy comparable to that reported for plain film cystography. We recommend CT cystography over plain film cystography in patients undergoing CT for other injuries associated with blunt trauma.

Adolescent↗

Bacteremia in the pathogenesis of retrograde E. coli pyelonephritis in the rat.

Female rats deprived of water overnight, and then given 1.0 ml of E coli 0111:B4 via the urethra, developed pyelonephritis. A nearly absolute association was found between the occurrence of bacteremia after the transurethral infusion and the development of pyelonephritis. An identical lesion was produced by a combination of forniceal damage and intravenous injection of E coli. The kidney damaged by reflux was shown to be more susceptible to hematogenous pyelonephritis than the obstructed kidney and the distribution of the infection was due to localization of bacteria in the damaged fornix but not to the route of infection. The induction of retrograde E coli pyelonephritis in the rat required a tear in the pelvic epithelium creating pyelovenous communications, and the resultant bacteremia produced pyelonephritis. The incidence of ureteral reflux and the volume of inoculum that refluxed to the renal pelvis was shown radiologically to be a function of bladder distensibility, which is reduced by withholding water for a few hours. In this system, retrograde E coli pyelonephritis developed from a combination of two factors: (1) reflux-induced damage to the renal pelvis so that E coli are introduced into the kidney and (2) hematogenous infection of the damaged kidney.

Animals↗