PubMed Health⌕ Search

Biomedical subjects

M Koenigsberg

Publications and source records attributed to M Koenigsberg.

At least 19 recordsLinked to original sources
PubMed1992

Placenta accreta. Additional sonographic observations.

Recent reports describe the antenatal sonographic diagnosis of placenta accreta based on failure to visualize a hypoechoic zone at the placental margin. This finding was confirmed in our series of seven cases. New observations in this series include prominent large or multiple placental venous lakes and periuterine vascularity in six of seven cases, and progressive thinning and disappearance of the retroplacental hypoechoic zone on sequential examinations in two of seven cases. Loss of normal venous flow pattern on Doppler interrogation of the peripheral placental margin also appeared to be of value in two patients. Histologic correlates for these findings are suggested on the basis of the primary histopathologic feature of placenta accreta: deficiency of the decidua basalis. Differential diagnostic considerations, including abdominal pregnancy and trophoblastic disease, also are discussed.

Adult↗
PubMed1991

Congestive heart failure, coronary events and atherothrombotic brain infarction in elderly blacks and whites with systemic hypertension and with and without echocardiographic and electrocardiographic evidence of left ventricular hypertrophy.

Hypertension was present in 50% of 196 blacks and in 36% of 382 whites (p less than 0.001). A prospective study of 84 elderly blacks (70% women) and 326 elderly whites (73% women) with hypertension correlated echocardiographic and electrocardiographic left ventricular (LV) hypertrophy with incidences of congestive heart failure (CHF), coronary events and atherothrombotic brain infarction (ABI). Echocardiographic LV hypertrophy (p less than 0.02) and concentric LV hypertrophy (p less than 0.001) were more prevalent in hypertensive blacks than in hypertensive whites. Hypertensive blacks were younger (78 +/- 9 years) than hypertensive whites (82 +/- 7 years) (p less than 0.001). Other coronary risk factors were similar, except for higher serum triglycerides in whites than in blacks (p less than 0.02). Follow-up was 37 +/- 18 months in blacks and 43 +/- 18 months in whites (p less than 0.01). Incidences of CHF and coronary events were not significantly different in blacks and whites. ABI incidence was 38% in blacks and 21% in whites (p less than 0.005). Multiple logistic regression analysis showed that prior CHF (p = 0.000), concentric LV hypertrophy (p = 0.018) and echocardiographic LV hypertrophy (p = 0.022) were independent risk factors for CHF. Echocardiographic LV hypertrophy (p = 0.001), serum total cholesterol (p = 0.002), concentric LV hypertrophy (p = 0.005) and prior coronary artery disease (p = 0.042) were independent risk factors for coronary events. Prior ABI (p = 0.001), echocardiographic LV hypertrophy (p = 0.001) and electrocardiographic LV hypertrophy (p = 0.034) were independent risk factors for ABI.

Aged↗
PubMed1990

Usefulness of echocardiographic left ventricular hypertrophy and silent ischemia in predicting new cardiac events in elderly patients with systemic hypertension or coronary artery disease.

The authors performed a prospective study to correlate echocardiographic left ventricular hypertrophy (LVH) and silent ischemia (SI) detected by twenty-four-hour ambulatory electrocardiographic monitoring with new cardiac events in 355 patients, mean age eighty-two +/- eight years, with systemic hypertension or coronary artery disease (CAD). Cardiac events included myocardial infarction, primary ventricular fibrillation, or sudden cardiac death. Mean follow-up was thirty-one +/- seven months (range twelve to forty). Cardiac events occurred in 28 of 147 patients (19%) without LVH or SI (A), in 56 of 113 patients (50%) with LVH and no SI (B), in 16 of 29 patients (55%) with SI and no LVH (C), and in 52 of 66 patients (79%) with LVH and SI (D). Significant p values were p less than 0.001 comparing D with A, D with B, C with A, and B with A; and p less than 0.02 comparing D with C. These data indicate that echocardiographic LVH and SI detected by ambulatory electrocardiographic monitoring are independent risk factors for new cardiac events in elderly patients with systemic hypertension or CAD.

Aged↗
PubMed1979

Examining the anterior right kidney. Frequent lack of appreciation in examination of the right upper quadrant.

An anteriorly positioned lower pole of the right kidney is often unappreciated on physical examination. Yet, on review of a large number of abdominal sonograms, more than 12% of the patients had a right kidney with a lower pole sufficiently anterior in position so as to lie at the same depth as the anterior surface of the liver. In a group of patients referred for ultrasound evaluation of hepatomegaly, 20% proved to have a normal liver and an anteriorly positioned lower pole of the right kidney.

Abdominal Neoplasms↗
PubMed1979

Experience with sonography as an adjunct to amniocentesis for prenatal diagnosis of fetal genetic disorders.

This report summarized our experience with a consecutive series of 800 women referred for midtrimester amniocentesis for prenatal diagnosis of a fetal genetic abnormality. The results are compared before and after introduction of sonography immediately prior to the tap as a routine adjunct of the procedure. Following use of sonography there was a statistically significant reduction in the frequency of bloody taps, and an increase in the proportion of successful and informative initial taps. Moreover, in many instances sonography provided information useful for identification of fetal abnormalities or for management of pregnancy. These findings support the recommendation that examination by sonography should be utilized routinely as an adjunct to amniocentesis, despite the uncertainities relating to possible long-term adverse effects of intrauterine exposure to ultrasound.

Amniocentesis↗
PubMed1979

Mural vegetations at the site of endocardial trauma in infective endocarditis complicating idiopathic hypertrophic subaortic stenosis.

In two patients infective endocarditis developed as the primary manifestation of idiopathic hypertrophic subaortic stenosis. Infected vegetations were present on the mitral and aortic valves. In addition, bacterial vegetations were observed on the septal endocardium at the site of contact between the mitral valve leaflet and the hypertrophic septum. Thus, chronic endocardial trauma, a common finding in idiopathic hypertrophic subaortic stenosis, may provide a fertile nidus for the development of bacterial vegetation.

Aged↗
PubMed1979

Diagnostic ultrasound: effects on the DNA and growth patterns of animal cells.

The effects of diagnostic levels of ultrasound on DNA of HeLa cells included: increased immunoreactivity to antinucleoside antibodies in G1 cells, strongly suggestive of unwinding of the helix or single-strand break induction, and low levels of non-semiconservative synthesis in logarithmically growing cells treated with hydroxyurea, indicating repair synthesis. In the C3H mouse cell line 10T-1/2, Cl 8, loss of contact inhibition with a criss-crossed growth pattern was seen. In one experiment, tumors developed in syngeneic mice at the site of injection of ultrasonically treated cells. Ultrasound in the diagnostic range appears to cause detectable effects on DNA and growth patterns of animal cells.

Animals↗
PubMed1979

The accuracy of sonography in the differential diagnosis of obstructive jaundice: a comparison with cholangiography.

The value of sonography in determining the site and nature of biliary obstruction with surgical jaundice is described in 32 patients. All diagnoses were subsequently established by surgery and pathology. The site of obstruction was delineated in 94%, while the nature of the lesion was established in 81%. In comparison, contrast cholangiography correctly delineated the site in 96%, but helped determine the etiology in only 82%. Sonography is sufficient to adequately evaluate patients prior to surgery, while percutaneous transhepatic cholangiography should probably be used only when satisfactory ultrasound examinations cannot be obtained.

Aged↗
PubMed1979

Demonstration of traumatic bile leakage with cholescintigraphy and ultrasonography.

Technetium-99m HIDA cholescintigraphy and ultrasonography are noninvasive, safe, simple procedures that can document the presence, location, and extent of a bile leak. Early detection of posttraumatic or postoperative biliary tract disruption can significantly reduce morbidity and mortality. The possibility of biliary tract disruption should be considered in any patient who has had blunt or penetrating abdominal trauma. In two cases reported, the new hepatobiliary radiotracer 99mTc dimethyliminodiacetic acid (HIDA) was quite useful in detecting such leaks. Sonography was particularly useful in detecting small intra- or perihepatic bile collections which no longer communicate with the biliary tree. An active bile leak at a surgical anastomosis may also be documented by 99mTc-HIDA cholescintigraphy and can yield information of potential prognostic importance. Serial cholescintigraphy is also useful in evaluating the response to medical or surgical treatment.

Aged↗
PubMed1978

Renal pseudotumor on urography secondary to gallbladder empyema.

A case of gallbladder empyema is presented, which opacified initially on excretory urography and then on nephrotomography, mimicking a renal mass. Correct diagnosis was accomplished by angiography and ultrasound examination. With normal renal function gallbladder visualization on urography is indicative of a gallbladder abnormality.

Aged↗
PubMed1978

Limits of sensitivity of radiopertechnetate flow studies in the detection of asymmetrical renal perfusion.

A canine model has been devised using electromagnetic flowmeter probes to study the sensitivity of radiopertechnetate renal angiography. Highly significant correlations were obtained when the measured flow rates were compared with normalized values of the peak activity and uptake slopes for each kidney. Analysis of the data suggests the unilateral renal disease associated with less then 20% difference in flow between the kidneys may not be diagnosed reliably from the pertechnetate perfusion test.

Animals↗
PubMed1978

Unruptured interstitial pregnancy. Diagnosis and treatment.

Symptoms and signs of interstitial pregnancy cannot be differentiated from symptoms and signs of other ectopic pregnancies. Unruptured interstitial gestations are usually diagnosed incidental to the work-up of a suspected ectopic gestation. Unlike some teaching, a characteristic pelvic mass was palpable in 3 of 4 cases. Incomplete induced abortion helped in diagnosing 2 cases. Ultrasound and laparoscopy will aid in establishing the correct diagnosis.

Adult↗