PubMed Health⌕ Search

Biomedical subjects

P C Freeny

Publications and source records attributed to P C Freeny.

At least 91 records · Page 5Linked to original sources
PubMed1986

Histologic analysis of tissue response to bucrylate-pantopaque mixture.

A toxicologic-pathologic study of isobutyl-2-cyanoacrylate (Bucrylate) was carried out first in dogs and then in humans whose arteriovenous malformations were infused with this embolic agent. The canine specimens obtained at 7, 18, 28, and 147 days after embolization showed the development of a mild histiocytic giant cell reaction, which evolved to end-state sclerotic arteritis. The response was confined to the vessels and did not involve contiguous parenchymal tissues. Ten human specimens, obtained from 1 hr to 7 years after treatment, showed a similar bland reaction with no evidence of suppuration or premalignant changes.

Adolescent↗
PubMed1986

Hepatic hemangioma: dynamic bolus CT.

Forty-seven patients with 58 hepatic hemangiomas were studied prospectively with a dynamic bolus CT protocol (single-level or incremental scans) that included precontrast scans, rapid-sequence scanning during the IV bolus injection of 150 ml of 60% contrast agent, and delayed scans taken as long as 60 min after contrast. Three CT criteria are believed to be necessary to make a specific diagnosis of hemangioma: lesion with diminished attenuation on precontrast scan; peripheral contrast enhancement during the dynamic bolus phase of scanning; and complete isodense fill-in on delayed scans obtained up to 60 min after contrast. These CT criteria were seen in only 32 (55%) of 58 hemangiomas, making CT a relatively poor imaging technique for diagnosis.

Adult↗
PubMed1984

Pancreatography in chronic pancreatitis: international definitions.

Terminology in classification of pancreatograms was discussed at a recent international workshop on chronic pancreatitis. A new terminology based on morphological radiographic appearances and a new classification to describe the severity and localisation of pancreatogram changes were agreed. Pancreatograms in chronic pancreatitis are graded as normal or equivocal, or as showing mild, moderate, or marked changes, either diffuse or local. It is hoped that these definitions will help communication between centres, serve as a basis for prospective and comparative studies, and facilitate computerisation.

Chronic Disease↗
PubMed1984

Endoscopic retrograde biliary drainage.

Endoscopic retrograde biliary drainage (ERBD) was completed in 30 of 34 attempts (88.2%). Sixteen patients are alive with functioning stents one to 14 months following insertion of the catheters. Eight patients died with functioning stents two weeks to four months following placement. Six stents were replaced due to sepsis or rising bilirubin one to eight months following initial insertion. The only immediate complication was sepsis, which developed in one patient. Since ERBD circumvents many of the complications associated with percutaneous transhepatic drainage, it has replaced this technique in our institution as the primary non-operative modality for biliary decompression. Percutaneous transhepatic drainage is now reserved for ERBD failures.

Adult↗
PubMed1983

Computed tomographic arteriography of the liver.

Computed tomographic arteriography (CTA) is one method of evaluating hepatic masses. It consists of simultaneous infusion of 30% iodinated contrast medium into the hepatic artery during computed tomography (CT). Twenty-two patients with suspected resectable hepatic tumors were evaluated prior to surgery. Initial imaging procedures included conventional CT, ultrasonography, scintigraphy, and selective angiography. CTA identified additional tumor nodules in 12 out of 22 patients (55%), rendering the initially detected neoplasms unresectable. However, 2 other patients were found to have a normal liver and thus were spared unnecessary laparotomy.

Adult↗
PubMed1983

Chemical cholecystitis associated with hepatic artery infusion chemotherapy.

The gallbladder often is included within the infusion territory during hepatic arterial chemotherapy, because the cystic artery usually originates from the right hepatic artery. Symptomatic cholecystitis associated with hepatic arterial infusion of mitomycin C and floxuridine or 5-fluorouracil was observed in four instances out of over 700 hepatic arterial infusions of chemotherapeutic agents performed over a 3-year period at two institutions. Arterial infusion chemotherapy is generally well tolerated by the gallbladder, and the true incidence of associated cholecystitis is unknown. Occasionally, angiographic features of cholecystitis are observed in asymptomatic patients after hepatic arterial infusion chemotherapy.

Adult↗
PubMed1982

Radiographic manifestations of extrinsic processes involving the bowel.

Extrinsic processes affecting the bowel are frequently mistaken for intrinsic gastrointestinal disease. However, extrinsic involvement of bowel produces morphologic changes distinguishable from those of primary diseases of bowel in most cases. These changes include (a) an intact mucosal surface, (b) mass effect, (c) fixation and angulation mucosal folds, (d) fixation and angulation of bowel loops, and (e) luminal constriction. The extrinsic process involving bowel most often encountered on barium studies is metastatic neoplasm; other causes are inflammatory disease, adhesions, and endometriosis. Although the radiographic manifestations of extrinsic processes affecting bowel are nonspecific, when correlated with clinical information they may permit an astute diagnosis.

Constriction, Pathologic↗
PubMed1982

Impact of high-resolution computed tomography of the pancreas on utilization of endoscopic retrograde cholangiopancreatography and angiography.

The impact of computed tomography (CT) on utilization of other diagnostic procedures was studied by comparing the results obtained in two groups of patients: (a) 278 patients studied prior to the availability of CT, and (b) 300 patients studied using CT. CT enabled an accurate diagnosis in 74% of patients without the use of additional examinations. Utilization of CT as the initial imaging procedure resulted in a decrease in the utilization of endoscopic retrograde cholangiopancreatography (ERCP) and angiography by 68% and 54%, respectively. This resulted in a 47% decrease in the overall cost of radiologic diagnosis.

Angiography↗
PubMed1982

Double duct sign: reassessed significance in ERCP.

The double duct sign, defined as an abnormality of both the pancreatic duct and the contiguous part of intrapancreatic common bile duct, was found in 52 of 1180 patients studied by endoscopic retrograde cholangiopancreatography. Thirty patients were proved to have pancreatic malignancy and 22, benign pancreatic disease. Specific ductal characteristics found to indicate a malignant process were ductal obstruction, especially of the common bile duct, close proximity of the biductal lesions, a short stenotic segment of the common bile duct removed from the papilla, an abrupt, irregular transition from normal to stenotic or obstructed duct. Ductal characteristics suggesting a benign process were long length of common bile duct stenosis, calcium deposits, pseudocyst formation, and ectasia of pancreatic ductal branches central to the main duct lesion. This analysis indicates that the double duct sign per se is not disease specific, but when other ductal characteristics are assessed as a component of this finding, the ability to differentiate benign from malignant pancreatic disease is enhanced.

Adenocarcinoma↗
PubMed1982

Adenocarcinoma of the gastroesophageal junction: barium and CT examination.

Seventy-seven patients with adenocarcinoma of the gastroesophageal junction were evaluated with upper gastrointestinal barium studies (single-contrast, 40: double-contrast, 37) and 21 of these had preoperative computed tomography for staging. Single- and double-contrast studies were equally sensitive in detecting exophytic tumors, but double-contrast studies were slightly more sensitive (25 of 26) than single-contrast examinations (21 of 25) in detecting infiltrating tumors. Computed tomography accurately staged 18 (86%) of 21 cases (16 unresectable, two resectable). The most reliable computed tomographic findings of tumor unresectability were metastases (liver, adrenal) and local tumor extension, both found in 10 (48%) of 21 cases, and regional adenopathy, present in eight (38%) of 21 cases. The presence or absence of the periesophageal soft-tissue planes was an unreliable finding and led to both false-positive (two cases) and false-negative (four cases) diagnoses. CT-guided percutaneous fine-needle aspiration biopsy was used successfully in four cases to obtain a cytologic diagnosis of metastatic adenocarcinoma.

Adenocarcinoma↗
PubMed1981

Endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC) in the evaluation of suspected pancreatic carcinoma: diagnostic limitations and contemporary roles.

The accuracy of ERCP and PTC in the diagnosis of pancreatic carcinoma was evaluated in a series of 376 and 112 patients, respectively. ERCP had a sensitivity of 94% and a specificity of 97%; PTC had a sensitivity of 100% and a specificity of 96%. Prior to the introduction of CT, these highly accurate examinations were the first major diagnostic procedures performed in patients with suspected pancreatic carcinoma. CT has had a significant impact on the role of ERCP and PTC and has replaced them as the initial procedure of choice. The current indications for ERCP and PTC were evaluated in a series of 211 patients with suspected pancreatic disease who were studied initially by CT. ERCP is now used to evaluate patients in whom CT is normal, equivocal, or technically unsatisfactory. PTC is used as a preoperative procedure for precise definition of biliary anatomy or for percutaneous placement of a palliative biliary drainage catheter.

Biopsy↗
PubMed1981

Cystic neoplasms of the pancreas.

Ten cystadenomas and cystadenocarcinomas of the pancreas are presented. We believe that the strong recommendations of the pathologists who feel that all cystic neoplasms of this type have malignant potential or contain malignant elements emphasizes the need for total excision if at all possible in these patients. It is conceivable that the reason for the high incidence of cystadenocarcinomas in our small series may be the meticulous searching of the cellular elements for evidence of malignancy. It strongly militates against anything less than total excision as treatment for these curable lesions. The correct preoperative diagnosis is mandatory for a logical plan for surgical intervention. All cysts, whether deemed benign or malignant, should be aggressively attacked surgically unless there is distant metastasis. The very high rate of malignant potential of benign cystadenomas coupled with the relatively indolent growth pattern of malignant cystadenocarcinomas combine to give a high rate of surgical cure.

Adult↗
PubMed1981

Hepatic focal nodular hyperplasia: angiography, CT, sonography, and scintigraphy.

Eleven patients with focal nodular hyperplasia of the liver underwent a combination of radiologic procedures, including sonography, computed tomography (CT), hepatic scintigraphy, and angiography. This paper describes the radiologic findings in this group of patients and reviews the current literature. In the present series, sonography was the most sensitive (100%) method for detection of focal nodular hyperplasia, while CT was able to detect only seven (78%) of nine cases. Arteriographic findings were felt to be characteristic in nine (82%) of 11 cases. Hepatic scintigraphy demonstrated normal colloid uptake in six (55%) of 11 lesions. In this series, an accurate radiologic diagnosis of focal nodular hyperplasia was made in 73% of cases. Hepatic scintigraphy is the pivotal examination. Normal colloid uptake by a focal hepatic mass is virtually diagnostic. However, in the patients in whom the colloid scan shows decreased or absent uptake, angiography may show findings diagnostic of focal nodular hyperplasia in up to 75% of cases, thus avoiding the need need for liver biopsy or surgery.

Adolescent↗