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Biomedical subjects

R A Kubicka

Publications and source records attributed to R A Kubicka.

12 recordsLinked to original sources
PubMed1994

Evaluation of the postoperative stomach and duodenum.

Patients who undergo a gastric or duodenal operation present challenging problems to the physician. Currently, gastric or duodenal operations are performed to correct peptic ulcer disease and its complications, resect benign or malignant masses, and control obesity. Indications for surgery in patients with peptic ulcer disease include hemorrhage, perforation, obstruction, ulcer intractability, and the inability to exclude malignancy in a gastric ulcer. Neoplasms of the stomach and duodenum require resection, depending on their benign or malignant nature, their location, the extent of disease, and the underlying physiologic status of the patient. Most clinically significant gastroduodenal masses are malignant and require formal anatomic resection, usually with distal or total gastrectomy. Stapling procedures have been shown to be effective in reducing excess body weight with creation of a small gastric pouch to restrict the outlet and cause early satiety, decreased caloric intake, and weight loss. Reliable radiologic findings depend on a thorough understanding of the complex anatomic and physiologic alterations that occur after surgery and familiarity with appropriate techniques of examination. With this background, complications unique to the surgical procedure as well as general complications found in all postoperative patients with be detected quickly and accurately.

Contrast Media↗
PubMed1993

Appearances of the postoperative alimentary tract.

In summary, patients who have had alimentary tract operations are looked upon by most radiologists as a travail rather than a challenge. This article has reviewed common operations and has given some definite guidelines to ensure accurate radiologic diagnoses of patients who have had even complicated alimentary tract surgery.

Digestive System↗
PubMed1992

Non-Hodgkin lymphoma of the gastrointestinal tract.

The gastrointestinal tract is the most commonly involved extranodal site of lymphoma. Primary gastrointestinal lymphoma must be recognized, characterized, and staged accurately, since, in some areas of the bowel, prognosis and therapy vary substantially when compared with those for other neoplasms, especially carcinoma. Radiologic studies, particularly barium studies of the bowel and computed tomography, may be crucial and only noninvasive modalities to use for the evaluation of gastrointestinal lymphoma. Symptoms are nonspecific and may be present for years before a diagnosis is established. Histologic appearance consists of a dense accumulation of lymphocytic tumor cells in a uniform pattern. Gastrointestinal lymphoma produces a spectrum of pathologic and radiologic appearances. Management of the condition may be accomplished with surgical resection, tumor debulking, or palliation. The advantages of postoperative radiation therapy and chemotherapy are not clear. Primary gastrointestinal lymphoma is encountered often enough to warrant familiarity with the clinical, radiologic, and therapeutic options.

Gastrointestinal Neoplasms↗
PubMed1991

Bone marrow transplantation: clinical and radiologic aspects.

With the advent of histocompatibility typing, use of bone marrow transplantation for treating hematogenous cancer has dramatically increased. Marrow grafting is preceded by intense immunosuppressive, marrow ablative treatment, usually with high-dose chemotherapy and whole-body irradiation. Because the recipient may be immunocompromised for months after transplantation due to this regimen, complications are numerous. Complications are classified according to the following intervals: pre-engraftment (from pretransplantation treatment to engraftment), postengraftment (3 months afterward), and delayed (longer than 3 months after engraftment). Pre-engraftment complications include bacterial, fungal, and viral infections; tissue-damaging effects (eg, toxic pneumonitis); hepatic veno-occlusive disease; and graft rejection. Postengraftment complications include viral, fungal, and protozoal infections; acute graft-versus-host disease (GVHD); and pneumatosis intestinalis. Delayed complications include chronic GVHD and recurrence of cancer. As part of the follow-up team, radiologists should be familiar with clinical aspects of marrow transplantation and be alert for early, potential life-threatening complications.

Bone Marrow Transplantation↗
PubMed1989

Evaluation of cardiopulmonary devices on chest radiographs: digital vs analog radiographs.

We compared digital and analog radiographs of the chest for use in detecting and evaluating a variety of cardiopulmonary devices in 40 patients. The devices included 23 endotracheal tubes, 21 Swan-Ganz catheters, 14 central venous pressure catheters, 11 prosthetic valves, 10 chest tubes, six pacemaker wires, and five intraaortic balloon pumps. Each patient had at least one device, with a maximum of five devices (average, 2.3). Forty digital/analog film pairs were compared by five radiologists, who assigned confidence levels for various judgments about each device. The results showed that there were no statistically significant differences in the identification of the devices except for prosthetic valves (all valves were detected on digital radiographs, compared with 62% on analog radiographs). The devices were detected on 96% of the digital radiographs and 90% of the analog radiographs. Although digital and analog radiographs were comparable for detection of most devices, the digital radiographs allowed greater confidence in the identification of the devices and in the identification of the tip and course of Swan-Ganz and central venous pressure catheters.

Catheterization↗
PubMed1986

How to interpret coronary arteriograms.

Whether or not a radiologist is primarily responsible for coronary arteriography, the "compleat radiologist" will want to review this excellent primer on the subject.

Angiography↗
PubMed1984

Gastric restrictive surgery for obesity: early radiologic evaluation.

This study was undertaken to determine the optimal radiologic examination techniques for the period immediately following gastric restrictive surgery to control obesity. Review of 450 examinations performed on 275 patients who underwent varied gastric restrictive procedures indicates that accurate evaluation requires prompt filming of the first swallow of contrast material in a specific initial patient position with only minimal fluoroscopic monitoring. It was found that the optimal patient position can be predicted, before contrast material is administered, by the orientation of the staples on an abdominal radiograph. Right posterior oblique (RPO) is the optimal starting position when vertical staple lines follow gastroplasty with a lesser curvature channel. Left posterior oblique (LPO) is optimal when horizontal staple lines follow gastroplasty. LPO is usually optimal when complex or confusing staple patterns follow gastric bypass operations and revisions of previous procedures to control obesity. However, RPO is the optimal orientation when the revision procedure is a vertical gastroplasty.

Humans↗
PubMed1981

The effect of sequential arterial stenoses on flow and pressure.

The additive effect of two sequential stenoses on arterial flow and pressure was studied in five dogs, using an extracorporeal aorto-femoral shunt. It was determined that the concept of flow being governed by the more severe stenosis is imprecise. This is true only of one critical and one subcritical lesion: two critical stenoses have an additive effect. Otherwise subcritical stenoses can become critical in the presence of hyperemia. When evaluating patients with vascular insufficiency due to arterial narrowing, all stenoses should be carefully assessed and attention directed to their cumulative effect.

Animals↗
PubMedDate not supplied

Reactive hyperemia vs. pharmacologic hyperemia in the canine iliac circulation. A comparison.

Different methods of selective vasodilation have been described. One method is reactive hyperemia, which occurs when an arterial occlusion is released, and another method involves injection of vasodilator drugs. Since both arteriography and pressure measurements are often performed during hyperemia, it is important to know whether these two methods differ in the degree or duration of hyperemia achieved. We measured reactive hyperemia in the hind limb of five anesthetized mongrel dogs after arterial occlusion times between 20 seconds' and 20 minutes' duration and after selective intra-arterial injection of 5, 10, and 20 cc of Renografin-76. Only 5 cc of Renografin-76 created greater and longer lasting hyperemia than the maximum reactive hyperemia achieved after 10 minutes of arterial occlusion. For this reason, contrast material-induced hyperemia appears to be preferable to reactive hyperemia as an aid to peripheral arteriography and as an aid to the evaluation of aortoiliac stenoses.

Angiography↗