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Biomedical subjects

R C Holgate

Publications and source records attributed to R C Holgate.

At least 37 records · Page 2Linked to original sources

Sellar enlargement with hyperprolactinemia and a Rathke's pouch cyst.

A woman with secondary amenorrhea was found to have hyperprolactinemia without clinical galactorrhea. Radiological findings of an enlarged sella turcica with displacement of the pituitary stalk were considered consistent with a prolactin macroadenoma. Treatment with bromocriptine corrected the amenorrhea and hyperprolactinemia, and the patient inadvertently became pregnant. However, no complications to the mother or fetus occurred during pregnancy or postpartum. On transsphenoidal surgery three months postpartum, the unexpected presence of a large Rathke's pouch cyst with a microadenomatous or nodular hyperplasia type of prolactin-secreting tumor was observed to account for the preoperative clinical and radiological findings.

Adult↗

Computed tomography in craniopharyngiomas.

Computed tomographic examinations of 28 children and 12 adults with surgically proved craniopharyngiomas were retrospectively studied for characteristic findings that might be diagnostic of this tumor. It was found that 8 of 10 children and 2 of 4 adults examined pre-operatively had at least 2 of 3 findings: calcification, cyst, or contrast enhancement on CT. The remaining pre-operative patients did not receive contrast in their initial exams. Unusual presentation of the tumor in adults is also discussed.

Adolescent↗

Synovial chondromatosis affecting the temporomandibular joint. Case report and literature review.

A case of synovial chondromatosis affecting the temporomandibular joint is reported and the literature is reviewed. Chondromatosis occurs most frequently in this joint in middle-aged women, and it presents with pain and tenderness over the joint. Radiologically, the condition is detected by widening of the joint space with variable presence of radiodense loose bodies. Pathologically, the loose bodies in the case presented were demonstrated arise from cartilaginous metaplasia of the synovial lining. The stimulus for synovial chondrometaplasia at this site is unknown.

Adult↗

Pulsatile tinnitus: the role of angiography.

Pulse-synchronous tinnitus is probably due to turbulent blood flow in or around the temporal bone. The anatomy of temporal bone blood supply is reviewed. Eight examples of tinnitus are presented to illustrate the spectrum of lesions that will produce this symptom and the role of angiography in its investigation.

Adolescent↗

The radiologic findings in synovial chondromatosis (chondrometaplasia) of the temporomandibular joint.

Synovial chondromatosis or chondrometaplasia is a rare disease in which foci of cartilage may develop in the synovial membrane, usually of the large diarthroidal joints. However, the temporomandibular joint may be affected, with less than 15 such cases documented. It is the purpose of this presentation to define the radiologic findings in synovial chondromatosis of the temporomandibular joint, not previously recorded, which allow for definitive diagnosis. These radiologic findings are: 1) widening of the joint space; 2) limitation of motion; 3) irregularity of joint surfaces; 4) presence of calcified loos bodies (cartilage); and 5) sclerosis of the glenoid fossa and mandibular condyle.

Adult↗

Sophisticated radiology in otolaryngology. I. Diagnostic imaging: roentgenographic (x-ray) modalities.

Conventional radiography is now complemented by a large range of newer radiologic diagnostic techniques, involving both roentgenographic and non-roentgenographic modalities. It is the purpose of this presentation to present these new roentgenographic modalities in graphic form, and demonstrate their application to otolaryngic diagnosis. The major roentgenographic modalities which will be stressed are: xeroradiography, angiography, and computerized tomographic scanning.

Adolescent↗

Sophisticated radiology in otolaryngology. II. Diagnostic imaging: non-roentgenographic (non x-ray) modalities (ultrasound, nuclear medicine, thermography).

Newer forms of radiologic diagnostic imaging now include non-roentgenographic modalities such as ultrasound, nuclear medicin, and thermography, all of which can be applied to otolaryngology. It is the purpose of this presentation to demonstrate these modalities, and indicate their clinical application, yet in its earliest stages, to otolaryngology.

Adult↗

The role of CT scanning in the diagnosis of acoustic neuromas.

CT scanning has an important role as a prime investigate technique in the patient with hearing loss and/or vestibular dysfunction. Lesions larger than two cm in size should be further investigated by angiography. Myelography of the posterior fossa remains the only test that can exclude an acoustic neuroma if small or if there is a negative CT scan. Plain films and tomography are used to exclude other lesions.

Angiography↗

The radiologic diagnosis of malignant tumors of the paranasal sinuses and related structures.

Paranasal sinus and related malignancies affect air-containing mucosal-lined bony structures which can only be studied by appropriate radiologic examination. Pre-treatment staging by radiologic study, primarily utilizing tomography with complex motion, is essential for election of proper treatment modalities. It is the purpose of this presentation to define the conventional tomographic and advanced radiologic modalities which can be used in paranasal sinus radiologic examinations. The indications for the studies as well as their limitations are demonstrated. Finally, the role of radiology in post-therapy evaluation is noted.

Adult↗

Pneumocephalus following mastoid surgery: a report of two cases.

Two cases of spontaneous pneumocephalus following mastoid surgery are presented. In both cases a fistula from the mastoid ended blindly in an area of cerebritis without any definite abscess formation. Etiological factors are discussed with congenital dural defects suspected as the precipitating factor.

Adult↗

Computerized tomography (CT) in otolaryngology.

Computerized tomography (CT) of the brain has been available since 1973 and has changed neurological, neurosurgical and radiological practice beyond recognition. A rapid growth of literature has documented it role in the diagnosis of intracranial hematoma, cerebral atrophy, brain tumor, orbital lesions and postoperative tumor evaluation. This computerized method of image reconstruction is now also being applied to the rest of the body and to other diagnostic modalities such as isotopes and ultrasound. The initial impact of CT scanning in otolaryngology is largely in four areas: 1. Facial deformities either acquired or congenital as hypertelorism, fibrous dysplasia, ossifying fibroma and Crouzon's disease. 2. Tumors involving sinuses primarily or by secondary invasion. 3. Cerebello-pontine angle lesions as meningiomas, acoustic neuromas, and glomus jugulare tumors. The larger acoustic neuroma is well visualized by this technique rendering contrast myelography unnecessary. In CT scanning, subtle differences in position and an increase in density before contrast enhancement should allow a differentiation of angle meningiomas from acoustic neuromas; in addition, CT scanning has a very important role in the postoperative assessment of angle tumors. 4. Infections as cerebral abscess or cerebritis secondary to sinus or mastoid disease. The future holds changes that will allow much finer detail, re-orientation of the horizontal information into any plane, and much more accurate differentiation of tissue density. The principle of CT image reconstruction is being applied to both isotope and ultrasound scanning and should improve their accuracy and yield. If the rapid growth of the new technology over the past two years continues, even greater usefulness can be anticipated.

Brain Abscess↗

Lumbar epidural venography in the diagnosis of disc herniations.

Epidural venography is a relatively simple and highly accurate method of diagnosing disc herniations in the lumbar region. Good opacification of the epidural venous plexus can be obtained by selective catheterization of ascending lumbar and/or internal iliac veins. Experience with 227 cases is described. The examination appears to be at least as accurate as myelography at the L4-L5 level and more reliable than myelography in cases of lateral disc herniations at L5-SI. Epidural venography is recommended as the examination of choice in patients with suspected lumbar disc herniation.

Catheterization↗