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Biomedical subjects

M P Frick

Publications and source records attributed to M P Frick.

At least 55 records · Page 3Linked to original sources

The plain abdominal radiograph in acute gastrointestinal graft-vs.-host disease.

The plain abdominal radiographs of 28 patients with acute gastrointestinal graft-vs.-host disease (GVHD) were examined to determine the plain radiographic findings associated with this disorder. These findings, in order of decreasing frequency, included air-fluid levels, bowel wall/mucosal fold thickening, gasless abdomen, bowel dilatation, pneumatosis intestinalis, and ascites. When a number of these findings are present, the plain abdominal radiographs may be sufficiently characteristic to suggest gastrointestinal GVHD. Differentiating acute gastrointestinal GVHD from small-bowel obstruction is often of major clinical importance. Fortunately, the bowel gas pattern in acute gastrointestinal GVHD rarely suggests obstruction and, thus, bowel obstruction can usually be excluded on the basis of plain radiographs alone.

Bone Marrow Transplantation↗

Obliteration of the gallbladder without formal cholecystectomy. A feasibility study.

Obliteration of the gallbladder without formal cholecystectomy was attempted in 36 rabbits, using an open technique for cannulation of the gallbladder during laparotomy. The gallbladder was cannulated, the proximal cystic duct was occluded with cyanoacrylate-nitrocellulose 2% wt/wt, and the gallbladder mucosa was exposed to various sclerosing agents to induce fibrosis. Heated 60% diatrizoate meglumine and absolute alcohol induced a controllable chronic cholecystitis with transmural fibrosis within two weeks, a result not seen with morrhuate sodium or in the control groups. All animals survived without complications, and no instances of common bile duct damage or occlusion was noted. The results reported are promising and indicate the need for further studies of this technique for its efficacy and safety.

Animals↗

Sonography of abdominal posttransplant lymphoma.

Five patients developed abdominal lymphoma an average of 89 months after successful renal transplantation. Sonographically, the lymphomas presented as bulky intraperitoneal masses or focal deposits in the liver. These lesions exhibited good sound transmission and intrinsic patterns ranging from sparse, soft echoes to coarse trabeculations. Prompt diagnosis of this serious late complication of renal transplantation is crucial.

Abdominal Neoplasms↗

Radiologic diagnosis of wandering spleen complicated by splenic volvulus and infarction.

Wandering spleen is a rare condition caused by malattachment of the dorsal mesogastrium. This condition is prone to torsion of the splenic pedicle leading to splenomegaly, hypersplenism, and infarction. Preoperative diagnosis can be suggested radiologically. A case of wandering spleen is reported and its embryologic, clinical, and radiographic features are discussed.

Adult↗

Pancreas imaging by computed tomography after endoscopic retrograde pancreatography.

A method using CT after endoscopic retrograde pancreatography (CT-ERP) is described for pancreatic imaging. When using an ERP technique in the canine model comparable to that used in humans, small amounts of contrast material in peripheral pancreatic radicles resulted in enhancement of the pancreas on CT scans. Nine patients were also studied by CT-ERP. In normal patients (n = 5) there was opacification of the entire pancreas on CT-ERP images. The main pancreatic duct was seen on delayed images. In cases of chronic pancreatitis (n = 2), pancreatic opacification was patchy and heterogeneous. There was no contrast-material enhancement in areas of pancreatic carcinomas (n = 2). CT-ERP showed the true extent of carcinoma better than ERP alone.

Adult↗

CT of abdominal lymphoma after renal transplantation.

Six patients aged 33-68 years developed posttransplant lymphoma of the abdomen an average of 105 months after successful renal transplantation. On computed tomography (CT), five lymphomas presented as bulky masses in intra- (four) or retroperitoneal (one) location. Infiltrative growth into transplanted kidney (three), colon (two), and retroperitoneum (one) resulted in poorly defined margins on CT. Central areas of lower attenuation presumably reflected tumor necrosis. Metastatic deposits in liver (two) and renal transplant (one) were of a focal nature. Prompt radiologic recognition of this serious late complication of renal transplantation is crucial.

Abdominal Neoplasms↗

The adhesiometer: a simple device to measure adherence of barium sulfate to intestinal mucosa.

A simple, inexpensive device assessing barium sulfate adherence to alimentary tract mucosa was tested in an animal study using pigs and dogs. Interaction of gastric, intestinal, and colonic mucosal lining with three different barium preparations was studied. In both pigs and dogs, barium adherence to gastric mucosa was significantly stronger when compared with colonic mucosa.

Animals↗

Computed tomography of neutropenic colitis.

Four patients developed neutropenic colitis as a complication of acute leukemia (three) or aplastic anemia (one). On computed tomography (CT), neutropenic colitis was characterized by cecal wall thickening (four) and pneumatosis (one). Intramural areas of lower density presumably reflected edema or hemorrhage. Clinical improvement and return of adequate numbers of functioning neutrophils coincided with decrease in cecal wall thickening on CT. Prompt radiologic recognition of this serious condition is crucial, since surgical intervention is probably best avoided.

Adolescent↗

Percutaneous aspiration and drainage for suspected abdominal infection.

Percutaneous drainage (PCD) of abdominal infection is a therapeutic modality whose role is not well defined. Surgical literature on abdominal infection cites a cumulative mortality rate in the range of 20% to 30%, markedly dissimilar from the 80% to 90% cure rates reported in the literature on PCD. We reviewed the PCD experience at a tertiary teaching hospital from 1981 to 1983. Fifty-five patients were suspected to have localized abdominal infection and underwent 66 procedures. PCD was attempted after percutaneous needle aspiration produced drainable fluid. Cure is defined by complete resolution of the abdominal process without any surgical intervention. Palliation is defined as acute decompression of the abdominal process permitting an elective corrective procedure to be performed. Failure is defined as false diagnosis, unsuccessful drainage requiring operation, or recurrence of infection. Diagnosis of the abdominal process was successfully made by aspiration in 59/66 (89%) attempts. PCD was curative in 31/66 (47%) attempts and failed or was palliative in 35/66 (53%). Simple nonfungal, nonfistulous abdominal abscesses were cured with PCD in 25/26 attempts (96%). PCD failure was encountered in 10 infected organized hematomas or thick phlegmons, nine fungal infections, nine abscesses with enteric communication, and five infected necrotic tumors. Abscesses with an underlying enteric communication were cured in 28%, were palliated in 32% and failed in 32% of PCD attempts. Abscesses with yeast as a major component or with necrotic tumor were never cured with PCD. PCD is a valuable diagnostic and therapeutic tool that is curative in simple abdominal abscesses. Its therapeutic role in complex abdominal infections seems to be limited.

Abdomen↗

Sonography of the gallbladder in bone marrow transplant patients.

Nonshadowing opacities in the gallbladder (sludge) occurred in nine of 44 bone marrow transplant patients as a nonspecific finding. Sludge occurring within 2 wk of bone marrow transplant was transient. Later, sludge accompanied hepatic graft versus host disease in seven of 10 patients with this complication of bone marrow transplant. During the course of graft versus host disease, disappearance of sludge matched clinical improvement. Persistence of sludge in patients with hepatic graft versus host disease was associated with a poor prognosis. The gallbladder of one patient who underwent cholecystectomy exhibited histopathologic findings of graft versus host disease.

Adolescent↗

Lymphoma after organ transplantation: radiologic manifestations in the central nervous system, thorax, and abdomen.

The radiographic findings of post-transplantation lymphoma in 15 patients are demonstrated. Variations in patterns from those of lymphomas in nonimmunosuppressed patients, etiologic factors, histologic features, and differential diagnosis are discussed. The common finding of central lucency of masses seen on CT scans correlated with necrosis seen at histologic examination. In the post-transplant patient, single or multiple masses, particularly if centrally lucent, should suggest post-transplantation lymphoma. Histologic proof with anatomic localization is important, however, to determine appropriate therapy.

Abdominal Neoplasms↗

The value of endoscopic retrograde cholangiopancreatography in patients with suspected carcinoma of the pancreas and indeterminate computed tomographic results.

Endoscopic retrograde cholangiopancreatography was used to evaluate 26 patients with clinically suspected pancreatic malignant growths and indeterminate compute tomographic result. Endoscopic retrograde cholangiopancreatography benefited preoperative diagnosis or clinical management in 25 of 26 patients by diagnosing carcinoma in six, chronic pancreatitis in ten or normal pancreas in nine. Endoscopic retrograde cholangiopancreatography missed one carcinoma in a chronically inflamed pancreas. Endoscopic retrograde cholangiopancreatography is useful in evaluating patients with indeterminate pancreatic computed tomographic results prior to exploratory laparotomy.

Adult↗

Clinical and secretory differences in pancreatic cancer and chronic pancreatitis.

The differential diagnosis between chronic pancreatitis and pancreatic cancer can be very difficult. In 60 patients with either of these conditions, who had satisfactory ERCP study, clinical features were correctly matched with the final diagnosis by discriminant analysis in 44 (73%). The sensitivity of ERCP radiographic findings in pancreatic cancer was 80% and sensitivity of cytology was 54%. To see if exocrine function was specific for cancer, fresh pancreatic secretions were aspirated in 27 patients at the time of ERCP. By isoelectric focusing, a pattern of extreme zymogen depletion was observed in chronic alcoholic pancreatitis (Group 1), pancreatic cancer (Group 2), and chronic nonalcoholic pancreatitis (Group 3). The three groups were not distinguishable. By contrast, significant changes in albumin, IgG and IgA concentrations were seen in Group 2. The albumin level was over ten-fold greater than in Groups 1 and 3 (p less than 0.02 and less than 0.05). The IgG was seven-fold and two-fold greater (p less than 0.01 and greater than 0.2) and the IgA was 15-fold and six-fold greater (p less than 0.002 and less than 0.05) than in Groups 1 and 3, respectively. The two groups of pancreatitis had similar concentrations of albumin and IgA. The ratio of albumin to IgG was also different in Group 2 from the other groups, suggesting different mechanisms for the appearance of proteins in pancreatic secretions. Nonzymogen protein levels can distinguish chronic pancreatitis from pancreatic cancer, and further study of them may identify useful tumor-specific markers.

Albumins↗